Developing Community Health Nursing Skills Collaboration in a Culturally Diverse Population

Article excerpt

Abstract: The graduate curriculum in Community Health Nursing at the University of South Alabama was revised to prepare nurses to function as a community health specialist. The revised curriculum model includes two semesters that focus on a specific population or high risk group of patients or clients. Emphasis is placed on the skills that community health nurses must have in order to assess communities, identify community needs, plan and implement interventions at the population aggregate or community level. During the first semester, or the practicum course, a community needs assessment is performed. In the internship course, the planned intervention is implemented and evaluated. The purpose of the paper is to describe the process of identifying and accessing a Cambodian population aggregate in a rural setting. The collaboration among faculty, student, preceptor, official agency, as well as lay leaders in the Cambodian community is described.

Key words: Diversity, Cambodians, Community Assessment, Rural Immigrants, Community Health Nursing

The graduate curriculum in Community Health Nursing at The University of South Alabama (USA) was revised to address the growing demand for advanced practice nurses who are able to identify the health care needs of population aggregates and reduce the risks for disease and disability. In 1986, the American Nurses Association (ANA) published Standards of Community Health Nursing which firmly established the role of community health nursing practice in the preservation and promotion of the health of populations. The fourth report of the Pew Health Professions Commission 1998) reaffirmed the importance of population-based health care and services as well as culturally sensitive care in a changing health care system. The current focus on population based health care supports the notion that effective health care services must be provided with regard to population characteristics and the environments in which the population lives, works, learns, and plays. Larsen (2000) referred to this as nursing where the patient or client is"(p. 140).

The revised curriculum at USA is designed to prepare a specialist in community health nursing. The curriculum is guided by The Essentials of Master's Education for Advanced Practice Nursing (American Association of Colleges of Nursing [AACN], 1996). Concepts from epidemiology, biostatistics, community structure and organization, organization management, program development and evaluation, demo&raphy, health policy, health economics, and research are the underpinnings of the advanced practice role in community health nursing. These concepts are addressed in the core courses as well as the specialty courses in the community health track. The first clinical course in the advanced community health nursing track is the practicum course.

During this course, a community needs assessment is performed. In the second clinical course, the internship, a planned intervention that addresses the identified need is implemented and evaluated.

The community needs assessment has been viewed as a vital component of community health nursing practice for decades. Billings and Cowley (1995) suggested that while community needs assessment has always been a focus of persons concerned with community health, there has been a renewed interest in this method as a means of planning for appropriate health services.

The community needs assessment is a method whereby the real and potential health concerns of populations and subgroups within the population can be identified and analyzed. It is also a complex and dynamic process that requires systematic planning, coordination, and collaboration with the many pep Ie who make up the community. For the purpose of this discussion, collaboration is defined as a deliberate and mutually beneficial process of exchange of ideas and resources among persons with shared goals and interests. Freeman (1970) asserted that it is through the behavior and action of people as patients, health workers, taxpayers, legislators, family members, neighbors, and citizens that health programs are largely effected" (p. …