The three historical nursing leaders are Florence Nightingale, Lillian Wald, and Nancy Millio.
Florence Nightingale: After the Crimean War, Nightingale organized hospital nursing practice and nursing education in hospitals. Nightingale concerned about the environmental determinants associated with health and disease. She identified principles that continue to guide the practice of public and community nursing, such as the importance of proper environment, nutrition, rest, sanitation, and hygiene to health promotion; these principles serves as major components for community health nursing today (Kalnins, 1999).
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Lillian Wald: the phrase public health used by Lillian Wald, founder of Henry Street Settlement. She describes the role of nurses was to address both the direct impact of sickness and the underlying relationship between social, economic disadvantage, environmental hazards, and disease. Wald’s stressed on illness prevention and health promotion through health teaching, nursing interventions and at the same time her use of epidemiology method; these principles became major elements of public health nursing practice (Buhler-Wilkerson, 1993).
Nancy Millio: She was a nurse leader in public health policy and education. She developed a frame work for prevention for community oriented and population focused care. She believed that through public policy, community nursing can influence communities and population health (Nies, & McEwen, 2015).
- Using definitions and examples from the lecture to explain the difference between population, community and aggregate.
- Population: is a group of people having common personal or environmental characteristics. Ex. All elders in rural region
- Community: is a group or collection of individuals interacting in social units and sharing common interests, characteristics, values, and goals. Ex. Residents of small town.
- Aggregate: Aggregates are subgroups or subpopulations that have some common characteristics or concerns. Ex. Pregnant teens within a school district (Nies, & McEwen, 2015).
- The Table 13-5 program – Choose one program and summarize its purpose. Then discuss how the program can help nurses to provide culturally competent care.
National Breast and Cervical Cancer Early Detection program (NBCCEDP) providing low income, uninsured, and underserved women access to breast and cervical cancer screening, diagnostic and treatment services. This program helps nurses to achieve cross -cultural communication, health related beliefs and practices, management of health problems in culturally diverse populations and their perspective, culture and socioeconomic factors, and culture and nutrition (Nies, & McEwen, 2015).
- Identify 3 roles that a community health nurses can assume. Discuss, using examples, what the CHN will do in each of the roles.
Three roles of the community health nurse: care provider, educator, and collaborator. Care provider: provider role in the community health means that the nurse provides health services, not just to individuals and families but to community also. The community health nurse especially emphasis on promotion of health and prevention of illness. Skills like Assessment, observation, listening, communication, and counseling becomes integral to care provider role.
Educator: health teaching is one of the major functions of a CHN. The educator role in community health nursing is major because wider audiences can be reached. CHN promotes learning opportunities for clients on broad range of topics. As educator CHN holds formal classes, shares information with clients, self care concepts, and health promotion strategies.
Collaborator: involves client and interdisciplinary team members or interagency groups working together toward improving client health and community health. Collaborate with nurses, and other interdisciplinary members of the health care team to advocate health care environments that are beneficial to ethical practice and to the health and well-being of patients and community.
- What is upstream thinking? (Hint – see McKinley’s analogy in the text book)
According to McKinley upstream thinking is analogy for prevention. According to McKinley, instead of using all resources and energy on rescuing people, why not stop the problem from even happening. Upstream analogy describes primary prevention, a major concept in community health approach. Thinking upstream is the actions that focus on modifying economics, politics, and environmental factors that are precursors of poor health (Nies, & McEwen, 2015).
- Identify a patient problem that you have recently encountered. Describe a microscopic approach to the problem. Describe a macroscopic approach to the problem.
I recently encountered a patient diagnosed with hypertensive disorder in my practice. The microscopic approach is to develop nursing diagnosis, interventions, and treatment. Adherence to therapeutic regimen, lifestyle modifications, and prevention of complications are the focus of the nursing care for patient with hypertension. Risk assessment, educated the patient and family about life style changes, diet, exercise and follow up care.
The macroscopic approach would be
- What is the prevalence of hypertension among various age, race, and population groups?
- Which population and sub population has the highest rates of untreated hypertension?
- What programs could help reduce the problems of untreated hypertension and lower the risk of further cardiovascular morbidity and mortality.
- What is the relationship between a macroscopic perspective and upstream thinking?
The concept of macroscopic is similar to the upstream thinking. Macroscopic is a broad concept that incorporated many variables to aid understanding a health problem. Upstream is a more specific concept and emphasizes the variables that play a role in the development of health problems. These two related concepts and their meanings can help nurses develop a critical eye in evaluating a theory’s relevance to population health (Nies, & McEwen, 2015).
- How does the Neuman System Model fit when using a macroscopic approach?
Neuman system views client as an open system that responds to stressors in the environment. Neuman system model fits in a macroscopic approach is to facilitate optimum wellness through interventions aimed at attaining, maintain, and retaining client stability by using primary, secondary, and tertiary prevention (Nies, & McEwen, 2015).
- List 3 core public health functions.
- “Assessment: regular collection, analysis, and information sharing about health conditions, risks, and resources in a community.
- Policy development: use of information gathered during assessment to develop local and state health policies and to direct resources toward those policies.
- Assurance: focuses on the availability of necessary health services throughout the community. It includes maintaining the ability of both public health agencies and private providers to mange day to day operations and the capacity to respond to critical situations and emergencies (Nies, & McEwen, 2015)”.
- Write a brief summary of 3 changes in the perspective that a nurse must have when providing population-based care as opposed to individual -based care.
When nurses are providing population based care, nurses need to identify high risk and vulnerable population in the early care delivery process; need to address not only populations, but also subpopulation within populations, and essential to develop outreach strategies (Nies, & McEwen, 2015).
Buhler-Wilkerson, K. (1993). Bringing care to the people: Lillian Wald’s legacy to public health nursing. American Journal Of Public Health, 83(12), 1778-1786. doi:10.2105/AJPH.83.12.1778
Kalnins, I. (1999). Sowing the seeds of public health nursing — 1920-39. International Nursing Review, 46(2), 47-51. Retrieved from https://libproxy.lamar.edu/login?
Nies, M. A., & McEwen, M. (2015). Community/public health nursing: Promoting the health of populations (6th ed., pp1-68). St. Louis, Mo.: Elsevier Saunders.
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