NCM 113
Community Health Nursing
Dr. V. Ludovice
Pem Irish Red 2BSN2
COURSE OUTLINE: PRELIMS multidisciplinary efforts to address various core
determinants of health.
3. Nursing is the art and science of caring.
REFERENCE BOOK According to Florence Nightingale (1973),
nursing is a means of ensuring that people are
placed in an optimum condition where nature
can contribute to healing and wellness.
Community Health Nursing
Principles of Community and Public Health
● A specialized field of nursing practice that Nursing
renders care to individuals, families and 1. Focus on the community as the unit of care
communities, focusing on health promotion 2. Give priority to community needs
and disease prevention through people 3. Work with the community as an equal partner of the
health team
empowerment.
4. In selecting appropriate activities, focus on primary
● Health promotion and disease prevention are prevention
the core of community health nursing. 5. Promote a healthful physical and psychosocial
● The major goal of community health nursing is environment
to preserve the health of the community and 6. Reach out to all who may benefit from a specific
surrounding populations by focusing on health service
promotion and health maintenance of 7. Promote optimum use of resources
individuals, families, and groups within the 8. Collaborate with others Working in the community
community.
● Thus, community health nursing is associated
with health and the identification of populations ROLES AND ACTIVITIES OF COMMUNITY HEALTH
at risk rather than with an episodic response to NURSE
patient demand (Nies & McEwen, 2019)
● The complex nature of the health needs of
communities calls for a holistic response from public
health nurses.
Side notes ● This in effect demands not only collaborative
Focus of CHN interventions but at the same time the nurse
working with communities is expected to
● promotion (empower the community) demonstrate competencies demanded by different
● prevention (major goal) settings and situations of his/her clientele.
● curative ● The Philippine Professional Regulatory Board of
● rehabilitation Nursing (NNCCS, 2012) expects beginning
Is associated with health and identification of population at professional nurses to be able to perform three
risk and focuses more for the people at risk roles:
➔ Health care provider
➔ manager-leader
3 BASIC CONCEPTS OF COMMUNITY AND PUBLIC ➔ researcher
HEALTH NURSING
Role of nurse in university
1. The community as a client Community is a ● Instruction
collection of people who interact with one ● research
another and whose common interests or ● extension - without research it is useless
characteristics form the basis for a sense of ● exposure - midwife
● immersion- BHW
unity or belonging (Alexander et al., 2009)
● someone in the community will lead, the nurse’s
2. Health as a goal Health is a state of complete role is to facilitate
physical, mental, and social well-being and not
merely the absence of disease or infirmity
(WHO, 2010). It is a multidimensional reality Healthcare Provider
● Caring is the essence of nursing and has been
that includes socioeconomic, environmental
widely accepted in all settings.
and even political factors. Healthcare needs to
● The use of the nursing process applied in the
be holistic. The nurse in the community foster natural environment of the client pertains to this role
1
NCM 113
Community Health Nursing
Dr. V. Ludovice
Pem Irish Red 2BSN2
● Examples include the occupational health nurse agencies in investigating to identify the etiology of
conducting a physical examination of an employee, the epidemic and ultimately identify potential
a school nurse providing first-aid to student who solutions to halt the progress of the problem
sustained a cut, and a nurse taking the history of a ● Apart from collecting actual data for research, the
pregnant nurse nurse utilizes research findings to provide evidence
to convince decision-makers to enact policies for
Health Educator health.
● Communicating information to help patients make
an informed choice regarding their health is a key Client Advocate
activity in public health works. ● The community/public health nurse takes a
● People's awareness will impact on their behavior to proactive stance in ensuring that the right to health
achieve health in their own hands. of the population he/she works with is realized and
● An example is instructing patients how to take their protected
prescribed medicine or sharing information about ● He/she engages stakeholders in clamoring and
the benefits of a healthy lifestyle lobbying for policies that impact health of
communities
● The nurse in the field also initiates organizing
Program Implementer activities to form coalitions and linkages to foster
● Nurses working under local government units awareness of people to various health-related
deliver healthcare to the grassroots. issues.
● This requires that programs initiated by the national
government thru the Department of Health (DOH)
are executed at all levels.
What is Community Organizing?
➢ Is a social development methodology used to
● The nurse works with the rural health midwife in
facilitate the process of forming self-reliant,
conducting routine vaccination in communities to
self-determining communities that are able to
achieve herd immunity and contribute to the over-all
sustain their development activities.
goal of reducing child mortality.
➢ It is complemented with community development
● Likewise, submitting reports per standards of
which addresses livelihood and other critical
documentation on targets reached and missed is
concerns to make a community truly self-reliant and
part of this role of the nurse in community/public
sustaining
health.
CHARACTERISTIC OF COMMUNITY ORGANIZING
Community Organizer
● Working with people in communities and providing ● Proceeds from people’s priority needs
them with ownership of their healthcare needs
● Based on community analysis
and to act collectively on their issues is best
captured by this role of the nurse in public health ● Reflects urgent issues and community’s resolve to
act in this issue
Manager/Leader
● Community and public health work deal with Process of Community Organizing
competing claims specifically on utilization of limited ➔ The process of community organizing is the core of
resources. all the activities of the community
● The nurse employs principles of management to organizer/community health nurse.
maximize resources effectively and efficiently. ➔ Most effective in terms of development is
Budgeting, inventories, scheduling and staffing, and COPAR(Community Organizing Participatory Action
conducting training sessions are likewise included Research) and CBPR (Community-Based
under this role. Participatory Research) model
Researcher/Epidemiologist Comparison of Traditional Research Approach and
● The nurse is regarded as the health monitor of the COPAR
community.
Points of Traditional COPAR
● Together with the rural health midwife, they keep comparison Research
track of illnesses encountered in their areas of Approach
jurisdiction and submit reports to health authorities
as required by law. Decision Top-down Bottom up
● In the event of an outbreak, community/public making Expert/nurse-driv Community
health nurses work with other professionals and
2
NCM 113
Community Health Nursing
Dr. V. Ludovice
Pem Irish Red 2BSN2
➔ process by which a community identifies its needs
emphasis en process Much driven process.
premium Is Premium is and objectives, develops confidence to take action
placed on the placed on the in respect to them and in doing so, extends and
data and output. process develops cooperative and collaborative attitudes
and practices in the community.
Roles Nurse’s role as Community ➔ A continuous and sustained process of educating
researchers; the members as the people to understand and develop the critical
community researchers: the awareness of their existing condition,
members are nurse is the
➔ Working with the people collectively and efficiently
subjects or facilitator and
objects of recorder. on their immediate and long-term problems,
research. Data analysis is ➔ And mobilizing the people to develop their capability
Data analysis is done collectively and readiness to respond and take action on their
done by the by the immediate needs towards solving their long-term
nurse, and then community problems.
presented to the
community
PRINCIPLES OF COPAR
methodolog Research tools Research tools
y and and ● People especially the most oppressed, exploited
methodologies methodologies and deprived sectors are open to change, have the
are are identified and capacity to change and are able to bring about
predetermined by developed by the change.
the nurse community ● COPAR should be based on the interest of the
organizer
poorest sector of the community.
Output Upon completion, Conclusions and ● COPAR should lead to a self-reliant community and
the study is recommendation society.
packaged, s are made by ● Concern toward society and nature;
submitted to the the community. ● Democratization of knowledge production and use;
agency and These will lead to and
published. agreed ● Commitment to nonviolent social change
Recommendatio community
● Concern toward society and nature;
n are made by actions/projects.
the researchers The whole ● Democratization of knowledge production and use;
based on the research cycle and
findings of the continues until it ● Commitment to nonviolent social change.
study becomes part of
community life, Emphasis of COPAR
leading towards
● Community working to solve its own problem
community
development. ● Directions established internally and externally
Community ● Development and implementation of a specific
members project less important than the development of the
formulate the capacity of the community to establish the project.
recommendation ● Consciousness raising involves perceiving health
s and medical care within the total structure of society
Definitions Importance of COPAR
➔ social development approach that aims to transform ● COPAR is an important tool for community
the apathetic, individualistic and voiceless poor into development and people empowerment as this
dynamic, participatory and politically responsive helps the community workers to generate
community community participation development activities.
➔ collective, participatory, transformative, liberative, ● prepares people/clients to eventually take over the
sustained and systematic process of building management of a development programs in the
people's organizations by mobilizing and enhancing future.
the capabilities and resources of the people for the ● maximizes community participation involvement;
resolution of their issues and concerns towards community resources are mobilized community
effecting change in their existing oppressive and services.
exploitative conditions
3
NCM 113
Community Health Nursing
Dr. V. Ludovice
Pem Irish Red 2BSN2
GOALS OF COMMUNITY ORGANIZING
● The goal of community organizing is to generate
durable power for an organization representing the
community, allowing it to influence key
decision-makers on various issues.
● It also focuses on distributing power more equally
throughout the community.
● Their efforts are aimed to:
➔ Influence governance, corporations and
institutions
➔ Seek to increase direct representation
within decision-making bodies.
➔ Foster social reform more generally.
➔ Inform others outside the community of the
issues and pressure decision-makers.
(callhub.io)
Critical Activities im Community Organizing
● Community Integration immersion to where the
people are
● Social investigation
● Ground Working- laying the starting point for
community organizing
● Meetings
● Tentative Program
● Planning
● Role playing
● Community Mobilization for action
● Evaluation
● Reflection
● Organization
COMMUNITY PARTICIPATION IN HEALTH
● Community participation in primary health care is
rooted in the Alma-Ata Declaration of 1978, which
states, "People have the right and duty to
participate individually and collectively in the
planning and implementation of their health
care" and that effective primary health care
"requires and promotes maximum community and
individual self-reliance and participation in the
planning, organization, operation, and control of
primary health care”
● The World Health Organization describes
community participation as "a process by which
people are enabled to become actively and
genuinely involved in defining the issues of concern
to them, in making decisions about factors that
affect their lives, in formulating and implementing
policies, in planning, developing and delivering
services and in taking action to achieve change"
