Cummunity Health Nursing

MollyJ · Oct 25, 2001

Dear SN,

I am a Community Health Nurse and what I do defies being put between the covers of a book, though I have seen and read some books on the subject. I would refer you to those. I'm going to say this as gently as possibly because I haven't seen a lot of posts from you here, but avoid posting things that sound like euphemisms for "Please do my homework." I know you have explained that these are for your colleagues. We don't want to do their homework, either.

You will get a better actual response if you ask a concrete question like, "what are some nursing interventions for working with high risk teen moms?" AND THEN name some you've already thought of.

SN, I really don't think you were asking us to do your homework BUT what you did ask for requires a lot of legwork and most of us just won't respond to such unfocused questions.

Good luck. Don't quit asking questions, but be focused and don't ask questions that require a lot of legwork on some one else's part.

tsubsn2002 · Oct 25, 2001

Thanks for the reply to my email. I do want to clear one thing up though. I know it sounds like I was trying to find someone else to do my homework, but is not the case whatsoever. I just need to see some examples of care plans that are family centered. I am use to doing PATIENT center care plans. It just helps me to do stuff correctly if I have an example to look at instead of just going into it blind. Again, I want to thank you for your reply, but I want to make sure that no one thinks I am trying to get them to do my homework. I believe in working hard for what you get, not making someone else work hard for what you get.

Enright · Oct 25, 2001

I am a community health nurse of sorts....I coordinate and teach an entire state on public health and safety issues related to illness and driving. There are no care plans for this. You do lots of research, talk to attorneys and legislators; formulate lectures and programs to best meet the perceived needs.

breanna · Oct 25, 2001

Care plans must consider a method to asses the effect of the nursing action in measurable terms. It is not so cut&dry in community programs. How do you measure the effect of the community education you provide? I would like to use your answer as a great example. I served in a govenor appt position in my state and we made recommendations for state funding. When I applied the concepts of the nursing process to the programs requesting funding, there was initially confusion until the program directors requesting funding "got it." They wanted us to hand them state funding, without explaining what they attempted to accomplish. I wish I had more nurses presenting their programs - like you! You know how to measure outcomes within the nursing process and defined in the care plan. So, that I can use this example: How did you define it?

Enright · Oct 25, 2001

Hi Breanna... were you asking me? I'll go ahead and give you an example even if you weren't....:)

I am the nurse with the WI Dept. of Transportation. I am the only health care professional here, everyone else is either customer service or program staff. Over the past year we identified that we were seeing a lot of accidents involving diabetics yet they were very resistant to our requests for medical information. We found that patients did not equate driving safety with their diabetes. I wanted funding to produce some educational materials/lectures for MDs, clinics and our DMV stations.

I did a survey of the literature and found that many surveys indicate that 30-50% of diabetic patients have never discussed driving with their MD. That about 40% severely underestimate their hypo- and hyper- glycemic episodes. Lots of numbers based on solid research. Identification of the problem with support, creation of an action plan to deal with the problem.

Convinced of the need for this as a fast track issue, funding was provided. In response, I use the lowest cost, highest efficacy methods possible to reach the target population of MDs, drivers and health plans. I also find that lectures and a willingness to provide community groups with a dynamic speaker on the topic (me) makes a big impact.

It comes down to doing a lot with very little funds. You have to be creative and have the facts to back you up. I hope that helps!

nicola · Oct 26, 2001

If you're looking for ideas for care plans for families, you could think of the family in terms of the patient's needs. For example, if you have some one with DMII, you could add the family to the plan by stating that they will be knowledgable in fingerstick testing by X date and will be aware of acceptable ranges etc. One nursing diagnosis I used lots was caregiver burn out. Basically, you need to use the nursing processs beyond the patient - assess, plan, execute, evaluate and start again...

Good luck!

hoolahan, ASN, RN · Oct 27, 2001

This is from Carpenito...

Ineffective Coping, Community: I would use an anthrax scare for thispersonally. In fact I work with a community of disabled pt's who live in the same apartment complex. One pt said the FBI was coming to his house to check on his exposure to anthrax. He was not exposed to anthrax, but part of his disablity is progressive psychosis. Needless to say, it got the community and the Certified Home Health Aides worked into a major upset. Not all of these people are developmentally and cognitively prepared to reason this out. So, the sup had to go out there and give them a lecture and reassurance. In fact Carpenito states this dx can be r/t "Traumatic effects of airplane crash, large fire, industrial disaster, or environmental accident."

Another one is ineffective family coping, disabling, or compromised.

Altered Family Processes, ex bread-winning family mbr has a stroke and becomes paralyzed, all roles of family members change, teens may have to become caregivers, wife may have to find a job for first time (or vice versa).

Caregiver Role Strain is another family-oriented one.

Risk for Violence

Fear

Grieving,

Spiritual Distress

Post Trauma response

These can all easily apply to the community and the country after WTC disaster.

Last one, Ineffective management of therapuetic regimen; community r/t presence of environmental hazards.

Go buy Carpenito'sHandbook of nsg diagnosis, saved my life in my RN to BSN program. Good Luck!

[email protected] · Oct 27, 2001

I know there are specialty books out there for this , how about a search at the on line files with theparameters" community health nursing and care plans" if a book pops up a few times.it would be a good bet that it is a refernce and avail at your school library, also check withyour local vna..they will hae something. and ive never known a nurse not to help someone asking for a point in the right direction. happy hunting. some schools of nursing have archives of previously done paper ect on file. doesn't hurt to ask