Community Nursing


Q1. Thefield of health care is an ever-evolving one. These changes affectall aspects of health care, ranging from the nature and scope ofdiseases to the technology used in providing medical services topatients. As a result, the role of health care providers also keepschanging at the same pace (Huston, 2014). The duties of a schoolnurse are significantly affected by these changes. This situationraises the question of how the changes in the health care sectoraffect the roles of the school nurse. The locality in which a schoolnurse offers their service has a direct relation to their servicedelivery. This section seeks to explore this relationship and pointout the possible problems it can create for the nurse.

Thelocale in which a school nurse works creates unique problems andcircumstances that vary from locale to locale. For example, thelocale directly affects how much the nurse earns for their services.The more affluent the locale is, the more the nurses earn for theservices they offer. Being that school nurses mostly work in schoolsand other learning institutions, most of their work revolves aroundattending to children and adolescents (Nies &amp McEwen, 2015).Consequently, the problems that they encounter in the course of thework depend on the health care needs of the children and adolescentsin their locale.

Theenvironments in which school nurses operate creates unique healthcare needs depending on the children and adolescents they treat. AsThornbory (2009) asserts, espite most health problems in childrenbeing universal, they vary in every local level. Over the last tenyears, the number of children who need specialized medical acre hasbeen on the rise. In schools, the duty of addressing their healthproblems falls squarely on the school nurses. Asthma, diabetes andobesity and other chronic conditions are common in children acrossthe globe. However, the prevalence of such conditions depends on thelocale. For example, a locale with wealthy families is likely to havechildren with obesity that a locale in a slum dwelling.

Safetyand security create a suitable environment for people to conducttheir daily businesses. This applies even to school nurses. As Huston(2014) agrees, in zones that are prone to violence, providing healthcare becomes a challenge. The nurses cannot perform optimally if theyhave to be constantly on the lookout for the sake of their protectionand that of the patients. In violent locale, the problem is two way.On top of making it difficult for nurses to perform theirprofessional duties, crime and violence also create unique healthcare needs. Gunshot wounds, knife stabs and other forms of injuriesare some of the situations that nurses have to address in the courseof their work. This happens to be one the greatest problems in myarea.

Q2. TheHealthy People program is a program geared towards promoting nationalhealth and preventing diseases in a bid to enhance the universalhealth of people in the United States. The program comprises of acollection of goals and objectives that are spaced in ten yearperiods. Currently, Healthy People 2020 is the phase of the programunder implementation with the vision of crafting “a society inwhich all people live long, healthy lives.” This section of thepaper seeks to explore HIV as one of the areas relating to communityhealth nursing under Healthy People 2020.

HIVis one of the objectives of the Healthy People 2020 program. Eventoday, HIV is a crisis in the healthcare sector in the United Statesthat needs addressing. Going by the figures provided by thisobjective, about 1.1 million Americans live with the disease withabout 56,000 new infections annually. Gender disparities are eminentin this setup. Most of the new infections occur in men, mostly in gayand bisexual men who take up more than50% of new HIV infections.Apart from sex and sexual orientation, the race also createsdifferences as far as HIV infections are concerned. The race alsocreates disparities. African American led the lot with 45% of theinfections while Hispanics record the lowest infections, taking upjust 17%.

TheHealthy People 2020 program has several objectives geared towardsaddressing the HIV crisis in the United States. One of theseobjectives is to reduce the number of new HIV infections that occurin adolescents and adults. The baseline for this objective is the2006 figure of HIV infections among people aged 13 and over. The datafor this objective is provided by the National HIV SurveillanceSystem. In this year, 48,600 of people in this age bracket wereinfected with the disease. With this background in mind, thisobjective seeks to lower this figure to 36,450 people by the year2020. In its implementation, the objective will be in line with othernational programs, laws, policies and regulations regarding the sameissue.

Thetask of a community health nurse is paramount in the achievement ofthis objective. The reason is that HIV infections occur in thecommunity and as a result, the community health nurse is in touchwith the situation than other health care providers (Nies &ampMcEwen, 2015). The community nurse can perform several duties in linewith the objective of reducing HIV infections. These roles mainlyrevolve around prevention. Some of the roles that community nursescan perform include increasing the community’s access to HIVprevention techniques and providing care to those who are alreadyinfected. Other interventions can include the formation ofcommunity-based awareness and self-help groups to create awareness ofHIV, its spread and how to curb it.


Huston,C. J. (2014). Professionalissues in nursing: Challenges &amp opportunities.

Nies,M.A., &amp McEwen, M. (2015). Community/public health nursing:Promotion of health of populations (6th Ed.). St. Louis, MO:Saunders/Elsevier

Thornbory,G. (2009). Publichealth nursing: A textbook for health visitors, school nurses andoccupational health nurses.Chichester, West Sussex: Wiley-Blackwell.

Community Nursing



Question1: Caring for vulnerable populations

Avulnerable population includes communities that at a higher risk ofsuffering from different diseases, poor health status, and facedifficulties in accessing health care services. Black American is apopulation that fits well with these characteristics of a vulnerablecommunity. Most of the black Americans had their roots in central andWest African and came to America during the slave trade. They make upabout a total of 13 % of the total population of the U.S., whichmakes African American to be ranked as the third largest minoritycommunity (U.S. Census Bureau, 2015). The majority of the blackAmericans have a poor social-economic status, which can be attributedto historical injustices that they experienced during the slavetrade. The white Americans accumulated a lot of wealth at the expenseof the sufferings of the enslaved black Americans. This resulted in asocial and economic gap that has never been sealed to-date. Thisimplies that the majority of the black Americans cannot access somecrucial services (such as healthcare) in the same way as their whitecounterparts can do, which makes the black Americans a vulnerablecommunity.

Riskfactors affecting the health outcomes of black American communities

Healthoutcome among the African American community is likely to be affectedby several factors, including cultural beliefs and practices andsocioeconomic challenges. First, black Americans are poor comparedto other communities, which denies them the opportunity to accessquality care. According to U.S. Department of Health and HumanServices (2001) about 22 % of black Americans live below the povertyline, which is associated with social challenges (such as stress)that in turn affect health outcomes in a negative way. Secondly, someof the cultural beliefs help by the majority of the black Americansaffects their health outcome in a negative or a negative way. Forexample, black Americans’ culture centers on the significance ofreligion and family, which means that the key health decisions areafter consultations, which may lead to quality decisions, while somemay believe in supernatural powers for healing and seek for formalmedical assistance when a disease has progressed to chronic stages(Kaiser, 2015). Therefore, negative cultural beliefs andsocioeconomic challenges are unique risk factors for the blackAmerican community.

Prioritiesfor a community nurse

Themajor priorities for community nurses working with the community ofblack Americans include cultural sensitivity and the affordability ofhealth care services. When dealing with the black Americans, acommunity nurse should understand some cultural beliefs thatinfluence the interaction between them and patients from thiscommunity. For example, medical history may be necessary for thenurse to offer quality services, but the black Americans feel that aninquiry into their medical history is an intrusion into their privatelife (Kaiser, 2015). Therefore, a community nurse should beculturally sensitive in order to avoid hurting clients. In addition,the nurse should be able to help the black Americans accessaffordable health care options. This is because economic hardship isamong the key factors that prevent black Americans from accessing theformal health care system.

Question2: Assuring resource for the vulnerable

TheMaryland Department of Health offers a wide range of pregnancy careservices. The most important programs offered by the department areprevention of chronic conditions and support for health behaviors(Department of Health, 2015). Under this program, women are offeredwith preconception as well as inter-conception health education. Thisprogram can be beneficial to Mary, who is concerned about healthyeating for the sake of her child, since education on proper nutritionfor pregnant women is part of the services offered by the MarylandDepartment of health.

Thewelfare office in Maryland help pregnant women with nutritionalservices, under different programs such as the “SupplementalNutrition Assistance Program”, SNAP. Under the SNAP program,pregnant women from poor backgrounds are provided with nutritionalfoods depending on their needs (People’s Law Library, 2015).Although the program also targets other groups that are in the needof food assistance, its focus on nutritional supplementation makes itmore appropriate for needy pregnant women, like Mary.

Selectedagency: Forestville Pregnancy Center

ForestvillePregnancy Center is an agency that offers free services to pregnantwomen from poor backgrounds. FPC mainly offers pregnancy testing aswell as counseling services. Most importantly, FPC serves its clientsby creating a compassionate and a non-judgmental environment forwomen who feel uncertain about their pregnancy Forestville PregnancyCenter (2015). This makes it more appropriate for Mary, who feelsuncertain about her current pregnancy and the future of her baby. Theagency is located in Marlow Heights, Maryland, which makes it quiteaccessible for Mary and other pregnant women residing in Maryland.However, accessibility may not be guaranteed given that FPC does nothave branches. In terms of acceptability, FPC target women who frompoor backgrounds, which means that Mary qualifies to get freeservices from the agency. Services offered by the agency can beconsidered to be affordable to Mary since they are offered free ofcharge as long as it has been confirmed that the woman comes from apoor background. FPC welcomes all needy and pregnant women, whichmeans that its services are available for Mary.


Departmentof Health (2015). Women’sHealth.Baltimore, MD: Maryland Department of Health.

ForestvillePregnancy Center (2015). Empower women for life. FPC.Retrieved November 11, 2015, from

Kaiser,H. (2015). How culture influences health beliefs. Med Information.Retrieved November 11, 2015, from

People’sLaw Library (2015). Supplemental Nutrition Assistance Program. PLL.Retrieved November 11, 2015, from

U.S.Census Bureau (2015). 2010Census Shows Black Population has Highest Concentration in the SouthPeople Who Reported as Both Black and White More than Doubled.Washington, DC: U.S. Census Bureau.

U.S.Department of Health and Human Services (2001). Mental Health:Culture, Race, and Ethnicity-a Supplement to Mental Health: A Reportof the Surgeon General. Rockville, MD: U.S. Department of Healthand Human Services, Substance Abuse and Mental Health ServicesAdministration, Center for Mental Health.