The practice of community health nursing is carried out in settings that involve non-acute health care (Rowell, 2001). Typically, it incorporates public and nursing health theories, which are employed to promote the health of particular communities (Mengistu & Misganaw, 2006). In the present study, the definition and the interrelationship between community and public health nursing are provided. The paper also discusses recent changes in health care settings and their impacts on communities. In addition, the terms ‘community’ and ‘population’ are examined. The definition of ‘health’ and its effect on the care of populations are then explored. Finally, the study discusses the primary factors that influence community health.
Definitions and Interrelationship between Community and Public Health Nursing
Community health nursing is defined as the practice of synthesizing information from the theoretical perspectives of public health and nursing with the goal of promoting, preserving, and maintaining populations’ health by delivering health services to different groups, families, and individuals (Mengistu & Misganaw, 2006). The practice focuses on improving a community’s general health by elevating the status of health of groups, families, and individuals that reside in a given community. Usually, community health nurses provide their services in homes, local clinics, and community hospices (Mengistu & Misganaw, 2006).
In contrast, public health nursing has been viewed as a component of community health nursing. Hence, the two areas of nursing share the primary objective of maintaining, preserving and promoting the health of a given community. According to Alphi and Adams (2007), public health nursing can be defined as “the practice of promoting and protecting the health of populations using knowledge from nursing, social, and public health science.” Thus, public health nursing has been shown to synthesize nursing and public health hypotheses while focusing primarily on promoting and preserving health at population levels (Alphi & Adams, 2007). In the US, public health nurses work in places such as the National Institutes of Health and the Bureau of Prisons. Boundaries often exist between community and public health nursing in terms of the assessment level. Typically, public health nurses have adequate training and education in the evaluation of a given population. In contrast, the knowledge of community health nurses includes the assessment of the health needs of different members of a given community (Mengistu & Misganaw, 2006).
Changes in Healthcare Settings in Recent Decades
Investigating the historical origins of community and public health can increase the understanding of its current focus and functions. Prior to mid-1800s, early health care focused on minimizing suffering and promoting healing (Mengistu & Misganaw, 2006). Initially, charitable and religious groups were the primary providers of home care nursing. However, the Reformation was followed by social upheavals that disbanded religious groups and decreased the provision of nursing care to the needy and the sick (Mengistu & Misganaw, 2006). In addition, the Industrial Revolution resulted in numerous health issues, such as occupational injuries, and increased the demand for community health. Florence Nightingale helped to shape community health through her nursing work during the 1854-1856’s Crimean War (Mengistu & Misganaw, 2006). The mid-1800s and early 1900s witnessed the development of district nursing, which focused mainly on individual health care and personal hygiene. Over time, financial support changed from religious groups to private philanthropists. Eventually, public funds began to support district nurses. At the commencement of the twentieth century, the need for the inclusion of welfare and health of both the affluent and the poor was widely recognized (Mengistu & Misganaw, 2006). Consequently, laws were established to make communities answerable for their citizens’ health. The trends led to the creation of specialized initiatives such as Tuberculosis clinics and infant welfare. Subsequently, the nursing practice was expanded by leading figures such as Lillian Wald- who was the first to coin the phrase ‘public health nursing’ (Alphi & Adams, 2007; Fee & Bu, 2010). She made enormous contributions to nursing, which allowed the practice to gain a professional stature. In the 1920s, specialty areas like rural and industrial nursing started to emerge, and nurses began to consider the family as a division of service (Alphi & Adams, 2007). As a result, the nursing care in every community health setting was focused on the family. In addition, public health agencies began to place increased emphasis on health promotion and disease prevention. Hence, they established the institutional foundation for the development of public health.
The modifications that have taken place in the recent history of the nursing profession have impacted positively on different communities. For instance, community nurses have been valued highly for their willingness to work in different settings, particularly schools, homeless lodgings, and community clinics (Meadows, 2009). The nurses provide patients with comprehensive care at agencies or institutions for people with special health needs, as well as in homes and organized events like health fairs. Advanced practice nurses ameliorate health care and reduce costs at college and school clinics that are managed by nurses (Meadows, 2009). Furthermore, they establish corporate wellness initiatives aimed at supporting the productivity and health of various organizations.
The Effect of the Definition of Health on the Care of Populations
MacQueen et al. (2001) defined “community as a group of people with diverse characteristics who are linked by social ties, share common perspectives, and engage in joint action in geographical locations or settings.” The term ‘population,’ however, has been used to describe a group of persons that share personal or environmental characteristics (Mengistu & Misganaw, 2006). For example, senior citizens can be considered as a population because they share the common feature of age. In public health, the word ‘population’ is often interchanged with the word ‘aggregate’ because the specialty area concentrates on communities, as well as the consequences associated with the health status of different communities (Mengistu & Misganaw, 2006). Such effects include access to various healthcare resources and the productivity of groups, families, and individuals. Since health is described “as a state of physical, mental and social wellbeing” (Mengistu & Misganaw, 2006, p. 3), the goal of community health is to prevent diseases and disabilities while promoting and protecting the health status of the whole community.
Major Influences on Community Health
Numerous factors helped to influence the development of community health nursing. Nonetheless, six elements were particularly significant in the growth of the nursing practice. First, advances in technology increased technological innovations, which enhanced nutrition and healthcare services. The subsequent changes in social lifestyles increased the need for quality community health nursing (Mengistu & Misganaw, 2006). Secondly, progress in studies associated with causality, especially in the field of epidemiology, affected the nursing profession as nurses were trained to examine the causes of illnesses and attack strategic causal points. Thirdly, increases in the level of education elevated the public’s understanding of various health issues. As a result, people felt the need to be informed about the care offered by nurses. Subsequently, community health nurses began to shift from making plans for their clients to involving them during decision-making processes (Mengistu & Misganaw, 2006). Fourthly, the increase in the demand for quality nursing services stimulated improvements in community health nursing hypotheses with the aim of ensuring the provision of more coordinated and comprehensive care. The fifth influence involved changes in demography. Shifts in immigration patterns, numbers of deaths and births, and increases in the population of senior citizens affected the programming and planning of community health nursing activities. Lastly, economic forces such as inadequate health services, expensive health care, and limited sources of healthcare finances influenced the growth of community nursing significantly (Mengistu & Misganaw, 2006). Accordingly, community nurses responded to such forces by establishing and implementing new projects and programs.
In conclusion, community health nursing is defined as the practice of synthesizing information from the theoretical perspectives of public health and nursing with the purpose of promoting, preserving, and maintaining populations’ health by delivering health services to different groups, families, and individuals. On the other hand, public health nursing has been viewed as an aspect of community health nursing. The two areas of nursing, therefore, share the primary objective of maintaining, preserving, and promoting the health status of a given community. In recent decades, changes in the nursing profession have impacted positively on different communities. Consequently, community health nurses have been valued for their willingness to work in different settings, particularly schools, homeless shelters, and community clinics. Additionally, factors such as advances in technology, causality studies, high education levels and the demand for quality nursing services, demographic changes, and economic forces continue to influence the development of community nursing.
References
Alphi, K. M & Adams, M. G., (2007). Mapping the literature of public health and community nursing. Journal of the Medical Library Association, 95(1), e6–e9. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1773026/
Fee, E. & Bu, L. (2010). The origins of public health nursing: the Henry Street visiting nurse service. American Journal of Public Health, 100(7), 1206–1207. doi: 10.2105/AJPH.2009.186049
MacQueen, K. M., McLellan, E., Metzger, D. S., Kegeles, S., Strauss, R. P., Scotti, R& Trotter, R. T. (2001). What is community? An evidence-based definition for participatory public health. American Journal of Public Health, 91(12), 1929–1938. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1446907/
Meadows, P. (2009). Community health nursing. American Journal of Nursing, 109. doi: 10.1097/01.NAJ.0000343102.62178.80
Mengistu, D. & Misganaw, E. (2006). Community health nursing. Retrieved from http://www.cartercenter.org/resources/pdfs/health/ephti/library/lecture_notes/nursing_students/comm_hlth_nsg_final.pdf
Rowell, P. A. (2001). Beyond the acute care setting: community-based nonacute care nursing-sensitive indicators. Outcomes Management for Nursing Practice, 5(1), 24-7.
