NCM 104 COMMUNITY HEALTH NURSING Goals of CHN

Community Health Nurses  To assist the individual, family, and community in

 Are in position to assist in the transition of the attaining their highest level of holistic health which
Philippine health care system from a disease- is attained through multidisciplinary effort and to
oriented system to a health-oriented system. promote reciprocally supportive relationship
 Community health activities focusing on health between people and their physical and social
promotion and disease prevention are therefore of environment.
the essence (Nursing care Essence. Nursing care of Mission of CHN
the community, 2013) 1. Health Promotion
 As define by Ruth B. Freeman  Actions related to lifestyles and choices that
o It refers to a “service rendered by a maintains / enhances a population’s health.
professional nurse with communities, 2. Health protection
groups, families, individuals at home, in  Includes activities design to detect or prevent
health centers, in clinics, in schools, in or alter disease processes.
places of work, for the promotion of 3. Health Balance
health, prevention of illness, care of the  State of wellbeing that results from a healthy
sick at home and rehabilitation. interaction between a person’s body, mind,
 Considering high cost of the care of the sick, to spirit and environment.
which a considerably large portion of the health 4. Disease Prevention
budget goes, Phil indicators have remained  Activities designed to protect people from
markedly below the health indicators of many disease and its consequences.
other countries. 5. Social Justice
Health  All people have the right to certain “basics” of
 The WHO define health in its broader sense in its life such as adequate income and health
1948 constitution as a “a state of complete protection.
physical, mental, and social well-being and not Basic Principles of CHN Practice
merely the absence of disease or infirmity.” 1. The community is the patient in CHN, the family is
Philosophy of CH Nursing the primary unit of care or basic unit of server and
 Is based on the worth and dignity of men. This there are 4 unites of clientele
philo of care is based on the belief that care  Individual
directed to the individual, the family and the group  Family
contributes to the healthcare of the population as a  Population
whole.  Community
Health status of the population within the Philippines 2. In CHN, the client is considered as an active partner
 Varies markedly across areas of the country and (ADL), not passive recipient or care.
among groups. 3. Change
 Nurses constitute a large group of health care  The practice of CHN is affected by changes in
workers; therefore, they can create a health care society in general, and by developments in the
system that will meet the health-oriented needs of health fields in particular.
the people. o The environment and the socio-economic
Two Major Fields of Nursing in the PH have been shown to affect the health of
1. Hospital Nursing the community
2. Community Health Nursing 4. The goal of CHN is achieved through multi-sectoral
 Public health nurse- those who work in efforts
RHUs. (Rural Health Units) 5. CHN is a part of health care system and the larger
 Occupational Health Nurses (company human services system
nurses)
 School Health Nurses
 Community Mental Health Nursing
Salient (Important) Features of CHN
1. Population Clients of the CH Nurse
 The hallmark of CHN is that it is population – or 1. Individuals
aggregate-focused. The whole community is the  People (sick/well) consult at the health center
patient/ client and receive health services (pre-natal
o Priorities for care when resources or supervision well-child follow ups and morbidity
supplies are primarily allotted for the health services) on a daily.
needs and problems of the individuals or 2. Family
families as they relate to the health of the  Is a very important social institution that
total population or community. performs two major functions – reproduction
o Population – based assessment, policy and socialization.
development, and assurance processes are 3. Population group or aggregate
systematic and comprehensive  A group of people who share common
2. Greatest good for the greatest number characteristics, developmental stage / common
 The emphases of CHN is on the importance of exposure to environmental factors and
the “greatest good for the greatest number consequently common health problems.
where the nurse first looks at the health needs o Ex. Women, children, people with
and problems of the community rather than disabilities
focusing solely on the needs of individuals or 4. Community
families  A group of people living in the same place
3. Utilizes the Nursing Process having a particular characteristic in common.
 CHN involves the assessment of health needs,  Faction – place where people under usual
planning, implementation, and evaluation of the conditions are found.
impact of health services on population groups
using the problem-solving method also known Since the advent of the internet, the concept of
as the nursing process. community no longer has geographical limitations, as
4. Promotive – Preventive by nature people can now virtually gather in an online
 The priority of CHN is on the health promoting community and share common interest regardless of
and disease preventing strategies over curative physical location.
interventions. The demand for curative services Some of these groups are
is higher because people usually go to the  Children
health centers when they are already sick, and  Men and women
all home remedies have failed. The health  Farmers, factory workers, commercial workers
center consultation becomes the entry point to  Military men
the Health care system and provides the initial  Elderly
contact between the nurse and the client.
5. Uses a variety of instruments Classifications Of A Community
 CHN makes use of tools for measuring and 1. Rural communities
analyzing community problems like public  Also known as open lands, often agricultural in
health statistics or vital statistics. Community nature which is more spacious and less densely
map is also a very useful tool. Interview, populated.
schedule, survey forms, and questionnaires may o Ex. Sto. Tomas, La Union
also be used. 2. Urban communities
6. Requires management skills  Often known city or cities which are non-
 CHN applies the principles of management agricultural by nature, are densely populated,
especially during the organization of the and marked by industrial products and
nursing service in the local health agency and in technology.
activities that require the effective o Ex. Central Business Districts
management of a certain program or health 3. Suburban
service.
  Usually the administrative capital of a province determination, the right to make their own
characterized by a unique mix of agriculture decisions.
and industry 4. Health Educator – Who aims towards health
o Ex. San Fernando City, La Union promotion and illness prevention through
dissemination of correct information;
General Characteristics Of A Community educating people.
1. A community is defined by the geographic o Identifies and interprets training needs
boundaries within a certain identifiable of RHM, Brgy. Health Workers/
characteristic. Volunteers and Hilots.
 It is made up of institutions organized into a o Formulates appropriate training
social system with the institution and program designs.
organization linked in a complex network o Provides and arranges training and lng
having a formal and informal power structure experiences of nursing and midwife
and communication system. affiliates.
 It has a common or shared interest that bind o Acts as a resource speaker on the health
the members together. and health related services as the need
 It has an area with fluid boundaries within arises.
which a problem can be identified and solved. o Participates in the development and
 It has an aggregate concept. distribution of info, edu, and
2. A community is regarded as an “organism” which communication (IEC) materials.
has its own stages of developments (matures fast o Health teaching is the primary
or slow) and responses to problems may be responsibility of the CHN.
adequate, inadequate, inappropriate or delayed. 5. Partner and Collaborator – The aim of
partnership and collaboration is to the people
Characteristics Of A Health Community to work together in order to address problem
1. Awareness that “We are a community” or concerns that affect them
2. Conservation of natural resources o Brings together strengths and
3. Recognition of and respect for the existence of weaknesses of people involved toward
subgroups a common goal.
4. Participation of subgroups in community affairs 6. Health Planner / Programmer – Identifies
5. Communication through open channels needs priorities and problems of individual,
6. Resources available to all families and communities.
7. Setting of disputes through legitimate o Formulates nursing components of
mechanisms health plants. In doctorless areas, she is
8. Participation by citizens in decision – making responsible for the formulation of the
9. Wellness of a high degree among its members municipal health plan.
o Provides technical and administrative
Roles of the CH Nurse support to Rural Health Midwife (RHM).
 Focuses on the prevention of illness, injury or Conducts regular supervisory visits and
disability, the promotion of health, and meetings to different RHMs and gives
maintenance of the health of populations feedback on accomplishments.
1. Clinician – Who is a health care provider, 7. Community Organizer
taking care of the sick people at home or in o Responsible for motivation and
the RHU. enhancing community participation in
2. Teacher – Application of teaching – learning terms of planning, organizing,
principles to facilitate behavioral changes implementing and evaluation health
among clients is a basic intervention strategy program / services.
in community health. o Initiates and participates in community
3. Advocate – Speaks or acts for those who development activities.
cannot speak or act for themselves. 8. Case finder – Because of the nurse’s proximity
Advocates for self-care and self- to families and aggregates in the community,
 case finding has been a strategic role for  In the care of the families
many years. o Provision of primary health care services.
o Ex. At-risk children are identified and o Development / utilization of family
followed periodically as they develop. nursing in the provision of care.
9. Epidemiologist  In the care of the communities
o The nurse uses the epidemiological o Community organizing mobilization,
method to study disease and health community development and people
among population groups and to deal empowerment.
with community wide health problems. o Case finding and epidemiological
o Collecting data on health problem and investigation.
care is an important epidemiological o Program planning, implementation and
role. evaluation.
o Reasons why people do or do not use
health care are important elements in
planning health services.
10. Community Leader – The CHN being a leader,
a role model and respected in the community,
is in a better position to empower others.
Empowerment is giving your influence to
others for purpose of personal and
organization growth.
11. Teacher – Application of teaching-learning
principles to facilitate behavioral changes
among clients is a basic intervention strategy
in community health.
12. Counselor – Key task is listening and providing
feedback and information.
13. Hospice Care –Providing care skills in a home
or other setting and balancing client’s needs.
14. Manager / Supervisor
o Formulates individual, family and
aggregates – centered care plan.
o Interprets and implements program
policies, memoranda and circulars.
o Organizes work force, resources,
equipment and supplies and delivery of
health care at local levels.

Other Specific Responsibilities Of A Nurse

(Spelled by the implementing Rules and Regulation of
RA 7164 [Philippine Nursing Act of 1991])
1. Supervision and care or women during
pregnancy, labor and puerperium.
2. Performance of internal examination and
delivery of babies.
3. Suturing lacerations in the absence of a
physician.
4. Provision of first aid measures and emergency
care.
5. Recommending herbal and symptomatic
medications.