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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 obstetrician for a 16-year-old, 20-weeks-gestation primipara. The client, Sara, has been diagnosed with anemia and is underweight with poor weight gain. She is single and living with her mother, her mother's girlfriend, and two younger siblings. Sara and her family are uncomfortable with the idea of a PHN who works for the government visiting them in their home.
Beth says, “Well, I think the first thing we do is 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, nor have I interacted with a lesbian couple. I don’t think I will feel comfortable. Will the family be OK with me there?”
Beth responds, “I asked Sara's mother if you could co-visit with me and she was OK 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. Then 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, Beth mentions, “We can start a windshield survey on our way to Sara's home as part of the local community assessment that you and your student work group are going to do.”
Kristi responds, “Great—I just happen to have my phone that takes good pictures with me.”
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KRISTI'S NOTEBOOK Competency #1 Applies the Public Health Nursing Process to Individuals, Families, Communities, and Systems
Identifies the population(s) for which the PHN is accountable
Assesses the health status of individuals, families, communities, and systems
Uses a health and social determinants framework to determine risk factors and protective factors that lead to health and illness in individuals, families, communities, and systems
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 individuals, families, communities, or systems to attach meaning to collected quantitative and qualitative data
Works in partnership with individuals, families, communities and systems to establish priorities
Creates public health strength, risk, and asset-based diagnoses for individuals and families, communities, and systems
In partnership with individuals, families, communities, and systems, develops a plan based on priorities (including nursing care plans for individuals and families)
Selects desired outcomes that are measurable, meaningful, and manageable
Selects public health interventions that
Are supported by current literature as ...