FOUNDATIONS OF NURSING PRACTICUM
METHODICAL INSTRUCTION
FOR BSN STUDENTS
OF THE III COURSE
LESSON № 26 (PRACTICAL – 6 HOURS)
Theme: Community Based Nursing Practice, Health and Wellness
Aim: In community-based nursing, the nurse focuses on “illness care” of individuals and families across the life span. The aim is to manage acute and chronic health conditions in the community, and the practice is family-centered illness care. Community based nursing is not a specialty iursing but rather a philosophy that guides care in all nursing specialties.
Professional orientation of students: Community-oriented nurses emphasize health protection, maintenance, and promotion and disease prevention, in addition to self-reliance among clients. Regardless of whether the client is a person, a family, or a group, the goal is to promote health through education about prevailing health problems, proper nutrition, beneficial forms of exercise, and environmental factors such as safe food, water, air, and buildings.
Methodology of Practical Class: 9:00-12:00
Algorithm of students’ communication with patients with pathology in subject (communication skills)
During examination of the patient students have to use such communicative algorithm.
Complaints and anamnesis taking in patients.
1. Friendly facial expression and smile.
2. Gentle tone of speech.
3. Greeting and introducing.
4. Take complaints and anamnesis in a patient.
5. Explain to the patient results of his/her lab tests correctly and accessibly.
6. Explain to the patient your actions concerning him/her (the necessity of hospitalization, certain examinations and manipulations), which are planned in future.
7. Conversation accomplishment.
Objective examination:
Physical methods of examination of patients with internal diseases
1. Friendly facial expression and smile.
2. Gentle tone of speech.
3. Greeting and introducing.
4. Explain to a patient, what examinations will be carried out and get his/her informed consent.
5. Find a contact with the patient and make an attempt to gain his/her trust.
6. Inform about the possibility of appearing of unpleasant feelings during the examination.
7. Prepare for the examination (clean warm hands, cut nails, warm phonendoscope, etc.).
8. Examination (demonstration of clinical skill).
9. Explain to the patient results of his/her lab tests correctly and accessibly.
10. Conversation accomplishment.
Estimation of laboratory and instrumental investigations
Informing about the results of examination of patients with internal diseases
1. Friendly facial expression and smile.
2. Gentle tone of speech.
3. Greeting and introducing.
4. Explain to a patient results of his/her lab tests correctly and clearly.
5. Involve the patient into the conversation (compare present examination results with previous ones, clarify whether your explanations are clearly understood).
Planning and prognosis the results of the conservative treatment
Friendly facial expression and smile.
1. Gentle tone of speech.
2. Greeting and introducing.
3. Correct and clear explanation of necessary treatment directions.
4. Discuss with a patient the peculiarities of taking medicines, duration of their usage, possible side effects; find out whether your explanations are clear for him/her or not.
5. Conversation accomplishment.
Work 1. Prepare Power Point Presentations 15 slides for the following topics:
1. Model healthy lifestyle behaviors and attitudes.
2. Facilitate client involvement in the assessment.
3. Implementation and evaluation of health goals.
4. Teach clients self-care strategies to enhance fitness, improve nutrition, manage stress and enhance relationships.
5. Assist individuals, families and communities to increase their level of health.
6. Educate clients to be effective health care consumers.
7. Assist clients, families and communities to develop and choose heal h promotion options.
8. Guide client’s development in effective problem solving and decision-making.
9. Reinforce client’s personal and family health promoting behaviors.
10. Advocate in the community for changes that promote a healthy environment
Work 2: Write a small essay for the following task, please:
An elderly client has been referred to the parish nurse. What are the different functions of the parish nurse? What educational background does an individual need to prepare for a role as a parish nurse?
Seminar discussion of theoretical issues: 12:30-14:00
1. Health—the combination of your physical, mental/emotional, and social well-being.
2. Wellness—an overall state of well-being or total health.
3. Heredity—all the traits that were biologically passed on to you from your parents.
4. Environment—the sum of your surroundings.
5. Peers—people the same age who share similar interest.
6. Culture—the collective beliefs, customs, and behaviors of a group.
7. Risk behaviors—actions that can potentially threaten your health or the health of others.
8. Abstinence—deliberate decision to avoid high-risk behaviors, including sexual activity and the use of tobacco, alcohol, and other drugs.
9. Lifestyle Factors—personal habits and behaviors related to the way a person lives.
10. Health Education—providing accurate health information and teaching health skills to help people make healthy decisions.
11. Health Literacy—a person’s capacity to learn about and understand basic health information and services, and to use these resources to promote one’s health and wellness
Individual Students Program
Test evaluation and situational tasks. 14:15-15:00
Initial level of knowledge and skills are checked by solving situational tasks for each topic, answers in test evaluations and constructive questions.
(the instructor has tests & situational tasks)
1. To identify members of a community, the nurse should ask all of the following questions EXCEPT
A. what are the relationships of these people
B. what is the shared culture of these people
C. what is their greatest health care need
D. who are the people
2. All of the following are considered communities EXCEPT
A. homeless shelters
B. an individual home
C. rural villages of the world
D. refugee groups
3. All of the following are frameworks for community care EXCEPT
A. systems theory
B. critical social theory
C. citizen ladder of participation theory
D. ecological approach to health care theory
4. The goal of this theory is the liberation of people from health-damaging environmental conditions.
A. systems theory
B. critical social theory
C. citizen ladder of participation theory
D. ecological approach to health care theory
5. One of the major differences between hospital and community care is that community care
A. is not as demanding as hospital care
B. focuses on groups or aggregates in the community setting
C. does not use standards of care
D. is not as responsible for care provided compared to hospital care
6. Wendy is a nurse working with high school girls who are nonworking single parents. The girls ask Wendy about ways for them to get money. Wendy personally does not believe in federally funded programs for nonworking single parents that are available to these girls. As a professional, Wendy must
A. let the girls know her feelings
B. find other ways for the girls to get money and not talk about the federally funded programs
C. advise the girls of the programs that are available for funding possibilities
D. explain to the girls why it would be best for them to obtain gainful employment
7. Nurses who study illnesses, their causes, and the illnesses’ distribution in groups of people are referred to as
A. infection control nurses
B. nurse epidemiologists
C. nurse scientists
D. Centers for Disease Control and Preventiourses
8. When working with the elderly population who require the use of technology in their care, the nurse should take into consideration all of the following EXCEPT
A. many elderly clients do not feel comfortable with the use of “high-tech” equipment
B. the nurse should use a single teaching method in explaining “high-tech” equipment to elderly clients
C. the nurse should allow time for questions and have the client return-demonstrate the use of the technology
D. the nurse can give the client audiovisual tapes that teach the use of the equipment to the client
9. The Visiting Nurses Association of which state developed a system of nursing diagnoses that identifies physical factors and external health factors important to community health?
A.
B.
C.
D.
10. The first issue that must be addressed when working with clients in community health nursing is
A. primary health care needs
B. safety issues
C. acceptance by the clients
D. budgetary considerations
Student should know:
1. Various community-based frameworks, including integrated health care systems, community initiatives and conditions, and case management.
2. Essential aspects of collaborative health care: definitions, objectives, benefits, and the nurse’s role.
3. Various types of communities.
4. The role of the nurse in providing continuity of care.
5. factors affecting health status, beliefs, and practices
6. Parsons’ four aspects of the sick role.
Student should be able to:
1. Discuss factors influencing health care reform.
2. Describe community-based health care, including the Pew Health Professions Commission recommendations for health competencies for future health practitioners.
3. Differentiate community health care settings from traditional settings.
4. Discuss competencies community-based nurses need for practice
5. Differentiate community-based nursing from traditional institutional-based nursing
6. Differentiate health, wellness, and well-being.
7. Describe five dimensions of wellness.
8. Describe factors affecting health care adherence.
9. Differentiate illness from disease and acute illness from chronic illness.
10. Explain Suchman’s stages of illness.
11. Describe effects of illness on individuals’ and family members’ roles and functions.
Correct answers of test evaluations and situational tasks:
FOUNDATIONS OF NURSING PRACTICUM
METHODICAL INSTRUCTION
FOR BSN STUDENTS
OF THE III COURSE
LESSON № 26 (PRACTICAL – 6 HOURS)
Theme: Community Based Nursing Practice, Health and Wellness
Aim: In community-based nursing, the nurse focuses on “illness care” of individuals and families across the life span. The aim is to manage acute and chronic health conditions in the community, and the practice is family-centered illness care. Community based nursing is not a specialty iursing but rather a philosophy that guides care in all nursing specialties.
Professional orientation of students: Community-oriented nurses emphasize health protection, maintenance, and promotion and disease prevention, in addition to self-reliance among clients. Regardless of whether the client is a person, a family, or a group, the goal is to promote health through education about prevailing health problems, proper nutrition, beneficial forms of exercise, and environmental factors such as safe food, water, air, and buildings.
Methodology of Practical Class: 9:00-12:00
Algorithm of students’ communication with patients with pathology in subject (communication skills)
During examination of the patient students have to use such communicative algorithm.
Complaints and anamnesis taking in patients.
1. Friendly facial expression and smile.
2. Gentle tone of speech.
3. Greeting and introducing.
4. Take complaints and anamnesis in a patient.
5. Explain to the patient results of his/her lab tests correctly and accessibly.
6. Explain to the patient your actions concerning him/her (the necessity of hospitalization, certain examinations and manipulations), which are planned in future.
7. Conversation accomplishment.
Objective examination:
Physical methods of examination of patients with internal diseases
1. Friendly facial expression and smile.
2. Gentle tone of speech.
3. Greeting and introducing.
4. Explain to a patient, what examinations will be carried out and get his/her informed consent.
5. Find a contact with the patient and make an attempt to gain his/her trust.
6. Inform about the possibility of appearing of unpleasant feelings during the examination.
7. Prepare for the examination (clean warm hands, cut nails, warm phonendoscope, etc.).
8. Examination (demonstration of clinical skill).
9. Explain to the patient results of his/her lab tests correctly and accessibly.
10. Conversation accomplishment.
Estimation of laboratory and instrumental investigations
Informing about the results of examination of patients with internal diseases
1. Friendly facial expression and smile.
2. Gentle tone of speech.
3. Greeting and introducing.
4. Explain to a patient results of his/her lab tests correctly and clearly.
5. Involve the patient into the conversation (compare present examination results with previous ones, clarify whether your explanations are clearly understood).
Planning and prognosis the results of the conservative treatment
Friendly facial expression and smile.
1. Gentle tone of speech.
2. Greeting and introducing.
3. Correct and clear explanation of necessary treatment directions.
4. Discuss with a patient the peculiarities of taking medicines, duration of their usage, possible side effects; find out whether your explanations are clear for him/her or not.
5. Conversation accomplishment.
Work 1. Prepare Power Point Presentations 15 slides for the following topics:
1. Model healthy lifestyle behaviors and attitudes.
2. Facilitate client involvement in the assessment.
3. Implementation and evaluation of health goals.
4. Teach clients self-care strategies to enhance fitness, improve nutrition, manage stress and enhance relationships.
5. Assist individuals, families and communities to increase their level of health.
6. Educate clients to be effective health care consumers.
7. Assist clients, families and communities to develop and choose heal h promotion options.
8. Guide client’s development in effective problem solving and decision-making.
9. Reinforce client’s personal and family health promoting behaviors.
10. Advocate in the community for changes that promote a healthy environment
Work 2: Write a small essay for the following task, please:
An elderly client has been referred to the parish nurse. What are the different functions of the parish nurse? What educational background does an individual need to prepare for a role as a parish nurse?
Seminar discussion of theoretical issues: 12:30-14:00
1. Health—the combination of your physical, mental/emotional, and social well-being.
2. Wellness—an overall state of well-being or total health.
3. Heredity—all the traits that were biologically passed on to you from your parents.
4. Environment—the sum of your surroundings.
5. Peers—people the same age who share similar interest.
6. Culture—the collective beliefs, customs, and behaviors of a group.
7. Risk behaviors—actions that can potentially threaten your health or the health of others.
8. Abstinence—deliberate decision to avoid high-risk behaviors, including sexual activity and the use of tobacco, alcohol, and other drugs.
9. Lifestyle Factors—personal habits and behaviors related to the way a person lives.
10. Health Education—providing accurate health information and teaching health skills to help people make healthy decisions.
11. Health Literacy—a person’s capacity to learn about and understand basic health information and services, and to use these resources to promote one’s health and wellness
Individual Students Program
Test evaluation and situational tasks. 14:15-15:00
Initial level of knowledge and skills are checked by solving situational tasks for each topic, answers in test evaluations and constructive questions.
(the instructor has tests & situational tasks)
1. To identify members of a community, the nurse should ask all of the following questions EXCEPT
A. what are the relationships of these people
B. what is the shared culture of these people
C. what is their greatest health care need
D. who are the people
2. All of the following are considered communities EXCEPT
A. homeless shelters
B. an individual home
C. rural villages of the world
D. refugee groups
3. All of the following are frameworks for community care EXCEPT
A. systems theory
B. critical social theory
C. citizen ladder of participation theory
D. ecological approach to health care theory
4. The goal of this theory is the liberation of people from health-damaging environmental conditions.
A. systems theory
B. critical social theory
C. citizen ladder of participation theory
D. ecological approach to health care theory
5. One of the major differences between hospital and community care is that community care
A. is not as demanding as hospital care
B. focuses on groups or aggregates in the community setting
C. does not use standards of care
D. is not as responsible for care provided compared to hospital care
6. Wendy is a nurse working with high school girls who are nonworking single parents. The girls ask Wendy about ways for them to get money. Wendy personally does not believe in federally funded programs for nonworking single parents that are available to these girls. As a professional, Wendy must
A. let the girls know her feelings
B. find other ways for the girls to get money and not talk about the federally funded programs
C. advise the girls of the programs that are available for funding possibilities
D. explain to the girls why it would be best for them to obtain gainful employment
7. Nurses who study illnesses, their causes, and the illnesses’ distribution in groups of people are referred to as
A. infection control nurses
B. nurse epidemiologists
C. nurse scientists
D. Centers for Disease Control and Preventiourses
8. When working with the elderly population who require the use of technology in their care, the nurse should take into consideration all of the following EXCEPT
A. many elderly clients do not feel comfortable with the use of “high-tech” equipment
B. the nurse should use a single teaching method in explaining “high-tech” equipment to elderly clients
C. the nurse should allow time for questions and have the client return-demonstrate the use of the technology
D. the nurse can give the client audiovisual tapes that teach the use of the equipment to the client
9. The Visiting Nurses Association of which state developed a system of nursing diagnoses that identifies physical factors and external health factors important to community health?
A.
B.
C.
D.
10. The first issue that must be addressed when working with clients in community health nursing is
A. primary health care needs
B. safety issues
C. acceptance by the clients
D. budgetary considerations
Student should know:
1. Various community-based frameworks, including integrated health care systems, community initiatives and conditions, and case management.
2. Essential aspects of collaborative health care: definitions, objectives, benefits, and the nurse’s role.
3. Various types of communities.
4. The role of the nurse in providing continuity of care.
5. factors affecting health status, beliefs, and practices
6. Parsons’ four aspects of the sick role.
Student should be able to:
1. Discuss factors influencing health care reform.
2. Describe community-based health care, including the Pew Health Professions Commission recommendations for health competencies for future health practitioners.
3. Differentiate community health care settings from traditional settings.
4. Discuss competencies community-based nurses need for practice
5. Differentiate community-based nursing from traditional institutional-based nursing
6. Differentiate health, wellness, and well-being.
7. Describe five dimensions of wellness.
8. Describe factors affecting health care adherence.
9. Differentiate illness from disease and acute illness from chronic illness.
10. Explain Suchman’s stages of illness.
11. Describe effects of illness on individuals’ and family members’ roles and functions.
Correct answers of test evaluations and situational tasks:
1. C
2. B
3. A
4. B
5. B
6. C
7. B
8. B
9. D
10. C
References:
Basic: .
1. Ternopil State Medical University http://intranet.tdmu.edu.ua/data/kafedra/internal/i_nurse/classes_stud/en/BSN-%284y%29/3%20year/1%20sem/Foundations%20of%20Nursing%20Practicum/26.%20Community%20Based%20Nursing%20Practice,%20Health%20and%20Wellnessdocx.htm
2. Study Guide: Chapter 38Altman G. Delmar’s fundamental and advanced nursing skills book, pp. 121-234.
Additional:
1. Potter and Perry. Fundamentals of Nursing. – 6th edition. – Mosby, Inc.
2. Study Guide and Skills Performance Checklist to Accompany Potter and Perry’s Fundamentals of Nursing. – 6th edition. – Mosby, Inc.
3. Altman G. Delmar’s fundamental and advanced nursing skills book / G.Altman, P. Buschel, V.Coxon. – Thomson Learning ©
4. Kozier & Erb’s Fundamentals Of Nursing: Concepts, Process, And Practice Eighth Edition Audrey Berman, Shirlee Snyder, Barbara Kozier, Glenora Erb.
5. Fundamental Nursing Care, 2/e by Roberta Ramont and Dee Niedringhaus
WEB RESOURCES
National Health Information Center http://nhic-nt.health.org
American Nurses Association http://www.nursingworld.org
Certification Board of Infection Control and Epidemiology www.cbic.org
HealthCare Report Cards www.healthcarereportcards.com
Hospital Infections Program, Centres for Disease Control and Prevention www.cdc.gov
Methodical instruction has been worked out by: T. Yu. Rybalka
Methodical instruction was discussed and adopted at the Department sitting 11 June 2012. Minute № 13
Methodical instruction was adopted and reviewed at the Department sitting 12 June 2013 Minute № 13
The Head of Clinical Immunology, Alergology and General Patients Care Department Prof. I. Ya.
The Head of
Assistant of Clinical Immunology, Alergology and General Patients Care Department T.Yu. Rybalka BSN, MSN
