What is the Functions of Community Health Nurses

Provides health services among people of the community

Focuses on the community as a client.  Combines aspects of public health with nursing.  “Greatest good for the greatest number.”

The focus of care often is on the aggregate

Emphasizes interdisciplinary collaboration

What are Aggregates

Groups of people who share one or more common characteristic

Groups who have a potential vulnerability to health problem

Groups that share a common diagnosis

Groups that are defined with a common type of employment

Focuses on preventive, protective and promotional health as highest priority over curative or episodic care

What does it mean for the comunity nurse to be 

Population Focused?

assesses, promotes, maintains and restores the health of  population groups

What does it mean to the community nurse to have Autonomy

encourages clients to take an active role in health care by supporting the client’s self determination 

What does it mean to the community nurse to have Continuity

evaluates long/short term goals on a continuing and comprehensive basis so that care flows uninterrupted

What does it mean to the community nurse to be a part of Collaboration

working together with patient and the multidisciplinary team that is involved to set and achieve goals

What does it mean to the community nurse to practice in a Sphere of Intimacy

What does it mean to the community nurse to be a 

Change Agent 

Unfreezing, Moving, Refreezing

dissatisfaction with status quo

Create an awareness of the need for change

Dealing with resistance through explaining, teaching, and discussing the benefits of the change

accepting and trying new methods or ideas

Modeling new behaviors, skills

Practicing sessions

Opportunities to voice emotions

Supportive climate

Energizer feedback

change is established and stabilized

Internalizing the change, part of routine

Continue to direct new behaviors

What does it mean to the community nurse to be an Educator

What does it mean to the community nurse to be a Counselor

help client to employ problem-solving process to decide on most appropriate course of action without telling them what to do.  

How does the comminity nurse help client to employ problem-solving process to decide on most appropriate course of action without telling them what to do.  

Help the client identify the problem

Explore alternative solutions

Examine acceptable solutions to meet specific needs

Implement the chosen solution 

Evaluate the effect  

What does it mean to the community nurse

to be a Researcher

engage in systematic investigation collection and analysis of data for solving health problems in the community

Empowers individuals and aggregates

Needs to be systemic planning for a teaching session

Be a cheerleader not a critic during teaching/learning

behavior has changed, can be measured and persists over time

What steps should you follow when planning to teach a topic

Assess the knowledge base of the client (who is my audience?)

Identify the broad purpose of the class

Develop specific learning objectives under the domains of learning

Cognitive – Intellectual, Affective – Emotions, 

Psychomotor – Physical Manipulation

Learning with the head (memory, recognition, application)

Recalling facts

What is Affective – Emotions learning

Learning with the heart

Focus on attitudes/acceptance

(What do I want the client to value?)

Learning with the hands

Skills performance needed to apply information – neuromuscular coordination opportunity to practice

(What do I want the client to do physically?)

What are Examples of written objectives at the end of this course:

The client will describe the sign/symptoms of hypoglycemia (Cognitive)

The client expresses the importance of controlling blood glucose levels to prevent complications (Affective)

The client demonstrates how to blood glucose monitoring (Psychomotor)

What is the outcome impact on the target audience?  Were the objectives met? (test taking)

What is a Process evaluation

Evaluating teaching strategies, materials and content and make modifications as appropriate (feedback cards)

Learning will increase in adults if the

following conditions exist:

Need for information/perception of relevance

Use a variety of teaching methods including AV aids

Audience trusts teacher – teacher walks the talk

Information is need to know vs. nice to know – application to life

Build upon existing knowledge – simple to complex, clear/succinct

Logically organized

Positive health behavior focus

Participate actively in learning encounter – retention of learning is increased

Repetition/reinforcement/review until new habits are formed

Positive genuine feedback – learner feels valued

Occurs in a shame free environment

What are the Influences that Affect Learning

Age, Maturation level – abstract vs. concrete thinking

Physical impairments i.e. visual/hearing

Physical environment – lighting noise

Psychological – court mandate, stress cost

Social – peer attitudes, educational level, language barriers

Lifestyle – occupation, recreational habits, nutrition

Values – apathy, impulsivity

Learning barriers – lack of time, money, energy, confidence, reading level, cultural differences, physical impairments

What Teaching Techniques should be used for Clients with Special Learning Needs

Provide oral instruction for clients with reading disabilities

Provide frequent progress check

Give immediate feedback with the relationship between what was taught and what was learned.

Make activities concise and short, whenever possible.

Avoid abstract terms and concepts.

Give lots of specific praise.

Utilize as many sensory modalities as possible i.e. hearing, seeing, smelling, touching

What is a Lecture 

What are the Advantage/Disadvantage

Presentation is traditional and widely accepted

Advantage:  Effective for lower level cognitive learning and in large Groups

Disadvantage:  Passivity of learner can cause boredom and disinterest

Provides problem solving skills and insight into attitudes

Advantage:  Active participation, comparison of values with others

Disadvantage:  Time consuming; focus of discussion may get off track

Objectives in the affective domain are optimized

Advantage:  Analysis and learner’s interest are enhanced, helps the participant develop their own views and values

Disadvantage:  Effective in smaller groups, quiet students may not engage in this environment

Effective for behavioral change, combined with cognitive

Advantage:  Provides models for new behaviors, person doesn’t feel  “alone” with challenges

Disadvantage:  Group can become absorbed in problems rather than Growth

Selected examples should reflect common life or work experiences of the group

Advantage:  Useful for clarification, makes learning “real”

Disadvantage:  Remembering can occur if they don’t Support the learning objectives

What is Demonstration and Guided Practice

   What are the Advantage/Disadvantage

Effective for psychomotor skills

Advantage:  Safe place to make mistakes, positive reinforcement is Crucial to learning

Disadvantage:  Difficult for learners who are left handed

Individualized learning needs are addressed

Advantage:  Useful for cognitive learning, augments retention through learning difficult concepts.  Clickers used in classroom to rapidly collect and summarize students in class.

Disadvantage:  Equipment needs and instructor’s time is costly

Outcomes and commitment to goals are emphasized

Advantage:  Individualizes learning, change over time is reflected

Disadvantage:  Learners with limited self-discipline may not adhere to the contract

Different types of learning approaches and activities

Advantage:  Interest and attention span is enhanced such as teacher movements, use of voice, shifting sensory types of learning, i.e. touch, see, smell, etc.

Disadvantage:  Some learners may be overwhelmed, lack of resources

Presenting real-life experiences to integrate knowledge through practical application discussions.

Advantage: Helps students develop logical problem solving skills and group interaction skills.

Disadvantage: Some clients don’t want to talk or participate or expose their challenges with saying the wrong thing.