Context of Community Health Care and Nursing - Essay Example

Context of Community Health and Nursing Nurses as Educators 1. Introduction The role of nurse as teacher and educators of the community has been one of the most consistent roles of the nurse since the beginning of nursing. Community-based nursing care is part of the continuing health care services and nurses are concerned not only with clients who approach them for the services but also with the larger population. Nurse teaches clients, families, groups, and communities with the goal of educating people and helps them focus on disease and illness prevention. The centre of this research is community-based nursing with emphasis on nurses as educators of the community. 2. Community-Based Nursing Community-based setting includes ambulatory care, home health care, school health, and hospital setting. Ricci (2006) explains clinical practice within the community may also include case management, research, quality improvement, and discharge planning. Nurses with advanced practice and experience may be employed in areas of staff development, program development, and community education. Nurses must be prepared educationally and experientially to provide care in very diverse settings as the focus of health initiatives today shifts the emphasis of health care to the people themselves and their needs, reinforcing and strengthening their capacity to shape their own lives. This shift of emphasis away from dependence on health professionals toward personal involvement and patient responsibility gives nurses the opportunity to interact with individuals in a variety of self-help roles. Nurses in the community-based arena are well positioned to be the “primary force in identifying the challenges and implementing changes in women’s health for the future” (p.23). 2.1 The Community It is because community-based nursing care is part of the continuum of health care services, it is important for nurses to understand the concepts of community. Community is often defined as a collection of people sharing common characteristics, interests, needs, resources, and environments that interact with one another. The common features of a community may be common rights and privileges as members of a designated city or common ties of identity, values, norms, culture, language, or social support. Women are caregivers to children, parents, spouses, and neighbours, and provided important social support in these roles. In a community-based setting, the providers of care are concerned with not only the clients who present themselves for service, but also with the larger population of potential or at-risk clients (Ricci 2006). 2.2 The Home Setting The most frequently used setting for community health nursing practice was the home. In the homes, all the community health-nursing roles, to varying degrees, are performed. Clients who are discharge from acute care institutions, such as hospitals or mental health facilities, are regularly referred to a community health nurses for continued care and follow-up. Here, the community health nurse can see clients in a family and environmental context, and service can be tailored to the client’s unique needs. The home also is a setting for health promotion. Many community health-nursing visits focus on assisting families to understand and practice healthier living behaviours. Nurses may for instance, instruct clients on parenting, infant care, child discipline, diet, exercise, coping with stress, or managing grief and loss (Allender and Spradley 2004). 2.3 Health Education and Learning Theories The purpose of health education according to Lundy and Janes (2003) is to change the behaviours that put people at risk for injury, disease, disability, or death. Modifying or influencing behaviour, nurses teach clients, families, groups, and communities with the primary goal of getting people to change behaviours in ways that focus on disease prevention, illness intervention, and health promotion. The mission of health education is to reduce the current and future suffering by addressing individual and social factors that contribute to health problems. Moreover, health education can also increase the knowledge, skills, and confidence needed to make decisions. It improves continuity of care, decreases the risk of problem recurrence, and uses resources more efficiently. Educated clients and families are better able to cope and more likely to recognize problems before they become severe. All of these benefits help nurse do their jobs because knowledgeable clients have fewer complications and present with fewer of the acute emergencies that require more complex care (p.192). Much health education is based on learning theories that have been developed over the past several decades and these theories are usually familiar to nurses. The behavioural theorist such as Pavlov, Thorndike and others showed how teachers could connect a stimulus to a desired response. This leads to a conditioned change in behaviour that occurs every time the stimulus is presented. A client could, for instance, learn that brushing her teeth in the morning is associated with taking her birth control pill. Developmental theories, on the other hand, state that individuals need to acquire competence at one level of a developmental process before moving to the next level. Children can go through specific developmental stages in their intellectual abilities while an adult learning theory provides important information for health education. This theory holds that motivation learn is based on four assumptions such as adult perception that they can be self-directed. They want to have a say in what they learn. Adult have a variety of life experiences and are insulted if these experiences are ignored. The wise teacher will build on these experiences. Adult learn better, when they see an immediate need as they are goal directed. More importantly, timing education to coincide with an immediate need is more effective because the learner will see the immediate goal and be ready to learn (Lundy and Janes 2006). 2.4 Nurse as Educators As nurse educators began to place students in community settings, especially nursing homes and long-term care facilities, it became evident that students at every level of education could find meaningful learning experiences in such care environments. Tagliareni and Marckx (1997) explain that beyond the traditional fundamental tasks were also higher order activities that stimulated the student’s creativity and resourcefulness. Simultaneously as nurse educators were responding to guidelines for future health practice as developed by national organizations, they realized how necessary it was to broaden such response into imperative for the curriculum itself. During the past several years interest by nurse educators in exploring innovative approaches to teaching in the community. Faculty from all levels of nursing education seek to move beyond traditional definitions of community nursing practice, which have been limited historically to home care. (p.13) The inclusion of policymaking and health policy courses in the curriculum is important to the socialization future members of the nursing profession. According to Koff (2004), studies have underscored the need for this subject matter as well as its significance. Nurses involved in policymaking roles developed their political interest as result of interaction with non-nursing elements after their formal nursing education had been completed (p.134). Learning style models are based on the premise that certain characteristics of style are biological in origin, whereas others are sociologically developed because of environmental influences. Recognizing that people have different approaches to learning helps the nurse educator to understand the differences in educational interests and needs of diverse populations. Bastable (2007) further explains that accepting diversity of style can help educators create an atmosphere for learning that offers experiences that encourage each individual to reach his or her full potential. Understanding learning style can help educators make deliberate decisions about program development and instructional design (p.115). Community nurses have derived basic programming principles from nursing, health, business, education, and social science theories as well as from their nursing practice. The term ‘program has various meanings but it is often defined as a collection of activities intended to produce particular results. In community health programs, activities focus directly on health issues or on health determinants, and the desired result, ultimately, is improved health of the community. However, when people talk about a ‘program’, they sometimes speak only about the activities that appear most directly connected to health improvements and not about the less visible but foundational interactive work. For instance, a prenatal education program might be thought of as a package of educational material on topics deemed relevant for prenatal health. In actuality, the program may include activities such as connecting with parents-to-be using multiple outreach strategies, meeting with participants in setting close to where they live, ensuring that participants have the opportunity to discuss their health interest, and adjusting educational topics in the program to focus on what participants see as most important. Therefore, the prenatal program may be somewhat different each time it takes place, although the same basic educational package is used and the same goal is met, that is, to have people better prepared for birth and new baby (Hitchcock et. al. 2002). In the United Kingdom, health care is being influenced by the consumer movement in ways as diverse as the shift to primary health care in the community. They are concern about the rising cost of heath care in the NHS. Consumers are becoming more vocal in their desire for high-quality care. Health care consumers are also becoming more aware of their rights as patients, and the nurse support these rights in the role of patient/client advocate. As nursed generally interact with patients more than other health care professionals, they must often answer questions about the quality of health care, and in some circumstances, the cost health care. Related to the consumer movement is a greater emphasis in society on health promotion and illness prevention. Exercise and nutrition are subjects that interest many people. Nursing has responded to this greater concern for health promotion in many ways, from programmes in the community to specific health promotion and teaching activities for patients/ clients in hospitals and other health care settings. Health promotion activities are a part of many of the roles of a nurse, including career, patient/client advocate, rehabilitator, communicator, and teacher. Health promotion gains more emphasis in a health system striving to make best use of limited resources (Heath 1995). The current philosophies and definitions of nursing demonstrates the holistic trends in nursing to address the whole person in all dimensions, in health and illness, and in interaction with the family and community. Nursing continues to draw on the social sciences and other fields as the focus of nursing care expand. Trends in nursing practice include a growing variety of settings in which nurses have greater independence. Nurses continue to gain autonomy and respect as members of the health care team. Nursing roles continue to expand with the broadening focus of nursing care. Trends in nursing as a profession include the growing emphasis on the aspects of nursing that characterize it as a profession, including education, theory, service, autonomy, and ethical codes. The activities of professional organizations reflect all the trends in nurse education and practice. “All the influences of society on nursing also reflect trends in contemporary nursing” (Heath 1995, p.16). “Nurse as educators are in a position to promote healthy lifestyles” (Bastable 2007, p.222). Combining content specific to the discipline of nursing, knowledge from educational theories, and health behaviour model allows for an integrated approach to shaping health behaviours of the learner. The roles of the nurse as educator include facilitator of change, contractor, organizer, and evaluator. The goal of the nurse as educator is of course, to promote health. Health education and health promotion are integral to this effort. At the same time, the nurse as educator is an important facilitator of change. When learning is viewed as an intervention, it needs to be considered in the context of the other nursing interventions that will effect change (Bastable 2007). 3. Conclusion Community-based nursing may also include case management, research, and quality improvement. Highly skilled nurses may also work on staff development, program development, and community education. Even during their training, nurses are taught of innovative approaches to teaching in the community. Nursing education seek to move beyond traditional definitions of community nursing practice with the inclusion of policy making and health policy courses in the curriculum. Community nurses activities include connecting with parents, discussing their health interest, and education topics that are most significant to participants. Nurses are responding to health promotion and teaching activities for clients in various health care settings. As educators of the community, they facilitate change and promote healthy lifestyles. 4. Reference List Allender Judith Ann and Spradley Barbara Walton, 2004, Community Health Nursing: Promoting and Protecting the Public's Health, Published 2004 Lippincott Williams & Wilkins, ISBN: 0781744490 Bastable Susan B., 2007, Nurse as Educator: Principles of Teaching and Learning for Nursing Practice, Published 2007 Jones & Bartlett Publishers, ISBN: 0763746436 Heath Hazel, 1995, Potter and Perry's Foundations in Nursing Theory and Practice, Published 1995 Elsevier Health Sciences, ISBN: 072342005X Hitchcock Janice, Schubert Phyllis, and Thomas Sue, 2002, Community Health Nursing: Caring in Action, Published 2002 Thomson Delmar Learning, ISBN: 0766834972 Koff Sondra, 2004, Nurse Educators and Politics, Published 2004 SUNY Press, ISBN: 0791460738 Lundy Karen Saucier and Janes Sharyn, 2003, Essentials of Community-based Nursing, Published 2003 Jones & Bartlett Publishers, ISBN: 0763723487 Ricci Susan Scott, 2006, Essentials of Maternity, Newborn, and Women's Health Nursing, Published 2006 Lippincott Williams & Wilkins, ISBN: 0781752205 Tagliareni Elaine and Marckx Barbara, 1997, Teaching in the Community: Preparing Nurses for the 21st Century, Published 1997 Jones & Bartlett Publishers, ISBN: 0887377262 Read More