This article describes a community nursing center that provided clinical learning experiences for students from two schools of nursing. Work at the center was based on the Neuman systems model, which views the client as a system in interaction with environmental stressors. Nursing interventions focused on health promotion services for an underserved elderly population. The benefits of using the Neuman systems model for patient care, education, and research are outlined.
Key Words Community-Based Health Care - Community Nursing Center - Health Promotion - Neuman Systems Model - Nursing Education - Underserved Elderly Population
COMMUNITY NURSING CENTERS that function as the first level of contact between members of vulnerable populations and the health care system deliver health care as close as possible to where people live (1). This approach to health care delivery lessens the cost of health care for the client as well as the stress associated with the financial burdens of health care. Specifically, centers offer direct access to nurses who offer holistic, client-centered health services and help clients feel valued and respected (2).
This article describes a community nursing center that is based on the Betty Neuman systems model, a useful guide for holistic, systems-based nursing practice that is the basis for the undergraduate curriculum at Neumann College (3-5). This nursing model, which is taught as part of a graduate Nursing Models and Theories course, views the client as a system in interaction with environmental stressors that may have positive or negative effects. Nursing interventions, characterized as prevention-as-intervention strategies, are used to modify the client-stressor interactions.
The Client and the Community Community nursing centers offer many advantages. They are ideal sites for faculty and student practice and research (6). They help determine health care needs and serve as an effective referral system for collaboration with other health care professionals. For senior citizens, they offer flexibility, collaboration, and creativity in promoting wellness and healing (7). Many seniors value centers for providing health care information that enables them to maintain their independence (2).
A community nursing center based on the Neuman systems model was established in Chester, Pennsylvania in 1997 to meet the health promotion needs of underserved senior citizens. The project, funded by the Independence Foundation of Philadelphia, was the result of a joint effort between the Health Advisory Committee of Chester (a committee formed under the auspices of the Health Promotion Council of Pennsylvania), Neumann College Division of Nursing and Health Sciences, and Widener University School of Nursing. Neumann College students and faculty practiced at the main office for the center, located at the Chester Senior Center. Widener University students and faculty practiced in a secondary office at Chester Twin Towers, an apartment complex funded by the Office of Housing and Urban Development.
Home health agencies, senior community services, visiting nurse agencies, physicians, and friends and neighbors referred clients to the center. Home visits were made depending on client need. Center staff worked collaboratively with community agencies to provide a natural extension of existing services to strengthen a multidisciplinary approach to client care. To avoid duplicating already established services, the center developed partnerships with existing agencies and providers.
Determining Community Needs The selection of the Chester Senior Center as the site for the community nursing center was made following discussions with elderly residents of Chester, local government officials, area physicians, and representatives of county offices for senior citizens and local colleges of nursing. Chester, located in Delaware County in southeastern Pennsylvania, is geographically the third smallest county in the commonwealth but second only to Philadelphia in population density. …