Functions Performed By Community Health Nurses

Functions of Community Health Nurse 

The functions of community health nursing includes Assessment,Planning,Implementation, Evaluation and Research.

Who is a Community Health Nurse

 Nurse who is practicing in the nursing profession should inform the population on health problems. Every act, the object of which is to identify the health needs of persons contribute to methods of diagnosis, provide and controls the nursing care required for the promotion of health, prevention of illness, treatment of certain ailments and rehabilitation, and to provide care according to a medical prescription constitutes the professional nursing.

    Community health nursing should be based on a general philosophy of nursing. Protection of life from conception until death, constitutes a fundamental element for every human being and implies protection against anything which might impede physical or emotional development or cause any stress or bio-psycho-social disorders. Community health nursing helps or assists in meeting physiologic and psychologic needs and in promoting physical and psychic integrity to enable every citizen to fulfill his role in society. 

    Community health nursing should respect autonomy and individuality of the human being and pay special attention to the integration and actualization of individual in his family, his work and living milieu and the community. Through promotion and protection of health, prevention and detection of illness, treatment rehabilitation and re-education nursing care enables the maintenance of the physical and mental condition of the individual as well as his independence in society, and the promotion of the health of a social group in the milieu.

    These functions may be carried out by a single public health nurse/local health volunteer/female health assistant or with the nursing team or with the health teaming auxiliaries. The overall functions of community health nursing personnel include direct nursing care, health teaching, referral, health counseling, anticipatory guidance, planning, co-ordination and health advocacy. 

    In addition to providing comprehensive nursing care/services to the individual, family and the community, community health nurses are now emerging prominent members in the health care administration by participating in planning and evaluation of the community health programs.

    Community health nursing practice must be operationalized, in terms of functions of the nurses which are inherent in the "nursing process", the philosophy and principles of nursing. The goal of nursing is to assist or help individuals and groups to attain, maintain and restore health. To achieve this goal, the nurses of any setting need to have an approach that should be systematic and dynamic. 

    The nursing process is a systematic and dynamic method and uses scientific steps in the delivery of nursing care to the patients. It consists of a series of scientific steps such as assessment, planning, implementation and evaluation. In the sphere of nursing practices as a whole, one more step may be included, that is of "research" for searching new knowledge in a systematic way. (Nursing process will be dealt with in detail in the next chapter).

Since the functions of the nurses are inherent in the nursing process, an elaboration of the meaning of the functions of the community health nurse is outlined below.

1.Assessment

A. Identifies present and potential needs and resources related to health of patients

i Gathers pertinent data relative to health needs; physiological, psychological and social aspects; aptitudes, attitudes, behavior, perception, habits, etc.

ii. Discovers/uncovers health needs and problems through observation, inter views, instruments, analysis of records, and use of vital information.

iii. Obtains information from the individual, his family, his associates, as well as his living milieu, his work milieu and the community.

IV. Observes, explores and evaluates the patients, physical and emotional conditions; reactions to drugs and treatment.

v. Considers age, sex, culture, economic status, geographic location, etc. which may influence the incidence or prevalence of health problems.

vi. Recognizes attitudes that influence individual and community health.

vii. Estimates the ability and readiness of individual and families to recognize and meet their own health needs.

viii. Identifies the availability and utilization of community resources.

ix. Evaluate the urgency and complexity of the need in determining priority of action.

x. Report in writing on the data gathered.

B. Contributes the methods of diagnosis:

i . Institutes detection tests or examination.

ii. Observes and notes signs and symptoms which indicate deviation from the during physical examination. observation or interview.

iii. Transmits the information gathered to the professional concerned in the multidisciplinary team.

IV. Requests laboratory analysis, X-rays or other diagnostic tests. v. Participates in epidemiological surveys or other researches regarding standard of living, and health/life and health status. C. Shares in identifying present and potential needs and resources related to the agency's program and nurses job responsibilities:

i . Appraises community health and social needs and resources for interpretation to administrative and planning groups.

ii. Appraises the adequacy of community health nursing services in her/his area in relation to community needs and agency's programs.

iii. Determines through her/his contacts with patients, members of related disciplines, and others, the extent of their knowledge of agency's programs .

IV. Estimates the effectiveness of intra and extra-agency communications.

v. Participates in exploration and identification of her/his own needs in relation to the job.

2. Planning

A. Plans for the comprehensive nursing care/ service to the patients:

i . It is arranging for the methods and techniques necessary to meet the assessed need.

ii. Assembles the data gathered.

iii. Analyzes information in order to classify the health needs identified in the order of importance.

IV. Formulates the nursing needs and/or nursing problems.

v. Selects appropriate actions from among various nursing intervention alternatives.

vi. Determines short-term and long-term objectives in collaboration with the individual, the family, and/or the group.

vii. Considers individual, family or the group. viii. Identifies the expected effects, con sequences or results.

ix. Co-ordinate the nursing plan and nursing program with the programs of other health professionals in the multidisciplinary team.

x. Provides for the different implementation steps of the measures selected.

B. Participates in planning for community health nursing services:

i . Helps to develop and arrange for community health nursing services in special settings, such as schools, places of employment, nursing homes, and similar institutions, hospitals, clinics and health conferences.

ii. Develops plans for group teaching to meet the special needs of various groups.

iii. Organizes the mechanisms of super vision, control and follow-up.

IV. Organizes or collaborates in the development of detection and immunization program according to the specific needs of various groups.

v. Organizes and/or collaborates in the development of programs. for the prevention of accidents, infections, illness and pollution in the environment.

vi. Develops information programs regarding nutrition, dental hygiene, posture, life habits, birth control, STD, AIDS, positive and negative results of stress, the importance of physical fitness, retirement, and medical health.

C. Contributes to planning for the development and operation of the community health agency:

i . Contributes to the development of philosophy, purposes, policies and procedures of the community health nursing services in the agency.

ii. Determines means of providing information to sensitize the community about health services available and care delivery methods.

iii. Participates in planning nursing aspects of new and ongoing programs.

IV. Contributes to the preparation and revision of the nursing budget.

v. Participates in planning the administration procedures of the nursing office.

vi. Participates in planning continuing education program for agency personnel.

vii. Establishes links between various methods of care delivery to ensure coordination and continuity of services and care.

D. Participates in planning with other agencies for community health programs:

i . Advises or participates in community group planning related to nursing and health

ii. Plans with professional organizations and civic groups for improvements. And advancement of the practice of nursing and community health.

3.Implementation

It is taking action required to carry out the plan to meet the need.

A. Provides comprehensive nursing care to patients.

i . Implements nursing care according to the established plans or program.

ii. Encourages participation by the clientele in the nursing care provided in programs.

iii. Motivates the individual, family, and groups to accept and assume responsibility for providing and arranging care and guides it towards self-help for improving their health.

IV. Helps the individual to discover and accept his functional, physical, psychological capacities.

v. Helps the patient to understand the implications of the diagnosis and recommended treatment consistent with their readiness and with the knowledge of doctor.

vi. Helps the individual to assume his family and social responsibilities.

vii. Helps groups to face the obligation of daily living especially in moments of crisis.

viii. Motivates the individual and groups to participate actively in the organization and use of leisure activities adapted to their physical, psychological, logical and economical conditions. ix. Helps groups to discover new interests and develop new habits of life according to their standard of health. x. Promotes participation and develops interest in community life.

xi. Interprets the extent and limitations of available nursing services.

xiii. Gives skilled care to patients who deserve it.

xiii. Gives preventive and therapeutic treatment according to the medical prescription, standing order or established protocol.

xiv. Obtains laboratory specimens, per form diagnostic tests, when indicated and interprets the significance of results to individuals and families when authorized.

xv. Utilizes her/his understanding of behavior pattern in providing nursing care.

xv. Initiates nursing measures to prevent complications and to minimize disabilities .

xvii. Maintains necessary records and reports.

B. Provides health education to inform population on health problems:

i . Informs the public philosophy and objectives of community health nursing and nursing care programs in community health. About the

ii. Informs the people to understand about patterns of growth and development and encourages attitudes and actions that will promote optimum health for each individual.

iii. Informs the individual and families of the importance of utilization of their capabilities and to make the best possible adjustment to these limitations.

iv. Gives information about personnel hygiene, nutritional hygiene, the. Hygiene of rest and activity, menstrual hygiene, sexuality, abortion, STD, AIDS, environmental hygiene, the hazards of alcohol, smoking, drug addiction, mental hygiene or any other subject according to expressed, perceived and real needs and to established program.

v. Explains the importance of detection and immunization tests. vi. Stresses the importance of periodic health evaluation to maintain biopsycho -social balance.

vii. Gives information regarding balanced life.

viii. Gives information on security measures in the home, at work, on the road. in sports, and at public places.

ix. Gives information on different methods of birth control and their effectiveness and side effects to maintain small family norms.

x. Gives information on the causes and effects of pollutions of the environment.

xi. Gives information on the community resources of the area. xiii. Reformulates or clarifies the necessary information given by other health professionals or community organizations.

xiii. Provides information through inter views, conferences, communities, meetings, discussions, films, slides, folders, pamphlets, bulletin boards, newspapers, articles, and role plays, etc.

4. Evaluation

It is testing the outcome of the actions against previously determined criteria. A. Appraisal of performance:

i . Evaluates the effectiveness of her/his nursing service to individuals and families.

ii. Evaluates the effectiveness of her/his service in health program in special settings.

iii. Contributes to the evaluation of workers for whom she/he shares supervisory responsibility.

IV. Uses available help to study and evaluate her/his own job performance and for continuing professional growth.

B. Control and evaluate the nursing care:

i . Analyzes the effects, consequences, or results obtained from the delivery of nursing care as well as the realization of nursing care program, and health education program according to the objectives determined.

ii Records reactions of the clientele to services received.

iii. Evaluates the degree of satisfaction of the clientele.

IV. Notes the evolution of the nursing and of the health needs of the population.

v. Assesses the degree of comprehension regarding information and advice given.

vi. Ensures the following of nursing care program.

vii. Prepares daily reports and statistics concerning nursing problems, nursing care and results obtained..

viii. Establishes mechanism to evaluate and control the quality of nursing practice, nursing care program, as well as their impact on the individual, the family, and the community.

5. Research

A. Engages in surveys, studies and research:

i . Identifies problem areas related to her/his function in assessing, planning, implementation and evaluation.

ii. Participates in defining problems for study.

iii. Participates in the conduct of surveys, studies and research related to her/his clinical and functional responsibilities.