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Kristi is listening to Beth, her public health nurse (PHN) preceptor, tell her about the client they are about to visit for the first time. The local public health agency received a maternal child health visit referral from a local OB/GYN for a 16-year-old, 20-weeks-gestation primipara. The client, Sara, has been diagnosed with anemia and is underweight with poor weight gain. Sara is single and living with her mother, mother's boyfriend, and two younger siblings. Sara and her family are uncomfortable with the idea of a public health nurse who works for the government visiting them in their home.
Beth says, “Well, I think the first thing we do is go and visit them. We need to get them to trust us if we are to help them.”
Kristi responds, “I have never visited a pregnant teenager or her family in their home. I don't think I will feel comfortable. Will the family be okay with me there?”
Beth responds, “I asked Sara's mother if you could covisit with me and she was okay with that. We will ask Sara and her mother what their health concerns and goals are and talk with them about how to arrange our visits and what we can do to help Sara. We will open a case file on Sara and begin to do a family assessment. You can observe and listen on this visit and take a more active part in future visits.”
Kristi says, “That sounds good to me!”
As they walk to Beth's car she mentions, “We can start to do a windshield survey on our way to Sara's home as part of the community assessment that you and your student work group are going to do of the local community.”
Kristi responds, “Great. I just happen to have my camera with me.”
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KRISTI'S NOTEBOOK: COMPETENCY #1 Applies the Public Health Nursing Process to Communities, Systems, Individuals, and Families
Identifies the population(s) for which the PHN is accountable
Assesses the health status of communities, systems, individuals, and families
Uses a health and social determinants framework to determine risk factors and protective factors that lead to health and illness in communities, systems, individuals, and families
Identifies relevant and appropriate data and information sources for the populations to which the PHN is accountable
Familiar with data used in the health department
Familiar with data in the programs in which the PHN works
Works in partnership with communities, systems, individuals, or families to attach meaning to collected quantitative and qualitative data
Works in partnership with communities, systems, individuals, and families to establish priorities
Creates public health strength, risk and asset-based diagnoses for communities, systems, individuals, and families
In partnership with communities, systems, individuals, and families, develops a plan based on priorities (including nursing care plans for individuals/families)
Selects desired outcomes that are measurable, meaningful, and manageable
Selects public health interventions that
Are supported by current literature as evidence-based
Reduce health determinant risk factors ...