2. Objectives:
1. Identify the three core public health
functions basic to community health
nursing.
2. Describe and differentiate among seven
different roles of the community health
nursing.
3. Discuss the seven roles with in the
framework of public health nursing
functions.
4. Explain the importance of each role for
influencing people's health.
3. Core public health functions
Community health nurses work partners
within team of professional,
nonprofessional and consumers to
improve the health of population.
4. Public Health Nursing Within The Core
Public Health Functions Model
The model includes
assessment, policy
development,
and assurance
surrounding the
individual, family, and
community.
5. Core public health functions Model
The various roles and settings for practice
hinge on three primary functions of public
health: assessment, policy development, and
assurance. These functions are applied at
three levels of service: to individuals, to
families, and to communities
6. Assessment
• An essential first function in public health,
assessment, means that the community health
nurse must gather and analyze information that
will affect the health of the people to be served.
• assessment is the systematic collection,
assembly, analysis, and dissemination of
information about the health of a community.
7. Assessment
• The nurse and others on the health team need to
determine health needs, health risks, environmental
conditions, political agendas, and financial and other
resources, depending on the individuals, community,
or population targeted for intervention.
• Data may be gathered in many ways; typical methods
include interviewing people in the community,
conducting surveys, gathering information from
public records and using research findings.
8. Policy development:
• Policy development uses the scientific
information gathered during assessment to
create comprehensive public health policies.
9. Assurance:
Assurance is the “pledge to constituents that
services necessary to achieve agreed-upon goals
are provided by encouraging actions of others
(private or public), requiring action through
regulation, or providing service directly.”
10. Assurance:
Focuses on the availability of necessary health
services throughout the community. It includes
maintaining the ability of both public health
agencies and private providers to manage day
by day operations as well as the capacity to
respond to critical situations and emergencies
13. 1. Clinician role (provider role):
It means that the nurse ensures that the
health services are provided not just to
individuals and families but also to groups
and populations
14. • The clinician role has emphasis on holism,
health promotion and skill expansion
Holistic practice = considering the broad
range of interacting needs that affect
the “collective health” of the client as a
larger system (Patterson 1998)
15. • Holistic nursing care encompasses the
comprehensive and total care of the client
in all areas, such as physical, emotional,
social, spiritual, and economic.
• All are considered and cared for when the
client is a large system, just as it should be
with individual clients
16. • EX: Assist several families with terminally
ill patients to gain strengths through a
support system of accepting death and the
dying process
17. Educator Role
• Health teacher: one of the major functions
of the CHN (Breckon et.al. 1998)
Important role because:
• Community clients are NOT usually
acutely ill and can absorb and act on
health information
• A wider audience can be reached leading
to a community-wide impact
18. • The public has a higher level of health
consciousness.
• Client self-education is facilitated by the
nurse. Based on the concept of self-care,
clients are encouraged to use appropriate
health resources
19. • For example, a nurse may teach parents
and teachers at a parent-teacher meeting
about signs of mood-modifying drug and
alcohol abuse,
• discuss safety practices with a group of
industrial workers, or give a presentation
on the importance of early detection of
child abuse to a health planning committee
considering the funding of a new program.
20. Advocate Role
• Based on clients’ rights: Every patient or
client has the right to receive just, equal,
and humane treatment.
21. Why Advocacy?
• Current health care system offers
• de-personalised and fragmented services.
Many clients who are poor and
disadvantaged are frustrated and the
nurse becomes an advocate for clients
pleading their cause and acting on their
behalf.
22. Goals of advocacy:
1. Help clients gain more independence
and self-determination
2. Make the system more responsive and
relevant to the needs of clients.
23. Manager Role
• Nurse directs and administers care to meet
goals by:
1.Assessing client needs
2.Planning and organizing to meet those needs
3.Directing and leading to achieve results
4.Controlling and evaluating the progress to
make sure that the results are met
24. • Nurse oversees client care as:
1. A case manager
2.Supervising other staff
3.Managing caseloads
4.Running clinics
5.Conducting community health needs
assessment projects
25. Nurse as Planner
• Sets the goals for the organization
• Sets the direction
• Determines the means (strategies) to
achieve them
• It includes defining goals and objectives
• It may be strategic ( long-term broader
goals)
26. Nurse as Organizer
• Designing a structure for people + tasks to
function to reach the desired objectives
• It includes assignments and scheduling
It includes:
1.Deciding what tasks to be done
2.Who will do them
3.How to group the tasks
4.Who reports to whom
5.Where decisions will be made
27. Questions to be addressed by the organizer
1. Is the clinic, program providing the
needed services?
2. Are the clients satisfied?
3. Are the services cost-effective?
28. Nurse as Leader
• The nurse directs, influences, or
persuades others to make change to
positively influence people’s health.
• Includes persuading and motivating
people, directing activities, effective two-
way communication, resolving conflicts
and coordinating the plan
29. • Coordination: Bringing people and
activities together to function in harmony
to achieve desired objectives
30. Nurse as Controller and
Evaluator
• Controller: Monitors the plan and ensures
that it stays on course.
– Sometimes plans do not proceed as intended
and need to be adjusted
– Monitoring, comparing and adjusting are
activities of controlling
– Comparing performance and outcomes
against set goals and standards = Evaluator
role.
31. Management Skills
(Cherry & Jacob, 2005).
• What types of skills and competencies
does the community health nurse need in
the manager role?
32. 1. Human: ability to understand,
communicate, motivate, delegate and
work with people. They are essential to
be successful in your role as a manager
2. Conceptual: The mental abilities to
analyze and interpret abstract ideas to
understand and diagnose situations
3. Technical: Apply special management-
related knowledge and expertise for e.g.
computerized management information
system
33. Collaborator Role
• Means working jointly with others on a common project to
cooperate as partners
Who?
– Clients
– Other nurses and physicians
– Teachers and health educators
– Social workers
– Physical therapists
– Nutritionists
– Psychologists
– Epidemiologists and Biostatisticians
– Attorneys محامون
– Secretaries
– City Planners and legislators
34. Leadership Role
• Community health nurses are becoming
increasingly active in the leadership role,
separate from leading within the manager
role mentioned earlier. The leadership role
focuses on effecting change the nurse
becomes an agent of change. As leaders
35. Researcher Role
• Systematic investigation, collection, and
analysis of data for solving problems and
improving community health practice
• This role is at several levels:
– Agency and organizational studies for job
satisfaction among public health nurses
– Some CHN participate in more collaborative
research with other health professionals
36. The Research Process
1. Identify an area of interest
2. Specify the research question or statement
3. Review the literature
4. Identify a conceptual framework
5. Select a research design
6. Collect and analyze data
7. Interpret the results
8. Communicate the findings
37. Settings for CHN Practice
1. Homes
2. Community health centers
3. Schools
4. Occupational health settings (business and
industry)
5. Residential institutions: Older age residences
6. Parishes or charitable mosques related
organizations
7. Community at large
38. Homes
• For a long time, the most frequently used setting
for community health nursing practice was the
home. In the home, all of the community health
nursing roles, to varying degrees, are performed.
Clients who are discharged from acute care
• institutions, such as hospitals or mental health
facilities, are regularly referred to community
health nurses for continued care and follow-up.
39. Schools
• Community health nurses’ roles in
school settings are changing. School
nurses, whose primary role initially
was that of clinician, are widening
their practice to include more health
education, interprofessional
collaboration, and client advocacy.
40. • For example, one school had been
accustomed to using the nurse as a
first-aid provider and record keeper.
Her duties were handling minor
problems, such as headaches and
• cuts, and keeping track of such
events as immunizations.
41. Occupational Health Settings
• Community health nurses in occupational
health settings practice a variety of roles.
The clinician role was primary for many
years, as nurses continued to care for sick
or injured employees at work.
42. Residential Institutions
• Any facility where clients reside can be a
setting in which community health nursing
is practiced. Residential institutions can
include a halfway house in which clients
live temporarily
• while recovering from drug addiction or an
inpatient hospice program in which
terminally ill clients live. Some
• residential settings, such as hospitals.
43. Parishes or charitable mosques
related organizations
• Parish nursing finds its beginnings in an
ancient tradition. The beginnings of
community health nursing can be traced to
religious orders
44. • When community health nurses work as
parish nurses, they enhance accessibility to
available health services in the community
while meeting the unique needs of the
members of that religious community,
practicing within the framework of the
tenets of that religion.
45. Community at Large
• Community health nursing is a specialty of
• nursing that is defined by the nature of its
practice, not its location, and it can be
practiced anywhere (Williams, 2000).
