Question

Community health nurses practice in a variety of settings. Choose one of the following CH settings and describe what you have learned about the setting and the role(s) of the nurse in that setting (see Nies & McEwen, 2015, Chapters 29–33).

School nursing

Occupational health nursing

Faith-based or parish nursing

Home health nursing

Hospice nursing

Forensic nursing

Correctional nursing

The federal government developed Healthy People as a set of national health objectives that are revised every 10 years. These objectives are very specific in order to guide and measure our nation's progress related to public health. Please visit http://www.healthypeople.gov/2020/topicsobjectives2020/ (Links to an external site.)Links to an external site.. Click on a topic area that relates to a role you chose to discuss. Click on the green Objectives tab in that topic area to choose one Healthy People 2020objective.

Discuss one specific, numbered Healthy People 2020 objective (not a goal) related to this community health role.

How could a community health nurse help meet this objective?

Answer 1

Home health nurses:

My original thought about home health nurses is nothing like what I now see that they do. I use to think that the nurses that went in to home health were ones that could not make it in the hospitals. I know now that I could not have been more wrong. Home health nurses are tough. They have to be to be able to survive out there. They do not have the backup in the patients home like they do in the hospital. They can not just yell for someone to come help. It is up to them to make sure that the patient has everything they need. According to Nies, "The generalist home health nurse must have community health assessment skills to assess client and caregiver needs, provide client and caregiver education, perform nursing actions following the client's plan of care, manage resources to facilitate the best possible outcomes, provide and monitor care, collaborate with other disciplines and providers to coordinate client care, and supervise ancillary staff and caregivers," (p.649, 2015). They carry all the weight on their shoulders alone while they are out in the field.

When looking at objectives, I chose the objective: Reduce the proportion of all hospital Emergency Department visits in which the wait time to see an Emergency Department clinician exceeds the recommended time frame, (Healthy People). The home health nurse tries to help the patient avoid reoccurrence to the hospital as much as possible. That's why it is important that the home health nurse utilize all of his/her skills, and look for certain signs and symptoms for certain patients. More and more people are coming to the hospital for issues that could be resolved at home or at their PCP or urgent care. For patients with heart failure that fluid overload starts to take place, the home health nurse could call the physician and have an order for IV Lasix put in. By the time the patient gets an IV started and the medication is administered, it is less time than it would have taken if gone to the Emergency room.

Community health nurses can help meet this objective by learning about their patients and their histories. One example that I saw was the stroke survivor interventions being tried in NYC. They are utilizing tele health for monitoring blood pressures along with the home health nurses to try and intervene before a stroke happens. Spruill and associates states, "These interventions have the potential to substantially mitigate racial and ethnic disparities in stroke reoccurrence," (2015). This can make a big difference in the health of this group.
References:

Nies, M. A., & McEwen, M. (2015). Community/Public health nursing: Promoting the health of populations (6th ed.). St. Louis, MO: Saunders/Elsevier.

Spruill, T. M., Williams, O., Teresi, J. A., Lehrer, S., Pezzin, L., Waddy, S. P., …Ogedegbe, G. (2015). Comparative effectiveness of home blood pressure telemonitoring
(HBPTM) plus nurse case management versus HBPTM alone among Black and Hispanic stroke survivors: study protocol for a randomized controlled trial. Trials, 16, 97.

Retrieved from http://doi.org/10.1186/s13063-015-0605-5

U.S. Department of Health and Human Services. (2016). Healthy People 2020:   2020 topics and objectives.