Community Health Nursing (N470/N471)

NURS 431- Transition to Professional Nursing Practice

Purpose of Assignment
The purpose of this assignment is to address the students attainment of all eight behaviors and/or
competencies that are specific outcomes of the program including: critical thinking, nursing
practice, communication, teaching, research, leadership, professionalism, and culture.

Student Approach to Assignment

This paper and accompanying presentation summarizes the progression that I have made from
my sophomore to senior year. Specific examples provide insight into exactly how I grew in the
eight core curriculum objectives. I am able to highlight my personal progress as I move towards
becoming a registered nurse. This paper is an excellent reflection of my experiences in nursing
school. The approach to the Community Health Nursing Presentation was to showcase my
involvement with various community partnerships, which includes to utilize the Health Planning
Model to improve aggregate health and to apply the nursing process to the larger aggregate
within a systems framework.

Reason for Inclusion of the Assignment in the Portfolio

This assignment is included in the portfolio because it showcases my progress in the eight core
curriculum behaviors of: critical thinking, nursing practice, communication, teaching, research,
leadership, professionalism, and culture. It is a required component in my portfolio that
highlights how I fulfilled a number of the end program outcomes.

Nursing Practice
Demonstrates an awareness of complementary modalities and their usefulness in
promoting health

Example: See slide 14-15 (Senior year)

Non-12 Step Program / Evidence based treatment in conjunction with holistic
practices. / Treats the whole patient / Does not believe that alcohol addiction is a
disease / There is an underlying issue to the addiction
Alternative Addiction Treatment / Promoting lasting physical, mental, emotional,
and spiritual balance / Life Skills Development / Yoga Classes / Mindfulness &
Mediation / Nutrition / Massage Therapy / EMDR
Example: See page 16 paragraph 2 (Senior year)
Educational needs provided by the feedback in Appendix B, show the aggregate
wants to learn more about health issues. Blood pressure management, stroke
prevention, heart attack prevention, and mental health are all of the areas that they
 would like to learn more about. The workshop can include how to measure blood
pressure and appropriate ranges, signs and symptoms of a stroke, signs and
symptoms of a heart attack, and lifestyle changes to improve physical and mental
health.

Communication
Accesses and utilizes data and information from a wide range of sources to
enhance patient and professional communication

Example: See page 14 paragraph 2 (Senior year)

The nurses role for this aggregate is to continuously formulate goals specific to
the population and revise these after evaluation of progress. One of the objectives
that would be very important for the aggregate is to verbalize understanding of
disease process and the prognosis, therapeutic needs, and potential complications.
This can be measured by asking the individuals directly or in conversation each of
these factors because this will be different for every person. Ideally, the aggregate
would verbalize understanding of each of these factors before entering into phase
two of the Drug Court program to allow for more focused teaching in later
stages.

Expresses oneself and communicates effectively with diverse groups and disciplines using
a variety of media in a variety of contexts.
Example: See page 16 paragraph 2 (Senior year)
Educational needs provided by the feedback in Appendix B, show the aggregate
wants to learn more about health issues. Blood pressure management, stroke
prevention, heart attack prevention, and mental health are all of the areas that they
would like to learn more about. The workshop can include how to measure blood
pressure and appropriate ranges, signs and symptoms of a stroke, signs and
symptoms of a heart attack, and lifestyle changes to improve physical and mental
health.

Research
Applies research-based knowledge from nursing as the basis for culturally sensitive
practice.
Example: See page 13 paragraph 3 (Senior year)
While doing research on the trends of alcohol and drug abuse, a study was found
based on the premise of alcohol effects through the decades on a specific
 population. This study followed a group of approximately 15,000 people with
follow ups 30 years after their selection into the study. To compare the results, a
control group was naturally created by selecting and studying trends in same-sex
monozygotic twins with no overt comorbidities, in which one twin self-reported
heavy drinking status. Measurements for drinking status included the number of
heavy drinking occasions and alcohol-induced blackouts. This was viewed against
their twins who reported low to no alcohol consumption and gave a controlled
comparison. Their findings suggested that more incidences of heavy drinking
occasions and alcohol-induced blackouts related to a higher mortality rate that
could not be explained through genetic or familial means. This shows that alcohol
cessation therapy is truly a need, as alcohol consumption increases mortality
significantly (Sipil, Rose, & Kaprio, 2016).

Leadership
Initiates community partnerships to establish health promotion goals and
implements strategies to meet those goals

Example: See page 16 paragraph 3 (Senior year)

Through consistent meetings with and support of the aggregate, the group was
able to assess and begin to plan how to improve the aggregates overall health and
well-being. Education will likely be the center of many of the interventions that
will be provided since knowledge deficit is identified as the priority diagnosis for
the aggregate. Mental health issues and coping skills were identified as needs for
more education by the aggregate (Appendix B), so the group will continue
participating in activities to gain trust and rapport in order for the aggregate to be
receptive to teaching on emotional topics. Overall, the goal for this aggregate is to
develop and carry-out new healthy habits after educating about different aspects
of health.

Articulates the values of the profession and the role of the nurse as member of the
interdisciplinary health care team

Example: See slide 21 (Senior year)

Nurses Role: Active considerations in the care for a patient with a traumatic
injury related to alcohol misuse would include: / Assess all persons seen for
alcohol abuse and alcohol abuse in the household-Family dynamics related to
high prevalence and the fact that more than 10% of children live with a parent
who misuses alcohol & alcohol is the most commonly abused drug / Assessment
of patients at high risk to substance abuse / Provide education / Providing
resources in the community for support to overcome addiction
Example: See page 3 paragraph 2 (Senior year)
 Drug Court participants are required to take part in certain events such as the
annual scavenger hunt and the Halloween costume party. Attendance to these
events by the student nurses further solidified the sense of partnership and the
therapeutic relationship established from the beginning. All means of gaining
entry to the aggregate were done with the purpose of establishing rapport in an
effort to develop a therapeutic working relationship.

Culture
Maintains an awareness of global environmental factors that may influence the
delivery of health care services

Example: See slide 4 (Senior year)

According to the World Health Organization (WHO) there is a direct link
between economic wealth and the amount of alcohol consumed (higher wealth =
increased amount of drinking and decreased amount of abstainers) / High-income
countries also have the highest rate of binge drinking
Example: See slide 5 (Senior year)
Lower economic status populations are at the most risk for deaths attributable to
alcohol because they are less likely to be able to avoid consequences / Higher
economic status populations have the luxury of drinking in safer environments as
well as checking themselves in to higher quality treatment facilities with better
health insurance / Approximately 3.3 million deaths, or 5.9% of all global deaths,
are related to alcohol worldwide / Alcohol leads to dependence and is related to
more than 200 diseases encompassing physical and mental conditions
Example: See page 10 paragraph 1 (Senior year)
Current literature consistently indicates a correlation between substance abuse
and lack of education, low income, and unemployment (Notara et al., 2013; Abreu
et al., 2012). There is also correlation between criminal arrest and concurrent
substance abuse (Holmes & Currid, 2013; Vandermause et al., 2012). Campbell-
Heider and Baird wrote, in regard to drug and alcohol abuse, More than 80% of
individuals behind bars have a serious history of abuse and approximately half of
them meet criteria for a clinical diagnosis of dependency (2012). Literature
suggests that if an individual is of low income, lacks education, and/or is
unemployed they are at a predisposition for substance abuse, which, subsequently,
predisposes them to criminal arrest and incarceration.