NUR448  COMMUNITY HEALTH NURSING  CARING FOR THE PUBLIC’S HEALTH
Module 1 Discussion
DQ1 Back to the Future
This module has provided you with an overview of the history and practice of Community/Public Health Nursing and expanded on the concept of client. In this discussion, you will explore these concepts further as you identify trends in public health nursing, health concerns in your own community, and the role of the community/public health nurse in dealing with population health issues.
When you have completed your readings for this module research the questions listed below and share the information with your classmates.
Discuss how the role of Community/Public Health Nurse has been impacted by one of the following events: terrorism, natural disasters, aging population, broken health care system, chronic healthcare issues, infectious diseases, and an economic downturn.
Identify health concerns in your community that have resulted in death, disease, or injury from one of these events or issues listed above.
Describe how population based community/public health nursing could assist with these issues and/or problems.
DQ2 Interprofessional (IPE) Discussion Contract
Please use this link to sign your Interprofessional (IPE) Discussion Contract (Links to an external site.)Links to an external site.. After you have submitted, post a discussion reply containing the word “Done” in order to receive credit.
 
NUR448  COMMUNITY HEALTH NURSING  CARING FOR THE PUBLIC’S HEALTH
Module 2 Discussion
DQ1 The Community as Client
A community’s health is reflected in its status (morbidity and mortality rates, crime rates, educational and economic levels), structure (availability, use and quality of services and resources), and processes (how well it functions regarding its strengths and limitations).
In this discussion, you will evaluate secondary data regarding your community’s health status to discover existing or potential needs and assets.
After reviewing table 18-3 Health Status Indicators (pg. 405 of text) and the data provided in County Health Rankings and Roadmaps (Links to an external site.)Links to an external site. identify leading health status indicators in your community.
Discuss how demographic factors and health disparities influence these indicators and what population(s) is most at risk.
Review Healthy People 2020 State and Territorial Healthy People Plans  (Links to an external site.)Links to an external site.for your state and identify how your state is addressing the health status indicators you have identified in your community.
DQ2 Major Health Issues
Today, C/PHNs are faced with a multiplicity of population based health problems within the community. Such public health problems as the quality of a community’s drinking water, the outbreak of Zika virus in the US, caring for returning veterans, an aging and more diverse population, as well as a major heroin epidemic further increase the burden on communities, services, and resources.  One of the core competencies for Public Health Nursing is the ability to describe the characteristics of a population-based health problem.  In this discussion, you will address this competency as you:
Identify a current population based health problem present in your community.
Describe the structures and government interventions in place in your community/state to address this issues.
Identify any gaps you perceive in how your community is dealing with this population based health problem.
Describe the steps a C/PHN would take to address your community’s population based health problem.
 
NUR448  COMMUNITY HEALTH NURSING  CARING FOR THE PUBLIC’S HEALTH
Module 3 Discussion
DQ1 Everything is Connected
Epidemiology offers C/PHNs a methodology to assess the health of a community/population. It provides a frame of reference for investigating as well as improving the health of communities.
The C/PHN is in fact a kind of detective who investigates a problem, unravels a puzzle, analyzes, and interprets clues, narrows down suspects, plans an intervention, and addresses the issue.
In this discussion, you will investigate a current public health issue in your community by
Identify a current health issue/concern in your community e.g. lead poisoning, Zika virus, West Nile virus, obesity, HIV/AIDs, gun violence, heroin and drug use, food safety, healthcare associated infections, nutrition, infant mortality, etc.
Describe the epidemiologic data & biostatistics used to identify this public health problem.
Describe primary, secondary, and tertiary prevention interventions being planned and/or implement in your community to address this public health problem.
DQ2 Reflection: The Community Assessment
The observations and data collected in your Comprehensive Community Assessment provides a snap shot of your community: its population, its strength and resources, its stability, any changes, and/or trends that influence the health and well-being of the community as well as it needs.
Post your Comprehensive Community Assessment (CCA) (M3A1 assignment) in the discussion area to share with your peers.
Describe how your CCA assisted you in identifying the needs of the community as well as vulnerable populations present.
Identify Healthy People 2020 goals relevant to improving population health in your community.
Discuss how the CCA informed your analysis of the community/neighborhood,  identify new fact(s) you learned about your community, including available health related agencies.
 
NUR448  COMMUNITY HEALTH NURSING  CARING FOR THE PUBLIC’S HEALTH
Module 4 Discussion
DQ1 Family Health
The family is a major client system which community and public health nurses interact with to promote health and reduce health risks. The nurse assumes many roles in the provision of care to families across the lifespan, including facilitating inter- professional care to optimize health outcomes.
Example:
Jennifer S. is an Army veteran of Operation Freedom. Since returning home, Jennifer has suffered from recurrent headaches, ringing in her ears, difficulty focusing, and dizziness. In addition, soon after returning home, she began to experience moments of panic when in open spaces, flashbacks reliving the blast and the death of fellow soldiers, feelings of emotional numbness and depression, and being easily startled. She was placed on medical leave and diagnosed with Post Traumatic Stress Disorder (PTSD) and is currently being seen by a psychiatrist at the VA hospital. Her husband understands the concept of PTSD but is unprepared to handle his wife’s deteriorating condition.
Recently, Jennifer was seen at the local urgent care center for recurrent headaches, complaints of shortness of breath, and chest pain. Her husband informed the urgent care nurse that for the past four weeks his wife has been unable to care for the children, remains in bed, complaining of headaches, and is very ‘jumpy’.
The nurse assesses Jennifer knowing that returning veterans with PTSD and their families face an array of challenges, with implications for the veterans, their partners, and their children.The nurse considers referring them to: a social worker specializing in crisis intervention for veterans, a family counselor, the school nurse, a family health care practitioner.
Key elements of the nurse’s assessment are as follows:
Jennifer is 33 year- old woman who enlisted in Reserve Officers’ Training Corps (ROTC) in college, where she majored in Journalism. Upon graduation, she obtained a position in the Army as public affairs broadcast specialist. Her first assignment was at a base in upstate New York. Three years ago, she was relocated to the St. Louis, Missouri area. Jennifer has been married to her husband, Zane, for 14 years and they have two children ages six and ten. Cameron is ten years- old and entering middle school and Zeta is six years- old and in kindergarten. Zane works as a civil engineer in the St Louis area. Both Jennifer and Zane come from large families who reside in the Boston area. Jennifer’s family is Portuguese and Zane’s is Irish, they were both raised Catholic. While Jennifer was deployed, her mother moved in with Zane and the children to provide additional support and child care.
One year ago, Jennifer was deployed to Afghanistan on a six month assignment to report on the events of the war: she thought she had a ‘safe’ assignment. While working on a story in the field an Improvised Explosive Device (IED) exploded near her: two soldiers and four citizens were killed including one child. Although she was unhurt, she was unable to sleep after this event. Upon returning stateside, she began experiencing vivid nightmares, sleeplessness, survivor guilt, and depression. She was recently diagnosed with PTSD and is attempting to find a support group and counseling. Unfortunately, she has found that treatment for female veterans is limited and the family continues to struggle.
Describe the health disparities present in this family and the impact PTSD has had on Jennifer herself as well as her family and community.
What members of the inter- professional team and/or community services might you refer Jennifer and her family to?
Discuss a current state and federal legislation program which addresses returning veterans’ health issues.
Describe the political advocacy role community/public health nurses have in addressing veterans’ health disparities.
DQ2 Reflection
Today the definition of family has undergone multiple changes from the more traditional image of father, mother, and children. Reflecting on one’s own definition of family and comparing this with other’s provides a new lens through which to view “family”.
In this discussion:
Present your own definition of family.
Compare and contrast your definition with other definitions presented by your classmates.
Discuss how an awareness of backgrounds, definitions, and attitudes about families might influence nursing care of families.
Reflect on this experience and what you have learned from this.
***We all may have different definitions of family. Please be caring and open to learning about diverse lifestyles, even they do not coincide with your value system.
DQ3 Student Learning Experience (SLE) Mentor Information
Please use this link to submit your Student Learning Experience Mentor Information (Links to an external site.)Links to an external site.. If we do not receive this completed form, your mentor will not be able to complete your performance feedback form at the end of this course, which will affect your grade.
 
NUR448  COMMUNITY HEALTH NURSING  CARING FOR THE PUBLIC’S HEALTH
Module 5 Discussion
DQ1 In the Community
The community and public health nurse plays a critical role in promoting the health of communities. C-PHNs often use the Healthy People 2020 educational objectives as a guide to identify community – based learning needs.
In this activity, you will apply public health nursing concepts, models, and theories in the promotion of health within communities.
Review:
For this discussion:
Describe the health promotion plan you have designed to address the gaps in services identified in the community.
Based on the identified gap(s) in service(s), identify members of the interprofessional health care team and or community services that could assist in improving health outcomes.
Identify the Healthy People 2020 educational objective that would align with this initiative.
Discuss the community health promotion model or framework you would use to implement your health promotion.
DQ2 Reflection: Health Promotion
Case management has been part of C-PHN since the days of Lillian Wald. Now common within other health care settings, its origins are firmly rooted in public health. While working with an individual or family, the case manager may uncover lack of services or educational resources in the community. In the role of advocate, the C-PHN addresses these gaps in services, researches evidence based practices, and institutes change within a community.
For this discussion, summarize the health promotion you designed and shared last week.
Identify evidence based practices and interventions that support your health promotion plan from M5D1.
Using Table 22-1 (pp 482 of text) as a guide, describe how your health promotion plan addresses each of the components listed in this table. Be sure to include examples of members of the inter- professional team who will assist in successful implementation of your plan.
Identify the C-PHN competency this activity would address.
 
NUR448  COMMUNITY HEALTH NURSING  CARING FOR THE PUBLIC’S HEALTH
Module 6 Discussion
DQ1 Internal and External Factors
Environment factors, legislative events, and health care financing influence public health and population based practice. Although progress has been made toward a healthier global society, problems remain. 
Describe evidence of external influences (diversity-globalization, ethics, environment, and economics) on the population served at your SLE.
Identify the funding source at your SLE site.
Discuss how governmental policy or budgeting has impacted services and available resources.
Discuss the role of the C-PHN in obtaining funding for population health initiatives.
DQ2 Reflection
In this week’s discussion, present M5A1: the SWOT analysis and summary, to the class.
Identify the problems or issues uncovered from this exercise.
Discuss the role the C-PHN plays in determining a community’s health policy need.
Discuss how you would work with the key stakeholders and or partnerships needed to implement health promotion plan. Describe any preconceived notions or bias you may have regarding the professions or community members who may be integral to the success of your plan.
Discuss what you learned from this exercise.
 
NUR448  COMMUNITY HEALTH NURSING  CARING FOR THE PUBLIC’S HEALTH
Module 7 Discussion
DQ1 Vulnerable Populations and Interprofessional Teams
This week you will have the opportunity to participate in an Inter-professional Educational (IPE) experience. The concept of IPE in educational programs has been a clarion call from the Institute of Medicine as a way to prepare healthcare practitioners to fully engage in collaborative practice roles. You will be learning virtually alongside with students from the Albany College of Pharmacy.
As mentioned in Module 1, in the IPE Discussion Contract, this discussion will take place within Google Groups. At this point, you should have already received, and accepted your invitation to join your assigned Google Group. Please login using this link (Links to an external site.)Links to an external site., and click on your group name (Group #_) to enter the “IPE Discussion”.
As one of the most disenfranchised, marginal groups in our country poor and homeless families are at high risk for severe physical, emotional, and social health problems. View: “Poor Kids” (Links to an external site.)Links to an external site. [Video file] [58 min 42 sec]. In this week’s discussion, you will be reflecting on the meaning of vulnerability and the role of the community health nurse as part of an Interprofessional team working with homeless families.
Here are the steps to engage in this exciting approach to learning:
Complete the assignment – that is watch the 55 minute video entitled “Poor Kids”. As you watch the video, reflect on your role as a nurse and educator in the community working with families in poverty.
Complete the pre-survey by clicking here (Links to an external site.)Links to an external site..
After the pre-survey, you can click on this link to enter the Google discussion forum (Links to an external site.)Links to an external site..
You have been placed in a specific team for the discussion. This helps to assure that representation from all disciplines is equal in all the teams.
Respond to the 5 discussion questions posted.
Be sure to review posts from other students in other programs, and respond to their posts, commenting on similarities or differences. Your responses can include your personal experiences, what new learning emerged from the discussions, how you embrace values or question social justice. You may also provide constructive comments and include questions to clarify a point or advance the dialogue with peers.
Complete the post survey by clicking here (Links to an external site.)Links to an external site..
Here are the discussion questions for the week:
Question 1: Explain the impact of poverty on health, from your perspective, in the lives of families with children.
Question 2: Provide examples of social, cultural, political, economic, and/or environmental factors that are observed shaping the lives of the families in the video and would need to be considered as you develop a culturally competent, holistic health promotion plan. [Assign 1 family from video to a team discussion].
Question 3: How would these families be likely to enter “the system” of care, in other words – meet you and the types of service you would provide? What would the family experience look like?
Question 4: Consider one of the families in the video. What role can your profession [or you] play to ensure this family receives equitable health services, treatment, and access?
Question 5: What views shared by members on your team, from other disciplines, helped to deepen your understanding of health and societal issues faced by children growing up in poverty?
DQ2 Being Prepared
Community and public health nurses play a crucial role in all phases of community preparedness. In this discussion, you will explore various scenarios dealing with community preparedness and the roles the community health nurse.
When you have completed your reading:
Both local and state health departments are required by law to have disaster preparedness plans.
Identify your local and or state health department’s preparedness plan and the specific areas covered in them.
Review the “phases of disaster linked to the nursing process” chart.
Identify one vulnerable population in your community and describe how you would apply the nursing process and disaster phases to this population to decrease potential risk during times of disaster.
Explain who else would need to be involved from a health professional background and or community leaders
 
NUR448  COMMUNITY HEALTH NURSING  CARING FOR THE PUBLIC’S HEALTH
Module 8 Discussion
DQ1 Reflection on the Lived Experience
For this activity, you will reflect over your Service Learning Experience as well as the course content. The shift that occurs when an individual experiences something for the first time, which can make life long impressions. Reflect on your experience:
Share a story from this experience that highlights the work of the agency, resource, and organization and the impact on those they serve.
Discuss what you learned about your community (i.e.: families, disability and culture, resources, and or interprofessional support) that you were unaware of.
Discuss what revelations this project brought to light for you regarding the needs of your community.
DQ2 The Future
During the past 14 weeks, you have acquired new knowledge about the nursing practice geared at population health. Historically, public health nurses have been the leaders in providing care in the community. In fact, some may say, nursing’s roots are in the community. “Despite the historical and current importance of public health nurses, the future of public health nursing is in jeopardy. This is due in part to a reduced emphasis on the training of public health nurses and faculty and the shrinking budgets for prevention in local and state health departments” (National Association of County and City Health Officials, 2013).
In this last discussion post in NUR448, reflect on your readings and your SLE and:
 Discuss components of your BS in nursing education that have provided you with the additional knowledge and resources necessary to assume the role of a bachelor’s prepared nurse.
Discuss how you will provide and advocate for safe quality care for patients and families in an environment that values the uniqueness, dignity, and diversity of patients.
Provide 2 exemplars of how you addressed the core competencies of public health professionals (Links to an external site.)Links to an external site. [PDF, file size 427 KB].
Discuss the impact of population health on your nursing practice