LAKEVIEW COLLEGE OF NURSING
Spring 2012
N 404 Nursing in Community Health 
Course Coordinator/Clinical Faculty:  Chastity Osborn RN, MSN/ED

Student Name__Gregory Cahill_______
Course Objectives
Level IV   
(LCON Student Handbook, p. 48, and 
http://www.lakeviewcol.edu/catalog/index.php)

N-404 Course Objectives and Evaluation:  	
1. Critical Thinking/Clinical Reasoning	
	
Discriminate theoretical and empirical knowledge from nursing scientific and humanistic disciplines to the adaptive responses of people, families, groups, communities & society for optimal nursing practice. 	
Operational in Theory:  
	
	Analyze the interrelationship between man’s cultural/ethnic diversity and the health care delivery system.
	Week 1.  As a nurse it is important to understand a patient’s cultural/ethnicity and how the two relate to the delivery of health care.  Different cultures will have a differing view of health care and it is important for a nurse to tailor the patient’s care to their beliefs.	
	Incorporate epidemiological and community assessment concepts and methods into the nursing process.
	The nursing process can be used to solve any problem.  The nursing process can be used to assess a community.  ADPIE- assess the communities needs, diagnose the problem, plan, implement the strategies, and evaluate the programs implemented in the community.	
	Integrate a needs assessment approach to develop a health education program for a target population within a community.
		
	Evaluate barriers to implementing programs in community health nursing.
	Week 1.  Barriers to implementing programs in community health nursing may include political, economics and social factors.  If an issue is politically controversial the government may cave in to political pressure to not implement certain community health interventions.  We live in a world of finite resources and unfortunately the government does not know how to balance a check book.  This leads to funding problems for community health.  Some people resist change and if society resists the changes that the community health nurse us trying to implement the program may not succeed.  	
Operational in Clinical:
	
	Develop community care plans that establish goals.
	Children for family services assessed the needs of families for parenting classes.  They use a method similar to the nursing process based on the individual client and mutually agree on goals and interventions.  Children for family services evaluate the goals and the progress of the goals.	
	Continuously collect and record data that is comprehensive, accurate, and systematic.
	Environmental health inspects the dump every quarter.  Environmental health takes pictures and records the data so that they can spot trends in the dump. 	
	Mediate to promote, maintain, or restore health, to prevent illness and to effect rehabilitation according to the care plan.
	Children for family services meet with at risk mothers and fathers to help promote and maintain the health of their families.  Children for family services educates parents about the development of their children to help promote long term health goals.	
2. Basic Organization and Systems Leadership Quality Care
	
Determine a leadership role in the provision & coordination of health care through collaborative relationships with other health care professionals including health care policy, finance and regulatory environments.	
Operational in Theory: 
	
	Examine the conceptual basis for public health nursing in relation to the development of standards of practice.	Public health nursing is governed by the nurse practice act.  The nurse practice act has a different set of rules for public health nursing compares to hospital nursing.  The nurse practice act allows trained personal under the supervision of the nurse, who may or nay not be at the facility, to dispense medications.  	
	Examine the roles assumed by nurses in public health education, case finding and follow-up of community clients.	Nurses are on the front lines of the community.  They are in schools, public health, the public safety building and the JDC.  Nurses are responsible for education the public and assessing the needs of the community.	
Operational in Clinical:
	
	Read additional professional material to maintain knowledge base.		
	Assess own strengths and learning needs.	My strengths in a leadership role and coordination of health care are that I am enthusiastic and that I can engage most people in a limited time frame.  My weaknesses include a lack of knowledge and experience that would help me form a more prudent nursing judgment.   	
	Seek out additional learning experiences.

3. Nursing Process
	
Organize the nursing process to assess, plan appropriately, safely implement and evaluate nursing interventions for individuals, families, communities and society.	
Operational in Theory:
	
	Analyze the role of the community health nurse as a participant/leader of a multidisciplinary team within community health systems.
	Nurses work with doctors, hospitals, mental health professionals and more.  Nurses are often the first line and have the most patient contact.  Nurses act as gatekeepers in giving referrals and are often the ones who coordinate with the many different agencies.	
	Assess the provision and coordination of community health in terms of efficiency and cost.
	In my opinion community health is not efficient and is costly.  There are multiple agencies doing the same thing.  These organizations should consolidate to help reduce administrative cost.  Community health is moving towards a position of health promotion and disease prevention which will hopefully reduce the overall cost of health care.	
Operational in Clinical:
	
	Collaborate with other health care providers.
	Danville Sanitary district collaborates with Danville, the water company and the surrounding area to make sure that the water is clean and safe.  Danville Sanitary district needs to collaborate with the health care industry when their may be a problem with the water.	
	Utilize referral sources.
	Nurses are educators and collaborators but they cannot do it all or know it all.  The community relies on agencies like Family services to refer client to the appropriate places.	
	Advocate for the community.
	Children Family services advocates for the children and families of the community. 	

4. Values
	
Employ professional values with ethical, moral, and legal aspects of nursing into nursing practice.	
Operational in Theory:
	
	Assess common ethical dilemmas currently experienced by community health nurses.
		
	Debate the issue of public health need verses personal rights.
	Week 2.  There is a clash between personal rights and public health needs.  Having any government or agency demand things from the public can lead to abuses in power.  When an entity demands that a person do something that entity must take responsibility for their actions, but it is difficult for a person to hold the government accountable.  The government is supposed to promote the general welfare.  If a person or group of people reject what the government is imposing on them, who is right?  These issues must be dealt with on a case by case basis to make sure that the balance of public health and personal rights is maintained.    	
	Debate the issues of client’s right to equal access and quality health care.
	Week 2. A moral right is different from a legal right.  In some countries they have a legal right to health care.  A moral right is a right that cannot be taken away and that applies to every person in the world.  Equal access and quality health care are not moral rights because there is no possible way to ensure that these rights are applied to everyone equally.  Equal access is not practical or logical.  Resources are limited; there are only so many doctors, nurses and other specialty medical personal to help the growing population.  Even if you mandated where doctors live so that everyone had the same amount of doctors to choose from, there would still not be equal access.  Some doctors perform their duties better and/or faster than others and their patients reap the benefits that other patients do not receive.  The same arguments can be made with regards to quality health care.  Developed nations would have to mandate that most of their doctors move to developing nations so that we all have the same quality and access.  I do believe that it is every person’s responsibility to help others.  I also believe that society should address these problems and do the utmost to help take care of other people.  	
	Formulate a philosophical framework for leadership activities in community health nursing.
		
	Demonstrate caring through a commitment towards the well being of groups and communities
		
	Exhibit sensitivity to sociocultural influences on the health belief systems within a community setting.
		
Operational in Clinical:
	
	Enable community health through supporting, coaching, and empowering.
		
	Demonstrate caring for others through comforting, anticipating needs, and protecting and preserving.
		
	Maintain belief in others		

5. Caring
	
Incorporate caring behaviors which reflect commitment to optimal health of people, families, groups, communities and society.	
Operational in Theory:
	
	Demonstrate caring through a commitment towards the well-being of groups and communities.
		
	Exhibit sensitivity to sociocultural influences on the health belief system within a community setting.
		
Operational in Clinical:
	
	Enabling others through supporting, coaching, and empowering behaviors.
		
	Demonstrate caring behaviors through comforting, anticipating and preserving while protecting client dignity.
	Week 3.  Having a clinical on the oncology floor at Carle gives me the opportunity to demonstrate caring behavior.  The patients are in a vulnerable position and rely on us for comfort.  Being able to answer their questions so that they understand provides them a little more piece of mind. 	
	Facilitate learning within a group.
	Week 2. The tour guides at the Danville Sanitary District facilitated learning by actively teaching us how they keep our water safe.  They also encouraged the group to ask questions and answered all questions thoroughly.    	
	Assess own strengths and learning needs.
	My strengths are that I am a caring person and treat everyone with respect.  I need to learn to be less opinionated and stubborn.	
	Create and maintain a professional image.
	Week2.  I always show up to clinical wearing the appropriate uniform and show respect to the staff and patients.  	

6. Communication & Technology 
	
Integrate communication skills to collaborate in finding solutions to problems and meeting the health needs of people, families, groups, communities and society.	
Operational in Theory:
	
	Analyze the impact of changing technology upon nursing research and the quality of community health nursing practice	Week 3.  As advances in technology continue to develop nursing will continue to become more and more integrated with technology.  Technology helps nurses obtain research and report information more quickly than ever before.  The quicker community nurses can give and receive information the more effective they can become.	
	Discuss the different roles of the community health nurse.
	Week 3.  Community health nurses fulfill many different rolls in the community.  They provide nursing services in schools, parishes, health clinics and help educate the community.	
	Examine teamwork concepts teambuilding, cooperative learning and professional roles for the nurse in the community setting.		
	Examine the relationship between nursing research and plans for community health promotion.
	Research is a big contributor to health care and nurses are being asked to perform more and more research.  Communities are trying to lower cost and use their limited resources wisely.  Research can help find problems with a given community and help find best practices that uses a communities’ resources wisely. 	
	Contrast various theoretical frameworks that apply to community health nursing practice.
		
	Critique nursing research in terms of methodology, significance, and relevance to community health.
		
Operational in Clinical:
	
	Collect data for understanding the community assessment process. 
	Data for community assessments is available many different places including: government data bases, web sites or driving around the community for a windshield survey.  Windshield surveys are a good way to obtain personal information about the community but can be time consuming driving around the community.h 	
	Construct health promotion teaching project.
		
	Appraise evidence based-practice research to develop a research paper/presentation.
		
	Relate information from community websites to current practice.
		
	Debate current theoretical research.

7. Adaptability
	
Evaluate nursing actions with regard for actual or potential changes in health status or environment to meet health care needs of individuals, families, communities, and society.	
Operational in Theory:
	
	Analyze the health, healthcare, and emergency preparedness needs of defined client population.
		
	Evaluate the use of clinical judgment and decision-making skills in appropriate, timely nursing care during disaster, mass casualty, and other emergency situations.		
	Collaborate with others to develop an intervention plan that takes into account determinants of health, available resources, and the range of activities that contribute to health and the prevention of illness, injury, disability, and premature death.
		
Operational in Clinical:
	
	Use evaluation results of teaching projects to influence the delivery of care, deployment of resources, and to provide input into the development of policies to promote health and prevent disease.
		
	Advocate for social justice, including a commitment to the health of vulnerable populations and the elimination of health disparities.
	Week 3.  The social justice that I advocate is for everyone to have the right to do what they deem right for themselves, within a very limited set of rules.  Nurses advocate for patients to have the right to self determine their medical care.  People should also have the right to self determine what is right for their life.  It is every ones responsibility to help out their fellow man and helping the less fortunate to have adequate health care is a worthwhile goal.  Many health disparities are caused by life style choices and it is not someone else’s responsibility to eliminate health disparities that are the patient’s own fault. 	
	Participate in clinical prevention and population-focused interventions with attention to effectiveness, efficiency, cost-effectiveness, and equity.

Course Objectives 	Met	Not Met	
1.	Critical Thinking/Clinical Reasoning

2. Basic Organization and Systems Leadership Quality Care
			
3. Nursing Process

4. Values

5. Caring

6. Communication & Technology 

7. Adaptability

End of Semester:

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