1. Select three populations or communities for whom you have some concern and describe three preventative actions (one primary, one secondary, and one tertiary) that might be taken to move each of your selected populations closer to optimal wellness. (Refer to ‘Levels of Prevention Pyramid, p.19)
The three populations I have chosen are a) young (18-35), chemically dependent, HIV positive individuals, b) middle aged (40-55) women who are taking atypical antipsychotics and are therefore at risk for metabolic syndrome, and c) elderly men (65+) with depression who are at high risk for completed suicide.
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2. Select a current health problem and identify corresponding activities/implementation strategy in which you, as a community health nurse, would engage for your selected population or community.
My selected community is a residential program for mentally disabled adults, and a potential health problem would be the need for clients to communicate what they are feeling. For example, a non- or low-verbal person would need help expressing the location and nature of pain. Using a diagram of five different facial expressions (photos or simple drawings), I would teach them to point to one of the faces to indicate how they are feeling. Similarly, intensity of pain could be indicated by progressively larger circles. Location of pain could be taught using gestures. A picture of someone vomiting would indicate nausea, and other pictures could be used to suggest other physical feelings. The same could be done with emotions such as happy, sad, scared, angry, etc.
Critical Thinking Exercises (Chapter 3)
1. Discuss ways for a community health nurse to make service holistic and focused on wellness with
a. Preschool-age children in a day care setting.
One of the most crucial aspects of young children’s wellness is their ability to express what they feel in their bodies. Adults have a hard time determining what is wrong when the child is too young to use words or even gestures. Therefore, as early as possible, I would teach children the words to describe parts of their bodies (there are some excellent songs for this) and how to express pain and other feelings (similar to the question above). I would make sure they learned words to express the kind of pain and its intensity. I would encourage them to tell an adult if there is a feeling that is bothering them.
b. A group of chemically dependent adolescents.
Adolescents have an intense need to belong, and some of them get involved with drugs and alcohol because they are trying to fit in. They need a group to belong to for a healthy reason, rather than an unhealthy reason. Although support groups specifically for chemical dependency are good, I would suggest groups should also be formed based on similar interests or backgrounds. For example, there could be a group of boys and girls who enjoy country music.
c. A group of elders living in a senior high rise building.
Wellness in a senior high rise building would have to include measures for the safety of residents in the event of an emergency. As a community health nurse, I want to ensure that all residents know where to go and how to get there if there is a fire, a tornado warning, or other emergency. Residents who needed help to get to safe areas should have someone specifically assigned to them. Those with hearing impairments would need equipment such as flashing lights to alert them to emergencies.
2. Describe a hypothetical or real situation in which you, as a community health nurse, would combine the roles of leader, collaborator, and researcher (investigator). Discuss how each of these roles might be played.
As a community health nurse specializing in maternal and child health, I might manage a well-baby clinic (leader role), work with managers of prenatal and postnatal care clinics as well as a sick-baby clinic to ensure all populations in the community were being served with excellence (collaborator role), and I might keep records of vaccinations in my clinic that, combined with information from other clinics and private physicians, would provide essential information to the county and state health departments, and even to the national level (researcher role). I would be able to carry out these different roles simultaneously through careful planning, critical thinking, and organization.
