Identify and discuss the required skills and competencies of a RN in the communi
ID: 124831 • Letter: I
Question
Identify and discuss the required skills and competencies of a RN in the community setting. Do these differ from those required in an acute care setting? Explain and support your answer. The RN working in the community setting faces a number of challenges which include but are not limited to: infection control practices, patient/family privacy, collaboration with health team at a distance, families’ financial concerns, and the RN’s personal safety. Choose one (1) of the five (5) listed challenges and explain actions the RN can do to meet these needs.
Explanation / Answer
Identify and discuss the required skills and competencies of a RN in the community setting. Do these differ from those required in an acute care setting? Explain and support your answer.
The roles and responsibilities of a Community Health Nurse (CHN) is totally different from that a nurse who works in an acute setting. For example, an emergency nurse must triage patients, manage and treat a patient very quickly to restore his normal functioning. However, a CHN’s role is totally different. She incorporates her learning for health promotion, disease prevention, medical treatment, rehabilitation and evaluation of healthcare system, etc.
The roles and functions of a community health nurse:
A CHN may provide direct patient care, educate the public regarding health promotion, disease prevention or health restoration, implement health improvement measures and may even perform research activities in community health. She may even interact and coordinate with other health workers, organizations, etc. to make a healthy society.
Some of the examples of a CHN’s work are:
Skills and competencies of a CHN:
An effective CHN performs these major roles:
Clinician:
The CHN provides care through the range of wellness-illness continuum; here, health promotion and illness prevention are the crucial roles. She possesses skills in assessing a large group of people within a community within a short period of time, screens for a specific disease (e.g. the presence of vitamin deficiency in a community). Therefore, she must possess enough skills in providing physical care, health education, counselling, listening and communication, etc.
Nurse educator:
A nurse educator educates the community about health and health-related problems. She also trains and educates licensed practical nurses, registered nurses with entry to practice professions. Besides this, a well-experienced educator also teaches advanced practice nurses, nurse administrators, nurse researchers, etc. by this way, she ensures that theory and practice are correlated.
Advocate:
A good CHN also acts as an advocate and tell the population about when to seek medical service, where the service is available, what service is available and how to obtain it. She also influences the people to get the service as they want. Similarly, she also influences changes in the health systems so that they meet the health needs of the population.
Apart from this, community nurses also serve the role of a manager, collaborator, a good leader and a researcher.
Challenges encountered by community health nurses:
Nowadays, community nurses face a number of challenges due to various reasons. For example, there are increasing prevalence of multiple comorbidities within a community requiring long-term care and support, however, due to financial constraints of patients and other reasons, they are discharge home quicker and sicker and as a result, community nurses have to take care of them. Moreover, the difference in the cultural patterns within a community also make difficulty for nurses to identify illness and educate the public. Here, we select a specific challenge say collaboration with health team at a distance and discuss this issue.
Coordinating with other healthcare workers:
Community health nurses must often coordinate with other healthcare team members like doctors, other nurses, etc. For example, if a CHN identifies a person in a community with tuberculosis or diabetes mellitus then she must be the patient sent to a primary health care or a community hospital to get appropriate treatment by a physician. The CHN must also communicate the doctor with the assessments noted, the findings and all the health-related information. However, the geographical distance, the accessibility of healthcare systems, etc. might interfere with the communication process and the coordination of care might be disturbed.
Measures to combat the challenge – Making effective coordination between health workers:
Some of the measures to enhance coordination of care are:
For example, if a patient with diabetes mellitus is discharged from a hospital and the latest lab report (blood sugar value) is pending, it might be communicated to the CHN through email. Once arrived, she then calls the hospital, obtain the report through email and later communicate the provider with the results through a phone call to ensure continuity of care.