Roles of a Nurse in Community Health Nursing

Community Health Nurse Roles and Responsibilities

Roles of a CHN are as Collaborator, Adviser, Consultant, Advocate, Preventer, Promotor, Manager ,Primary Health care Provider,Observer and Potentiator.

Concept Of Role and Its Trend In Nursing

    There was a time when the nurses were meant only for carrying out the orders of physicians for curing the diseases. Now the traditional role of an assistant to doctor has been changed in the following ways with the evolution of community. The nursing has evolved from that of focusing on illness in the care of patients only in the hospital to concern for promotion, restoration and maintenance of health in all settings of a community.

    More and more nurses are assuming roles in industries, schools, community agencies, clinics and convalescent homes where care is health-oriented rather than illness-oriented. The nursing has become knowledge-based rather than task-oriented. Many nurses are engaged in research and in dependent scholarly work. The dependent function of a nurse, of carrying out prescriptions of physicians, has changed to a more independent and assertive role in the given community. 

    Nurses are more self-directed and willing to assume greater responsibility and accountability for the care of the patients. The role of a nurse moved from merely following physicians' orders to a collaborative or joint working relationship with medicine and other disciplines concerned with health care.

    In community health setting, the roles of a collaborator, advisor, consultant, advocate, preventer of illness, promoter of health, provider of direct care, good observer, potentiator, manager, participant in planning and primary health care practitioner are being incorporated into nursing practices.

As Collaborator

    The community health nurse works collaboratively with patients and also with members of the health team in assessing, planning, implementing and evaluating interventions. The patient may be an individual, a family or a group of persons in the community.

As Adviser

    Since community health nurses work with the families in the community, they naturally develop a good interpersonal relationship with the people of a particular community. However, individuals and families are looking towards the nurse as an adviser mainly in practical and emergency matters which relates to health acceptance of advices from the community health nurses are well documented.

As Consultant

    Sometimes the community health nurses are consulted by the authorities in planning a program as there is a source of information in relation to particular program which is to be organized, for example, program. As a consultant, the nurse shares nursing knowledge and expertise to help solve a problem or meet a need.

As Advocate

    Community health nurse is an advocate of patients' rights in relation to their care Nurse will act as an advocate as far as health of the particular individual is concerned. She encourages the individuals to take right food for maintaining health, right drugs for the treatment and refers to right services at right place whenever needed. 

    As a patient's advocate the nurse provides the patient with sufficient information to make the necessary health care decision. The nurse also supports the patient's rights to make these decisions. The nurse explains, protects and defends the rights of the patient.

As Preventer of Illness

    The primary focus of community health nursing is prevention of illness. The nurse practices disease prevention in such endeavors as conducting immunization clinics, assisting with case-finding during outbreaks of cholera and other epidemics, nutrition counseling and many more diseases preventing programs. A community health nurse acts as an epidemiologist in this direction and uses epidemiological skills before or during the outbreak of communicable diseases.

As Promoters of Health

    The major component of nursing care is health promotion. The role of health promoter includes consideration of the unique individual characteristics as well as predictable health needs of a community member. She also acts as a health educator, teaching self-examination of breast to mothers or teaching self-care to the individual during house visit.

As Provider of Direct Care

    The nurse who works in the community is authorized to provide required care. The nurse provides direct care in many ways. He/she carries standing orders of physicians while giving continued care to individuals who needed it at their doors, during home visits. The nurse provides appropriate care including bed-baths, range-of-motion exercises, treatment of minor ailments and also provides first-aid and emergency nursing care.

    Good Observer Community health nurse is expected to be alert to any deviation from expected behavior with respect to illness, growth and development, response to drugs and general well-being of an individual, family and community. As an observer, the nurse is supposed to be aware of her surroundings and reports unusual occurrence of disease symptoms, environmental threats, unusual stresses in the community which may cause threat to the health of community.

As Potentiator

    The individuals have their own potentials to maintain their health, but by virtue of her/his specialization in the community health and nursing practice, the nurse is expected to act as catalyst or potentiator. This role is achieved by assuming central position in enabling the individual family or group to make decision about health, to take appropriate and prompt action and by dealing constructively with inescapable diseases and death by providing care, arranging health promotion and disease prevention programs regularly.

As Manager

    The community health nurse assumes the role of manager in a variety of situations. He/she is expected to organize and manage various planned programs of health and assume leadership of nursing team for supervision of nursing and other auxiliary personnel.

As Participant in Planning

    As a representative of the nursing community, the health nurse will be molding decisions not only about nursing but also about community health and health related facets of and welfare program. The decision of timing and method of approach of a particular program to succeed, eg immunizations program is taken by a community nurse.

As Primary Health Care Practitioner

Since community health nurses have to play many roles according to health situations in the community, they are the fit persons to take up a prominent position in the community health setting, particularly in primary health care program. These roles may be: primary health care practitioner, middle level manager; and administrator of nursing services within the health services program. The role of nurses in primary health care is to:

Specific Roles as Primary Health Care Nurse

    i:Arouse people's awareness of an interest in health particularly in measures that would promote their general well-being and wholeness.

    ii: Develop the capacities of the people to investigate and assess their health status, needs, resources inside and outside the community, the decision making process and how values, and knowledge are propagated in the community.

    iii: Equip the people in the community with appropriate knowledge and health care competence to attend to common simple medical conditions with stress on the use of indigenous resources.

    iv. Develop and sharpen people's ability to critically analyze their problems and the process involved in their solution so that they will always be conscious of their role in the social transformation. . 

    v.Enhance local initiating, leadership and cooperation in the solution of identified health needs and problems and to develop mechanism whereby their efforts could be linked with those of other community groups involved in health and other socially transforming program.

    vi. Link herself/himself with the rest of the health professionals and in order to continually sustain her/his work of social transformation.