CURRENT TRENDS IN COMMUNITY NURSING:

Forces affecting health care in the future will also affect the role of the nurse.
One can onlyspeculate about what that future will be.some broad changes can also certainly
be predicted.theseinclude emphasis on cost containmentresultingfrom market- driven
economic policy, advancement in technology, knowledge explosion,expanded uses of
alternative and complimentary therapies, demographic shift.

THE FUTURE OF NURSING CARE:

Nurses must be prepared to used critical thinking skills to solve problems and
make independed clinical judgement regarding care based on the most recent evidence.they
must be knowledgeable about making age-appropriate referral to other disciplines and
community agencies.because more acute care will be provided in the home and clinics,
nurses must be more technically advanced in their skills, able to practice autonomously, and
adept at detailed documentation to ensure payment for service. As a larger number and
percentage of the population are living with chronic conditions and managing symptoms at
home, there will be a need for competent, skilled nursing practionerswho are comfortable
practicing independently in the area of disease management.
In home care nursing is evidenced by nurse doing venipunctures( a laboratory
technicians role) and teahing and monitoring administration of oxygen ( a respiratory
therapist role). To prepore for home care role, nurse must be competent case mangers and
health educators.
In the last decades, our profession has made major proceessin several areas in
public policy. The issue of delegating to no licenced personal has been addressed and
continues to need clarification. Today, advanced practice nurses (APN) Can bill directly
through medicare and in most states can prescribe medication. In some states hospitals are
mandated to maintain a safe level of staffing registered nurses based on the research on
staffing ratio and hospitasl mortality.

EDUCATIONAL PREPARATIONS AND ADVANCEDPRACTICE

NURSING :
Specialty areas of nurse practisioner have expanded to numerous subspecialties
in the last 3 decades. These include adult gerontology, neonatal, occupational ,pediatric,
psychiatric, schools or college students, and women’s health. Nurses practioneres work in
both rural and urban areas, from rural North Dakota to New yorkcity. They practice in
diverse setting such as community health centers, hospital, college student health clinics,
physician offices, nursing homes, home health care agencies and nursing schools.
The 2018 National sample survey of Registered nurses discovered the following :
 Most of the Registered nurses workforce has received a bachelor’s of degree or higher
( 63.9%) of them nursez with master’s or doctorate degree accounted for 19.3%.
 Advanced practice RNs were Approximately 11.5% of the nursing workforce.
TECHNOLOGY AND INFORMATION
Computer technology has freed the nurse from some paper works, allowing
more time for client care and teaching about self care. The expanding implementation of
computer based client records allows the preservation of a clients history from birth to death.

ALTERNATIVE AND COMPLIMENTARY THERAPIES:

To follow the holistic perspective, nurses must be knowledgeable about alternative
therapies with such knowledge they can monitor care, treatment and provide information about
benefit and potential harm for clients.
In the future nurses will increasingly be called on to provide knowledge and use of
alternative therapies. Therefore, it is imperative that nurses continue to build their knowledge
and skill base about alternative therapies. As the population becomes more diverse ethnically,
it irs anticipated that more method of promoting health and treating illness will be necessary.

SHIFTING DEMOGRAPHICS
The nursing shortage is latest demographic trend that will impact community
-based care in the future. of. one national survey of RNs indicated that 82% nurses reported a
shortage in their hospital or community. These nurse did not have positive expectations of the
impact of shortage on work conditions , believing that some tasks currently assigned to
nurses will shift to other staff. They anticipate the shortage will result in nurses leaving
nursing for non- nursing jobs, thus intensifying the shortage. These changes could result in
lower quality of care provided.
Because community based nursing practice will be central to the care of a
population of ageing and chronically ill peoples, nurses will be confronted will many
challenges. In the future, regardless of the nurses own ethnic background, the nurse must be
proficient at transcultural nursing to be effective caregiver. Nurses will play a major role in
promoting self-careand addressing health promotion and disease prevention issues for elderly
clients
.

PREVENTIVE CARE :
Focusing on prevention will be particularly changing as tge percentage of the
population ages and living with chronic conditions. Growing trends in alternative health
therapies allow more culturally sensitive option in priventive care. There are different ways
that nurses can operationalize the concept of health promotion and disease prevention in
community – based nursing. The nurses can position themselves as the first link between
clients and the hospitals, thus developing long- term relationships. This involves developing
systems and models of care that require periodically contacting client with chronic problems.
CONTINUITY OF CARE AND COLLABORATIVE CARE:
The hospital may known as health care organization or an integrated health care
system. These system already exist in many part of the country. More community based care
programs will comes from these integrated system. Another them uses in seamless care, in
which all level of care are available in an integrated form .continuity allows quality care to be
preserved in a changing health care delivery system.

CURRENT TRENDS IN NURSING EMPLOYMENT :

As a result of cost containment measure and medical practice modifications,
nursing employment has changes over the past several years. The public health service’s
division of nursing has chronicled this change in practice settings through periodic survey of
registered nurses
The 2004 sample survey of Registered nurses discovered the following :
 Rate of Registered Nurses who is working out side of hospitals 43.8%
 Although the number of Registered Nurses working in hospitals increases, the
proportion of nurses working in hospitals declined significantly.
 The number of Nurses employed in public health and community health setting
increased.

COMMUNITY BASED EMPLOYMENT OPPORTUNITIES FOR

REGISTERED NURSES:
1. AMBULATORY CARE:

 Adult day care centers

 Day care centers for ill children’s
 Mental health clinics
 Family planing clinics
 Cardiac rehabilitation programs
 Geriatric clinics
 AIDS clinics
 Diabetes management and education services
 Pulmonary clinics ( asthma, COPD, cystic fibrosis )
 Genetic clinics and counselling services
 Bloodmobiles
 Freestanding diagnostic centers
 Diagnostic and imaging centers
 Mobile mammography centers
 2. HEALTH DEPARTMENT SERVICES :

 Maternal /child clinics

 Family planning clinics
 Communicable disease control program
 HIV/AIDS (testing, counselling and treatment )
 Tuberculosis clinics (testing, treatment and surveillance )
 STD
 Immunization clinics
 Mobile clinics service
 Substance abuse program
 Jail and prison
 Indian health services

3. HOME HEALTH CARE SERVICES :

 Skilled nursing care

 Intravenous therapy
 High risk pregnancy and neonatal care
 Maternal/ newborn care
 Privet duty ( hourly care)
 Respite care
 Hospice care

4. LONG-TERM CARE :

 Skilled nursing facilities

 Hospital – based facilities
 Freestanding / nursing home – based facilities
 Hospice facilities
 Nursing homes
 Skilled nursing care
 Assisted living

OTHER COMMUNITY HEALTH SETTINGS:

 School health program
 Occupation health program
 Parish nursing homes
 Summer camp program
 Child birth education program
CHALLENGES OF COMMUNITY HEALTH NURSING :

 AUTONOMY :

Rural community health nurse have the opportunity to use

autonomy in daily practice . Nurses much rapidly assume independent and
interdependent decision making roles because of the small workforce and large
workload. Rural community health nurse learn to prioritize tasks quickly and
work efficiently with other’s to “ get the job done”.

 “Always a Nurse”:
Anonymity is not easy for the rural community health nurse, who is always“on duty”.
A trip to the grocery shop may include interaction with rural clients and their families
about their pressing health concerns. Rural community health nurse may have
confidentiality and personal / professional boundary issues that need to be addressed.
Rural community health nurses are often respected, known and trusted by the
population they serve.

 FUNDING FOR EDUCATION ;

Now days nursing education is very expensive therefore many of the interested
person’s are not joining in this course .or otherwise they seek or depend educational
loans to full fill the goal.

 WORKPLACE MENTAL VIOLENCE :

Workplace violence is wide spread in healthcare settings. Huge amount of workload
and responsibilities on the staff can often lead to disturbed mental peace which will
ultimately lead to less efficient care. Multiple tasks can pose a problem in a health care
unit

 .LACK OF SYNCHRONICITY :
Disharmony and lack of team work is an emerging challenge in the health care sector.
Harmonious relationship amongst health care workers is a essential requirement for the
health care system

.
 NON NURSING ROLES :
In almost all health care settings, nurses undertake roles which are not of their forte,
hence they are left with minimal time to carry out their actual roles and
responsibilities. They are spending more time than necessary doing non-nursing-
related work for eg:-Record keep
 ing, inventory, diet etc.
 AGEING POPULATION :

In the rapidly growing world were 8% of tge current population are elderly
healthy ageing, has become a vital need in the country.
The country will face a heavy Double burden of infectious and non
communicable disease with existing lack in significant resources including
comprehensive ageing policies to cope.

 CHALLENGES IN THE AREA OF DEMOGRAPHIC AND

MORTALITY PROFILE IN OUR COUNTRY;

Large population base and tapering top in the age pyramid is a

typical sign of under developed country.32% of population between 0-14,years in the
basis of pyramid reflect the need for health care services in abundance as morbidity
and mortality among them are high in our country.

 WORK PLACE HEALTH HAZARDS AND COMMUNICABLE

DISEASES:

Nurses confront a high risk of developing occupational health hazard if not

taken proper precautions and care. they are confronted with variety of
biological, physical and chemical hazards during the course of performing their
duties. Nurses are high risk groups prone to get communicable diseases they
are more contacted person with the
clients.
SCOPE OF COMMUNITY HEALTH NURING:

 Industrial nursing : In industries the nurse play a important role

to protect and maintain health of the employees and also keeping
physical records updating periodically

 Domicilary nursing
 Mental health nursing : Nurse is act as a counselor and care taker
in mental heath centres
 School health nursing : school health nurse will conduct periodic
physical examinations and health education at school for
students
 MCH and Family planning : Under MCH &Family planning the
nurse will assist labour, maternal and neonatal care, family
planning counsiling.
 Nursing Care
 Home care: providing nursing care to community through home
visit
 Geriatric care:caring elderly peoples in geriatric homes.
 Rehabilitaioncenter:Nurse will act as a recreationalist for
chronically illedones
 CONCLUSION :

Community health nursing is a wide ranged profession .care giving is

not only the aim .community health nursing trends are updating day by day. The
scope of community health nursing is unexplained. They are try to over come their
challenges by new innovations. The role of nurse is changing according to thiere
situations eg: In school she act as school health nurse,

REFERENCE
 Kamalam S ,Essentials in community health nursing practice,2ndedition,
New delhi Jaypee brothers medical publishers, 2012 page number :340-341
 K park preventive social medicine, 24 th edition, jabalpur2017
Page number: 493-494
 http:// www.National sample survey ofRegisteredNurses. Com //