Community Health - Role of Nurse - Essay Example

Community Health Role of Nurse: Case Study Community health nursing essay Health promotion is aimed at assisting the patient and family to change behavior in order to produce better physical and emotional health for the patient in the future. According to Chitty (2004), in order to reach this goal, the nurse encourages better health maintenance practices that would promote normal growth and development, help foster attitudes and values that are compatible with health and teaches appropriate use of health services. Health is largely subjective; and according to Pryor and Smith (2002) each person’s judgment of health is related to physical and mental capacities, self-concepts, relationships with others and fulfillment of personal goals and values according to Berkman LF, Glass T, Brissette I, Seeman TE ( 2000). Health cannot just be understood in terms of physical wellbeing of the person but in terms of the social and cultural heath of the individual (Umberson D. 1987). This would mean that in order for a person to be correctly treated the medical practitioner would need to be aware of, and sensitive toward the cultural views of the person, especially in the context of the healthcare professional. Health has been defined by WHO as a state of complete physical, mental and social wellbeing is recognised as both a fundamental human right and an important worldwide social goal (James S. Larson, 1996). This would come as a result of the patients’ treatment and would manifest in the nurses’ respect for him as a health consumer-which is based on the innate requirement of the nurse to recognize her capability for active and informed participation in their own health care (H. M. Chochinov, 2002). One would need to therefore work hard at ensuring that the dignity of the patient is preserved (M. Calnan, G. Woolhead, P. Dieppe, and W. Tadd., 2005). This can be best achieved through practiced kindness and by recognizing the vulnerability and powerlessness that the patient would invariably face. In the specific case of the patient in the given context, the duty of the nurse therefore is to recognise the shortcomings of the man in their care and despite the restrictions that caring for a man with language barrier problems would mean, there would need to be a certain respect for his thought and decision making abilities. The duty of the RN would therefore be ensure that the ward nurses understand and comply with this basic principle (The Essence of Care, 2001). According to recent research by Johnson (2007) one in every six adult Australian males suffers from clinical depression and teenagers and elderly men have higher rates. DePaulo and Horvitz (2002) state that depression in men is associated with destructive behavior, alcohol and drug abuse, and numerous medical disorders such as cardiovascular disease and diabetes. According to Yates (2009), statistics have proven over time that with the increasing complexities of daily life increase the levels of stress and hence the numbers of disorders that are related to the psychology of the human mind. It has in fact been stated by Horgan (2008) that an need for an improvement in the process governing the treatment of depression is a critical factor in the current low levels of appropriate care. Horgan (2008) further states that a health plan in this context is useful for the measurement of the dosage of medicines that the patient requires and the other factors that need to be kept in mind in the administration of treatment- the absence of which has meant that progress in terms of levels and quality of care have been stagnating at relatively low levels. It must therefore be remembered that it is necessary to come up with identifications of the characteristics of a health plan so that these could be utilized as factors contributing to quality improvement in various aspects of depression treatment (Claire M Spettell, Terry C Wall, Jeroan Allison, Jaimee Calhoun, Richard Kobylinski, Rachel Fargason, and Catarina I Kiefe, 2003). One can also assume right at the beginning of the discussion that most health plan characteristics are associated with the quality of one important aspect of depression care along with aspects of antidepressant medication management. Patel (2003) states that there are various options for effective treatment of depression which are available, despite the fact that the impact that these treatments have in terms of effects of societal burden like the return on resource utilization are minimal. That apart under such a scenario it becomes imperative for the caregiver team to check whether or not there has been any history of drug or alcohol dependence. If there has been then it could be considered as a major issue to be handled towards the rehabilitation of the patient. In this case the approach towards treatment has to be different from what is given for the general depression cases. There has to be a twin-pronged approach towards this issue; one, that deals with the patient and two, that brings into account the patient’s relationship with the family. This is because it has been generally seen that alcohol-dependence leads to strained familial relationships. The challenges are manifold. According to Hammen and Brennan (2001) the causes of the prevalence of culture of depression among the contemporary population include equal combination of social, biological, and psychological factors. According to Matthews (1995) a management plan also known as treatment plan for depression is organized into various areas hence a multidisciplinary approach is needed. One can start the discussion on an assumption that depression as a disorder has causes that are unique in every given case which would then mean for every individual there would be a specific path or a method that could be employed in the effective treatment of the problem. It can therefore also be assumed that for a treatment to be effective, in the case of a patient suffering from depression, the physician would automatically have to understand the factors that have caused the depression in the first place. Hammen and Brennan (2001) state that these factors would then ultimately have to find reflection in a clinical health plan for depression patients if the plan has to have any hopes of being effective. Matthews (1995) believes that a key problem in diagnosis that has baffled non-psychiatrist is the fact that the elaborate classification systems that exist today are solely based on the subjective descriptions of symptoms. One of the most often applied models of patient care in the context of depression is the recovery model (Jacobson N, Greenley, 2001). Reeper and Perkins (2003) state that the model, based on the innate belief that every patient has within himself an immense capability to recover from any kind of mental health problems hundred per cent, the model aims at coming up with health care objective fulfillment that would cure the illness effectively and forever. The health plan in the context of the mental health and depression affected patients take cues from this particular method in the light of the fact that the steps prescribed by the method are those that work on assumptions for cure and care that have already been outlined. These, Reeper and Perkins (2003) state are inclusive of a process of problem acceptance, solution discovery in the context of the discovered problem, and changing of lifestyle to find a more balanced way of life. Brown and Donohue (2003) believe that one of the basic reasons that the method is especially effective and is recommended in the formulation of a mental health care management plan is the fact that the method is deeply focused on the role played by the patient in process of recovery. By making the patient a part of the process, the process allows the patient to think for themselves and to participate actively in the process of their recovery (Williams Tyna, 2002). Community nursing interventions could be classified in three major categories: education, engineering and enforcement. Educative nursing interventions help clients voluntarily acquire knowledge essential for understanding healthy functioning, develop attitudes that foster preventive health behavior, and establish practices conducive to effective living. Educative strategies are commonly used in community health nursing practice in variety of situations (Green S. 1996). In the position of a community health nurse, the idea would be to help families learn about normal growth and development and childcare; conduct discussions related to sexuality issues in the school setting and distribute health education materials in clinics, industrial plans and other community health settings. Nurses visiting clients whose care is being reimbursed by Medicare also help clients whose care learn about their health concerns. The idea would be top focus on clients learn about the fact that there is concern that needs to be shown towards their health. The idea governing the practice of community nursing is innately based in the fact that given the belief of the community nurse that client and families are in charge of their own lives and will ultimately take the decisions that influence their own health. This would ultimately then mean education is considered a strategic intervention. Community health nurses work on the principle that people need to be active participants in the health care process and that knowledge helps in their empowerment aiding them in making informed decisions (Zotti M, Brown P, Stotts R. 1996). Engineering nursing interventions focus on environmental modification for the purpose of eliminating or managing environmental risk factors that affect healthy living (Judy G. Ozbolt, 1986). One of the best methods of dealing with the problem at hand at present would be to educate and help the girl understand about the negatives of the advertisements that promote alcohol and smoking on television and negate the “cool” image it has in the pop culture. One of the best methods for this would be to ensure that the client is able to see the harm that is wreaked by the substance abuse to her personal life. This would mean that first and foremost, Lauren would have to accept in front of her parents that there are still issues of substance abuse that she has to deal with. These issues are never going to just go away or vanish, but would have to be dealt with in a firm manner. One of the primary tasks of the community nurse at this juncture would be to try and convince both Lauren and her parents to try and accept family counseling, given the fact that there are obvious issues related to the expectations that the parents had of her and her inability to have fulfilled them. This has left an obvious void in her and her parents’ with them thinking of her as a disappointment due to her abuse issues and her being unable to get over her problems because she thinks that she is a disappointment to her parents. Here the educative function of the community nurse’s task would be to try and ensure that there is an acceptance within the variables involved in the problem of the fact that there is indeed a problem that needs to be dealt with. Enforcement nursing interventions are actions that impose regulatory controls and are designed to prevent disease and promote health, and protect society from harmful substances and conditions. Enforcement actions encourage the passage of regulations, and legislations. The idea here is the promotion of the value of “public good”. The second aspect of the task here would be to try and figure out a career path for Lauren in light of the fact that very often relief from abuse is connected with professional and personal achievement. Also in light of the fact that Lauren is in fact now a single mother, there is the issue of the child to be dealt with, in a manner of Lauren being able to support herself and her child. In this context, the role of the nurse would be to aid Lauren in terms of a choice of career by way of providing help from the support of the community itself. Community college, vocational training and part time work would be a good starting point in this case. Also for dealing with the issues of abuse and trauma, there is a need for Lauren to first and foremost deal with her depression, through regular counseling sessions. This could start with the nurse itself and then advance to taking help or being part of a self help group. The role of the nurse here would be to help Lauren accept and to talk about the problems that characterize her issues at present. Administration of opioids dealing with abuse could also be an option. In conclusion, therefore one could reiterate the fact that in the modern day and age with the increasing of complexities that characterize society as a whole, there is a need for a growing participatory and more aggressive role to be played by the community nurse in aiding people such as Lauren, accept and deal with the problems of their lives, in the holistic and not just the medical capacity. This paper also enumerates the several aspects of mental illnesses vis-à-vis their relevance to what is ‘seen’ or actually remains ‘unseen’ in terms of prognosis of the disease. The seen aspect is the symptomatic one and the unseen aspect is the one that lurks beneath what the patient actually describes. This refers to underlying tensions – mostly stress-induced -- that are present in a patient. This is why, as the paper details, such patients need extra and wholistic care rather than just medication-based. References: Brown, C. and Donohue, M. V., (2003). 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