COMMUNITY
HEALITH NURSING:
The concept of community is defined as "a group of people who share some important feature of their lives and
use some common agencies and institutions." The concept of health is defined as "a balanced state of wellbeing resulting from harmonious interactions of body, mind, and spirit."
The term community health is defined by meeting the needs of a community by identifying problems and
managing interactions within the community
Basic Elements:
The six basic elements of nursing practice incorporated in community health programs and services are:
(1) promotion of healthful living
(2) prevention of health problems
(3) treatment of disorders
(4) rehabilitation
(5) evaluation and
(6) research
Major Setting:
Settings for community health nursing can be grouped into six categories:
(1)Homes
(2) ambulatory care settings
(3) Schools
(4) occupational health settings
(5) residential institutions, and
(6) the community at large. Community health nursing practice is not limited to a specific area, but can be
practiced anywhere.
COMMUNITY HEALITH NURSING
DEFINING C H N :
Leaders of the field in CHN have stressed the importance of the definition of
NSG & PUBLIC H. WINSLOW (1952) described public health:
The science & art of preventing , prolonging life & promoting physical & mental health efficiency
through organized community effort.
In 1900s it was a simple matter to define PHN as specialty area with nsg .
PHN took place outside the hospital setting NSG that was community focused & family & group oriented.
The (APHA) define PHN as:
Synthesizes the body of knowledge from the PH & the profession nsg theories for the purpose of
improving the health of the entire community .
The ( ANA) 1980 defines CHN as a field of practice that synthesizes knowledge & skills from nsg
& ph & applies them toward to promotion of optimal health for the total community .
According to the ANA CHN promotes & preserves the health of the population by integrating the
skills & knowledge relevant to both nsg & PH .
Both associations emphasized on “population as a whole “
Historical development of CHN
CHN is the product of growth & adaptations. It is
long with changes & the needs of the society. & maintaining the goal of improved CH.
Stages of development
1. Early Home Care NSG (Before Mid _ 1800)
It was being done for many centuries as sick people were tended at home by the female family
members & friends . Religious groups such as nuns along with lay women served the sick poor &
needy people .
District NSG ( 1860 ) OR visiting NSG :
Started as a voluntary service for the poor. In
1859 William Rathbone became convinced of the value of home visiting as a result of private care
given to his wife . He is the first to promote the establishment of visiting nurse service.
Frances Root in US is the first CH nurse to the poor . In 1877 first visited nurses were employed
by the New York City Mission .
In 1885 the district nsg associations , In 1886 in Boston & Philadelphia serve the poor .
Florence Nightingale ideas & methods to influence home nsg practice in England & US . Nurses
the temp. & pulse rates & give simple treatments. They also give some instructions.
At that time there is No any nsg education program . All served by voluntary organizations.
In 1893 Lillian Wald initiated a district nsg service in New York City. With her friend organized a visiting
nsg service for poor.
Public health nursing (1900_ 1970 )
At this period the including health & welfare of the general public , Not just the poor . the sense of
improving the health of all people increase the number of voluntary agencies which supplemented the
ineffective government health departments .some specialized programs were developed such as
tuberculosis & venereal diseases
In 1902 , the school Nurse in the US was developed . by 1910 new federal laws made stages &
communities accountable of their citizens .
The role of the nurse expanded & using the term PUBLIC HEALTH NURSING . with all the
growing & environmental influences on health nurses broadened their practices more . Same as skills
& knowledge.
In 1902 , the school Nurse in the US was developed . by 1910 new federal laws made stages
& communities accountable of their citizens .
The role of the nurse expanded & using the term PUBLIC HEALTH NURSING . with all the
growing & environmental influences on health nurses broadened their practices more . Same as skills
& knowledge.
Next the family began to emerge as the unit of service, the needs & problems of the
Next , the family began to emerge as the unit of service . The needs & problems of the families
started to Be met.
By 1920s, PHN was acquiring more professional status. It assumed greater leadership in increasing
the standards of nsg education & practice . Nurses gained more autonomy. Their relationship with groups
grew. They also started recording their care giving.
At this stage the responsibility shifted to the government. As well as rural expanded.
4. community Health Nursing: (1970-present)
Since many nurses now practicing in the comm. the strength of traditional public health nursing was combined
with new consciousness of services to communities or population. Nurses practices community regardless of
their educational preparation & to avoid any confusion they need the basic level with public health content at
post basic level .
Some event that cause concern about the nature of public health.
1. Recognition of the importance of the public content, introducing of baccalaureate level. They are expected
to include health promotion & disease prevention in to nursing practice.
2.
Avoiding role confusion, new kinds of responsibilities were defined. Home visits were considered to
be the cornerstone of the community health nursing, as well as care given through clinic visits.
3. New services appeared, professionals responsibilities e.g. health educators, counselors, social- workers.
They forced nurses to re-examine their own contribution to public health.
4. The health care changes, technology & social issues made increasing demand on community health
nursing ability to adapt to new pattern of practice.
The term CHN more functional than the term PHN. Both used interchangeably. CHN deals with the new
roles, including independent practice.