GLOSSARY
- Models—Models are graphic or symbolic representations of phenomena that objectify and present certain perspectives or points of view about nature or function or both.
- Concept—Concepts are the elements or components of a phenomenon necessary to understand the phenomenon and derived from impressions that human mind receives about phenomena through sensing the human environment.
- Philosophy—philosophy is statement of belief and values about human being and their world.
- Theory—refers to a set of logically interrelated concepts, statement, proposition and definitions which have been derived from philosophical beliefs of scientific data and from which questions or hypothesis can be deduced, tested and verified.
- Health—Health is a state of physical, mental and social well-being and the absence of disease or other disorders. It involves constant change and adaptation to stress.
- Community—Community is defined as a group of inhabitants living together in a localized area under the same general regulations and having common interests, functions, needs and organizations.
- Nursing—Nursing is an art, science and profession by which we render, serve to human being to help her to regain or to keep a normal state of body and mind and when it cannot accomplish this, it help him/her for the relief from physical pain, mental anxiety or spiritual discomfort.
- Community health—Community (public) health is a science and art of preventing disease, prolonging life and promoting health and efficiency through organized effort.
- Community health nursing—Community health nursing is a synthesis of nursing and public health practice applied of promoting and preserving the health of people. The practice is general and compressive. It is not limited to a particular age group or diagnosis, and continuing, not episodic.
- Profession—A profession is an occupation with moral principles that are devoted to the human and social welfare. The service is based on specialized knowledge and skill developed in a scientific and learned manner.
CONCEPT OF COMMUNITY
Community can be defined in numerous ways, depending on the application. The variety of individuals, families and cultural groups represented in a community contributes to the overall character of the community. Community –based nursing need to understand the community within which they practice. Knowledge of the community helps nurses to maintain quality of care.
The characteristics of the families living in a community contribute to the overall complexion of that community and in turn the community health care needs. In communities where families are strong and nurturing, there is an opportunity for a strong and caring community. In communities where families are nonexistent or fail to provide an adequate basis for individual growth, problems with abuse, neglect, substance abuse and violence may arise. A strong family unit is the basic building block for strong communities.
Culture contributes to the overall character of a community and in turn, its health needs. In most of the world, a scarcity of resources necessitates extended family resistances included in the extended family are grandparents, aunts, uncles and other relatives. When living together in one household many members may be involved with child care and care of sick or injured.
The role of individuals according to their age is often dictated by culture. In some culture the older people are retired from leadership and governing responsibilities, whereas in other cultures these members considered essential to the governing structure of the community. In this situation, the more prestigious positions of authority and responsibility are assigned to the older members of the community.
Characteristics of Community
- Distinctiveness—Each community has defined as geographical boundaries having its beginning and end. These boundaries are more remarkable in smaller communities than in larger communities.
- Homogeneity—There is similarity in psychological characteristics of people living in the defined boundaries of the community e.g. similarity in language, lifestyle, customs, tradition, etc.
- Closeness—The people in the community have face to face interaction and free communication. The extent of closeness varies. The community people frequently participate in common activities, etc.
- Sense of belongingness—The degree and intensity of this feeling may vary among members in the community.
- Sense of togetherness—There is unity and cohesiveness among the members in the community which is based on their interaction and sense of belongingness to community.
- Self-sufficiency—The community provides all such means and facilities which help in meeting the basic needs of its people, i.e. space to live, education, protection and security, etc.
Characteristics of Healthy Community
- Awareness that “We are community”
- Conservation of natural resources.
- Recognition of and natural resources.
- Participation of subgroups in community affairs.
- Preparation to meet crisis.
- Ability to solve problems.
- Communication through open channels.
- Resources available to all.
- Settling of disputes through legitimate mechanisms.
- Participation by citizens in decision making.
- Wellness of high degree among its members.
Functions of Community
- It provides space for housing, shelter, for socialization and recreation.
- It provides safety and security by protecting the community members.
- Linkages with social system outside the community for meeting needs of its members.
- Provides opportunity for employment and sustenance.
- Protection, distribution and consumption of goods and services.
- Socialization and education for its members.
- Provides opportunities for interaction amongst members, transmits information, ideas and beliefs and, provides support system.
CONCEPT OF HEALTH
Health is considered by many as the opposite of illness or disease. For some, it means a well developed or adequately nourished body, capable of various activities and able to withstand physical stress. All communities have their concepts of health integrated as a part of their culture. Widely differing culture groups share the concept of health as a state of balance and harmony.
The WHO has defined health as a “State of complete physical, mental, social, spiritual well-being, and not merely absence of disease or infirmity. The concept of positive wholeness or completeness is emphasized and health is seen as more than a physical state. An individual's health is never static and is always in a dynamic equilibrium with his environment.
Physical well-being is measurable although it is varying ranges and validity. As regards mental well-being, measurable standards vary from culture to culture and hence the criteria for mental well-being may differ from one country to another or from place to place within the same country. There is also difference of opinion as to what is precisely meant by social well-being. Social well-being may be regarded as a state of predisposing condition of health.
Traditionally health has been defined in terms of the presence or absence of disease. Nightingale defined health as a state of being well and using every power the individual possess to the fullest extent. It reflects concern for the individual as a total person functioning physically, psychologically and socially. Mental processes determine people's relationship with their physical and social surrounding their attitudes about life and their interaction with others.
Multiple Facts of Health-WHO
- Health a tridimensional state—“Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.”
- Health for peace and security—“The health for all peoples is fundamental to the attainment of peace and security and is dependent upon the fullest cooperation of individuals.”
- Health a government responsibility— “Government have a responsibility for the health of their peoples, which can be fulfilled only by the provision of adequate health and social measures.”
- Health and health information—“The extension to all people of the benefits of medical, psychological, and related knowledge is essential to the fullest attainment of health‥”
- Health and people co-operation—”Informed opinion and active cooperation on the part of the public, are of the at most importance in the improvement of health of the people.”
- Health and health care—“Unequal development in different countries in the promotion of health and control of disease, especially communicable disease is a common danger.”
- Health and child development—“Healthy development of the child is of basic importance the ability to live harmonically in changing total environment is essential to such development.”
- Health for all—“The achievement of any state in the promotion and protection of health is of value to all.
CONCEPTIONS OF HEALTH MODELS
Smith (1983) describes the various conceptions of health in four models. Theses are the clinical, role-performance, adaptive and eudemonistic models. Each of these models can be defined by the characterization of the extremes of health – illness continuum.
- Clinical model:
- Health extreme—Absence of signs or symptoms of disease or disability as identified by Medical science.
- Illness extreme—Conspicuous presence of these signs and symptoms.
- Role performance model:
- Health extreme—Performance of social roles with maximal expected output.
- Illness extreme—Failure in performance role.
- Adoptive model:
- Health extreme—Flexible adaptation of the person to the environment and interaction to it with maximal advantage.
- Illness extreme—alienation of the person from the environment and failure to adapt. Self-corrective responses.
- Eudemonistic model:
- Health extreme—exuberant well-being.
- Illness extreme—Enervation, languishing debility.
CONCEPT OF DISEASE
Disease can be considered as something more than mere deviation from health, each disease being a distinct entity, with distinguishing qualities in its pathologic process, its typical clinical appearance and often its characteristic epidemiologic pattern of distribution in terms of time, place and person. The concept of disease also may vary from one society to another society. There will be no difficulty in distinguishing an illness which is severe enough to necessitate bed rest and treatment.
But milder condition of disease and in apparent or subcilinical conditions which do not make these individuals take to bedrest are likely to be missed or ignored. Just like the border-line health conditions, diseases of mild nature and in apparent or sub-clinical conditions are supposed to lie in the middle of a spectrum.
At one end of this spectrum is “optimal health” and at the other end “serious disease” and in between those two ends, various grades of health and disease are located. The milder the disease or the more border – line the health, the more difficult it is to differentiate between health and disease.
Cultural Factors in Health and Disease
The member of a particular society quite unconsciously agrees upon a common pattern of living. It includes basic rules for living together. These rules could be understood as the culture of the society. The behavior pattern of a particular culture are not biologically inherited but socially acquired through learning.
Concept of etiology and cure – Supernatural causes like wealth of God and Goodness, breach of taboo, past sins, evil eye and spirit or ghost intrusion. Physical causes include the effects of weather, water and impure blood.
- Environmental sanitation—Sanitation is the science of safeguarding health. It is the quality of living that is exposed in the clean home, the clean farm, the clean business, the clean neighbourhood and the clean community. Environmental sanitation is nothing but the introduction of such methods which bring about control of all the factors in the physical environment.
- Food habits—Food habits have deep psychological roots and are associated with love, affection, warmth, self-image and social prestige. The diet of the people is influenced by local conditions, religious customs and beliefs.
- Mother and child health—Mother and child health is surrounded by a wide range of customs and beliefs all over the world. MCH care and good customs such as prolonged breast feeding, oil bath, massage and exposure to sun.
- Personal hygiene—Hygiene is the science of health and includes all factors which contribute to healthful living. Personal hygiene includes all those personal factors which influence the health and well-being of an individual. The practice of an oil bath is a good Indian custom. Circumcision is a prevalent custom among Muslims which has a religious sanction.
- Sex and marriage—Sexual customs vary among different social, religious and ethnic groups. Orthodox Jews are forbidden to have intercourse for seven days during the menstruation Marriage is sacred. It is the usual social custom in India to perform marriages early at about the age of puberty. Child marriages are fortunately disappearing.
CONCEPT OF NURSING
Nurses provide care for three types of clients: Individuals, families and communities. Nursing practice involves four areas: Promoting health and wellness, preventing illness, restoring health and care of dying.
- Promoting health and wellness—Wellness is a state of well-being. It means engaging attitudes and behavior that enhance the quality of life and maximize personal potential. Nurses promote wellness in clients who are both healthy and ill. This may involve individual and community activities to enhance healthy lifestyles such as improving nutrition and physical fitness, preventing drug and alcohol abuse, restricting smoking and preventing accidents and injury in home and work place.
- Preventing illness—The goal of illness prevention programmes is to maintain optimal health by preventing disease. Nursing activities that prevent illness include immunizations, prenatal and infant care and prevention of sexually transmitted disease.
- Restoring health—Restoring health focuses on the ill client and it extends from early detection of disease through helping the client during the recovery period. Nursing activities such as providing direct care to the ill person, performing diagnostic and assessment procedures, teaching clients about recovery activities and rehabilitating client to their optimal functional level following physical or mental injury.
- Care of dying—This area of nursing practice involves comforting and caring for people of all ages who are dying. It includes helping clients live as comfortably as possible until death and helping support persons cope with death. Nurses caring out these activities work in homes, hospitals and extended care facilities.
DEFINITIONS OF HEALTH, COMMUNITY AND NURSING
The Health
Health is recognized as a “fundamental right of every human being.” The widely accepted definition of health is that given by the World Health Organization (WHO) which states:
“Health is a state of complete physical, mental, social, spiritual well-being, and not merely an absence of disease or infirmity.”— WHO
“Health as a quality of life resulting from total functioning of the individual that empower him to achieve personally satisfying and socially useful life.”– Webster
“Health as quality of life that enables individuals to live, and serve best.” – William
“Health is defined as dynamic state of wellness which exists on a continuum and ranges from a high level of wellness to high level of illness.”—Dunn
The Community
A community is a social group determined with geographical boundaries, common values and interests. It's members know and interact with each other. Its functions within a particular structure and exhibits and creates norms, values and social institutions.
Community consist of population with several groups of people living in a definite geographic area representing various religions, values, goals, beliefs, interests and practices. The group of people include males, females, children and adults both health and ill, rich and poor. Thus community represents the society at large.
Nursing
Nursing is a service which includes care to the sick, care of the whole patient (his mind as well as body), the care of the patient's environment (physical as well as social), health education and health services to the individual family and society for the prevention of disease and promotion of health.
Nursing is the unique function of the nurse that is to assist the individual (sick or well) in the performance of those activities contributing to health or its recovery (or to a peaceful death) that he would perform unaided if he had the necessary strength, will or knowledge—Virginia Henderson.
Nursing practice is a direct service, goal directed and adaptable to the needs of the individual, the family and community during their health and illness—American Nurses Association.
Community Health Nursing
Community Health Nursing defined as “Community health refers to the health status of the members of the community, to the problem affecting their health and to the totality of health care provided to the community.”
Community health refers to the health status of the members of the community, the problems affecting their health and the totality of health care provided for the community—Blum.7
Community health or public health is defined as “the art and science of maintaining protecting and improving health of people through organized effects.” (American Association of Public Health).
Public health is total development of individual and society. Public health is dedicated to the common attainment of the highest level of physical, mental and social well-being and longevity consistent with available knowledge and resources at given time and place.
Community health nursing is defined as nursing services organized by a community or agency to carry out nursing aspects of community health programme in the homes, schools, industries or in the health centers.
NATURE OF COMMUNITY HEALTH NURSING
The community is responsible for providing all facilities and total care to all. Such changes have led to the placement of the term public health with community health. Hence “Community Health” encompasses all those process of prevention of disease, promotion and protection of health of all people.
Community health nursing implies making systematic assessment and diagnosis of health status of people and their problems, planning and implementing comprehensive health care services for the entire community with their active co-operation and participation. In community health nursing, the major emphasis is laid on primary level prevention through community approaches.
The community health nursing implies sound preparation of community health personnel so that they are knowledgeable and skillful. They need to acquire knowledge about community's structure, community dynamics, community approaches, population statistics, and community health indicators, epidemiological aspects of health problems, health planning, administration and delivery system.
The community health demands are places on the nurse and the nursing profession as a result of changes in society, especially changes in modern technology. Social consciousness and the quality, type and financing of health care. Emphasis has shifted from acute hospitalized based care to preventive community health care. All changes that affect the health care delivery system affect nursing.
PHILOSOPHY OF COMMUNITY HEALTH NURSING
Nursing contributes to the health services in a vital and significant way in the health care delivery system. It recognizes national health goals and is committed to participate in the implementation of National Health Policies and Programmes. It aims at identifying health needs of the people, planning and providing quality care in collaboration with other health professional and community groups.
- The essential dignity and worth of the individual.
- The right of an individual for basic necessities.
- The right of the individual to help in times of need and crisis.
- The great capacity for growth within all social beings.
- The possession by individuals of potentialities and resources for managing their own lives.
- The need for individuals to struggle and strive to improve their life and environment.
- The importance of freedom to express one's individuality.
Individual's Right of Being Healthy
Health is believed to be one of the rights of all human beings nationally and internationally. Indian constitution provides directives to ruling political party to design health care delivery system to promote and preserve this right by providing effective health services to all without any discrimination.
Working Together Towards Common Goal
Health is no longer considered in an isolated manner but it is an integral part of socio-economic, socio-cultural; and political components. Willingness to share the responsibility of helping each other is the basis of modern concept of community health.
Social Systems
Social systems have an impact on a community and consequently, the halts of that community. Social system include a community's economy, education, religion, welfare, politics, recreation, legal system, health care, safety and transportization, etc. should be shared with all people (proper distribution). There should not be any type of discriminations; rather weaker sections should be helped to have these means and facilities.
OBJECTIVES OF COMMUNITY HEALTH NURSING
Nursing seeks to help people understand the importance of all segments of their life and the environment to their well-being. Nursing uses scientific knowledge to perform activities to prevent illness and to help those with health problems to regain vigor and joy of living. Social change taking place in the community must be considered in planning health care.
Nurses are key persons in providing health care in our changing society. Health education has for a long time been considered a major nursing responsibility. That responsibility is increasing with our social trends. Because nurses live in the community and have their own families, they are accessible to the people of the community. They are often called for help in emergencies or to give advice.
DETERMINANTS OF COMMUNITY HEALTH
Community Health influenced by various factors which interact with each other and determine the health status of many individual, family and community at large at any given point of time. These factors known as determinants of health. According to WHO expert committee on community health nursing–Technical report series 558 (1974) and Blum, theses factors are categorized as human biology, environment, lifestyle, health and health allied resources.
Human Biology
- Genetic inheritance—Hereditary or genetic predisposition to specific illness is a major physical risk factor. For example, a person with a family history of diabetes mellitus is at risk for developing the disease later in life. Other documented genetic risk factors include family history of cancer, coronary disease and renal disease.
- Age—Age increases susceptibility to certain illness. For example, the risk of cardiovascular disease increases with age for both sexes. The risk of birth defects and complications of pregnancy increase in women bearing children after age 35. Age risk factors are often closely associated with other risk factors such as family history and personal habits.
- Race—Race increases susceptibility to certain illness. For example, the risk of sickle cell anemia is more common in Africans and Mediterranean people.
- Self-concept—Self-concept implies individual's perception of his or physical, intellectual and social abilities.
Environment
The physical environment—The physical environment includes atmospheric pressures, gravity, light and sound waves, temperature, humidity, wind velocity, solar radiation, electromagnetic fields and seasonal variations etc. The variety of pollutants are found to pollute air, water, food and soil and are the cause of 9various acute and chronic diseases, e.g. gastrointestinal, respiratory, skin cancer, cardiovascular diseases, etc.
The biological environment—Most of the plants and animals are useful to human being to promote health but are the same time, they produce diseases like malaria, insect bits and allergic reactions.
The social environment—The social environments include other people and social institutions, socio-cultural events, religious beliefs, moral and ethical values and social rules and regulations, pertaining to living society, socio-economic support system.
Lifestyle
Many activities, habits and practices involve risk factors, the stress of life crisis and frequent life changes also risk factors. Health practices and behaviors can have positive or negative effects in health. Practices with potential negative effects are risk factor these include overeating or poor nutrition, insufficient rest and sleep and poor personal hygiene.
Other habits that put a person at risk for illness include smoking, alcohol or drug abuse, and activities involving a threat of injury such as skydiving or mountain climbing. Some habits are risk factors for specific diseases. For example, excessive sunbathing increases the risk of skin cancer, and being overweight increases the risk of cardiovascular disease.
Prolonged emotional stress may increase the chance of illness. Emotional stress may occur with events such as divorce, pregnancy and arguments. Job related stresses, for example, many overtax a person's cognitive skills and decision making ability leading to mental overload or burnout.
Health and Health Allied Resources:
- Health services—Health services are directly concerned with improvement of health status of people. Health services can also contribute on socio-economic development of people because sound health can improve and increase the physical, intellectual and emotional capacity of people to get educated, work and earn for their livelihood improve their life style which will further reinforce their health.
- Socio-economic conditions—Socio-economic conditions have significant influence on community health. In developed countries like America, UK and Canada, there has been significant reduction in the morbidity and mortality rates and increases in longevity at birth because of socio-economic, developments. Socio-economic conditions include economic status, education, occupation and living standards.
- Political system—The political system has a very strong role in health promotion of people in the country. The health care delivery system is determined by the political system though there is constitutional control. Decisions pertaining to health policy, allocation of funds, programmes, manpower development, infrastructure, health technology and delivery of health services are made by the ruling party within the parliament system.
- Health related services—The health related services include education governmental policies; social welfare developmental programs food and agriculture, industry, communication and broadcasting rural and urban development and transportation facilities. The health related services needs to have balanced approach between National Health Policy and voluntary health promotes active participation.
PRINCIPLES OF COMMUNITY HEALTH NURSING
Sound community health nursing and behavioral science preparation enables nursing students today to utilize scientific principles and concepts 10in carrying out a systematic nursing care at community setup. Scientific principles, which are drawn from all fields of learning, may be defined as comprehensive and fundamental laws, doctrines, truths or sets of facts that form the basis for established rules of action. The following are some main principles which may used to guide for the community health nurse.
- Effective health workers, irrespective of position or place of work, function as a team.
- The community nurse should be a qualified person by a recognized school or college.
- Health services should be based on the felt need of an individual family and community.
- Health services should make available to all people, irrespective of their stage, sex and status.
- Community health nurses are accountable/ responsible authorized health authority for her services.
- Health services should be realistic in terms of available personnel and facilities.
- Professional relationship and etiquette are essential in community health services.
- Community health nurse must be a nonpolitical and non-sectarian in her relationship with people.
- Evaluation and follow-up services is an important aspect in community health programmes.
- Facilities for further training and continuing education should be provided by the health authority.
- Community health nurse should organize a periodical in-service education programmes.
- Community health nurse should organize and lead a team effectively and efficiently to provide best service to the community.
- The family and community are the units of work. There should be adequate and accurate baseline data of the community is essential.
- Supervision and guidance are needed to help the worker to produce a high quality of work.
- Records and reports are essential in community health services.
- The community health nurse should prepare update records and reports and sent to their higher level promptly.
- The public health worker must never accept gifts or bribes.
- Professional interest should be developed and maintained.
- Job condition should be conductive to optimum satisfaction.
GOALS OF COMMUNITY HEALTH NURSING
- To increase the capacity of families, groups and communities to cope with health and illness problems.
- To support and supplement the efforts of other professional restoration and preservation of health.
- To control or counteract as much as possible physical and social environmental conditions that threaten health or decrease the enjoyment of life.
- To contribute to the reinforcement and improvement of nursing practice and public health practice and service.
SCOPE OF COMMUNITY HEALTH NURSING
Community health nursing is concerned with the people who are sick as well as the healthy, young and old, male and female. At the same time community health nurse is responsible for family centered care rather than an individual oriented one. The community health nurse job is not only limited to the sick but has equal responsibility to prevent the disease and to preserve and promote the health of the people.11
- Home care—Nursing practice is applied in meeting the health needs of communities, families and individuals in their normal environment such as at home.
- Nursing homes—The community health team which provides nursing care, treatment to the sick and health counseling given in nursing homes.
- MCH and family planning—The public health nurse plays a major role in the MCH and family planning services. It comprises antenatal, postnatal and child care services.
- School health nursing—The school health nurse provides services to promote and protect the health of the school children. She provides services like early detection of diseases, immunization, first-aid, dental health, school sanitation, maintenance of health records, health education, follow-up and referral services.
- Health care services—The purpose of health care services to improve the health status of the population. It aims at mortality and morbidity reduction, increase in expectation of life, decreased in population growth rate, improvements in nutritional status, provision of basic sanitation, health, manpower requirements and resource development and certain other parameters such as food production, literacy rate, levels of poverty etc.
- Industrial nursing services—The nursing service at industrial area includes periodic health check-up, care of the sick, first-aid, health counseling, industrial sanitation and safety, organization of services to women and children, rehabilitation of the ill and disabled workers and administration.
- Domiciliary nursing service—Community health nurse focused at domiciliary nursing services includes maternity services health supervision, and disease prevention services and service for illness and accidents.
- Geriatric nursing services—Community health nurse should take care of old people in the community. The need of the geriatric nursing care is different and they need more care than the younger age groups.
- Mental health nursing service—Mental health nursing services of a community health nurse includes early diagnosis and treatment, rehabilitation, psychotherapy, use of modern psychotropic drugs and after care services.
- Rehabilitation centers—The community health nurse provides care in rehabilitation units. Nursing is an important component in the rehabilitation of the disabled.
COMMUNITY HEALTH TEAM AND FUNCTIONS
Community health nursing is concerned with the people who are sick as well as the healthy, young and old, male and female. Community health and community health nursing draw knowledge and practices from other disciplines such as medicine, surgery, pediatrics, obstetrics, gynecology, dentistry, health education and vital statistics.
The community center may refer a patient directly to the state level hospital or the nearest medical college hospital. The community health centre has the following staffs and collectively called community health team.
Functions of Community Health Team Members
Medical officer
- Medical officer is planner, promoter, organizer, supervisor, co-coordinator and evaluator of all functions in PHC.
- Medical officer monitor the OP patients in the morning and afternoon, he does field visits.
- Visit sub-center on fixed days and hours. He gives guidance to team.
- He ensures that national health programmes are implemented properly.
Functions of Female Health Worker
- Registration and care of prenatal and postnatal mothers at home.
- Registration and follow-up of all eligible couples.
- Provide nutrition advice and immunization to mother and children.
- Refer mothers and children at the time of need to hospitals and follow them up after discharge.
- Carryout family planning services including the distribution of contraceptives.
- Provide treatment for minor ailments.
- Notify communicable diseases.
- Maintenance of records and register of all the services provided and also of vital events such as Births and Deaths.
Functions of Male Health Worker
- Conduct survey of the sub-center area and maintain record of all families.
- Maintain information of all vital events.
- Participation in Malaria Control Programme.
- Participate in family planning services by keeping a list of all eligible couples, provide information on the family planning acceptors.
- Participate in nutritional programme.
- Promote health education activities.
- Identifying and reporting about communicable diseases
- Coordinating the activities with female health worker and block staff.
- Maintaining records.
A qualified community health nurse is prepared to give a generalized or multipurpose service in home, school and in industry. She functions in the field of administration and supervision, education, training personnel, health services and research.
COMMUNITY HEALTH NURSE
Community health nurse is a personnel, serving at the community level provide basic promotive, preventive curative and rehabilitative services directly to the community. The specific nursing activities which are performed by the nurse will vary according to community needs and the structure of the primary health care system.
Qualities of Community Health Nurse
- A qualified community health nurse is one who has undergone basic general nursing, midwifery training and postbasic education in community health nursing.
- A community health nurse must have interest in people and in understanding human behavior.
- Sincerity and ability to empathize are basic qualities required for a nurse.
- A well poised nurse has a friendly disposition, honest, charitable, resourceful, and cooperative and takes responsibilities with initiative.
- Minimum essential skills of a nurse are observation, communication, interviewing, and bedsides supportive and technical skills.
- She must have abilities to make interpretations, make judgments and take decisions.
Functions of Community Health Nurse
Community health nursing functions vary according to the designation for which the nurse is employed and according to her education and experience. Some community health nurses function on the staff level, while others serve in the capacity of administrator, supervisor or instructor in health organizations.
- Community health nurse provides comprehensive health care to individuals, families and groups by teaching, counseling and providing guidance.
- Community health nurse develop goals to meet the need. She develops an action programme, evaluates progress and plans again as needed.
- Assistance to the family in improving environmental conditions that affect health, she helps plan a safe environment in the home, school and industry.
- Providing supportive services to doctor such as early symptom detection and giving technical help.
- Demonstration and teaching of skilled nursing care of the sick in the home.
- Supervision of work of midwives, dais and other nursing personnel.
- Helping in the adjustment of social and emotional conditions that affect health.
- Coordination of her work with other members of the health team working in the community.
- Revising and revitalizing plan and programmes.
- Epidemiologic investigation in the field of communicable diseases such as tuberculosis, sexually transmitted diseases, leprosy etc.
- Organizing planned group classes in health with emphasis on applied nutrition, sanitation, child care and parent craft and family welfare services.
- Development and utilization of facilities such as other branches of health and welfare services for making referrals and for promotion of sound and adequate health programmes.
- She is responsible for planning, implementation and evaluation of a practical plan of nursing administration within the primary center and its associated sub centers.
- The community health nurse involves in nursing research and collection of vital statistics.