What is the Role:
It is a pattern of behavior structured around specific rights and duties that are associated with particular status within a group.
There are different types of roles.
1) An Achieved Role: an individual chooses or earns through his/ her own efforts and actions such as the role of nurse.
2) An Ascribed Role: acquired by an individual automatically at birth or on the attainment of certain age such as sexual role
In community health settings following roles are incorporated into nursing practice.
Roles of Community Health Nurse
1. ADVISER
Since community health nurses work with the families in the community, they naturally develop a good interpersonal relationship with the people of a particular community. However, individuals and families are looking towards the nurse as an adviser mainly in practical and emergency matters which relates to health acceptance of advices from the community health nurses are well documented.
2. ADVOCATE
Based on clients’ rights: Every patient or client has the right to receive just, equal, and humane treatment.
Current health care system offers de-personalized and fragmented services. Many clients who are poor and disadvantaged are frustrated and the nurse becomes an advocate for clients pleading their cause and acting on their behalf.
CHN help clients gain more independence and self-determination and make the system more responsive and relevant to the needs of clients
3. CLINICIAN/ CARE PROVIDER
The nurse ensures that health services are not only provided to individuals and families but also provided to groups and populations. The clinician role has emphasis on holism, health promotion and skill expansion. Focus on promoting wellness is a major clinician’s role. Nursing service includes seeking out clients at risk for poor health to offer preventive and health promoting services rather than waiting for them to come for help after problems arise.
4. COLLABORATOR
CHN works collaboratively with patients and also with members of the health team(nurses, physicians, health educators, Social workers, Physical therapists, Nutritionists, Psychologists etc) in assessing, planning, implementing, and evaluating interventions. The patient may be an individual, a family or a group of persons in the community.
5. CONSULTANT
Nurses are consulted by the authorities in planning a programme as there is a source of information in relation to particular programme which is to be organized, for example, in immunization program nurse shares nursing knowledge and expertise.
6. CONTROLLER AND EVALUATOR
CHN Monitors the plan and ensures that it stays on course. Sometimes plans do not proceed as intended and need to be adjusted. Monitoring, comparing and adjusting are activities of controlling.
Comparing performance and outcomes against set goals and standards are activities of Evaluator role.
7. HEALTH EDUCATOR/ HEALTH TEACHER
It is one of the major functions of the CHN in which community clients are NOT usually acutely ill and can absorb and act on health information. A wider audience can be reached leading to a community-wide impact.
Self-care concepts, techniques for preventing illness, and health promotion strategies are emphasized throughout the health teaching process.
8. GROUP LEADER
Community health nurse use the group process to provide targeted preventive services and to manage caseload responsibilities. Through group process, community health nurses are able to assist small client or community groups to learn new knowledge and skills, to support group members during stressful times, or to problem solve around issues important to the community.
9. HEALTH PLANNER
Community health nurses use the health planning process to develop, implement, and evaluate health services for populations at risk. This process is used in provide community-wide or population specific health services.
10. LEADER
Community health nurse directs, influences, or persuades others to effect change that will positively affect people's health. Acting as a change agent and influencing health planning at the local, state and national levels are elements of the role of the leader.
11. MANAGER ROLE
Nurse directs and administers care to meet goals by;
• Assessing client needs,
• Planning and organizing to meet those needs,
• Directing and leading to achieve results
• Controlling & evaluating progress to make sure that the results are acheived
Nurse oversees client care as a;
• Case manager
• Supervising ancillary staff
• Managing caseloads
• Running clinics
• Conducting community health needs assessment projects
12. ORGANIZER
Designing a structure for people and tasks to function to reach the desired objectives. It includes assignments and scheduling. Which includes:
• Deciding what tasks to be done
• Who will do them
• How to group the tasks
• Who reports to whom
• Where decisions will be made (Robbins 1997)
Questions to be addressed by the organizer
• Is the clinic, program providing the needed services?
• Are the clients satisfied?
• Are the services cost-effective?
13. PLANNER
CHN Sets the goals for the organization. Sets the direction. Determines the means (strategies) to achieve them. It includes defining goals and objectives. It may be strategic ( long-term broader goals)
14. RESEARCHER
In this role nurse systematically investigate, collect, and analyze data for solving problems and improving community health practice.
This role is at several levels:
• Agency and organizational studies for job satisfaction among public health nurses
• Some CHN participate in more collaborative research with other health professionals
15. GOOD OBSERVER:
CHN is expected to be alert to any deviation from expected behavior with respect to illness, growth and development, response to drugs and general well-being of an individual, family and community. As an observer, the nurse is supposed to be aware of her surroundings and reports unusual occurrence of disease symptoms, environmental threats, and unusual stresses in the community, which may cause threat to the health of community.
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