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Today I will be discussing community health/public health nursing. The purpose of this post is to compare and contrast community/public health nursing with hospital base nursing practice in regards to core functions and essential services. Health promotion is a vital component to the overall health and wellbeing to individuals (Nies & McEwen, 2015). There are many different ways that nurses are able to promote health and wellness in different settings.
There are many similarities and differences to nursing in the community and nursing in the hospital setting, but one of the main goals for nursing overall is to promote healthy living (Nies & McEwen, 2015). The way these two areas of nursing work toward this goal often differ, but depend on each other. Discharge planning in the acute hospital setting begins at the time of admission (Graham, Gallagher, & Bothe, 2013). The nurse in the acute care setting is responsible for assessing the patient and identifying potential outpatient needs throughout the duration of their stay (Graham et al., 2013). Discharge planning can be an arduous task at times, and nurses are not always able to adequately prepare a patient and their support system, for an impending discharge (Graham et al., 2013). Acute care nurses are tasked with addressing a patient’s immediate issues, educating them during their stay, and arranging the appropriate outpatient resources (Graham et al., 2013). The unit I work on often has readmissions of patients who are noncompliant outpatient. Community nurses are a vital resource that assist patients with continuing their outpatient care in the hopes of decreasing readmissions (Cramm, Hoeijmakers, & Nieboer, 2014). An essential service of the community health nurse is to reaffirm and expand upon the education the patient received while in the inpatient setting.
In conclusion, the goal of nursing is the same for the community health nurse and the acute care nurse. Both areas of nursing rely on each other to identify a need, and to then continue the patient’s plan of care. Coordination of care is an important aspect across all areas of nursing, and by utilizing different skills, their mutual goals are achieved.
Cramm, J. M., Hoeijmakers, M., & Nieboer, A. P. (2014). Relational coordination between community health nurses and other professionals in delivering care to community-dwelling frail people. Journal of Nursing Management, 22(2), 170-176. doi:10.1111/JONM.1204
Graham, J., Gallagher, R., & Bothe, J. (2013). Nurses’ discharge planning and risk assessment: Behaviours, understanding and barriers. Journal of Clinical Nursing, 22(15-16), 2338-2346. doi:10.1111/JOCN.12179
Nies, M. A., & McEwen, M. (2015). Community/Public Health Nursing: Promoting the Health of Populations. St. Louis, MO: Elsevier.
Being the daughter of a nurse who did home health, I got to hear a little bit of how community/public health worked. It is very different from hospital nursing. Community/public health nursing focus on helping the patients thrive at home. The goal of community/public health nursing is to help individuals maintain their health at home and improve the health of the community they serve (Nies & McEwen, 2014). The hospital nursing I am used to is to get them in and out because our ED is overcrowded and we need beds for those patients. I feel that hospital nursing has moved away from being able to actually care for our patient to getting them in and out as fast as they can so that we can help the next person, it feels like an assembly line.
Just the other week at work, we had severe overcrowding in our emergency department. That morning our manage came out and said that anyone that is potentially or is discharged needs to be out by noon, mind you she tells us this at 10 in the morning and we are taking more patients that we are supposed to have. Needless to say, that was such a busy day and eating lunch was out of the question. Since our patients are living longer with chronic conditions, it has resulted in increased needs from the nursing staff (Vallés et al, 2018).
Community/public health nursing on the other hand is designed to be there to help the public when they are needing advice their health (Nies & McEwen, 2014). Health promotion is defined as a combination of education, related organization, economic, and environmental support for individuals or communities on their health (Nies & McEwen, 2014). Community/public health nurses are the nurses that do the booths to help the public become aware of certain diseases and provide the community ways to either prevent it or help manage the symptoms.
Hospital nursing and community/public health nurses focus on very different things in their day to day tasks. Hospital nurses focus on getting the acute illness fixed while community/public health nurses work on helping the patient’s manage their long term illnesses. While both types of nurses do very different things they are both as important to the healthcare system and we couldn’t help our patients the way we do without one another.
Nies, M. A., & McEwen, M. (2015). Community/public health nursing: promoting the health of populations. St. Louis, MO: Elsevier.
Vallés, S., Valdavida, E., Menéndez, C., & Natal, C. (2018, January 10). [Impact of chronic illness on hospital nursing workloads]. Retrieved January 15, 2018, from https://www.ncbi.nlm.nih.gov/pubmed/29331220