Overview Of Public Health Nursing PDF

Handout OVERVIEW OF PUBLIC HEALTH NURSING INTRODUCTION: In the same manner that the Department of Health and the public health system have evolved into what is it now in response to the challenges of the times, so has Public Health...

Handout OVERVIEW OF PUBLIC HEALTH NURSING INTRODUCTION: In the same manner that the Department of Health and the public health system have evolved into what is it now in response to the challenges of the times, so has Public Health Nursing practice been influence by the changing global and local health trends. These global and country health imperatives brought public health nursing into new frontiers and have positioned nurses to emerge as leaders in health promotion and advocacy. This perception has been validated by a WHO report acknowledging the significant contribution of the nursing workforce to the achievement of health outcomes, particularly that of the Millennium Development Goals (MDG). Public Health Nursing in the Philippines evolved alongside the institutional development of the Department of Health, the government agency mandated to protect and promote people’s health and the biggest employer of health workers including public health nurses. Historical accounts show that as far back as the 1900s, nurses working in the communities were already given the title Public Health Nurses. In the light of the changing national and global health situation and the acknowledgement that nursing is a significant contributor to health, the Public Health Nurse is strategically positioned to make difference in the health outcomes of individuals, families and communities cared for. Definitions and Focus Community Health Ø Extend the realm of public health to include organized heath efforts at the community level through both government and private efforts. Community Health Nursing Ø The utilization of the Nursing Process in the Different Levels of Clientele-Individuals, Families, Population Groups and Communities, concerned with the Promotion of Disease and Disability and Rehabilitation (Dr. Arceli Maglaya, et, al) PHILOSOPHY According to Dr. Margaret Shetland, the philosophy of Community Health Nursing is based on the worth and dignity of man. PRINCIPLES The following principles of community health nursing were adapted from those formulated by Mary S. Gardner and by Leahy ,Cobb ,and Jones. 1. Community Health Nursing is based on recognized needs of communities, families, groups and individuals 2. The community health nurse must understand fully the objectives and policies of the agency she represents 3. In Community Health Nursing, the family is the unit of service. 4. Community Health Nursing must be available to all regardless of race, creed and socio-economic status 5. Health teaching is a primary responsibility of the community health nurse. 6. The community health nurse works as a member of the health team. 7. There must be provision for periodic evaluation of Community Health Nursing services. 8. Opportunities for continuing staff education programs for nurses must be provided by the Community Health Nursing agency. The community health nurse also has a responsibility for his/her own professional growth. 9. The community health nurse makes use of available community health resources. 10. The community health nurse utilizes the already existing active organized groups in the community. 11. There must be provision for educative supervision in Community Health Nursing. 12. There should be accurate recording and reporting in Community Health Nursing. Public Health Nursing Book, 10th Edition GOAL The ultimate goal of community health services is to raise the level of health of the citizentry. To this end, the goal of community health nursing is to help communities and families to cope with the discontinuities in health and threats in such a way as to maximize their potential for high level wellness, as well as to promote reciprocally supportive relationship between people and their physical and social environment. OBJECTIVES 1. To participate in the development of an over-all health plan for the community and in its implementation and evaluation. 2. To provide quality nursing services to individuals, families and communities utilizing as basis, the standards set for community health nursing practice. 3. To coordinate nursing services with various members of the health team, community leaders and significant others, government and non-government agencies/organization in achieving the aims of public health services within the community. 4. To participate in and/or conduct researches relevant to community health and community health nursing services and disseminate their results for improvement of health care. CONCEPT 5. To provide community health nursing personnel with opportunities for continuing education and professional growth through staff development.  ROLES OF THE COMMUNITY HEALTH NURSE Clinician or Health Care Provider - Utilizes the nursing process in the care of the client in the home setting through home visits and in public health care facilities; conducts referral of patients to appropriate levels of care when necessary Health Educator – utilizes teaching skills to improve the health knowledge, skills and attitude of the individual, family and the community and conducts health information campaigns to various groups for the purpose of health promotion and disease prevention Coordinator and Collaborator – establishes linkages and collaborative relationships with other health professionals, government agencies, the private sector, non-government organization and people’s organizations to address health problems Supervisor – monitors and supervises the performance of midwives and other auxiliary health workers; also initiates the formulation of staff development and training programs for midwives and other auxiliary health workers as part of their training function as supervisors Leader and Change Agent – influences people to participate in the overall process of community development Manager – organizes the nursing service component of the local health agency or local government unit (ex. Nursing service plan component of the overall municipal health plan); also, as program manager, the PHN is responsible for the delivery of the package of services provided by the health program to the target clientele (ex. The PHN is almost always the program manager of the National Tuberculosis Program) Researcher – participate in the conduct of research and utilizes research findings in practice (ex. Disease surveillance or the continuous collection and analysis of data on diseases and causes of death. *The determinants of health as a concept can be further explained in the framework (pls refer to Link: http://docshare01.docshare.tips/files/24316/243160399.pdf page 8.) The framework refers to an Optimum Level of Functioning (OLOF) of individuals, families and communities being influenced by several factors in the eco-system. (PHN Book, 10thedition) These factors are: 1. Political – Politics greatly influence the social climate in which people live. Political jurisdictions have the power and authority to regulate the environment. Examples are safety, oppression and people empowerment. Increase of crimes and the lack of safety in streets and even in the homes are major concerns of society. Oppression especially of the poor differential treatment in various classes of society affects health. 2. Behavioral – A person’s level of functioning is affected by certain habits that he/she has. These may be in the form of smoking, intake of alcohol drinks, substance abuse and lack of exercise. The people’s lifestyle health care and child rearing practices are shaped to a large extent by their culture and ethnic heritage. 3. Hereditary – Understanding of genetically influenced diseases is increased through knowledge about the nature of genetic traits are transmitted. New opportunities for preventive health care are also produced. For example, more precise estimates of the risk of transmitting undesirable traits make it possible to provide prospective parents with information that will enable them to make decisions about child rearing. Early knowledge of the genetic risks makes it possible to anticipate and counteract genetic outcomes, as when knowledge of incompatible Rh factors in the paternal genes enable the medical team to prepare for necessary therapeutic intervention. 4. Health Care Delivery System – In the Philippines, primary health care is a partnership approach to the effective provision of essential health services that are community based, accessible, acceptable, sustainable and affordable. Although promotive and preventive health measures are emphasized in community health the availability and accessibility of curative and rehabilitative services also affect peoples’ health. 5. Environmental Influences – The menace of pollution has been growing over the years and has greatly affected the health of the people. The diseases today are largely manmade. Examples of these are communicable diseases due to poor sanitation, poor garbage collection, smoking, air pollution and utilization of chemicals such as pesticides. Cutting of tress has brought about floods and drought. If the quality of air that we breathe continues to deteriorate, life cannot be sustained. Uncontrolled dumping of organic wastes, detergents and pesticides including industrial wastes continue to threaten man’s supply of food, his drinking water and his health in general. 6. Socio-economic Influence – Families from the lower income groups are the ones mostly served in public health services and by the community health nurses. This is because, people form the lower income groups tend to have proportionately greater number of illnesses and health problems that those in the higher income groups. However, the middle and upper income group have also very pressing health problems such as drug abuse and lifestyle diseases. (PHN Book, 9th Edition)