LESSON PLAN

NAME OF LECTURER Orudiakumo Barratt-bau Sylvia

NAME OF SCHOOL Bayelsa State College of Nursing Sciences, Tombia-

Ekpetiama

SUBJECT/COURSE Foundation of Nursing

TOPIC Unit I – Introduction of Basic concepts in

Community Nursing

CLASS Third year (Second Semester)

COURSE CODE/DURATION OF LECTURE CNP/ 2 Credit Unit

INSTRUCTIONAL METHOD Lecture, Socratic, Discussion

INSTRUCTIONAL MATERIAL Whiteboard, duster and marker

ENTRY BEHAVIOUR To establish the entry behaviour, the students are

asked the following questions;

1. define Community Nursing

2. state the terminologies used in
Community Nursing
3. list five (5) services provided the
Community Nurse

BEHAVIOURAL OBJECTIVES At the end of the lesson, students should be

able to;

1. explain the concept of Community

Nursing
2. demonstrate the ability to provide basic
care to clients
3. explain legal aspects of nursing
INTRODUCTION TO BASIC CONCEPTS IN COMMUNITY NURSING
Introduction
Nursing is a health care profession that "integrates the art and science of caring and focuses on
the protection, promotion, and optimization of health and human functioning; prevention of
illness and injury; facilitation of healing; and alleviation of suffering through compassionate
presence". Nurses practice in many specialties with varying levels of certification and
responsibility. Nurses comprise the largest component of most healthcare environments. There
are shortages of qualified nurses in many countries.

Nurses develop a plan of care, working collaboratively with physicians, therapists, patients,
patients' families, and other team members that focuses on treating illness to improve quality of
life. Nursing encompasses autonomous and collaborative care of individuals of all ages, families,
groups and communities, sick or well, and in all settings. Nursing includes the promotion of
health, prevention of illness, and the care of ill, disabled and dying people. Advocacy, promotion
of a safe environment, research, participation in shaping health policy and in patient and health
systems management, and education are also key nursing roles.

Topic I: Definition of Terms

(i) Definition of Nursing
Nursing, as defined by the International Council of Nurses (ICN), is a health profession
focused on the promotion of health, prevention of illness, and care of ill, disabled, and dying
people, encompassing all ages and settings.

American Nurses Association (ANA) defined “Nursing as the protection, promotion and
optimization of health and abilities, prevention of illness and injury, alleviation of suffering
through diagnosis and treatment of human response, and advocacy in the care of individuals,
families, communities, and populations”.

Virginia Avenel Henderson definition of nursing: "The unique function of the nurse is to assist
the individual, sick or well, in the performance of those activities contributing to health or its
recovery (or to peaceful death) that he would perform unaided if he had the necessary strength,
will or knowledge".

 Core Focus: Nursing aims to protect, promote, and optimize health and human
functioning, prevent illness and injury, facilitate healing, and alleviate suffering through
compassionate presence.
 Scope of Practice: Nurses work with individuals, families, groups, and communities,
providing care in various settings, including hospitals, clinics, homes, and community
health centers.

Key Roles and Responsibilities:

  Promoting Health: Educating individuals and communities about healthy
behaviors and lifestyle choices.

 Preventing Illness: Implementing preventative measures, such as vaccinations

and screenings.
 Caring for the Ill: Providing direct patient care, including administering
medications, monitoring vital signs, and providing emotional support.
 Advocacy: Advocating for patients' rights and needs, ensuring they receive the
best possible care.
 Research: Participating in nursing research to advance knowledge and improve
patient care.
 Education: Educating patients, families, and other healthcare professionals
about health-related topics.
 Leadership: Participating in shaping health policy and in patient and health
systems management.

Nurses as a Critical Part of the Healthcare System:

Nurses are often the first to detect health emergencies and work on the front lines of
disease prevention.
Historical Context:
The word "nurse" originally came from the Latin word "nutrire", meaning to suckle,
referring to a wet-nurse; only in the late 16th century did it attain its modern meaning
of a person who cares for the infirm.

Definition of Community Nursing

Community nursing focuses on promoting and preserving the health of populations or groups,
rather than individual patients, within a community setting. It involves applying public health
principles to address the health needs of individuals, families, and entire communities. Key
aspects include health promotion, disease prevention, health education, and advocacy.
Here's a more detailed breakdown:

Core Principles:

 Focus on Populations:
Community health nurses work with entire populations or groups, not just individual
patients.
 Health Promotion and Prevention:
They prioritize activities that promote healthy lifestyles and prevent disease.
 Health Education and Advocacy:
They educate individuals and families about health issues and advocate for policies and
resources that support community health.
 Community-Based Care:
They provide care in various settings, including homes, clinics, schools, and other
community locations.
 Partnerships:
They collaborate with community members, other healthcare professionals, and government
agencies to address health needs.
Examples of Community Nursing Roles:

 School Nurses: Provide healthcare services to students, manage chronic illnesses, and
promote health and safety.
 Public Health Nurses: Address broad health issues, conduct health screenings, and
implement programs to improve community health.
 Home Health Nurses: Provide care to individuals in their homes, often after hospital
discharge or for chronic illness management.
 Faith Community Nurses: Address the health needs of individuals within faith
communities.
 Community Mental Health Nurses: Provide mental health services in community
settings.
 Community-based nurses: Provide care to individuals, families, and groups wherever
they are, such as where they live and work.
In essence, community nursing is a vital link between the healthcare system and the community,
ensuring that individuals and families receive the care and support they need to live healthy and
fulfilling lives.

Topic II: Ethics/Etiquettes in Nursing

Introduction
The word ethics is derived from the Greek word “ethos”, which means custom or guiding beliefs.
Ethics determines the characteristics of a profession and is also called as a “code of conduct”.
Nursing ethics provides the professional standards for nursing activities, which protect the nurses
and the patients from legal and ethical issues.
Ethics in nursing involves moral principles guiding practice, while etiquette encompasses
professional conduct and behavior. Both are crucial for maintaining patient trust, respect, and a
positive work environment. Core ethical principles include autonomy (patient self-
determination), beneficence (promoting good), nonmaleficence (avoiding harm), and justice
(fairness). Etiquette examples include maintaining confidentiality, being courteous, and
respecting colleagues.

Ethical Principles in Nursing:

 Autonomy: Respecting patients' right to make their own decisions about their care.

 Beneficence: Acting in the patient's best interest and promoting their well-being.

 Nonmaleficence: Avoiding or minimizing harm to patients.

 Justice: Ensuring fair and equitable distribution of resources and care.

 Fidelity: Keeping promises and being trustworthy.

 Veracity: Telling the truth and being honest.

Nursing etiquette refers to the professional norms or manners that should be upheld by a nurse
in interactions with patients, colleagues, and the wider hospital environment. This includes
notions of respect, civility, and providing patient-centred care.
Etiquette and Professional Conduct:

 Maintain professional boundaries: Avoid inappropriate relationships with patients or

colleagues.

 Respect patient confidentiality: Protect sensitive information and maintain privacy.

 Communicate effectively and compassionately: Listen attentively, use clear language,

and show empathy.

 Cooperate with colleagues: Respect their roles and contribute to a positive team
environment.

 Adhere to health and safety guidelines: Follow protocols for infection control and
safety practices.

 Be punctual and organized: Arrive on time, maintain a clean work environment, and
manage time effectively.
  Display a neat and professional appearance: Maintain a tidy uniform and follow dress
code guidelines.

 Practice good manners: Be courteous, use polite language, and show respect for others.

 Avoid unprofessional behavior: Refrain from gossip, negativity, or disrespectful

comments.

Topic III: Concept of Health and Illness

Introduction
Understanding the distinction between health and illness is crucial for individuals, healthcare
professionals, and policymakers. Recognizing the multifaceted nature of health and the
individual's experience of illness allows for more effective interventions and supports in
promoting well-being.

Definition of Health: World Health Organization (WHO) defined Health as a state of

complete physical, mental, and social well-being, not merely the absence of disease. Illness, on
the other hand, is a broader term encompassing an individual's subjective experience of disease
or discomfort, including physical, emotional, and social impacts. While disease refers to a
biological or physiological disruption, illness is the individual's personal experience of that
disruption within a social and cultural context.
Key Differences:

 Health: A state of well-being, encompassing physical, mental, and social aspects.

 Illness: An individual's subjective experience of discomfort or disease, including

physical, emotional, and social impacts.

 Disease: A biological or physiological disruption or malfunction.

Example:

A person with a chronic illness like diabetes may still be considered healthy if they are able to
manage their condition effectively and maintain a good quality of life, both physically and
mentally. The "illness" of diabetes may be a part of their life, but it doesn't necessarily define
their overall health.
Factors Influencing Health and Illness:

 Individual Factors:

Genetics, lifestyle choices (diet, exercise, stress management), and individual coping
mechanisms.

 Environmental Factors:

Access to healthcare, social support networks, and the physical environment (air quality,
sanitation).

 Societal Factors:
Cultural beliefs about health and illness, social inequalities, and access to education and
resources.

Topic IV: Structure of Primary, Secondary and Tertiary Health Facilities and Social
Services

Introduction
Healthcare is an essential aspect of human life as it is vital for maintaining good health,
preventing diseases and improving the quality of life. Healthcare services are divided into
various types, depending on the patient’s condition and the level of care required. The Nigerian
healthcare system is structured into primary, secondary, and tertiary levels, with primary care
focusing on general medical services, secondary care handling more specialized conditions, and
tertiary care addressing complex and advanced medical needs. Social services, while not directly
part of the healthcare system, offer support and assistance to various groups, addressing societal
needs through government agencies and other organizations.
 (i) Primary Health Care (PHC):
Primary healthcare is the first point of contact for patients seeking medical attention. It is the
initial level of care that focuses on the provision of local care to a patient. Primary healthcare
professionals are usually generalists who deal with a broad range of psychological, physical
and social problems. They are not specialists in any particular disease area.
 Focus:
Basic healthcare services, including disease prevention, health promotion, and treatment of
common illnesses.
 Providers:
General practitioners, nurses, and other health professionals in community health centers
and clinics.
 Examples:
Routine checkups, vaccinations, treatment for common infections, and maternal health
services.

(ii) Secondary Health Care:

Secondary healthcare is provided by medical specialists and other health professionals who do
not have direct contact with a patient. These specialists include urologists, dermatologists,
cardiologists, etc. According to the National Health System policy, a patient requires a primary
care professional’s referral to proceed further for secondary care.
 Focus:
Specialized care for conditions requiring more advanced medical expertise and resources
than primary care.
 Providers:
Specialists like cardiologists, surgeons, and other medical professionals in general
hospitals.
 Examples:
Surgical procedures, specialized diagnostic tests, and treatment of conditions not readily
managed in primary care. Other examples of secondary care doctors include:

 Allergists: Allergists treat allergic diseases and conditions, like hives, asthma or
medicinal allergies.
 Infectious disease doctors: Infectious disease doctors specialize in the treatment of
contagious diseases like pneumonia, cellulitis, influenza and post-surgery infections.
 Ophthalmologists: Ophthalmologists are doctors who specialize in vision and eye care,
including routine eye exams, eye surgeries and eye conditions or diseases.
 Endocrinologists: Endocrinologists focus on the endocrine system of hormones and
glands to treat things like thyroid conditions, infertility or hormonal imbalances.
 Gastroenterologists: Gastroenterologists treat the digestive system, including the
esophagus, pancreas, colon, gallbladder, intestine, stomach and liver.
 Nephrologists: Nephrologists care for kidneys and kidney conditions like renal failure,
lupus, kidney stones, hypertension and more. They also perform dialysis and transplants.
 Neurologists: Neurologists are doctors who specialize in conditions of the spine, nerves
and brain, often performing surgery and treating conditions like migraines, stroke,
epilepsy, multiple sclerosis and Parkinson's and Alzheimer's diseases.
 Urologists: Urologists focus on urinary tract health, including reproductive health and
infertility issues.
 Pulmonologists: Pulmonologists care for the lungs and heart as they relate to breathing.
They handle ventilation procedures and treat lung conditions and breathing disorders.
 Otolaryngologists: Otolaryngologists are doctors who treat the ear, nose and throat
(ENT), including sinus, tonsils and throat.
 Psychiatrists: Psychiatrists are doctors who treat mental health conditions through
medication, counseling and hospital treatment. Some focus further on specific areas like
substance abuse and addiction medicine or adolescent mental health.
 Radiologists: Radiologists diagnose and treat medical conditions through image tests like
X-rays, mammograms, ultrasounds, computed tomography (CT) scans and magnetic
resonance imaging (MRI).
 Rheumatologists: Rheumatologists diagnose and treat rheumatic diseases and
autoimmune conditions of the joints, bones and muscles like gout, psoriatic arthritis,
rheumatoid arthritis and scleroderma.
 General surgeons: General surgeons care for a patient before, during and after general
surgery, mostly for organs like the stomach, skin, breast and endocrine or gastrointestinal
systems.
 Orthopedic surgeons: Orthopedic surgeons specialize in performing surgery for bone
tumors, broken bones, sports injuries, carpal tunnel syndrome or osteoporosis.
 Cardiac surgeons: Cardiac surgeons perform intricate and specialized heart surgeries,
like valve repair or replacement, aortic dissections, bypass and stents.
 Anesthesiologists: Anesthesiologists assist before, during and after all surgeries,
monitoring a person's vital signs and administering anesthesia to put a person to sleep for
procedures and surgeries. They also assist with pain medication following surgery.

(iii) Tertiary Health Care:

Tertiary healthcare is known as specialized consultative healthcare, usually for inpatients and
on referral from primary and secondary healthcare for advanced medical investigation and
treatment. Tertiary care services are specialized services provided by medical specialists who
are highly trained in their area of expertise. Tertiary care services include plastic surgery,
burn treatment, cardiac surgery, cancer management, neurosurgery, complex medical and
surgical interventions, etc. These services are often provided in specialized hospitals and
clinics that are equipped with advanced medical technologies and facilities.
 Focus:
Highly specialized and complex care for severe and life-threatening conditions, often
involving advanced medical equipment and procedures.
 Providers:
Specialists in teaching and specialist hospitals, often with the support of research and
academic institutions.
 Examples:
Advanced surgeries, cancer treatment, organ transplantation, and other highly specialized
procedures.

(iv) Social Services:

 Focus: Addressing various societal needs through a range of public services, including
support for disadvantaged groups.
 Providers: Government agencies, NGOs, and private organizations.
 Examples: Child care, housing assistance, disability support, and employment services.
Key Differences:
 Specialization:
Primary care is general, secondary care is specialized, and tertiary care is highly
specialized.
 Complexity:
Tertiary care involves more complex and advanced medical procedures and treatments.
 Resources:
Tertiary care requires specialized equipment and expertise, while primary care is often
community-based.
 Referral:
Patients are typically referred from primary care to secondary care and, if necessary, to
tertiary care.
Integration and Collaboration:
 The different levels of care are intended to work together as an integrated system, with
patients being referred from one level to another as needed.
 Collaboration between primary, secondary, and tertiary care providers is crucial for
ensuring continuity of care and optimal patient outcomes.
 Social services can also play a role in supporting patients and their families throughout
the healthcare journey.
Topic V: Basic Human Needs

Introduction
Basic human needs are the fundamental requirements for survival and well-being. These needs
encompass physiological, safety, and social aspects, forming the foundation for human
development and thriving.

Maslow’s Hierarchy of Needs

In 1943, Maslow developed a Hierarchy of Needs to explain the five levels every human being
must progress through to self-actualization. Most homeless people are seeking to achieve their
physiological needs and the search for food, clothing, and shelter is prioritized above everything
else. Understanding how humans progress up the ladder of needs can help us better understand
what support people need to reach self-sufficiency. Maslow suggested that “higher” needs can
begin to develop even when “lower” needs are not fully satisfied.
Physiological needs
Physiological needs are the base of the hierarchy. These needs are the biological component for
human survival. According to Maslow's hierarchy of needs, physiological needs are factored into
internal motivation. According to Maslow's theory, humans are compelled to satisfy
physiological needs first to pursue higher levels of intrinsic satisfaction. To advance higher-level
needs in Maslow's hierarchy, physiological needs must be met first. This means that if a person
is struggling to meet their physiological needs, they are unwilling to seek safety, belonging,
esteem, and self-actualization on their own.

Physiological needs include: Air, Water, Food, Heat, Clothes, Reproduction, Shelter and Sleep.
Many of these physiological needs must be met for the human body to remain in homeostasis.
Air, for example, is a physiological need; a human being requires air more urgently than higher-
level needs, such as a sense of social belonging. Physiological needs are critical to "meet the
very basic essentials of life".This allows for cravings such as hunger and thirst to be satisfied and
not disrupt the regulation of the body.

Safety needs
Once a person's physiological needs are satisfied, their safety needs take precedence and
dominate behavior. In the absence of physical safety – due to war, natural disaster, family
violence, childhood abuse, etc. and/or in the absence of economic safety – (due to an economic
crisis and lack of work opportunities) these safety needs manifest themselves in ways such as a
preference for job security, grievance procedures for protecting the individual from unilateral
authority, savings accounts, insurance policies, disability accommodations, etc. This level is
more likely to predominate in children as they generally have a greater need to feel safe –
especially children who have disabilities. Adults are also impacted by this, typically in economic
matters; "adults are not immune to the need of safety". It includes shelter, job security, health,
and safe environments. If a person does not feel safe in an environment, they will seek safety
before attempting to meet any higher level of survival. This is why the "goal of consistently
meeting the need for safety is to have stability in one's life", stability brings back the concept of
homeostasis for humans which our bodies need.

Safety needs include:

 Health
 Personal security
 Emotional security
 Financial security
Love and social needs
After physiological and safety needs are fulfilled, the third level of human needs is interpersonal
and involves feelings of belongingness. According to Maslow, humans possess an effective need
for a sense of belonging and acceptance among social groups, regardless of whether these groups
are large or small; being a part of a group is crucial, regardless if it is work, sports, friends or
family. The sense of belongingness is "being comfortable with and connection to others that
results from receiving acceptance, respect, and love." For example, some large social groups may
include clubs, co-workers, religious groups, professional organizations, sports teams, gangs or
online communities. Some examples of small social connections include family members,
intimate partners, mentors, colleagues, and confidants. Humans need to love and be loved – both
sexually and non-sexually – by others according to Maslow. Many people become susceptible
to loneliness, social anxiety, and clinical depression in the absence of this love or belonging
element. This need is especially strong in childhood and it can override the need for safety as
witnessed in children who cling to abusive parents. Deficiencies due
to hospitalism, neglect, shunning, ostracism, etc. can adversely affect the individual's ability to
form and maintain emotionally significant relationships in general. Mental health can be a huge
factor when it comes to an individual's needs and development. When an individual's needs are
not met, it can cause depression during adolescence. When an individual grows up in a higher-
income family, it is much more likely that they will have a lower rate of depression. This is
because all of their basic needs are met. Studies have shown that when a family goes through
financial stress for a prolonged time, depression rates are higher, not only because their basic
needs are not being met, but because this stress strains the parent-child relationship. The
parent(s) is stressed about providing for their children, and they are also likely to spend less time
at home because they are working more to make more money and provide for their family.

Social belonging needs include:

 Family
 Friendship
 Intimacy
  Trust
 Acceptance
 Receiving and giving love and affection
In certain situations, the need for belonging may overcome the physiological and security needs,
depending on the strength of the peer pressure. In contrast, for some individuals, the need for
self-esteem is more important than the need for belonging; and for others, the need for creative
fulfillment may supersede even the most basic needs.

Esteem needs
Esteem is the respect, and admiration of a person, but also "self-respect and respect from
others". Most people need stable esteem, meaning that which is soundly based on real capacity or
achievement. Maslow noted two versions of esteem needs. The "lower" version of esteem is the
need for respect from others and may include a need for status, recognition, fame, prestige, and
attention. The "higher" version of esteem is the need for self-respect, and can include a need for
strength, competence, mastery, self-confidence, independence, and freedom. This "higher"
version takes guidelines, the "hierarchies are interrelated rather than sharply separated". This
means that esteem and the subsequent levels are not strictly separated; instead, the levels are
closely related.

Esteem comes from day-to-day experiences which provide a learning opportunity that allows us
to discover ourselves. This is incredibly important for children, which is why giving them "the
opportunity to discover they are competent and capable learners" is crucial. To boost this, adults
must provide opportunities for children to have successful and positive experiences to give
children a greater "sense of self". Adults, especially parents and educators must create and ensure
an environment for children that is supportive and provides them with opportunities that "helps
children see themselves as respectable, capable individuals". It can also be found that "Maslow
indicated that the need for respect or reputation is most important for children ... and precedes
real self-esteem or dignity", which reflects the two aspects of esteem: for oneself and others.

Cognitive needs
It has been suggested that Maslow's hierarchy of needs can be extended after esteem needs into
two more categories: cognitive needs and aesthetic needs. Cognitive needs crave meaning,
information, comprehension and curiosity – this creates a will to learn and attain
knowledge. From an educational viewpoint, Maslow wanted humans to have intrinsic
motivation to become educated people. People have cognitive needs such as creativity, foresight,
curiosity, and meaning. Individuals who enjoy activities that require deliberation and
brainstorming have a greater need for cognition. Individuals who are unmotivated to participate
in the activity, on the other hand, have a low demand for cognitive abilities.

Aesthetic needs
After reaching one's cognitive needs, it would progress to aesthetic needs to beautify one's life.
This would consist of having the ability to appreciate the beauty within the world around one's
self, on a day-to-day basis. According to Maslow's theories, to progress toward Self-
Actualization, humans require beautiful imagery or novel and aesthetically pleasing experiences.
Humans must immerse themselves in nature's splendor while paying close attention to their
surroundings and observing them in order to extract the world's beauty. One would accomplish
this by making their environment pleasant to look at or be around. They might discover personal
style choices that they feel represent them and make their environment a place that they fit well
into. This higher level of need to connect with nature results in a sense of intimacy with nature
and all that is endearing. Aesthetic needs also relate to beautifying oneself. This would consist of
improving one's physical appearance to ensure its beauty to balance the rest of the body. This is
done by making and finding ways one wants to dress and express oneself through personal
beauty and grooming standards and ideas.

Self-actualization
"What a man can be, he must be.” This quotation forms the basis of the perceived need for self-
actualization. This level of need refers to the realization of one's full potential. Maslow describes
this as the desire to accomplish everything that one can, to become the most that one can
be. People may have a strong, particular desire to become an ideal parent, succeed athletically, or
create paintings, pictures, or inventions. To understand this level of need, a person must not only
succeed in the previous needs but master them. Self-actualization can be described as a value-
based system when discussing its role in motivation. Self-actualization is understood as the goal
or explicit motive, and the previous stages in Maslow's hierarchy fall in line to become the step-
by-step process by which self-actualization is achievable; an explicit motive is the objective of a
reward-based system that is used to intrinsically drive the completion of certain values or
goals. Individuals who are motivated to pursue this goal seek and understand how their needs,
relationships, and sense of self are expressed through their behavior. Self-actualization needs
include:

 Partner acquisition
 Parenting
 Utilizing and developing talents and abilities
 Pursuing goals

Transcendence needs
Maslow later subdivided the triangle's top to include self-transcendence, also known as spiritual
needs. Spiritual needs differ from other types of needs in that they can be met on multiple levels.
When this need is met, it produces feelings of integrity and raises things to a higher plane of
existence. In his later years, Maslow explored a further dimension of motivation, while
criticizing his original vision of self-actualization. Maslow tells us that by transcending you have
a set of roots in your current culture but you are able to look over it as well and see other
viewpoints and ideas. By these later ideas, one finds the fullest realization in giving oneself to
something beyond oneself—for example, in altruism or spirituality. He equated this with the
desire to reach the infinite. "Transcendence refers to the very highest and most inclusive or
holistic levels of human consciousness, behaving and relating, as ends rather than means, to
oneself, to significant others, to human beings in general, to other species, to nature, and to
the cosmos."