Community Based Nursing. Perspectives in Health Care Delivery.
Influences on Health Care Delivery and Community Health Nursing
After studying this chapter, you should be able to:
- Connect the historical development of community health nursing to present-day issues.
- Describe factors influencing community health nursing in the 21st century.
- Explore the theoretical underpinnings of community health nursing practice.
- Analyze the nurse’s role in promoting health.
Introduction
The 21st century is bustling with phenomenal opportunities and challenges for health care delivery and community health nursing. There is no better time to be a community health nurse. The discussion that follows represents some reflections on what we believe will characterize the practice of community health nursing in the 21st century. We use the term community health nursing to denote the practice of nursing by professional nurses who have been educated in the processes of population-based nursing and whose principal client is the aggregate community.
In the past, population-based nursing was referred to as public health nursing. Public health nurses usually worked in health departments. This text uses the term community health nurse, which was adopted in recent years and intended to be more inclusive of population-based nursing practiced in a variety of community settings, including schools, worksites, shelters, health departments, and a multitude of others, some of which will be discussed in Part 3 of this text. You will encounter both terms, public health nursing and community health nursing, during your education and practice. Titles and practice settings are not as relevant as the nature of the practice itself. This chapter discusses the essence and diversity of that practice along with its theoretical underpinnings.
Until now the majority of your nursing education has focused on individual behavior. The theoretical basis for your nursing care has included knowledge about chemistry, physiology, pharmacology, and so on. Community health nursing, too, relies on that basic knowledge, but is also based on theories about populations. Hence, you will discover in subsequent chapters the concepts of epidemiology, demography, ethics, environment, culture, and policy. To understand why these theories are important to the community health nurse, let’s begin with a bit of historical context.
Reflections on the Past
As we move forward into the 21st century, reflecting on the historical contributions of community health nurses is both instructive and inspirational. Examining our roots allows us to take the best from the past in order to shape the future. Community health nurses can gain motivation and direction from the work of Lillian Wald, Lavinia Dock, and Margaret Sanger who “make up nursing’s вЂ
