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Community Nursing - Week 1

• Early community health nursing in Canada originated from Indigenous medicine, healing practices, and the Duchesse d'Aiguillon sisters in 17th-century New France.
• The Grey Nuns were the first Canadian community nursing order, recognizing health inequity by providing health access, food, shelter, and education to vulnerable populations, engaging with First Nations.
• Jeanne Mance, Canada's first nurse, established community health services, advocated for social justice, and acted as Hotel-Dieu Hospital administrator, addressing health inequities through community outreach and advocacy.
• The Nightingale model significantly shaped nursing, with the first nursing school in St. Catharines, Ontario, in 1874.
• The Red Cross advanced Public Health Nurse (PHN) education by funding public health certificate courses at five Canadian universities.
• The 1932 Weir Report advocated for more nurses and supported higher education standards for public health nursing as a specialty.
• Socioecological challenges arose from immigration and failure to provide basic health services to settlers and Indigenous peoples, who faced immigrant-introduced epidemics.
• Florence Nightingale and Mary Seacole influenced health promotion, emphasizing epidemiology, statistics, environmental factors, and social determinants of health.
• Early Pioneer Community Health Nurses (CHNs) were adventurous and humanitarian, serving poor urban communities and isolated rural areas.
• They addressed community needs via direct care, midwifery, and health and prevention education through volunteerism and leadership.
• Lady Aberdeen and women's groups formed the Victorian Order of Nurses (VON) to develop community health services for poor, rural, and immigrant women.
• The Canadian Indigenous Nurses Association has helped establish culturally competent healthcare and cultural safety in the North.
• Elizabeth Smellie's military nursing displayed CHN competencies, including population health, primary, secondary, and tertiary prevention, and emergency preparedness.
• Community Health Nurses (CHNs) must be strong policy advocates, emphasizing the social determinants of health.
• A 2002 report by the Romanow Commission suggested shifting policy toward primary healthcare, home healthcare, and health promotion, led by nurses.
• Community Health Nurses (CHNs) address health inequities in Northern Indigenous communities by working with Indigenous communities/organizations and supporting the Truth and Reconciliation Commission's calls to action.
• In 1947, Saskatchewan established publicly funded healthcare, followed by the federal government in 1957.
• The 1984 Canada Health Act emphasized public administration, comprehensiveness, universality, portability, and accessibility in provincial healthcare systems.

Paradigm shift

• The 1974 Lalonde Report presented a vision for health promotion services and identified four health determinants: environment, lifestyle, human biology, and healthcare.
• The Epp Framework formed the Ottawa Charter for Health Promotion's basis, which marked a significant shift in health promotion.

Organization of community health nursing care

• The organization and delivery of community health nursing in Canada are influenced by emerging diseases and health emergencies.
• Most provinces and territories have transitioned to regional health authority structures to integrate most or all health services, including CHN services.
• Some provinces lack legislative frameworks for healthcare responsibilities in Indigenous communities.
• Ontario was the first province to develop an Indigenous Health and Wellness Strategy in 1990 and an Aboriginal Health Policy in 1994.

Policy, politics, and power

• Community health nursing occurs in a sociopolitical environment
• Community Health Nurses (CHNs) need to understand how policy and politics affect patient care quality, safety, and accessibility, and their working conditions.
• Health equity is undermined when social conditions prevent health-promoting decisions or actions.

Challenges

• Community Health Nurses (CHNs) encounter health system challenges, including a lack of role clarity and a need for strong leadership and interprofessional relationship skills.
• A central strategy for Community Health Nurses (CHNs) is improving leadership and community influence.
• Nurse leaders should establish a clear vision, integrating community aspects, the political environment, and the broader health and social systems.
• Attributes supporting health nursing include management practice, organizational culture, and government policy.

Community Nursing-Week 2

• The 2011 Blueprint for Action for Community Health Nursing in Canada offers a national framework for advancing community health nursing practice.
• The Blueprint guides decisions and activities to promote and protect the health of Canadians.
• Six areas Blueprint identifies are Scope of Practice, Leadership, Nursing Education, Interprofessional/intersectoral Partnerships, Health Systems, and Workplace Development.
• There are eight Canadian Community Health Nurses Standards of Practice.
• Employers use the standards to advance professional development programs, advise educational curricula, and guide research.
• Current practice places greater emphasis on social justice and the social and environmental determinants of health.
• The next version of the standards will incorporate Indigenous nursing and health.
• Community Health Nurses (CHNs) work in homes, schools, workplaces, streets, shelters, churches, field hospitals, community health centers, and outpost nursing stations.
• Various roles encompassed include Public Health Nurse, Home Health Nurse, Rural Nurse, Occupational Health Nurse, Community Mental Health Nurse, Primary Care Nurse, Forensic Nurse, Military Nurse, Parish Nurse, Telehealth Nurse, Outreach/street Nurse.
• Home health nurses clinically care for clients in homes, schools, or workplaces.
• Primary care nurses are the first point of contact within the health care process.
• Telehealth nurses triage health issues, consult, advise, support, educate, and coordinate care.
• Outreach/street nurses focus on building relationships while maintaining safety, dignity, and respect.
• Rural and Northern Canada nurses engage with communities, homes, schools, clinics, outpost nursing settings, and First Nation, Inuit, & Métis communities.
• Occupational health nurses base their actions on individual health, occupational health nursing, and the environment.
• Parish nurses integrate faith and health into nursing practice within a faith community.
• Forensic nurses offer healthcare and collect evidence for the legal system, respecting clients' rights and dignity.
• Community mental health nurses mix community nursing with mental health/psychiatric nursing.
• Public health nursing uses knowledge from public health, nursing, social and environmental sciences, and research.
• There exist four regulated nursing groups in Canada: RNs, nurse practitioners, licensed/registered practical nurses, and registered psychiatric nurses can be found.
• Nurse practitioners are advanced practice nurses with varying titles across practice settings and provinces/territories. Registered psychiatric nurses are educated and regulated in western provinces and the Yukon.
• Practice standards include political and social advocacy to change conditions leading to marginalization and inequities.
• Information communication technology (ICT) is expanding nursing practice.
• Evidence-based practices are becoming more important.
• Preparation for Community Health Nurses (CHNs) in undergraduate programs is becoming more important due to rising rates of chronic preventable diseases.
• Ethical nursing practice requires critical reflection, sound ethical decisions, and appropriate action.
• The CNA's ethical values are providing safe, compassionate, competent, and ethical care, promoting health and well-being, promoting and respecting informed decision-making, Honouring dignity, Maintaining privacy and confidentiality, Promoting justice, and Being accountable.
• Ethics refers to values, norms, moral principles, virtues, and traditions that guide human conduct.
• Social justice emphasizes equitable distribution of societal benefits and responsibilities.
• Social justice focuses on the relative social advantage of individuals or groups and the root causes of inequities.
• Attributes of social justice include equity, human rights, democracy and civil rights, capacity building, just institutions, enabling environments, poverty reduction, ethical practice, advocacy, and partnerships.
• Social justice assumes that societies experience systematic oppression and inequities.
• Social justice approaches are concerned with the ethical use of power in health care.
• Social justice views persons relationally, connected to others, and interdependent.
• Social justice elicits concern for issues of everyday life.
• Community Health Nurse (CHN) advocacy often has a strong social justice orientation for populations sensitive to health inequities and/or otherwise marginalized.
• Ethical issues in community health nursing include health promotion, prevention, health protection, health maintenance, restoration, and palliation.
• Specific areas of ethical and legal concern relate to capacity building, access and equity, and professional responsibility and accountability, as well as negligence.
• Maintaining privacy and confidentiality is a legal responsibility of Community Health Nurses (CHNs).
• CHNs must disclose health information on a need-to-know basis and abide by privacy legislation.
• Legal issues may arise from negligence resulting from a breach in the standard of care.
• Community Health Nurses (CHNs) work collaboratively when building individual and community capacity by using strategies involving empowerment and advocacy.
• Community Health Nurse (CHN) advocacy takes a stand for practices, aims, and reforms aligned with the moral goals of public health.
• Ethical problems in the community can take on a political nature.
• The use of power is of ethical significance.
• Efforts to prevent disease and injury restrict individual liberty.

Community Week-3

• A theory is an organized and systematic articulation of statements related to significant questions in a discipline.
• Understanding theory is essential because it provides a foundation for both practice and research in nursing.
• Theory can guide practice where research-based evidence is lacking.
• Theory assists practitioners, decision makers, educators, and researchers in explaining experiences, informing actions/decisions, and articulating possible outcomes.
• Key public health concepts include social justice, population health, health promotion, and ethics.
• Community health nursing concepts include health equity, determinants of health, capacity building, a strengths-based approach, cultural safety, and collaboration.
• Nursing theories focused on illness in clinical settings are not always easily adapted to community health nursing.
• Perspectives of First Nation, Métis, and Inuit peoples are not well represented in community health nursing theory and practice due to a lack of acknowledgement of colonial roots.
• Two-Eyed Seeing and Two-Row Wampum demonstrate traditional Indigenous knowledge and Western scientific understanding. Theoretical foundations include the Community Health Nurse (CHN) metaparadigm, philosophies encompassing CHN ethics and values, and broad theoretical perspectives such as complexity science theory, social ecological theory, feminist theory, and postcolonial theory.
• Conceptual models/frameworks include various health promotion models & the Intervention Wheel, as well as grand, middle range & practice theories.
• Theory-informed practice is important to clients, including Indigenous peoples and people experiencing social and health inequities, health system, the profession, policy, and research.
• For Indigenous peoples, the First Nations Perspective on Health and Wellness model guides care and decolonizes and redesigns health programs for First Nations in BC.
• Theories help to broaden the scope of effective and considerate care beyond treating illness in a clinical context.
• Critical social theory supports nurses in collaborating with other sectors to influence public policy and address the structural and systemic determinants of health.
• Health is a dynamic process with multiple assumptions and understandings that evolve over time and with varying professional professional perspectives and purposes.
• Health promotion is the process of enabling people to increase control over, and to improve their health.
• An Indigenous understanding of health includes the family and community and focuses on a balance between the body, mind, emotion, and spirit.
• For many Indigenous people, health includes nature as an integral component.
• Upstream approaches benefit the whole population via policy interventions to address root causes of preventable ailments. Downstream interventions provide acute care, and are usually tertiary prevention measures individually focused on treatment and cure. The underlying values of Primary Health Care (PHC) are social justice and equity.
• The principles of Primary Health Care (PHC) are accessibility, public participation, health promotion, appropriate technology, intersectoral collaboration or co-operation.
• The first international health promotion conference took place in Ottawa in November 1986, which made the Ottawa Charter for Health Promotion.
• Five key actions of the Ottawa Charter are building healthy public policy, creating supportive environments for health, strengthening community action, developing personal skills, and reorienting health services toward preventing diseases and promoting health.
• Serious illness and early death related to poverty are connected to low social standing.
• The Toronto Charter recognized that Canadian women, Canadians of colour, and new Canadians were significantly more at risk than others.
• Population health promotion involves acting on the interrelated conditions affecting a population's health to create healthy change.
• Collaborative and partnership approaches are effective community-development and relationship-building strategies.
• These approaches build trusting relationships, enhance personal confidence/skills by valuing clients' expertise, and engage in empowering educational strategies.
• The Population Health Promotion Model (PHPM) emphasizes comprehensive action on all health determinants, multiple planning entry points, and the understanding that certain groups may be disproportionately affected.
• The Population Health Promotion Model (PHPM) recognizes that health results from individual practices, social, and physical environments, and emphasizes social justice, equity, and participation in community.
• Social marketing uses marketing principles to advance a social cause, idea, or behavior to promote behavior change.
• The "marketing mix" includes the four Ps: product, price, place, and promotion.
• Additional Ps might include "policy change" or "people" (e.g., training).
• Using only promotion as an intervention is considered social advertising, and not social marketing.
• The term "at risk" can create stigmas and prejudices leading to oppressive attitudes.
• Communication of risk is vital due to rapid changes in associated risks from newer technologies.
• A risk management approach is more amenable to implementing multiple strategies to address various determinants of health.
• Prevention occurs at primordial, primary, secondary, tertiary, or quaternary levels.
• Primordial prevention avoids illness/injury by addressing issues before they become risk factors.
• Primary prevention uses risk factor identification/awareness to avoid illness/injury.
• Secondary prevention promotes health through early disease identification & timely treatment.
• Tertiary prevention begins once an individual is symptomatic, focusing on maintaining or restoring function and preventing further disability.
• Quaternary prevention identifies those at risk for medical mishaps, focusing on patient safety and ethical practices.
• Harm reduction focuses on protecting the health of individuals engaging in high-risk activities & reducing secondary harms.
• The goal is to reduce immediate harms related to behavior, address health inequities & provide care to the marginalized.
• Activism has been used for people living in poverty, address child labor & distribute birth control info.
• Research/action aims to form partnerships w/ individuals & communities to promote health.
• Advocacy is a mandatory component of public health/community nursing practice & a social justice issue.

COMMUNITY NURSING- WEEK 4

• Public health involves organized societal efforts to prevent injury, illness, and premature death.
• Public health aims to protect/promote the health of all Canadians through services, programs, and policies.
• Public Health Nurses (PHNs) practice in various settings and focus on preventing lifestyle risks, chronic diseases, diseases, and injuries.
• Public Health Nurses (PHNs) prioritize the health of the environment considering climate change and ecosystem deterioration.
• Public Health Nurses (PHNs) are committed to social justice and reducing health inequities.
• Public Health Nurses (PHNs) advocate for health and quality of mothers and children, primarily those youner, or of low socioeconomic status.
• Public Health Nurses (PHNs) run immunization and vaccination.
• Public Health Nurses (PHNs) function within government bodies, must understand government, and may challenge laws to support community support.
• Early Public Health Nurses (PHNs) worked with low-income communities, setting them apart from private or hospital nurses.
• They worked to improve physical environmental conditions to reduce maternal/child morbidity.
• Early Public Health Nurses (PHNs) worked with charitable and religious organizations.
• As programs grew, Public Health Nurses (PHNs) were employed to work in civic health departments.
• Public Health Nurses (PHNs) focus on social justice for all.
• Public Health Nurses (PHNs) aim to reduce health inequities by targeting health prerequisites like shelter, education, food, and income.
• A population-oriented approach to public health allows for effective cross-sector collaboration.
• Public Health Nurses (PHNs) require derived knowledge from nursing/public health science.
• Public Health Nurses (PHNs) require general skills relating to assessment/analysis, evaluation, programming, and policy.
• Public Health Nurses (PHNs) focus on inclusiveness, achieving partnerships/collaboration/advocacy, effective communication capacity, professional accountability, and leadership capabilities.
• Core functions of Public Health Nurses (PHNs) include health protection and surveillance, population assessment, emergency preparation/response, and prevention.
• Public Health Nurses (PHNs) advocate for equal rights.
• Public Health Nurses (PHNs) lobby to change programs, contact citizens, advocate healthy policy, and participate in policy-making.
• Primordial prevention prevents conditions for issues.
• Primary prevention halts ailments from disease.
• Secondary prevention stops the disease advancement.
• Tertiary prevention halts impairments from advancing.
• Quaternary prevention involves action againse over-medicalisation
• Home care began in Quebec by religious orders in the 17th century.
• By 1988, the federal government and provinces launched home care programs, extending to Indigenous communities in 1999.
• Home health focuses on care for acute and unwell in any community at any age.
• Home Health Nurses (HHNs) are inter professional and work with families to detect health needs.
• Home Health Nurses (HHNs) apply primaty health focus, scientific knowledge, social analysis, and deteriation preventation.
• Home Health Nurses (HHNs) focus on maintanence or palliation and evaluation of patients.
• Categories of competencies for nurses are Health Nursing; Foundations, and Professional Responsibilites.
• One competencyis to respect customs while helping home patient health.
• A support for high home qualitity is support for factual/proven decision making.
• Hospitals must give nursing to ensure support
• Nursing involves changing demographics/unstable setting, and lack of resources.
• Vulnerable people don't obtain equitable health.
• Tech advancement will increase nurse data use.

COMMUNITY WEEK 5

• A community is a group sharing an environment, time and beliefs.
• Community functions are essential for sustaining daily.
• Dynamics support these decisions by leaders through comunication. Healthy conditions have community that help environtments support health.
• Model emphasizes nursing that partakes in comunity.
• Communtiy approaches need planning empowering.
• Nursing is easier where communit is more empowering.
• Needs data based models consider the help determinants.
• Triangles and enivoroments test disease data.
• The process involves cycling evaluations.
• Address challenges by inequality and community awareness. - Focuses preventions from disease.
• Risk tests can find a potential disease .
• Decision make is based on a community.
• Engagement builds the goalsetting skills that people need.
• Involement works with to help plan.
• Solving grassroots, and community all work to support communities. -People need a list of issues from communities, visualization of health barriers and a model. -Helps visualize aspriations.
• Address equal opportunity
• Uses community engagement to address community needs.
• Involves all of this evaluation planning
• Models support and expose gaps.
• Model steps is CAT SOLO steps.
• Monitor implentation.
• Framework gives a framework over information
• Charts present sequence of projects.
• Targets complexity in intervention programs.
• Implemetations and reaseach informs each iteration.
• Elements show the model as well.
• Community allows for more authenticy
• Changes affect. and population intervation.
• Comunity is very important.
• Priority buying helps, and transparency helps.
• Evaluation helps, and ouputs spin and sustainability for models
• Indications relate to steps. Social is important by a variety of measure

COMMUNITY NURSING - WEEK 6

• The process for health realtionships, data and casuality are invovled for what's in a population.
• Models allow for data use to prevent/cure illness in populations.
• Epidemiology helps understand relationships between population health.
• Stimulus factors or challenge factors. To prove realtionship and response,
• Models visualize a challenge.
• Screening means check ups that lead to health checks, monitoring data.

Data data is analysed is to see how much and why for why population for different population reasons.

• Mortality is analyzed over health to test for the model good.

• Measurmeent is to ask questions and help test people with the measuremnt plan.

• Common checks are tested over a set amount of time.

• Help promote healthy with what they eat.

• Use environmental consideration for factors.

• Reduce time with recognition To find a disease a need for action is action.

• Have preventable diseases,

• Have infections from transmissions.

• Have water and air infections.

• Micro organisms affect resistance.

• Too many agents increase over use.

• Shared responsibility on surveillance of health.

• Local public health check numbers.

• Guidelines and provices test diseases.

• Phac is health CHN needs for control.

• Help create the need preventions.

• To help monitor the help for help.

• Changing processes.