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COMMUNITY HEALTH NURSING

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COMMUNITY HEALTH NURSING

COMMUNITY HEALTH NURSINGOverview of Community Health NursingThe term "community health nursing" is composed of three major concepts:Community- ClientHealth- GoalNursing-The means

Two Major Fields of Nursing in the Philippines:1.Hospital Nursing2.Community Health Nursing

Definition of CHN:Science and art of preventing disease, prolonging life, promoting health and efficiency, through organized community effort for the sanitation of the environment, control of communicable diseases, the education of individuals in personal hygiene, the organization of medical and nursing services for the early diagnosis and preventive treatment of disease, and the development of the social machinery to ensure everyone a standard of living adequate for the maintenance of health, so organizing these benefits as to enable every citizen to realize his birthright of health and longevity-Dr. C.E. Winslow

Art of applying science in the context of politics so as to reduce inequalities in health while ensuring the best health for the greatest number- WHO

Special field of nursing that combines the skills of nursing, public health and some phases of social assistance and functions as part of the total public health programme for the promotion of health, the improvement of the conditions in the social and physical environment, rehabilitation of illness and disability-WHO Expert Committee of Nursing

Community healthnursing practice promotes and preserves the health of populations byintegrating the skills and knowledge relevant to both nursing and publichealth. The practice is comprehensive and general, and is not limited toa particular age or diagnostic group; it is continual, and is not limited toepisodic care.- The American Nurses AssociationANAs definition of community health nursing highlights the followingimportant points:1.The goal of professional practice is the promotionand preservation of the health of populations2.The nature of practiceis comprehensive, general, continual and not episodic3.The knowledgebase comes from nursing and public health4.The different levels ofclientele individuals, families and groups5.The practitioner'srecognition of the primacy of the population as a whole.Community health nursing is a specialized field of nursing practice.Its basic knowledge and skills are anchored on nursing theories andimportant concepts from the science of public health such as:

1.Emphasis on the importance of the "greatest good for the greatest number"2.Assessing health needs, planning, implementing andevaluating the impact of health services on population groups3.Priorityof.health-promotive and disease-preventive strategies over curativeinterventions4. Tools for measuring and analyzing community healthproblems5.Application of principles of management andorganization in the delivery of health services to the community.

Basic Concepts and Principles of CHN:1.The FAMILY is the unit of care, the community is the patient and there are four levels of clientele in CHN2.The goal of improving community health is realized through multidisciplinary effort3.The community health nurse works WITH and not FOR the individual patient, family, group or community.The latter are active partners, not passive recipients of care4.The practice of CHN is affected by changes in society in general and by developments in the health field in particular5.CHN is part of the community health system which in turn is part of the larger human services system

Roles of community nurse

Assessor

-Assessing the health needs of a community is the starting point for community nurses. -They determine the health needs of families and the community at large, as well as any social determinants that impact the health status of that community. - It includes health risks, injuries and disabilities.Educator

-Teaching them about healthy lifestyle choices.-Educating the public on eating healthy, the basics of looking after their own health and other information -Public-speaking skills and the ability to clearly communicate complex ideas to an audience -including one-on-one or as part of community programs and events. Evaluator

-Implementing a plan to improve the health of a community is not enough. Someone must evaluate the re- also helpful to improve preventive strategies, as well as determining the health trends of the population.- evaluations to determine the health priorities for a given area.

Community Builder

- A healthy community is a strengthened community, and a competent and compassionate community - a community nurse is responsible for building relationships and partnerships throughout the community, in order to improve the health of individuals and families. Additional Roles of the nurse in caring for communities and population groups:

Clinician health care provider, taking care of the sick people at home or in the RHUHealth Educator aim is towards health promotion and illness prevention through dissemination of correct information; educating peopleFacilitator establishes multi-sectoral linkages by referral systemSupervisor monitors and supervises the performance of midwives

Other specific responsibilities of a Nurse[spelled by the implementing rules and regulations of R.A. 7164 (Phil. Nursing Act of 1991)]

Supervision and care of women during pregnancy, labor, and puerperiumPerformance of internal examination and delivery of babiesSuturing lacerations in the absence of the physicianProvision of first aid measures and emergency careRecommending herbal and symptomatic meds.

In the care of the families:provision of primary health care servicesdevelopmental/utilization of family nursing care plan in the provision of care

In the care of the communities:Community organizing mobilization, community development, and people empowermentCase finding and epidemiological investigationProgram planning, implementation, and evaluationInfluencing executive and legislative individuals or bodies concerning health and development

Brief History1901Act # 157 (Board of Health of the Philippines); Act # 309 (Provincial and Municipal Boards of Health) were created.

1905Board of Health was abolished; functions were transferred to the Bureau of Health.

1912Act # 2156 or Fajardo Act created the Sanitary Divisions, the forerunners of present MHOs; male nurses performs the functions of doctors

1919Act # 2808 (Nurses Law was created) - Carmen del Rosario, 1st Filipino Nurse supervisor under Bureau of Health

Oct. 22, 1922Filipino Nurses Organization (Philippine Nurses Organization) was organized.

1923Zamboanga General Hospital School of Nursing & Baguio General Hospital were established; other government schools of nursing were organized several years after.

19281st Nursing convention was held

1940Manila Health Department was created.

1941Dr. Mariano Icasiano became the first city health officer; Office of Nursing was created through the effort of Vicenta Ponce (chief nurse) and Rosario Ordiz (assistant chief nurse)

Dec. 8, 1941Victims of World War II were treated by the nurses of Manila.

July 1942Nursing Office was created; Dr. Eusebio Aguilar helped in the release of 31 Filipino nurses in Bilibid Prison as prisoners of war by the Japanese.

Feb. 1946Number of nurses decreased from 556 308.

1948First training center of the Bureau of Health was organized by the Pasay City Health Department. Trinidad Gomez, Marcela Gabatin, Costancia Tuazon, Ms. Bugarin, Ms. Ramos, and Zenaida Nisce composed the training staff.

1950Rural Health Demonstration and Training Center was created.

1953The first 81 rural health units were organized.

1957RA 1891 amended some sections of RA 1082 and created the eight categories of rural health unit causing an increase in the demand for the community health personnel.

1958-1965Division of Nursing was abolished (RA 977) and Reorganization Act (EO 288)

1961Annie Sand organized the National League of Nurses of DOH.

1967Zenaida Nisce became the nursing program supervisor and consultant on the six special diseases (TB, leprosy, V.D., cancer, filariasis, and mental health illness).

1975Scope of responsibility of nurses and midwives became wider due to restructuring of the health care delivery system.

1976-1986The need for Rural Health Practice Program was implemented.

1990- 1992Local Government Code of 1991 (RA 7160)

1993-1998Office of Nursing did not materialize in spite of persistent recommendation of the officers, board members, and advisers of the National League of Nurses Inc.

Jan. 1999Nelia Hizon was positioned as the nursing adviser at the Office of Public Health Services through Department Order # 29.

May 24, 1999EO # 102, which redirects the functions and operations of DOH, was signed by former President Joseph Estrada.