Health Workers in Community Setting

A community health worker is one who provides basic community health care services for promotion of health, prevention of illness, simple treatment and rehabilitation. The services utilizes the philosophy, content, method and skills of public health care. While most nurses care for one patient at a time, public health nurses care for entire populations. By working with whole communities, public health nurses are able to educate people about health issues, improve community health and safety and increase access to care.

Public health nurses:

Monitor health trends and identify health risk factors unique to specific communities.

Set local priorities for health-related interventions to provide the greatest benefit to the most people. Advocate with local, state and federal authorities to improve access to health services for underserved communities. Design and implement health education campaigns and disease prevention activities, such as immunizations and screenings. Tell people about locally available health care programs and services to improve access to care. Educate and provide direct health care services to vulnerable and at-risk populations.

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Public health nurses believe a person's health is affected by many factors, including genetic makeup, lifestyle and environment. Instead of waiting for patients to come to the hospital with an illness, they go into communities to try and help people improve their health and prevent disease.

For people who don't have access to care, public health nurses may also provide direct health care services, including preventive care, screening services and health education. Health education is a primary focus of public health nurses. Drawing on their training as registered nurses, public health nurses give people reliable, useful information about how to protect their health.

In presentations at schools, community groups, senior centers and other local groups, public health nurses explain proper nutrition, demonstrate effective safety practices, promote early detection of common diseases, tell people how to care for disabled or ill family members and inform people about other important health issues.

Their goal is to make health information easy to understand, so people can take greater control over their well-being. In low-income and rural communities, public health nurses also provide critical health care services. They immunize schoolchildren, provide pre-natal and well-baby care and teach the elderly how to stay safe and healthy at home. They also must be able to recognize and respond to potential health crises.

B. CARE ENHANCEMENT QUALITIES OF HEALTH WORKERS IN COMMUNITY SETTING

1. Efficient
a. Plans with the people, organizes, conducts, direct health education activities according to the needs of the community.
b. Knowledgeable about everything relevant to his practice; has the necessary skills expected of him.

2. Good listener
a. Hear what’s being said and what’s behind the words.
b. Always available for the participant to voice out their sentiments and needs.

3. Keen observer
a. Keep an eye on the proceedings, process and participants’ behavior.

4. Systematic
a. Knows how to put in sequence or logical order the parts of the session.

5. Creative/Resourceful
a. Uses available resources.

6. Analytical/Critical thinker
a. Decides on what has been analyzed.
7. Tactful
a. Brings about issues in smooth subtle manner.
b. Does not embarrass but gives constructive criticisms.

8. Knowledgeable
a. Able to impart relevant, updated and sufficient input.

9. Open
a. Invites ideas, suggestions, and criticisms.
b. Involves people in decision making.
c. Accepts need for joint planning and decision relative to health care in a particular situation; not resistant to change.

10. Sense of humor
a. Knows how to place a touch of humor to keep audience alive.

11. Change agent
a. Involves participants actively in assuming the responsibility for his own learning.

12. Coordinator
a. Brings into consonance of harmony the community’s health care activities

13. Objective
a. Unbiased and fair in decision making.

14. Flexible
a. Able to cope with different situations.

C. Unique Characteristics of Community Health Care

1. It’s imperative to remember that you are a guest in the client’s home and the client directs the care being given with the guidance from your clinical expertise.

2. Your nursing practice is driven by the current Regulations and legislation governing Nursing and Home Health Care. You must have an understanding of the Standards of Community Health Nursing. (www.chnac.ca)

3. As a Community Health Nurse you must possess a desire to practice with an attention to detail, critical thinking, excellent assessment and problem solving skills.

4. You must have the flexibility of scheduling to accommodate the client’s needs while still meeting their health care goals.

5. It is imperative to have access to a reliable vehicle to meet the demands of your role and be competent to drive in all weather conditions.

6. As a Community Health Nurse your are the advocate and liaison for the client’s health care goals, as such you will be communicating, directing, and liaising with other health professionals to ensure the client meets the desired outcomes of their care.

7. Community health nurses have strong clinical skills with special attention given to the Nursing Process and the ability to incorporate new technology and technical skills. Excellence in written and verbal communication is imperative.

8. As a Community Health Nurse you must be able to function both as a generalist and a specialist. You must feel confident in competently and proficiently care for a wide range of clinical issues and best practices, examples include: wound care, psychiatry, maternal and child health, pediatrics, foot care, palliative care, chronic disease management, and geriatrics

9. Community Health Nurses have the ability to function autonomously in a non-structured atmosphere and possess self-direction and independence.

10. Community Health Nurses are driven to continuously learn new skills and technology and adapt their education into practice to best meet the client’s needs and goals.

11. As a Community Health Nurse you must possess an acceptance, appreciation and understanding of the diversity of the client’s you service, and must incorporate their values and beliefs in to the care you provide in a non-judgmental, open-minded manner.

12. You must genuinely care for the client’s wellbeing and possess good listening skills.

13. Managing your time and effectively planning you day is imperative to ensure you’re able to meet the needs of your client’s while still maintaining safe practice.

14. Community Health Nurses are able to acknowledge change and know that change is a constant in home health nursing.

15. Community Health Nurses possess a sense of humor.
D. FUNCTIONS OF A HEALTH WORKER

1. Community health service provider
Carries out health services contributing to the promotion of health, prevention of illness, early treatment of illness and rehabilitation. Appraises health needs and hazards (existing or potential).

2. Facilitator
Helps plan a comprehensive health program with the people.
Continuing guidance and supervisory assistance.

3. Health counselor
Giving appropriate advice and broadening the client’s insight about a problem so that Appropriate decisions are made which can lead to positive resolution of the problem. Provides health counseling including emotional support to individuals, family, group and community.

4. Co-Researcher
Provides the community with stimulation necessary for a wider or more complex
study of problems. Enforce community to do prompt and intelligent reporting of epidemiologic investigation of diseases. Suggest areas that need research (by creating dissatisfaction) Participate in planning for the study and in formulating procedures. Assist in the collection of data.

Help interpret findings collectively.
Act on the result of the research- Plan and conduct of nursing and related studies that contribute to the improvement of nursing and health services, either alone or independently, or in collaboration of other members of the health and intersect oral teams.

5. Member of a team
In operating within the team, one must be willing to listen as well as to contribute, to teach as well as to learn, to lead as well as to follow, to share authority as well as to work under it. Helps make multiple services which the family receives in the course of health care, coordinated and comprehensive as possible. Consults with and refers to appropriate personnel for any other community services.

6. Health Educator
Health education is an accepted activity at all levels of public work. A health educator is the one who improves the health of the people by employing various methods or scientific procedures to stimulate, arouse and guide people to healthful ways of living. She takes into consideration these aspects of health education. Information- provision of knowledge.

Education- change in knowledge, attitude and skills.
Communication- exchange of information.

E. Health Education

WHO define Health Education as any combination of learning experiences designed to help individuals and communities improve their health, by increasing their knowledge or influencing their attitudes. Health education is often very visible and tangible (i.e., it’s what most health education programs are “known for”), and it may often include educational programs, activities and skill-building group or individual sessions. Health education is part of health promotion, but health promotion is more than health education. Health education has been defined in many ways by different authors and experts. Lawrence Green defined it as “a combination of learning experiences designed to facilitate voluntary actions conducive to health.” The terms “combination, designed, facilitate and voluntary action” have significant implications in this definition.

Combination: emphasizes the importance of matching the multiple determinants of behavior with multiple learning experiences or educational interventions. Designed: distinguishes health education from incidental learning experiences as systematically planned activity. Facilitate means create favorable conditions for action. Voluntary action means behavioral measures are undertaken by an individual, group or community to achieve an intended health effect without the use of force, i.e., with full understanding and acceptance of purposes. Most people use the term health education and health promotion interchangeably. However, health promotion is defined as a combination of educational and environmental supports for actions and conditions of living conducive to health.

F. Nurse as Health Educator

Health education is the duty of everyone engaged in health and community development activities. Health Extension Workers are primarily responsible in working with the families and community at a grass root level to promote health and prevent disease through provision of health education. If health and other workers are not practicing health education in their daily work, they are not doing their job correctly. When treating someone with skin infection or malaria, a health worker should also educate the patient about the cause of the illness and teach preventive skills. Drugs alone will not solve the problems. Without Health Education, the patient may fall sick again from the same disease. Health workers must also realize that their own personal example serves to educate others. Role of health educator

Talking to the people and listening of their problems. Thinking of the behavior or action that could cause, cure and prevent these problems. Finding reasons for people’s behaviors. Helping people to see the reasons for their actions and health problems. Asking people to give their own ideas for solving the problems. Helping people to look as their ideas so that they could see which were the most useful and the simplest to put into practice. Encouraging people to choose the idea best suited to their circumstances.

Reference:

Marrelli, Tina M. (1997) Handbook of Home Health Orientation, St. Louis, Mosby Home Health Care Practice Page A Day in the Life of a Home Health Care Nurse . Retrieved from: http://www.rnao.org/storage/15/979 practice page home health pdf