NCM113: CHN II

- POSITIVE QUALITIES AND VALUES OF A

COMMUNITY HEALTH NURSE

- PUBLIC HEALTH NURSING

COMPETENCIES

PREPARED BY: Paul Michael Poblete, RN

 Attributes of a Community Nurse
Communication Skills
• Solid communication skills are a basic foundation for any career, but
for nurses, it’s one of the most important aspects of the job.
• A great nurse has excellent communication skills, especially when it
comes to speaking and listening and based on team and patient
feedback, they are able to problem-solve and
effectively communicate with patients and families.
• Nurses always need to be on top of their game and make sure that
their patients are clearly understood by everyone else. A truly stellar
nurse is able to advocate for her patients and anticipate their needs.
Emotional Stability
• Nursing is a stressful job where traumatic situations are common.
• The ability to accept suffering and death without letting it get
personal is crucial.
• That’s not to say that there aren’t heartwarming moments in nursing,
examples are helping a patient recover, reuniting families, or bonding
with fellow nurses are special benefits of the job.
• A great nurse is able to manage the stress of sad situations, but also
draws strength from the wonderful outcomes that can and do
happen.
Empathy

• Great nurses have empathy for the pain and suffering of patients,
they are able to feel compassion and provide comfort.
• Patients look to nurses as their advocates — the softer side of
hospital bureaucracy. Being sympathetic to the patient’s experience
can go a long way in terms of improving patient care.
• Sometimes, an empathetic nurse is all patients have to look forward
to.
Flexibility

• Being flexible and rolling with the punches is a staple of any career,
but it’s especially important for nurses.
• A great nurse is flexible with regards to working hours and
responsibilities. Nurses, like doctors, are often required to work long
periods of overtime, late or overnight shifts, and weekends.
• Know that it comes with the territory. The upside is that a fluctuating
schedule often means you’re skipping the 9 to 5, cubicle treadmill.
Sounds perfect, right? Run errands, go to the movies, or spend time
with the family — all while the sun still shines!
Attention to Detail

• Every step in the medical field is one that can have far-reaching
consequences and a great nurse pays excellent attention to detail and
is careful not to skip steps or make errors.
• From reading a patient’s chart correctly to remembering the nuances
of a delicate case, there’ s nothing that should be left to chance in
nursing.
• When a simple mistake can spell tragedy for another’s life, attention
to detail can literally be the difference between life and death.
Interpersonal Skills

• Nurses are the link between doctors and patients and a great nurse
has excellent interpersonal skills and works well in a variety of
situations with different people.
• They work well with other nurses, doctors, and other members of the
staff.
• Patients see nurses as a friendly face and doctors depend on nurses
to keep them on their toes. A great nurse balances the needs of
patient and doctor as seamlessly as possible.
Problem Solving Skills

• A great nurse can think quickly and address problems as — or before

— they arise.
• With sick patients, trauma cases, and emergencies, nurses always
need to be on hand to solve a tricky situation.
• Whether it’s handling the family, soothing a patient, dealing with a
doctor, or managing the staff, having good problem solving skills is a
top quality of a great nurse.
Quick Response

• Nurses need to be ready to respond quickly to emergencies and other

situations that arise. Quite often, health care work is simply the
response to sudden incidences, and nurses must always be prepared
for the unexpected.
• Staying on their feet, keeping their head cool in a crisis, and a calm
attitude are great qualities in a nurse.
Respect

• Great nurses respect people and rules.

• They remain impartial at all times and are mindful of confidentiality
requirements and different cultures and traditions.
• Above all, they respect the wishes of the patient him- or herself.
• Great nurses respect the staff and each other, understanding that the
patient comes first. And nurses who respect others are highly
respected in return.
 Public Health Nursing Competencies

I. PUBLIC HEALTH and NURSING SCIENCES

• This category includes key knowledge and critical thinking skills related to: the
public health sciences (behavioral and social sciences, biostatistics, epidemiology,
environmental public health, demography, workplace health, prevention of chronic
diseases, infectious diseases, psychosocial problems and injuries) as well as nursing
theory, change theory, economics, politics, public health administration,
community assessment, management theory, program planning and evaluation,
population health principles, community development theory, and the history of
public health.
• Competency in this category requires the ability to apply knowledge in practice. A
public health nurse is able to:

Ø Apply knowledge about the following concepts: the health status of populations; inequities in
health; the determinants of health and illness; social justice; principles of primary health care;
strategies for health promotion; disease and injury prevention; health protection, as well as
the factors that influence the delivery and use of health services.
Ø Apply knowledge about the history, structure and interaction of public health and health care
services at local, provincial/territorial, national, and international levels.
Ø Apply public health and nursing sciences to practice and synthesize knowledge from a broad
range of theories, models and frameworks.
Ø Critically appraise knowledge gathered from a variety of sources.
Ø Use evidence and research to inform health policies, programs and practice:
• contribute to the development and generation of evidence-based nursing
• use available resources to systematically plan and evaluate public health nursing practice
Ø Pursue lifelong learning opportunities in the field of public health that are consistent with:
current public health nursing practice; new and emerging issues; the changing needs of
individuals, families, groups and communities; emerging research and evolving information
about the impact of the determinants of health.
Ø Integrate multiple ways of knowing into practice.
II. ASSESSMENT AND ANALYSIS

• This category describes the core competencies needed to collect, assess, analyze
and apply information (including data, facts, concepts and theories)
• These competencies are required to make evidence-based decisions, prepare
budgets and reports, conduct investigations and make recommendations for
policy and program development.
• Community members are involved in identifying and reinforcing those aspects of
everyday life, culture and political activity that are conducive to health.
• A public health nurse is able to:
Ø Recognize that a health concern or issue exists:
o apply principles of epidemiology
o conduct comprehensive community assessments with individuals, families, groups and
communities using quantitative and qualitative strategies
o recognize patterns and trends in epidemiological data and service delivery
o assess the impact of the broad social, cultural, political and economic determinants of
health.
Ø Identify relevant and appropriate sources of information, including community assets,
resources and values in collaboration with individuals, families, groups, communities and
stakeholders.
Ø Collect, store, retrieve and use accurate and appropriate information on public health issues.
Ø Analyze information to determine appropriate implications, uses, gaps and limitations.
Ø Assess impact of specific issues on health such as; political climate and will; values and culture;
social and systemic structures; settings; as well as the individual, family, group, and community’s
readiness and capacity.
Ø Assess the health status and functional competence of individuals, families, groups,
communities or populations within the context of their environmental and social supports.
ØDetermine the meaning of information, considering the ethical, political, scientific,
socio-cultural and economic contexts:
o identify attitudes, beliefs, feelings and values about health and their effect on
relationships and interventions
o support individuals, families, groups and communities to identify risks to health
and make informed choices about protective and preventive health measures
o describe the role of power in relationships by giving voice to the vulnerable
o demonstrate skill in dealing with diversity and high levels of ambiguity.
ØRecommend specific actions based on the analysis of information:
o identify a range of appropriate interventions including health promotion; health
protection; disease and injury prevention and clinical care using a multi strategy
and multi target approach.
o identify short and long term goals
o identify outcome indicators
o identify research questions
ØRecognize opportunities to promote social justice. .
III. POLICY AND PROGRAM PLANNING, IMPLEMENTATION
AND EVALUATION
• This category describes the core competencies needed to effectively choose options, and
to plan, implement and evaluate policies and/or programs in public health. This includes
the management of incidents such as outbreaks and emergencies.

• 3(A) - POLICY DEVELOPMENT

A public health nurse is able to:
Ø Describe selected policy options to address a specific public health issue.
Ø Describe the implications of each policy option, especially as they apply to the determinants of
health and recommend or decide on a course of action.
Ø Develop a plan to implement a course of action taking into account relevant evidence, legislation,
emergency planning procedures, regulations and policies.
Ø Implement a policy.
Ø Support community action to influence policy change.
Ø Build community capacity to improve health and address health inequities.
Ø Advocate for healthy public policy and services that promote and protect the health and well-
being of individuals, families groups and communities.
Ø Advocate for the reduction of inequities in health through legislative and policy making activities.
• 3(B) - PROGRAM PLANNING
A public health nurse is able to…
ØDescribe selected program options to address a specific public health issue.
ØDescribe the implications of each option, especially as they apply to the
determinants of health and recommend or decide on a course of action.
ØDevelop a plan in collaboration with individuals, families, groups and
communities to implement a course of action that is responsive to needs
taking into account relevant evidence, legislation, emergency planning
procedures, regulations and policies.
• 3(C) - IMPLEMENTATION AND INTERVENTION

A public health nurse is able to:

Ø Take action, across multiple levels, to address specific public health issues by using a comprehensive
mix of public health strategies to address unique needs and to build individual, family, group and
community capacity.
Ø Facilitate planned change with individuals, families, groups, communities, systems or population(s)
by applying the Population Health Promotion Model, primary health care principles and
appropriate change theory.
Ø Demonstrate the ability to integrate relevant research and implement evidence informed practice.
Ø Participate in collaborative, interdisciplinary and intersectoral partnerships to enhance the health
of individuals, families, groups, communities and populations.
Ø Maximize the capacity of the individual, family, group or community to take responsibility for and
to manage their health needs according to resources available and personal skills.
Ø Set and follow priorities and maximize outcomes based on available resources.
Ø Fulfill functional roles in response to a public health emergency.
Ø Facilitate access to services in the health sector and other sectors.
Ø Adapt practice in response to the changing health needs of the individual, family, group and
community and in response to the unique characteristics of the setting.
Ø Take action to protect individuals, families, groups and communities from unsafe or unethical
circumstances.
Ø Advocate in collaboration with, and on behalf of, and with individuals, families, groups and
communities on social justice related issues.
• 3(D) – EVALUATION

A public health nurse is able to:

ØEvaluate an action, policy or program in a systematic and
continuous manner by measuring its effect on individuals, families,
groups or communities.
ØEvaluate programs in relation to determinants of health and health
outcomes.
ØEvaluate programs in partnership with individuals, families, groups,
communities and other stakeholders.
IV. PARTNERSHIPS, COLLABORATION AND ADVOCACY

• This category captures the competencies required to influence and

work with others to improve the health and well-being of the public
through the pursuit of a common goal. This includes the concepts of:

osocial justice, which is the fair distribution of society’s benefits and

responsibilities and their consequences
opartnership and collaboration which is to optimize performance
through shared resources and responsibilities
oadvocacy which is to speak, write or act in favor of a particular
cause, policy or group of people and aims to reduce inequities in
health status or access to health services.
A public health nurse is able to:

Ø Advocate for societal change in support of health for all:

o collaborate with partners to address public health issues and service gaps in order to
achieve improved health outcomes
o build coalitions, intersectoral partnerships and networks
o facilitate the change process to impact the determinants of health and improve health
outcomes.
Ø Use skills such as team building, negotiation, conflict management and group facilitation to
build partnerships and to support group development.
Ø Mediate between differing interests in the pursuit of health and well-being, and advocate for
appropriate resource allocation and equitable access to resources.
Ø Advocate for healthy public policies and services that promote and protect the health and
well-being of individuals and communities.
Ø Involve individuals, families, groups and communities as active partners to identify assets,
strengths and available resources and to take action to address health inequities, needs,
deficits and gaps.
V. DIVERSITY AND INCLUSIVENESS

• This category identifies the competencies required to interact effectively with diverse
individuals, families, groups and communities in relation to others in society as well to
recognize the root causes of disparities and what can be done to eliminate them.
• It is the embodiment of attitudes and actions that result in inclusive behaviours, practices,
programs and policies.
A public health nurse is able to:
ØRecognize how the determinants of health (biological, social, cultural, economic and
physical) influence the health and well-being of specific population groups.
ØAddress population diversity when planning, implementing, adapting and evaluating
public health programs and policies.
ØApply culturally-relevant and appropriate approaches with people from diverse
cultural, socioeconomic and educational backgrounds, and persons of all ages,
genders, health status, sexual orientations and abilities.
VI. COMMUNICATION

• Communication involves an interchange of ideas, opinions and information. This category

addresses numerous dimensions of communication including internal and external exchanges;
written, verbal, non-verbal and listening skills; computer literacy; providing appropriate
information to different audiences; working with the media and social marketing techniques.
A public health nurse is able to:
ØCommunicate effectively with individuals, families, groups, communities and colleagues:
o use verbal, non verbal and written or graphic communication skills
o speak and write in plain language
o use multi-sensory forms of communication to address unique communication styles
o use culturally relevant communication when building relationships.
Ø Interpret information for professional, non professional and community audiences.
Ø Mobilize individuals, families, groups and communities by using appropriate media,
community resources and social marketing techniques.
Ø Use current technology to communicate effectively.
VII. LEADERSHIP
• This category focuses on leadership competencies that build capacity, improve performance and enhance the
quality of the working environment.
• They also enable organizations and communities to create, communicate and apply shared visions, missions
and values.
A public health nurse is able to:
Ø Describe the mission and priorities of the public health organization where one works, and apply them
in practice.
Ø Contribute to developing key values and a shared vision to assess, plan and implement public health
programs and policies in the community by actively working with health professionals and in partnership
with community partners to build capacity.
Ø Use public health and nursing ethics to manage self, others, information and resources and practice in
accordance with all relevant legislation, regulating body standards and codes (e.g. provincial health
legislation, child welfare legislation, privacy legislation, Canadian Nurses Association Code of Ethics for
registered nurses).
Ø Contribute to team and organizational learning in order to advance public health goals.
Ø Contribute to the maintenance of organizational performance standards.
o Demonstrate an ability to build capacity by sharing knowledge, tools, expertise and experience:
participate in professional development and practice development activities
o mentor students and orient new staff
o participate in research and quality assurance initiatives.
VIII. PROFESSIONAL RESPONSIBILITY AND ACCOUNTABILITY

• This category addresses a number of dimensions including the recognition that

nurses are accountable for their actions and are responsible for making sure they
have the required knowledge and skills needed to ensure the delivery of safe,
compassionate, competent and ethical care.
• It includes the competencies required to maintain quality work environments and
relationships needed in a professional practice.
• Public Health nurses are responsible for initiating strategies that will address the
determinants of health and generate a positive impact on people and systems.
• They are accountable to a variety of authorities and stakeholders as well as to the
individual and community they serve.
• This range of accountabilities places them in a variety of situations with unique
ethical dilemmas.
A public health nurse is able to:
Ø Demonstrate professionalism in independent practice in multiple settings with multiple
stakeholders.
Ø Apply ethical standards and principles taking into consideration appropriate public health and
nursing ethics.
Ø Consult as needed to determine the best course of action in response to: ethical dilemmas,
safety issues, risks to human rights and freedoms, new situations and new knowledge.
Ø Use reflective practice to continually assess and improve practice:
o examine practice in relation to personal and individual, family, group or community
attributes, existing knowledge and context
o adapt public health nursing techniques, approaches and procedures to the challenges in
a particular community situation or setting.
Ø Advocate for effective, efficient and responsible use of resources.
Ø Act upon legal and professional obligations, and practices in accordance with relevant
legislation.
Ø Contribute to the quality of public health nursing work environments by identifying needs,
issues, solutions and mobilizing colleagues by actively participating in team and
organizational structures and mechanisms.