For the past two years of our nursing schooling we have been required to take a class on community nursing. In our final year we participate in a clinical rotation in an area in our Saskatoon community. Each of us experienced various clinical settings, but would agree that none of them can compete with the experiences we have had here working in the Filipino community. After sitting through endless hours of classes where we were lectured on community and related theories we saw and experienced firsthand data in action.
Community health nursing is defined as a nurse who works in the community where people live, work, learn, meet, and play in order to promote health (NEPS 427 Notes). Once this was just a definition to us, but now it has become a way of nursing. For the past four weeks we spent every day in the community working in various roles and capacities. When we were in Iloilo we hiked to our adopted community through very muddy rice paddies and endured the suns extreme heat. It was new for us to actually leave the hospital or health center and see people in their homes. For each of us we learned that in order for health to improve with individuals/families we need to go directly to the people. The people of this community would not normally seek medical help, because it is too far to travel thus their current health status is poor. Even with our visit only 3 times a week, the health of the community has seen improvement. People opened their homes to us and were interested in what we had to offer in terms of health teaching and physical assessment. It was an incredible experience to participate in community nursing at the very core of what it was intended to be. In Canada we would never have had this opportunity to learn and for the reality of bringing health care to the people became so real. It has forever changed the way we view community nursing and the phrase “health care for all”. We believe that bringing health to the people where they live is essential in seeing long term medication compliance and positive health outcomes.
We also learned and applied the nursing process for community nursing, which consists of:
It is one thing to learn about this process in class and memorize it for an exam, but it is even more worthwhile when we use it. We applied these important steps with our adopted community in Antipolo in the Barangy of Inarawan. Here the process became real for each one of us and we gained a greater understanding of how to use it and why it is important.
The Process in Action:
a) On our first day of assessment we walked through the community and did an ocular survey. This means we noted the type of people who lived there, the living conditions, environmental hazards, and other important factors what would affect our plan of action. We then did home visits which means going into homes where people live and interviewed them using an assessment sheet we were given. Here we looked at the number of people who lived in the home, their education status, age, and health problems. We looked at the living conditions, income, community involvement, and other relevant information. In total we interviewed 10 families.
b) We then used the information from the assessment and looked for common themes. This is the basis we used to figure out what was our health care focus. From our data we concluded that high blood pressure, or hypertension was the main issue we needed to address. We took this topic and created a program for the members of the community that we would present to later in the week. Our program consisted of: a registration table where blood pressure was taken, heart healthy exercises to get people moving, a pamphlet (we made in English and was translated to Tagalog) for further reading to take home with them, verbal teaching of the information in the pamphlet, and education about proper meal planning. We concluded with some fun, dancing with us Canadian students (taught them a line dance), laughing yoga for stress relief, and a healthy culturally appropriate snack.
c) We met the leaders of the community and asked their permission to run the program at the main “covered court”. We were granted permission and thus implemented the program. In total we had forty people attend the session.
d) Due to the lack of time in this area we were unable to go back and evaluate the effectiveness of our program. We did leave our information we gathered on the community with the students so they can do some follow up with the residents later.
Overall it was a very fun and worthwhile experience. It is one thing to learn about the community development process in class, but it is another thing to go out and apply our skills that can raise awareness and better the health of those we encounter.
Side Note: Hypertension and strokes are very common here as the poor high salt diet and lack of exercise are a precursor for these conditions. In the hospital they are some of the main issues. Many people dies from both.
Lerissa and Sharaya holding the invitation posters for our Hypertension program
Lerissa and Brooke walking through the community during our ocular survey for the community assessment.
The Posters we created and used to teach the members of the community.