Community-Oriented Nursing: History and Perspectives

Introduction

Health is a critical aspect in our day to day lives. It entails an individual’s mental, psychological as well as physical condition that could be either ill or free from illness or injury. It is a person’s state of the body, mind, and spirit especially with respect to being free from pain, injury or disease. According to the World Health Organization (WHO), health is the state of absolute social, physical, and mental well being as opposed to just mere absence of illness. There are different ways through which an individual’s health could be maintained. Community health nursing is a branch of nursing that entails a combination of primary health care and nursing practice with public health nursing. Some of the aspects involved include prevention, cure, and rehabilitation with regard to different health issues (Hunt, 2009).

Community health nursing works under the principle that states; provision of health care to an individual, a family or a group of people is a great contribution to the health care of the entire population. Therefore, proper care should be given to all for the best of the society. Community health nursing combines public health science and nursing science to come up with a community based and population oriented practice. The main goal of community health nursing is to enhance the health of communities and the susceptible populations through provision of proper health care particularly at an individual level. This piece of work gives an in depth discussion of the issue of community health nursing.

The community under study is the Alabama community. It is composed of people of a Southeastern culture from native America. The community has its origin in Mississippi. The Alabama community is composed of members of a military and loose trade institution with their homelands being located on the upper region of the Alabama River. The community has undergone a lot of problems moving from one area to another as a result of land issues. The community finally settled in Texas. Here, it fused with the Coushatta community to form the Alabama-Coushatta community. This is a community in which community oriented nursing could be studied since it has great diversity and various aspects can be identified.

Community health nursing necessitates that the characteristics of a particular community is well understood. This helps in the application of the best nursing process and practices in an effort to fulfill the objectives of community nursing. Demographic and infrastructure data of a community is therefore essential. In regard to the community of study, it is composed of approximately 1,137 members occupying about 4,500 acres of reserved land. The infrastructure is relatively good and therefore most of the population can easily be reached. These information is important since provision of community oriented nursing is affected by such aspects like accessibility and the conditions of living of the people, for instance, economic status (Alabama Department of Archives and History and Riley, 2009).

The Healthy People 2010 is a very crucial element in the health sector. It offers science based objectives aimed at improving the health of the American people. It challenges people including communities and professionals to take steps in ensuring that all people get a chance to enjoy good health as well as long life. Some of the leading health indicators used where I live include; increased physical activity, checking of overweight and obesity, reduction of tobacco and substance abuse, encouraging responsible sexual behavior, checking on mental health, enhancing environmental quality and more so enhancing accessibility to health care. These indicators are used to check on the health status of the community. Campaigns and education programs have been implemented to allow success through dealing with ignorance (Institute of Medicine (U.S.). Committee on Leading Health Indicators for Healthy People 2010, 1998).

Community Oriented Nursing: History and perspectives

Nursing is not a new field. It has been there for a considerable period of time. However, there has been emergence of new aspects day after day as different health care needs keep on emerging and thus the need to deal with them in an appropriate way. Modern Community Health Nursing can be traced back in the mid 19th century. It has its origin in the New York City, London, and England. There was the development of District Nursing between 1854 and 1856. This entailed the division of a community into districts whereby each district was assigned a nurse and a social worker. The idea of Home Nursing was later developed in 1893 by Florence Nightingale. This entailed making the district nurse more involved. For instance, the nurse could now take the responsibility of educating the community as well as nursing the sick in their homes. Another significant element that is worth noting in regard to the history of community oriented nursing is the Lillian Ward, which established the House on Henry Street in 1893. This was after the Women’s Board of New York City had sent Francis Root into the home of the sick in 1877 and the emergence of the Visiting Nurse Associations in Buffalo in the year 1885. The Ward is the origin of American Community Health Nurses (Greenlick, 1992).

Over the past few decades, the nursing practice in the community has undergone considerable transformation. The changes are fueled by the public concern with respect to the health care systems. The concerns center on aspects such as the quality of health care, the accessibility of heath care services, the cost of health care as well as the disintegration of health care. The changes have been deemed quite crucial in transforming the field of nursing through giving the nursing professionals an opportunity that allows shaping the health care to a desired state. From the mid 19th century all through to the early 20th century, for example, there has been considerable progress in enhancing societal health. The state of community health nursing at present time can be attributed to the health care reforms, nursing education as well as community empowerment that were established by nursing pioneers. This was made possible through collection and analysis of statistical data (Greenlick, 1992).

Although people usually take community based nursing to be the same as public health nursing, there is a difference between the two. The major difference is however in relation to the delivery system involved in the two. While public health nursing is population focused and community oriented, community based nursing centers around individuals and families in their usual settings within the societies. Community based nursing could also be defined as the application of the nursing process and practice in caring for individuals, families as well as groups of people in different places where they could be. For instance, their homes, their work places, learning institutions or even as they go through the health care system. This therefore indicates that the responsibilities and location of the community based nurses’ practice is based on a specific setting. For this reason, there is a need for the community health nurses to have adequate knowledge and skills that are required in working with diverse communities. For instance, it is essential that they learn how to deal with different groups within the community and respect the ways in which they handle problems (Hunt, 2009).

In an effort to secure the health of a population the community health nurses emphasize on the concept of prevention and wellness. This is achieved through promotion of client responsibility as well as self care. Another crucial aspect is the utilization of the principles that are stipulated in the organizational theory (Lundy and Janes, 2009). In the present times, there has been a need to enhance the health care delivery systems in an effort to ensure that the goals and objectives of nursing and health care are achieved. Community based health care delivery systems are advocated for by responsible individuals and groups. This is because they are associated with a lot of benefits. For instance, it is deemed to be comprehensive, accessible, and convenient making it efficient in the delivery of the different health care services. As a result of the importance attached to a community based and population centered approach to planning, delivery, and evaluation of nursing care, there is a dire need for the professional nursing to realign its accountability and commitment. This will only be possible through taking a turn from the traditional emphasis of the profession and instead responding to the emerging trends. As the health care needs change, so are the health care systems expected to adjust in an effort to meet the changing demand among people in the society.

There has been an increased urge to maintain a healthy community. Some of the characteristics that are associated with a healthy community include the following: A safe environment, access to health care services that revolves around the treatment as well as prevention of health problems among the members of the community, emergency preparedness and a high degree of wellness among the citizens. A healthy community is also characterized by effective communication through open channels, active involvement of the citizens in decision making and participation of subgroups in the various community affairs as well as a proper problem solving mechanism. A healthy community should also have some legitimate mechanisms aimed at settling health related disputes. Such facilities as schools, roads, and playgrounds are also necessary in meeting the diverse needs of a community (Stanhope and Lancaster, 2008).

The above characteristics show that there is dynamic relationship that exists between health and communities. Health is for instance considered with respect to the community’s individuals, the location of the community as well as its social system. Health plays a great role in a community. Healthy individuals usually contribute to the overall health, vivacity as well as the economy of the community and vice versa. Where a community has a great percentage of unhealthy individuals, the community suffers significantly from lack of vitality and productivity. This therefore indicates that there is a need to maintain healthy communities at all times irrespective of the costs that may be incurred. This has as a result called for transformation of various aspects in the nursing field. Community oriented nursing is one of the desired aspects in nursing as it has been associated with a lot of benefits especially due to the fact that the community is viewed from an individual perspective and that health is the main focus as opposed to illness (Stanhope and Lancaster, 2008).

The evolutions in health care settings and consumer involvement have played a great role in changing the directions of health care. The different perspectives of community oriented nursing could be looked at with respect to its components. Some of the components include; self care, continuity of care, preventive health care, collaborative care as well as care within the context of the community. Self-care is a crucial element in allowing for a healthy community. It entails taking care of oneself in an effort to remain healthy as opposed to neglecting health. There is a need to empower individuals to make informed health care decisions as a way of allowing self-care. Despite the fact that community based nursing is in a position to offer direct intervention, self-care teaching for the clients and caregivers remain essential. This is because self-care plays a great role in preventing most health related problems. The nursing practices such as planning, implementation, and evaluation should therefore be directed towards looking at the extent to which the clients and caregivers can safely provide care to themselves (Hunt, 2009).

As earlier noted, community based nursing emphasizes on preventive health care. Community based nursing mainly focuses on tertiary prevention. This can be seen in all the settings that are associated with community based nursing. Care within the context of the community is also a significant element in community oriented nursing. This is because there is a close relationship between health and social issues. In the provision of nursing care, aspects such as the clients’ values, culture, income level, family background and community should be considered. This allows proper provision of health care services to the communities. Care within the context of the community is affected by various factors, for instance, social systems of the community and its location. This determines the accessibility of the community to health care services (Hunt, 2009).

Continuity of care is also crucial in community based nursing or health care. It allows for quality care through consistency. Fragmentation of care (where a client is attended to by different physicians) is associated with a number of health problems. They include; overmedication or under medication and conflicting directions for care. Community based nursing avoids this problem through continuity of care even where different practitioners are involved. This is made possible through adherence to basic principles of continuity of care to avoid any confusion. The other perspective of community based nursing is collaborative care. Here, every practitioner aims at promoting wellness and restoring health. Professionalism is emphasized in the processes of assessment, planning, implementation, and evaluation of the care for the client. There are various health practitioners who may be involved in the provision of health care to clients for instance a physician, a pharmacist, a dietitian, and a social worker. Despite the fact that each professional is involved with specific tasks, they ought to collaborate to ensure that care is provided appropriately. Collaboration allows for proper coordination and thus continuity (Hunt, 2009).

Conclusion

From the above discussion, it is evident that the field of nursing has undergone considerable transformation over the recent past. The transformation is geared towards enhancing the provision of health care to populations and thus ensuring that a healthy community is maintained. There has been an increased urge to maintain a healthy community. Community oriented nursing is one of the desired aspects in nursing as it has been associated with a lot of benefits especially due to the fact that the community is viewed from an individual perspective and that health is the main focus as opposed to illness. There are also various perspectives of community based nursing as discussed above.

Reference List

Alabama Department of Archives and History and Riley, B. (2009). The Alabama Guide: Our People, Resources, and Government 2009. USA: University of Alabama Press.

Greenlick, M.R. (1992). Educating physicians for population based clinical practice. JAMA 267:1645–8.

Hunt, R (2009). Introduction to Community-Based Nursing, 4th Ed. New York: Lippincott Williams & Wilkins

Institute of Medicine (U.S.). Committee on Leading Health Indicators for Healthy People 2010. (1998). Leading Health Indicators for Healthy People 2010: First Interim Report. New York: National Academies Press

Lundy, S. K. and Janes, S. (2009). Community Health Nursing: Caring For The Public’s Health, 2nd Ed. New York: Jones & Bartlett Learning

Stanhope, M., & Lancaster, J. (2008). Public Health Nursing: Population-Centered Health Care In The Community, 7th ed. St. Louis: Mosby Elsevier.