01.05 Day in the Life of a Community Health Nurse

Today we’re going to be talking about what a day in the life of a Community Health Nurse looks like.

First, let’s talk about the difference between community health and public health. These are used interchangeably, and depending on where you are, that may be okay. But the community nurses I know, myself included, are very protective of the community health nurse title. Both disciplines are focused on the same things: improving and protecting health, but they have different means of getting there. So public health is actually an umbrella term that includes community health. It’s mostly based on population health. Public health focuses on treatment and prevention, like flu shots, for example. On the flip side, community health is based on specific subsets of people and their role in their own health. Definitely more person-centered, for lack of a better word. Community health nurses focus more on maintaining and protecting an individual’s health than we do improve it. We are working with what we have. So what do I do as a community health nurse? I work for a State agency where the population is aging adults and the physically disabled. So I’m seeing clients in the community 18 years or older with cognitive and/or physical deficits. I don’t know many people that want to move into a nursing home when they get old or when they’re physically unable to do the things they used to do. Most people want to live out their lives in the least restrictive environments possible. Also known as HOME! So, our goal and our job is to promote independence and support these individuals by helping manage care in their homes so they can live the rest of their best lives the way they want to. By doing this we are helping maintain some quality of life. The services we offer are designed to provide support not only for the elderly and the physically disabled but also for caregivers and families. Sometimes what we’re providing overlaps for the benefit of the caregiver and the client.  Caregivers and families are just as important as our clients because caring for a loved one is super hard and we recognize that sometimes they can use some guidance or just a simple break! Sometimes our clients and families need what we aren’t able to provide within my agency, and sometimes they don’t really want what we have to offer. As much as we want to play superheroes, we realize there are limitations. Regardless of those limitations, we never leave any home without providing education. Nurses are always in the business of educating and it doesn’t stop in community health. We provide information about preventative care (something as simple as the importance of seeing your primary care provider regularly), interventions (like safeguarding the home for those high fall risk clients) and support from any outside agencies or support groups, things of that nature. These are just examples because we have so many resources, but just to give you some ideas on how we roll. In addition to providing supports, resources, and education, we also collaborate with other agencies when we have to. Mental health resources, emergency personnel, hospitals, home care programs, nutrition programs, adult protective services. We talk to them all. Sometimes our referrals come from these programs because they recognize a need, and sometimes we call these referrals in because we recognize it’s bigger than us and as I said, our goal is to protect and maintain. These assessments are skill on their own guys! But this is a list of what we are looking for when we go into someone’s home. At the end of it all, we are making recommendations for the type of support our clients can use based on what we find in these assessments. Let’s zero in specifically on Activities of Daily Living and Instrumental Activities of Daily Living here. ADLs are those things we do daily that we need in some form to survive like bathing, dressing, eating, or just making it from one place in the house to another safely. ADLs are not as basic as ADLs but they are necessary. These are things like housekeeping, meal preps, med management, finances, shopping. I’m focusing on these because for my agency, deficits in any of these determine eligibility for our services.  Once we identify the deficits here, we recommend in-home services to assist where we can. What kind of skills do you need to be a Community Health Nurse? We go into people’s homes and ask a lot of questions so it’s important that they feel comfortable enough to give us what we need so we can return the favor. So you need good communication skills. This is a skill needed all throughout nursing, it doesn’t just stop here. Also, no two days are the same so having that understanding and knowing your routine may not always work or stay the same is a good understanding to have. I know you’ve been beaten in the head about cultural competence but I promise it comes in handy when you’re in someone else’s home. Remember we are building trust and rapport. You can avoid a huge headache by having some understanding of other’s values. Lastly, although there is support when you need it, this is a very autonomous career path so be organized and know how to problem solve and make decisions! We love you guys! Go out and be your best self today! And as always, Happy Nursing!