Sample Summaries of Class and Group Discussions Posted by the Instructor at the Course Site at the End of One of the Major Discussion Weeks Summary 1 Differences: Explain how community and population-focused care differs from private practice in its impact on individual, family, community, and global population-focused care. Many examples were given explaining how private practice differs from population-focused care, and illustrations were given by citing different diseases and scenarios. The best illustration was given by _______, from Group 7, who wrote the following: Example: In my home health experiences I may have seen something like the following: A 65 year-old retired farmer, 2 p/d smoker, is diagnosed with inoperable lung cancer. Chemo and radiation therapies are prescribed. Patient has Medicare but no supplemental insurance. The rural community the farmer lives in has a population of 1000 people, 40% are under 18 years of age. Individual Care: Education and assistance in smoking cessation. Nutritional counseling concerning what to eat in order to maintain strength after going through therapies. Grief counseling and support for dealing with diagnosis. Family Care: Grief counseling and support to help family cope with diagnosis of cancer in family patriarch. Help family members understand the diagnosis. Make referrals to Medicaid if needed to seek financial assistance for prescription medications and other health care needs. Community Care: Educational programs taken to local schools about health hazards of smoking and any tobacco products, including snuff and cigars. Puppet show (anti-smoking) at Public Library coordinated with children's librarian. Health Booth at local rodeo promoting good lung health. Screening for pulmonary function and chest x-rays available through mobile pulmonary lab. Global: American Cancer Society has advertisements on TB, radio, newspapers advising of hazards of smoking and tobacco. Promotion of exercise, adequate nutrition, and a healthy lifestyle through positive image advertisements. National Day to give up smoking recognized and promoted. Physical barriers might be the distance the patient has to travel to receive treatment. Financial barriers would include not having any supplemental insurance outside of Medicare, and a limited income which is not sufficient to handle the extra expenses associated with this diagnosis. Social and cultural barriers might include the very private and independent, "don't go to the Dr. unless I have to" idea that may bring denial into the picture and make compliance with care regime an issue. Environmental barriers might include a spouse who is a 2 p/d smoker as well. Educational barriers might include a closed mind attitude toward the negative effects of smoking. Most of the groups stated that public health care is more holistic than private care. It includes the family and community and also an assessment is performed to determine whether the disease affects the whole community. Summary 2 History: What do you think is the most important historical event affecting the development of public health care services? Most of the groups concurred that the influence Florence Nightingale and Lillian Wald had definitely affect the development of public health care services and public health nursing. Other historical events mentioned were war and poverty, which brought about improvements in public health care. The Industrial Revolution impacted the improvement of health care services because of so many people, who migrated to the cities were impoverished and lived in crowded, dirty homes. They had no access to health care, lived with inadequate nutrition, sewage and water standards, etc. Other historical events that were mentioned in less frequency are as follows: The governmental social programs, such as, Medicare, Medicaid, WIC, Healthy Start, insurances, and Public Health Services; the creation of the public boards of health stemming from the Chadwick and Shattack Reports; mass immunizations and development of vaccines; Joseph Lister, who introduced hand washing, the theory of antisepsis, and sterilization of
instruments; Louis Pasteur for pasteurization; St. Vincent de Paul for founding the Sisters of Charity in France (home health services); and John Snow for discovering cholera. Each historical event is very significant and impacted how health care services are delivered today. Summary 3 Practice: Explain how you incorporate any of the 10 public health services in your professional practice. Most of the groups agreed that the nursing process is used whether nurses are giving care to an individual, family, or community. The process is still the same. However, the nursing processes that are used most frequently whether practicing in an acute care setting or community/public health care setting are the assessment of lifestyles and how it impacts the health of the individual, family, or community; informing and educating individuals, families, and communities; enforcing health regulations; linking people to services; maintaining competency through continuing education; and evaluating the service or education to determine its effectiveness. Summary 4 Models: Give examples from your own experiences to illustrate why you think each model (Construct for Public Health Nursing Model and ASTDN Public Health Nursing Practice Model) works. Several of the groups thought that the Construct PHN Model was difficult to understand but could provide examples. The most favorite model seemed to be the ASTDN, because it was simple and applicable even to nurses who work in non-public health care settings. They felt this model could be applied to all nurses and could use the nursing process, but on a large scale. They could apply the three core functions of public health nurses (assessment, assurance, and policy development) in their practice, especially the hospital where it is considered a community. Those who participated in the group discussion did an excellent job of answering the questions and applying it to their nursing practice. Nice job! For those who did not participate, please do so, for it will affect your grade each week. Many thanks for your wonderful participation. Dr. Betta