Community Health Nursing

By: Ekho Lainez

Community health nurses are also known as public health nurses. They may work in many
health care settings such as homes, ambulatory care centers, schools and residential
institutions. Essentially, community health nurses can work anywhere there are people in
need. They are not only care providers they also fulfill the roles of educator, advocate,
collaborator, leader, and researcher.

This class was intended for us to understand the role of the community health nurse. It is
designed to provide you with an exploration of how you can best serve your community to
promote health and prevent illness. It was meant to increase our awareness of professional
nursing ethics and civic responsibility. It provided us with experiences that raised our
conscious awareness of community health issue and how we can advocate for change. We
were required to complete a total of 40 service hours. 23 of those were active service
hours, 10 were reflection, and 8 were composed of forums on Ethics in Nursing, Civic
Responsibility, and Community Nursing. For every event, we were required to keep a
journal of our experience and this book is composed of those journals and a Community
Needs Assessment.

 Orientation

Journal entry 1
05/08/17
2:00-4:00pm
Today was the first day of Community Health class. We gathered in the classroom

after psych and went over everything we needed to do for this class. The woman from iced,

Linda Levin, came to talk to us and get us registered online for service learning. She

explained how we were registering differently than other students who would normally be

doing hours and one location instead of multiple.

We learned that we had to complete 23 community service hours at a facility, 10

reflection hours, 4 forums that were being held on different days and lastly, we needed to

complete 5 case studies online on evolve. They also told us about an opportunity for hours

this coming weekend at school. The event was for immigration and was to help people

apply for citizenship and receive law advice for their immigration questions. I learned

everything that was expected from us by the end of community health class and I can use

this to complete all necessary assignments.

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 Ethics in Health care
Journal entry 2
06/05/17
07:00-9:00am

Today in our Community Health

care class we spoke about Ethics in

health care. Professor Hicks-Johnson

came and spoke to us about the different ethical dilemmas nurses and other

healthcare professionals face on a day to day in the workplace. One of our

classmates mentioned abortions and what to do if your patient is electing to get an

abortion but you personally as her nurse do not believe in abortion. We spoke back

and forth but all agreed than in situations like this, we all have to maintain a

professional neutral attitude.

As nurses we are there to care for the patient, not to judge their choices. We

also discussed how if you as the health care provider feel uncomfortable with a

situation you are in with a patient, and think it will impede your care for them you can

speak with your supervisor. I learned that it is ok to separate yourself from the

situation if you feel unable to separate your own beliefs from caring for this patient. I

can use this in the future when I become a nurse and have to work with people of all

kinds and cultures. I feel more prepared if I am proposed with an ethical dilemma to

make the best decision for myself and my patient.

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 Community Health Lecture
Journal entry 3
06/05/2017
09:00-11:00am
Today in Community health we spoke about community health nursing. Community health

nursing is something I think a lot of people forget about but really plays such a big part in nursing.

Community health nurses provide care in so many settings such as, community health clinics,

churches, homeless shelter, and schools. Specialized nurses help lower income families obtain

high quality health services and provide health-related resources to the entire community. They

can help patients with referral to make sure they have access to proper help and resources offered

to them.

Some services often provided by public/community health nurses include prenatal care,

welfare services, disability, domestic violence and abuse consulting services, child development

consulting services, and health education services. Education is very big in community health

nursing, teaching low income patients about general health and wellness, such as finding

affordable health care, choosing healthy and low-cost foods, stress management, safety, and

fitness. Knowing about the role of the community health nurse and how to access the resources

available to the community you can assist your patients in gaining access to those resources.

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 Breast Cancer Forum
Journal entry 4
06/19/2017
8:00-10:00am
Today we had a guest speaker at school. She came to talk to us about Breast

Cancer awareness. I found it a very informative forum because she gave us a lot of facts

and statistics that I never knew. The youngest girl to ever get breast cancer was 8 years

old. That was very eye opening for all of us because I feel like the common stigma with

breast cancer is that it happens to older people. To hear that you can really get it at any

age caught all of our attentions. Breast cancer is actually the leading cause of death related

to cancer in Hispanic women. Being a Hispanic woman, I feel the need to be more

adamant about doing my breast self-exams. She also talked about how being aware of

your own risks.

She suggested talking to both sides of your family to learn about family health

history. Also, to talk with your doctor about your risk factors such as gender, age, genetics,

family history, personal health history, bone density, etc. We were given a pamphlet that

showed the Breast self-awareness messages 1. Know your risk; 2. Get screened; 3.

Know what is normal for you; 4. Make healthy lifestyle choices. Lastly, we spoke about

mammography and she passed out what looked like a tribal necklace because it was a

bunch of different sized beads on a string but was actually the sizes, approximately of

tumors found by mammography. All in all, it was a very informative forum and gave me

sufficient information to pass on and help raise awareness of one of the biggest cancer

killers.

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 Smoking Cessation Forum
Journal Entry 5
06/12/2017
8:00-10:00am

Today was awesome! We had a speaker come from tobacco free Florida to talk to us

about smoking cessation. She was very interactive and kept all of us interested. We

learned a lot of facts and statistics about how cigarette smoke affects our bodies. I always

knew cigarettes were bad but now I know that they have 7000 chemicals and compounds

in cigarette smoke. Hundreds of those chemicals are toxic and 68-81 are actual

carcinogens. This was really put into perspective for me when she told us that smoking

hookah for just one hour was the equivalent to five packs of cigarettes. Thats thousands

and thousands of chemicals youre putting into your body.

Smoking can cause CVD, stroke, PVD, COPD, pneumonia, multiple cancers, and

poor wound healing. With just those few facts I was ready to walk through the halls of

school will nicotine patches. Then at the end of the forum she showed us the two sets of

real lungs. They should show every smoker those lungs. To actually see in person the

difference between healthy non-smokers lungs and longtime smokers lungs is so eye

opening and may help smokers realized what they are doing to their bodies. I can use this

to raise awareness to the people around me and my patients the effect smoking can have

on your body and even the people around you. Raising awareness about smoking

cessation can contribute to reducing cigarette smoking adults and adolescents.

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 Chapman (Kitchen)
Journal entry 6
06/20/2017
1:30-4:30pm

Today I started my community service hours at Chapman homeless shelter. When I

first got there, I had to fill out confidentiality agreements and volunteer paperwork. Once I

was done Sharon, the woman in charge of volunteer clearance took me back to the

kitchen. While there, I asked her a lot about the facility. Chapman Partnership operates two

Homeless Assistance Centers. The one in homestead houses roughly 300 families. The

way she explained it to me, if you are homeless without a job they will allow you to stay for

60 days. If you are homeless but are working and saving money, they will allow you to stay

for 6 months and work with you to help you get back on your feet once you are ready. This

means helping them with bills, rent, clothing, appliances etc. In the kitchen, I mostly helped

prepare the food and teach hand hygiene to the cooks.

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 Verde Gardens (Orientation)
Journal Entry 7
06/21/2017
10:00-11:00am

Today I went to Verde Gardens Orientation. I met with Celia Izaguirre, the youth services

and activities coordinator. She went through a little bit of everything they do at Verde

Gardens. The facility is a part of the Carrfour community that houses Chapman, Camilas

house, Verde gardens and a 22-acre organic farm component which includes a produce

nursery and an on-site public farmers market. At this facility, they offer after school care

and summer camps for children of the families living in the community. The kids are of all

ages and cultural backgrounds so its really interesting to see how they interact. We were

informed of the dos and donts of being a volunteer at the summer camp. Lastly, we

arranged the days and times I would do my hours and she collected all of the necessary

documentation for me to being.

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 Chapman (Kitchen)
Journal entry 8
06/23/2017
8:00-12:00pm
Today was the second time I did community service hours at Chapman. Along with

food preparation I got to serve the food to the homeless who were staying at the facility. It

was interesting to hear some of their stories, especially the young ones. After we fed the

adults, we fed the children who came from the summer camp and this is when I got to do

some teaching. As they would come through the line, many of them would ask for no

vegetables but we would explain how the nutrients from vegetables are what you need to

grow big and strong. I also showed them the picture of MyPlate and explained that the

sections on the picture shows how much of that food should be on your plate. Lastly, we

spoke to them about the importance of staying hydrated, especially in the hot summer

when they are playing outside!

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 Verde Gardens (Summer Camp)

Journal entry 9
06/30/2017
12:00-4:00pm
Today I did my first really day at Verde Gardens summer camp. I didnt realize on the

first day at orientation that they have a lot of students from the BSN program that come to

do hours. When I got there Celia introduced me to the other volunteers and gave us a

rundown of the activities that were planned that day. We actually did a lot with the kids in

the four hours I was there. I was assigned one-to-one with a 5-year-old little girl named

Abby who didnt like being around crowds and who would try and run home if you werent

watching her. We read, painted, sang songs, and made straw paper rockets. Lastly, before

the day was over we brought the kids inside and taught proper hand hygiene before we

made ice-cream. I showed them a fun and colorful chart to show the steps to washing their

hands and we sang the hand washing song.

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 Patches/Orientation
Journal entry 10
07/13/2017
10:00-12:00pm
Today I went to PATCHES for the first time to do orientation and ended up staying

for a few hours. I will definitely go back and wish I would have gone sooner. That place is

so wonderful! During orientation, Mary, explained to us how at PATCHES they have

children with complex medical needs and give culturally sensitive, compassionate nursing

care regardless of the ability to pay. Their mission is providing best practice interventions,

their nurses and therapists help each child reach maximum health so they can develop,

thrive, and grow. This is very apparent from the moment you walk in the door. You can tell

that everyone there is not there for the money, they all are there because they care. We

toured the facility and learned how they group the children by ages.

They have all types of therapy, play, speech, music, physical, etc. I was so

impressed with everything theyre doing there. They really give these families the chance to

thrive. Children that are ill require more time, attention, and care. PATCHES give parents

the opportunity to still work and know that their children are being well cared for. I was in

the room with the babies and I assisted the nurses with changing and assessments. I also

got to played with them and pick up how some of them were the same age and yet were

one different developmental levels. I enjoyed seeing how the nurses dynamic out of a

hospital setting is. I will definitely be returning next week and maybe even after we finish

community! Now if I have any future patients in need of a service like patches provides, I

can refer them.

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 Homestead Food Bank

Journal 11
07/15/17
8:00-12:00pm

Today I went to the First

Methodist Church of Homestead, for

the last 10 years they have been the

homestead food bank. Every

Saturday from 9:00am to 12:00pm

they hand out food to families who are either homeless or of low income. At 8:00am when I

got there, I saw a huge line of people outside who were waiting to get food. We began

packing everything off the truck and then at 9:00 when they opened, we gave the packs

out. Rusty, the gentleman that started the food bank 10 years ago says they feel close to

500 families every weekend. The items they give can range from canned goods to fresh

produce.

Each household can make one visit and receives one of everything they have that

week. I found it very interesting that the people in charge of the food bank really want to

make a difference. They give every person coming the benefit of the doubt. By this I mean,

they do not verify anyones income when they show up. All they ask for is your drivers

license to make sure only one household is visiting per week. That to me is good and bad

because obviously that leaves the door open for people who dont really need it to abuse

but just like one of the volunteers Pam told me that's between them and God.

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 Patches
Journal entry 12
07/19/2017
08:00-1:00pm

Today was my last day doing community service hours. I finished my hours at

Patches and I think Ill definitely be coming back. I was assigned to the sensory/wheelchair

room today where they have the kids who need the most care. Most of the children in this

area have some type of feeding tube or need routine breathing treatments. None of the

children in this room are verbal and their disorders range from cerebral palsy to

neurofibromatosis.

The RN I was with all day was named Terry, a recent MDC homestead campus grad.

She was an older woman who told me she had been an LPN for over 20 years before she

decided to go to Miami-Dade to get her ASN. She explained to me that there werent many

hands-on things I could do by myself other than vitals but she was nice enough to take it

upon herself and show me everything she did that day. She taught me about a lot of the

medications these patients are on and also gave me a better understanding about feeding

tubes. She told me about the different types of feeding tubes a patient can have and, when

and why they would put one in place. I can honestly say I learned so much today and Im

so grateful she took the time out of her day to teach and explain to me all that she did. I will

always think about Terry when I become a nurse and have a student paired with me.

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 Reflection #1
06/05/2017
7:00-8:00am
Today was the first reflection hour we had in community health class. Professor

Hicks-Johnson came and began the hour by having us all go around and share how our

service hours were going so far. Most people at this point didnt have many hours done yet

because we had just finished psych and it was still early in the semester. The ones who

had already started their hours said they were having some trouble finding places to

volunteer at because it was the summer. Our professor suggested food banks, 5k runs,

and health fairs. One girl said she had done hours at her church with the youth group

teaching hand washing and sun safety. Another classmate of mine said that she was doing

hours at the Chapman homeless shelter. She was nice enough to share the contact

information for the woman in charge of screening volunteers to me and I contacted her to

set up a time for me to go and begin my hours.

Reflection #2
07/07/17
9:00-11:00am
Today was the second reflection hour session we had for community health. This

one was held by professor Walsh. I was running a few minutes late this morning so I wasnt

able to hear how she started off but when I got there she was going one by one to ask each

student to share about their experiences so far doing community service. Many of us had

gone to the same or similar places so many of our experiences were the same. However,

there were people who had done things I had never heard of before. One student said they

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went to participate in a Miami-Dade AHEC summer internship program where they made

mobile stops. During these stops they would stop in low income areas daily for 9 weeks

and deliver nutritious food for children as well as providing them with different types of

education and physical activities. (topics will range from nutrition/sun safety/oral health,

etc.) - education provided will be for 5-10 mins and different activities and materials will be

provided depending on the subject matter. To hear the students reaction was interesting

because they said they felt like these people were really making a difference because the

kids were always so happy to see that they were coming and they really benefitted from the

short time they were able to spend together.

Reflection #3
07/14/17
9:00-11:00am
Today we sat through our third reflection hour for community health class held by

professor Hicks-Johnson. It was slightly repetitive because most of us hadnt done many

hours since the previous week. However, the few people that did speak about the places

they had done were interesting. Some people when to AA meetings and narcotics

anonymous classes and told us about the stories they heard while there. They said many

of the people who attended talked about how important these meetings were to them. I felt

that when I went to an AA meeting for Psychiatric Nursing clinical. The people who went

really seemed to support one another and find hope from going that they can stay sober.

Professor Hicks mentioned that this is something we should think about as student nurses.

Being a nurse can be a very stressful job and has pushed some people to substance

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abuse. Knowing there are resources available to you such as AA meeting makes you

realize you can get help and support before possibly making a mistake and ruining your

life. I think support groups are great places for people struggling through the same thing

can go to feel they can open up about their problems without being judged and can help

each other heal and lift one another up.

Reflection #4
07/20/17
9:00am (Blackboard submission)

I went to PATCHES today to finish my community service hours. I was in the sensory

room, which is also known as the wheelchair room. Patches is a PPEC (Prescribed

Pediatric Extended Care). In other words, it is a medical daycare dedicated to care of

medically fragile infants and children of all ages. Many of the children in the room I was

assigned to had deeply debilitating disorders. They required the most nursing care and

attention. The nurse I was assigned to was actually a recent MDC grad who attended the

Homestead campus. She was nice enough to explain everything about her day with me

from how many kids she cares for to detailed explanations of the medications they get. As

a volunteer/student, I wasnt allowed to do much more than vitals by myself. However, my

nurse let me assist with all of her tube feeding and taught me a lot about each of their

feedings. I think once I get my license I will still go back every now and then to volunteer.

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 Community Needs Assessment

1. Location: Miami, Florida

Date: July 02,2017
Instructor: Jamika Hicks-Johnson
Activity: Miami-Dade Heart Walk
Health Issue: Heart Disease and
Stroke

2. What are the demographics of the

population in the community that you will be addressing with this activity? (gender, race,
ethnicity, age group, etc.)

The total population of Miami-Dade County increased by 94,578 people between
2010 and 2012 to 2,591,035. Net migration accounted for 70% of the increase.
Hispanic or Latinos accounted for over 64% of the total population in 2012. White
and not Hispanic accounted for 16% of the total and Black or African American made
up 17%.
The median age of the county population in 2012 was unchanged from the prior year
at 38.6 years. Foreign born residents still accounted for a majority of the population in
2012 at 51%, down from 51.6% in 2011.
The average family had 3.7 persons in 2012. Married couple families accounted for
64% of all families and families with a female householder and no spouse were 27%
of all families.

3. Prevalence. What are the risk factors facing this population(s)? What is the prevalence of this
particular health problem among this population?

About 610,000 people die of heart disease in the United States every year. That is 1 in every 4
deaths. When looking at total patients in Miami-Dade County, FL, 1,153 Medicare enrollees were
treated for Congestive Heart Failure in 2014, followed by 1,029 for Pneumonia and 579 for Acute
Myocardial Infarction. Heart disease accounts for 3 out of 10 deaths in Florida and in 2014 there
were 42,835 heart attack hospitalizations, or an average of 117 heart attack hospitalizations each
day. About half of all Americans have at least one of these three risk factors for heart disease: high
blood pressure, high cholesterol and smoking. Miamis population is 64% Hispanic and Heart
Disease is the number one killer of Hispanic Americans. Hispanic and Latino Americans face
higher risks of heart disease than White Americans because of high rates of high blood pressure,
obesity and diabetes. Among Latino Americans age 20 and older, 75% of men and 72% of women
are overweight or obese. Hispanic Americans are more likely to be inactive (39.8%) than Whites
(26.2%).

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4. Identify some of the major health problems that this particular community faces.

Lack of knowledge about own health, risk for/CVD, stroke, high cholesterol, hypertension, obesity.

5. Why do you think that this community needed this educational program/health screening/other?

The Heart Walk is the American Heart Associations premiere event that brings communities
together to raise funds in the fight against this countrys number 1 and 5 killers, heart disease and
stroke. This event is designed to promote physical activity and heart healthy living, the Heart Walk
creates an environment that is fun and rewarding for the entire family.

6. Could you assess the communitys knowledge of your health issue during the activity? After the
activity?

This event usually brings over 12,000 walk/runners. Many of the participants have been affected
by heart disease or stroke either directly, indirectly, or both. The event also has people who are
there to further raise awareness and hand out information about community resources.

7. How will your activity influence the long-term health of this community?

Thousands of people take part in the Miami-Dade Heart Walk each year. Together their goal this
year is to raise $735,000 to fund research, aid in education programs and support the American
Heart Associations mission: building healthier lives, free of cardiovascular diseases and stroke.

8. In your opinion, what are the specific needs of the population as a community?

The population of this community needs to implement a healthier lifestyle. Cardiovascular disease
and stroke are greatly influenced by lifestyle choices. Teaching and raising awareness of risk
factors and healthier lifestyle choices such as eating better, exercising, smoking cessation, weight
control etc. can maybe have an effect on the incidence of cardiovascular issues in this community.

9. In terms of your health issue, what type of resources do you believe this community could
utilize to help alleviate the problem at hand?
Community health institutes
Health fairs
CHI Healthy Living Program
Group exercise events such as this one
Access to health screening tools and information about heart healthy living

10. Identify one agency/organization/facility in this community that the population could refer to if
they had to deal with this health problem.

Miami Cardiac & Vascular Institute

8900 N Kendall Dr, Miami, FL 33176
(786) 596-5991
https://baptisthealth.net/en/health-services/cardiovascular-services/pages/default.aspx

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 Community Health
Nursing Book

Professor: Hicks-Johnson
By: Ekho Lainez
Date: 07/19/2017

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