3.2 Community Health Concepts
Open Resources for Nursing (Open RN)
Community Health Nursing
Nurses working in a community setting include public health nurses, school nurses, and parish nurses, to name a few.
Public health nurses work across various settings in the community such as government agencies, community-based centers, shelters, and vaccine distribution sites. They provide disease prevention and health promotion services, such as working with mothers and children to improve nutrition, operating immunization clinics, and leading public health education initiatives such as smoking cessation campaigns. Public health nurses also prepare to respond quickly to public health emergencies such as natural disasters or epidemics.[1],[2] Emergency preparedness is further discussed in the “Environmental Health and Emergency Preparedness” chapter. See Figure 16.2[3] for an image of a community health nurse providing health screenings in a maternal and child health clinic.
School nurses work with over 56 million school-age children and adolescents. They provide direct care for chronic health problems and administer medications prescribed during school hours. They also provide mental health care, a need that has grown during the COVID-pandemic. Their work also affects the larger community. For example, school nurses may help develop disaster plans that coordinate activities in the school with the larger neighborhood.[4],[5]
Parish nurses use their nursing skills for church or parish members in paid or volunteer positions. They provide health education, screening, advocacy, and referrals to other services in the community.[6]
Barriers for Community Health Nurses
Community health nurses serve important roles in identifying priority health needs of a community, as well as planning and implementing preventative health initiatives. However, community health nurses may face unique barriers when providing care to individuals, families, and community members. Three barriers are referred to as gaining entry, role negotiation, and confidentiality:
- Gaining Entry: Community health nurses may be considered “outsiders” as representatives of the established health care system and may not necessarily be trusted by community members. It is vital for community health nurses to build trust and supportive relationships. When working with individuals and families, nurses should assess specific community issues affecting that individual’s health or their access to health care and then address those issues in their nursing care plan. Nurses can also investigate if there are community resources available to refer the client and/or their family members for additional services. See Figure 16.3[7] for an image of Red Cross volunteers working with caregivers of clients receiving palliative care.
- Role Negotiation and Confidentiality: Community health nurses must separate their roles as data collectors, health professionals, and neighbors. These roles can be difficult to differe