TERNOPIL STATE MEDICAL UNIVERSITY

INSTITUTE OF NURSING

DEPARTMENT OF CLINICAL IMMUNOLOGY, ALLERGOLOGY

AND GENERAL PATIENT CARE

Lecture 9

Roles and Functions of the Community Health Nurse

After studying this chapter, you should be able to:

 Describe the role of the CHN as Clinician, Collaborator, Manager , and

Leader as he/she works in communities with other health care providers

 Describe the role of the CHN as Educator, Advocate, and Researcher in

his/her Community
Introduction

Role and Functions of the Community Health Nurse

Community health nurses have always practiced in a wide variety of

settings and assumed various roles. In this topic, the seven major roles and six
of the most common settings for CHN practice are examined.

The seven major roles are:

 clinician
 educator
 advocate
 manager
 collaborator
 leader
 researcher

Clinician

The role of the clinician or care provider is a familiar one for most
people. In community health the clinician views clients in the context of larger
systems. The family or group must be considered in totality. The community
health nurse provides care along the entire range of the wellness-illness
continuum; however, promotion of health and prevention of illness are
emphasized. Skills in observation, listening, communication, counselling, and
physical care are important for the community health nurse. Recent concerns for
environment, sociocultural, psychological, and economic factors in community
health have created a need for stronger skills in assessing the needs of
populations at the community level.

Peran dokter atau perawatan penyedia adalah satu akrab bagi kebanyakan orang. Dalam
kesehatan masyarakat klinisi memandang klien dalam konteks sistem yang lebih besar. Keluarga
atau kelompok harus dipertimbangkan dalam totalitas. Perawat kesehatan masyarakat memberikan
perawatan sepanjang seluruh rentang kontinum kesehatan-penyakit; Namun, promosi kesehatan
dan pencegahan penyakit ditekankan. Keterampilan dalam pengamatan, mendengarkan,
komunikasi, konseling, dan perawatan fisik yang penting bagi perawat kesehatan masyarakat.
kekhawatiran baru-baru ini untuk lingkungan, sosial budaya, psikologis, dan faktor ekonomi dalam
kesehatan masyarakat telah menciptakan kebutuhan untuk keterampilan kuat dalam menilai
kebutuhan populasi di tingkat masyarakat.

Educator

One of the major functions of the community health nurse

is that of health educator. As educators, nurses seek to
facilitate client learning on a broad range of topics. They
may act as consultants to individuals or groups, hold formal
classes, or share information informally with clients. Self-care concepts,
techniques for preventing illness, and health promotion strategies are
emphasized throughout the health teaching process.

Salah satu fungsi utama dari perawat kesehatan masyarakat adalah bahwa dari pendidik kesehatan.
Sebagai pendidik, perawat berusaha untuk memfasilitasi pembelajaran klien pada berbagai topik.
Mereka dapat bertindak sebagai konsultan untuk individu atau kelompok, mengadakan kelas formal,
atau berbagi informasi informal dengan klien. konsep perawatan diri, teknik untuk mencegah
penyakit, dan strategi promosi kesehatan yang ditekankan di seluruh proses pengajaran kesehatan
 A nurse educator is a nurse who teaches and prepares licensed practical
nurses (LPN) and registered nurses (RN) for entry into practice positions. Nurse
Educators also teach in graduate programs at Master’s and doctoral level which
prepare advanced practice nurses, nurse educators, nurse administrators, nurse
researchers, and leaders in complex healthcare and educational organizations.

Seorang perawat pendidik adalah seorang perawat yang mengajar dan mempersiapkan perawat
berlisensi praktis (LPN) dan perawat terdaftar (RN) untuk masuk ke posisi praktek. Pendidik perawat
juga mengajar di program pascasarjana di Master dan tingkat doktor yang mempersiapkan perawat
maju praktek, pendidik perawat, administrator perawat, peneliti perawat, dan pemimpin dalam
kesehatan yang kompleks dan organisasi pendidikan.

Nurse educators combine clinical expertise and a passion for teaching

into rich and rewarding careers. These professionals, who work in the classroom
and the practice setting (hospital setting or community setting), are responsible
for preparing and mentoring current and future generations of nurses. Nurse
educators play a pivotal role in strengthening the nursing workforce, serving as
role models and providing the leadership needed to implement evidence-based
practice. Nurse educators are responsible for designing, implementing,
evaluating and revising academic and continuing education programs for nurses.
These include formal academic programs that lead to a degree or certificate, or
more informal continuing education programs designed to meet individual
learning needs.

pendidik perawat menggabungkan keahlian klinis dan gairah untuk mengajar ke karir yang
kaya dan bermanfaat. profesional, yang bekerja di kelas dan pengaturan praktek (rumah sakit atau
pengaturan masyarakat), bertanggung jawab untuk mempersiapkan dan mentoring generasi
sekarang dan masa depan perawat. pendidik perawat memainkan peran penting dalam memperkuat
tenaga kerja keperawatan, berperan sebagai teladan dan memberikan kepemimpinan yang
diperlukan untuk melaksanakan praktik berbasis bukti. pendidik perawat bertanggung jawab untuk
merancang, melaksanakan, mengevaluasi dan merevisi akademik dan melanjutkan program
pendidikan bagi perawat. Ini termasuk program akademis formal yang mengarah ke gelar atau
sertifikat, atau program pendidikan berkelanjutan yang lebih informal dirancang untuk memenuhi
kebutuhan belajar individu.

Nurse educators are critical players in assuring quality educational

experiences that prepare the nursing workforce for a diverse, ever-changing
health care environment. They are the leaders who document the outcomes of
educational programs and guide students through the learning process. Nurse
educators are prepared at the master's or doctoral level and practice as faculty in
colleges, universities, hospital-based schools of nursing or technical schools, or
as staff development educators in health care facilities. They work with recent
high school graduates studying nursing for the first time, nurses pursuing
advanced degrees and practicing nurses interested in expanding their knowledge
and skills related to care of individuals, families and communities. Nurse
educators often express a high degree of satisfaction with their work. They
typically cite interaction with students and watching future nurses grow in
confidence and skill as the most rewarding aspects of their jobs. Other benefits
of careers in nursing education include access to cutting-edge knowledge and
research, opportunities to collaborate with health professionals, an intellectually
stimulating workplace and flexible work scheduling. Given the growing
shortage of nurse educators, the career outlook is strong for nurses interested in
teaching careers. Nursing schools nationwide are struggling to find new faculty
to accommodate the rising interest in nursing among new students. The shortage
of nurse educators may actually enhance career prospects since it affords a high
level of job security and provides opportunities for nurses to maintain dual roles
as educators and pendidik perawat adalah pemain penting dalam memastikan kualitas
pengalaman pendidikan yang mempersiapkan tenaga kerja keperawatan untuk lingkungan
perawatan kesehatan yang beragam, selalu berubah. Mereka adalah pemimpin yang
mendokumentasikan hasil dari program pendidikan dan membimbing siswa melalui proses
pembelajaran. pendidik perawat disiapkan di master atau tingkat doktoral dan praktek sebagai
dosen di perguruan tinggi, universitas, sekolah berbasis rumah sakit keperawatan atau teknis
sekolah, atau sebagai pendidik pengembangan staf di fasilitas perawatan kesehatan. Mereka bekerja
dengan lulusan sekolah tinggi baru-baru belajar menyusui untuk pertama kalinya, perawat mengejar
gelar maju dan berlatih perawat tertarik dalam memperluas pengetahuan dan keterampilan yang
berkaitan dengan perawatan individu, keluarga dan masyarakat. pendidik perawat sering
mengungkapkan tingkat kepuasan yang tinggi dengan pekerjaan mereka. Mereka biasanya mengutip
interaksi dengan siswa dan menonton perawat masa depan tumbuh dalam keyakinan dan
keterampilan sebagai aspek yang paling berharga dari pekerjaan mereka. Manfaat lain dari karir di
bidang pendidikan keperawatan mencakup akses ke pengetahuan mutakhir dan penelitian,
kesempatan untuk berkolaborasi dengan profesional kesehatan, tempat kerja intelektual
merangsang dan penjadwalan kerja yang fleksibel. Mengingat kekurangan tumbuh pendidik
perawat, prospek karir yang kuat untuk perawat tertarik dalam karir mengajar. sekolah keperawatan
nasional yang berjuang untuk menemukan fakultas baru untuk mengakomodasi meningkatnya minat
dalam keperawatan di kalangan mahasiswa baru. Kekurangan pendidik perawat dapat benar-benar
meningkatkan prospek karir karena affords tingkat tinggi keamanan kerja dan memberikan
kesempatan bagi perawat untuk mempertahankan peran ganda sebagai pendidik dan penyedia

perawatan pasien langsung direct patient care providers

A nurse educator is a registered nurse who has advanced education,

including advanced clinical training in a health care specialty. Nurse educators
serve in a variety of roles that range from adjunct (part-time) clinical faculty to
dean of a college of nursing. Professional titles include Instructional or
Administrative Nurse Faculty, Clinical Nurse Educator, Staff Development
Officer and Continuing Education Specialist among others. Nurse educators
combine their clinical abilities with responsibilities related to: Designing
curricula developing courses/programs of study Teaching and guiding learners
evaluating learning documenting the outcomes of the educational process.

Seorang perawat pendidik adalah seorang perawat terdaftar yang telah pendidikan maju,
termasuk pelatihan klinis lanjutan dalam spesialisasi perawatan kesehatan. pendidik perawat
melayani dalam berbagai peran yang berkisar dari tambahan (paruh waktu) fakultas klinis
untuk dekan sebuah perguruan tinggi keperawatan. gelar profesional termasuk Instructional
atau Perawat Administrasi Fakultas, Clinical Nurse Educator, Staf Officer Development dan
Continuing Spesialis Pendidikan antara lain. pendidik perawat menggabungkan kemampuan
klinis mereka dengan tanggung jawab yang berkaitan dengan: Merancang program / program
studi Pengajaran pengembangan kurikulum dan membimbing peserta didik mengevaluasi
pembelajaran mendokumentasikan hasil dari proses pendidikan

Nurse educators have the unique opportunity to share their clinical expertise
in educational settings to shape the next generation of nurses. Current faculty
indicates that the most positive aspect of their role is the interaction with
students. Nursing faculty may also engage in scholarly inquiry that will further
illuminate the nature of teaching and learning and will ultimately shape future
educational processes and outcomes

pendidik perawat memiliki kesempatan unik untuk berbagi keahlian klinis mereka dalam
pengaturan pendidikan untuk membentuk generasi berikutnya perawat. fakultas saat ini
menunjukkan bahwa aspek paling positif dari peran mereka adalah interaksi dengan siswa. fakultas
keperawatan juga dapat terlibat dalam penyelidikan ilmiah yang lebih lanjut akan menerangi alam
belajar mengajar dan pada akhirnya akan membentuk proses pendidikan masa depan dan hasil

Advocate

In health care the concept of advocacy has become increasingly important

over recent years as consumers demand better quality, more responsiveness and
easier access to such services. The rise of consumerism through every walk of
life has had its influence on expectations of health care, and there is an
increasing demand for user-empowerment and public accountability for
services.

Dalam perawatan kesehatan konsep advokasi telah menjadi semakin penting dalam beberapa
tahun terakhir sebagai konsumen menuntut kualitas yang lebih baik, lebih responsif dan akses yang
lebih mudah untuk layanan tersebut. Munculnya konsumerisme melalui setiap jalan kehidupan telah
memiliki pengaruhnya terhadap ekspektasi perawatan kesehatan, dan ada peningkatan permintaan
untuk user-pemberdayaan dan akuntabilitas publik untuk layanan.

Two underlying goals in client advocacy are described. One goal of the
community health nurse as advocate is to help clients find out what services are
available, which ones they are entitled to, and how to obtain these services. A
second goal is to influence change and make the system more relevant and
responsible to clients' needs.

Dua gol yang mendasari dalam advokasi klien dijelaskan. Salah satu tujuan dari perawat
kesehatan masyarakat sebagai advokat adalah untuk membantu klien mengetahui layanan apa yang
tersedia, mana yang mereka berhak untuk, dan cara mendapatkan layanan ini. Tujuan kedua adalah
untuk mempengaruhi perubahan dan membuat sistem lebih relevan dan bertanggung jawab dengan
kebutuhan klien '

"Nurses must transmit the values of the nursing profession to society, in order
that society may change in accord with these values"

(Fowler, 1989, p 98)

Four characteristics required for successful advocacy are:

 assertiveness
 willingness to take risks
 good communication and negotiation skills
 ability to identify resources and obtain results

Empat karakteristik yang dibutuhkan untuk advokasi sukses adalah:

• ketegasan
 • kemauan untuk mengambil risiko

• kemampuan komunikasi dan negosiasi yang baik

• kemampuan untuk mengidentifikasi sumber dan mendapatkan hasil

Advocacy has been defined and implemented in many different ways, the
major concepts include citizen advocacy; self-advocacy; collective or class
advocacy; legal advocacy; and the focus of this paper, the nurse at patient-
advocate. The advocate may be the person themselves (self-advocacy); an
appointed official employed by a service organisation; an independent person or
"befriender"; an "expert" (e.g., legal advocate), or a professional who works
closely with the person (such as the nurse as advocate). In any of these different
forms and interpretations of advocacy, the nature of the act, the relationship
involved, and the goals and outcomes are likely to differ significantly. This
proposed is concerned with the nurse acting as the patient’s advocate within his
or her professional role, and other formulations are therefore excluded.

Advokasi telah ditetapkan dan diimplementasikan dalam berbagai cara, konsep utama termasuk
advokasi warga negara; self-advokasi; kolektif atau kelas advokasi; advokasi hukum; dan fokus dari
makalah ini, perawat pada penderita-advokat. advokat mungkin orang itu sendiri (self-advokasi);
pejabat yang ditunjuk dipekerjakan oleh organisasi jasa; orang yang mandiri atau "Bertemanlah";
"ahli" (misalnya, advokat hukum), atau profesional yang bekerja sama dengan orang (seperti
perawat sebagai advokat). Dalam setiap bentuk-bentuk yang berbeda dan interpretasi dari advokasi,
sifat tindakan, hubungan yang terlibat, dan tujuan dan hasil yang cenderung berbeda secara
signifikan. Ini diusulkan berkaitan dengan perawat bertindak sebagai advokat pasien dalam perannya
profesional, dan karena itu formulasi lain dikecualikan

Superficially, an advocate may be considered to be one who will always be

acting in the person’s "best interest" whatever that might be, and concerned with
doing "good", however closer examination of the ethical basis of advocacy
suggests that this is a simplistic and perhaps inaccurate portrayal of the role.

In nursing, the concept of the nurse as the patient’s advocate has been a familiar
one for a considerable time; it is implied in various nursing codes (e.g., ANA,
1985; UKCC, 1984 & 1992).

Dangkal, advokat dapat dianggap sebagai salah satu yang akan selalu bertindak dalam
"kepentingan terbaik" seseorang apa pun yang mungkin, dan peduli dengan melakukan
"baik", pemeriksaan namun lebih dekat dari dasar etika advokasi menunjukkan bahwa ini
adalah sederhana dan penggambaran mungkin tidak akurat peran.
Dalam keperawatan, konsep perawat sebagai advokat pasien telah menjadi salah satu yang
akrab untuk waktu yang cukup; itu tersirat dalam berbagai kode keperawatan (mis, ANA,
1985; UKCC, 1984 dan 1992).

There has been a common assumption that advocacy is a major role for
the nurse (Marks-Maran, 1993) and for some, advocacy is definitive of nursing
(e.g., Gadow, 1980, 1990) or as Murphy (1983) states "the highest order
nursing act..." Others, (e.g., Miller etal, 1983; Trandel-Korenchuk, 1983)
however argue that nurses cannot act effectively as advocates because of their
duties and loyalties to their employers, and the medical profession.

Some nurses who have taken their advocacy role to its full extent have
often found themselves in conflict with their employers, other professionals or
even their peers when they pursue issues on the behalf of their patients. In some
instances (for example Graham Pink, cited by Snell, 1991) this has ultimately
lead to disciplinary action and dismissal, even though the nurses professional
body had judged that they had not acted outside of their professional code of
conduct. Support for advocacy and patient advocates may therefore be more
theoretical than actual, and an appreciation of this situation may well inhibit
other nurses from full realisation of the patient advocacy role. The dilemmas
posed for nurses considering this role are therefore significant. It is arguable
that for many nurses advocacy is acknowledged and implemented only within
certain limits and boundaries, and it is suggested that nurses often curtail or
modify their advocacy activities when conflict with powerful authority figures,
within or without nursing, appears to be likely.

Models of advocacy:

The advocate as guardian of patient’s rights

This model of advocacy has some parallel with the legalistic definition
given above. It is based on the premise that the nurse is able to inform the
patient of their rights, and can then enable them to exercise those rights, or
intervene to ensure that their rights are respected (Gillette, 1988). Gates (1994)
definition of advocacy could be seen as fitting within this model.

Criticisms of this model are that the nurse-patient relationship is not

conceived in these terms by either party, and the nurse is not the best skilled or
equipped to fulfil this role (Fowler, 1989; Melia, 1987). The legalistic or
patient’s rights model may be too narrow a conception to deal with everyday
problems experienced by patients and their nurses, for example, treatment and
care decisions are rarely as clear-cut as being supported by claiming a right.

Also this perspective tends to pre-suppose a confrontational stance that may

prevent nurses from taking an advocacy role.
The advocate as conservator of the patient’s best interests

The idea that the advocate should be involved in helping the patient
receive care or make decisions that are in his or her best interests would at first
consideration seem unarguable. The great difficulty with this approach is
deciding what the patient’s best interests are, and by whose definition?

Paternalism, described by Gadow (1983) may often be the rationale or motive

behind "best interest" decisions. Paternalism is defined by Gadow as:

"The use of coercion to provide a good that is not desired by the one whom it is
intended to benefit"

(Gadow, 1983, p 43)

The advocate as conservator of the patient’s best interests

An example of this might be the patient who is persuaded to continue

with aggressive treatment of terminal illness because they have a theoretical
chance of survival. In such an example "good" provided (i.e. potential cure) is
defined according to the nurse’s or physician’s values based on cure (Gadow,
1989), however "good" for the patient may relate much more to the care
experience in such a situation. In this instance, advocacy as paternalism cannot
be defended as offering benefit in relation to the patient’s values, and it also
negates the principle of self-determination. The nurse’s actions may be guided
by "beneficence" (to do well) or "utilitarianism" (actions that are judged by their
social utility, or that offer the greatest good to the greatest number of people
(Harman, 1977). The outcomes derived may not coincide with the patient’s self-
determined best interests.

The advocate as protector of patient’s autonomy

Kohnke (1982) is a proponent of this model of advocacy, and identifies

two principle tasks for the nurse, informing and supporting. Informing involves
providing sufficient information for making informed decisions about health
care, and the supporting task which is concerned with reinforcing and upholding
the patient’s decision.

This model, however offers little assistance for the nurse caring for
patients who are unable to communicate or make informed decisions, and the
justification of action (or non-action) based on the client’s right to self-
determination may often bring the nurse into conflict with other ethical and
legal considerations. Also, Quinn & Smith (1987) argue that respect for
autonomy does not presume that the individual will make the best or even safe
decisions for themselves, and there is much evidence in daily life that
individuals do not do so, although it possible to make arguments such as that a
decision to commit a "dangerous" act, say for example misuse of drugs, may be
in the persons "best interests" given their own value system. Gadow (1979,
1983, and 1989) is a significant contributor to the advocacy literature with her
concept of "Existential Advocacy". She proposes this concept as the
philosophical
The advocate as protector of patient’s autonomy

Kohnke (1982) is a proponent of this model of advocacy, and identifies

two principle tasks for the nurse, informing and supporting. Informing involves
providing sufficient information for making informed decisions about health
care, and the supporting task which is concerned with reinforcing and upholding
the patient’s decision.

This model, however offers little assistance for the nurse caring for
patients who are unable to communicate or make informed decisions, and the
justification of action (or non-action) based on the client’s right to self-
determination may often bring the nurse into conflict with other ethical and
legal considerations. Also, Quinn & Smith (1987) argue that respect for
autonomy does not presume that the individual will make the best or even safe
decisions for themselves, and there is much evidence in daily life that
individuals do not do so, although it possible to make arguments such as that a
decision to commit a "dangerous" act, say for example misuse of drugs, may be
in the persons "best interests" given their own value system. Gadow (1979,
1983, and 1989) is a significant contributor to the advocacy literature with her
concept of "Existential Advocacy"

The advocate as a champion of social justice

 This view of advocacy as Fowler suggests, takes the nurse’s role as an
advocate from the patient’s bedside to beyond the institutional walls (1989, p
98). There may be an element of advocacy for individual patients, but the focus
is on social and political change to deal with inequities and inequalities in
provision of care at both macro’ and micro-allocation levels.

Manager

The manager's role is common to all nurses. Nurses serve as managers

when they oversee client care, supervise ancillary staff, do case management,
run clinics and conduct community health needs assessment projects. The nurse
engages in four steps of the management process of planning, organizing,
leading and controlling evaluation. Each of these functions is described in the
text. Specific decision-making behaviours are part of the manager's role as well
as human, conceptual and technical skills.

Peran manajer adalah umum untuk semua perawat. Perawat berfungsi sebagai manajer
ketika mereka mengawasi perawatan klien, mengawasi staf pendukung, melakukan manajemen
kasus, menjalankan klinik dan kesehatan perilaku kebutuhan masyarakat proyek penilaian. Perawat
terlibat dalam empat langkah dari proses manajemen perencanaan, pengorganisasian, memimpin
dan mengendalikan evaluasi. Masing-masing fungsi dijelaskan dalam teks. Spesifik perilaku
pengambilan keputusan merupakan bagian dari peran manajer serta keterampilan manusia,
konseptual dan teknis

The Nurse Manager plays an essential role in healthcare. She sets the tone of
any Healthcare System. The Manager is the backbone of the organization. The
quality of patient care, as well as staff recruitment and retention success, rests
with this key role. Over time it will be the strength of the nurse manager group
that determines the success or failure of nursing leadership, the COO, and even
the CEO.

And yet it is rare that nurse managers are given the opportunity to acquire the
operational, financial, and management skills essential to their success – and the
success of their organization.

The Nurse Manager plays an essential role in healthcare. She sets the tone of
any Healthcare System. The Manager is the backbone of the organization. The
quality of patient care, as well as staff recruitment and retention success, rests
with this key role. Over time it will be the strength of the nurse manager group
that determines the success or failure of nursing leadership, the COO, and even
the CEO.

And yet it is rare that nurse managers are given the opportunity to acquire the
operational, financial, and management skills essential to their success – and the
success of their organization

As critical as it is to develop those concrete and pragmatic skills noted above,

there is also a delicate subtle art to being a Nurse Manager... to balancing the
tensions between quality and cost ... to dealing with multiple stakeholders,
presenting conflicting agendas ... to dealing with stress and pressure every day
...to implementing processes needed to ensure that individualized
compassionate care is provided consistently in the most efficient and effective
manner possible...and we show you a system to succeed.

There are three keys to succeeding as a Nurse Manager

  A Complete and Comprehensive Understanding of the Nurse Manager
Role and Access to Best Practices

 A Comprehensive System for Success;

 A Toolkit to Succeed

Nurse Managers keys :

1. They balance the many pressures they face every day: budget
challenges; dealing with multiple stakeholders; managing up,
down, and across; handling labour issues and shortages; and, of
course, finding time to provide excellent care for patients.
2. They set themselves apart as stellar performers in your
organization and enjoy greater recognition, respect, and career
success.
3. They exhibit increased confidence in their role.
4. Work becomes more professionally gratifying.
5. The organization enjoys enhanced productivity, as well as
improved patient and staff satisfaction.

Description: The goal of a nurse manager is to facilitate and deliver

quality nursing care as well as to coordinate and manage
 the environment in which the care is delivered. The first-
line manager/head nurse assumes responsibility for the
personnel, resources, and patient care on a nursing unit. A
nurse supervisor is often responsible for several nursing
units or all units for a particular function such as staffing
or a shift, such as night supervisor. A manager directs and
promotes the development of nursing staff assigned to the
unit. Nurse administrators establish and control the budget
and support the implementation of standards of nursing
practice and guidelines of care

Settings: Hospitals, long-term care, ambulatory care, or

community/public/home health agencies

Characteristics: Personal satisfaction, power, recognition, prestige, and

economic gain; opportunities for promotion

Drawbacks: Scope of responsibility, pressures of competition, hard

work, and high degree of flexibility; consumer issues,
economy, politics, manpower, and technology

Desirable skills: Fact finding, analyzing, advice seeking, listening,

negotiating, and collaborating; risk-taking, tolerance for
ambiguity, assertiveness, self-reliance, and achievement
orientation; human relations, coaching, and compassionate
approach

Education: RN with BSN, MSN, or doctorate

Collaborator
 Collaboration with clients, other nurses, physicians, social workers, physical
therapists, nutritionists, attorneys, secretaries, and other colleagues is part of the
role of the community health nurse. Collaboration is defined as working jointly
with to hers in a common endeavour to cooperate as partners.

Kolaborasi dengan klien, perawat lainnya, dokter, pekerja sosial, terapis fisik, ahli gizi,
pengacara, sekretaris, dan rekan-rekan lain merupakan bagian dari peran perawat kesehatan
masyarakat. Kolaborasi didefinisikan sebagai bekerja bersama-sama dengan miliknya dalam usaha
bersama untuk bekerja sama sebagai mitra.

Skills required for successful collaboration are

 Communication skills,

 Assertiveness,

 Consultant skills.

Keterampilan yang dibutuhkan untuk kolaborasi sukses

• Kemampuan berkomunikasi,
• Ketegasan,
• keterampilan Konsultan.

Leader
 The role of leader is distinguished from the role of manager.
As a leader, the community health nurse directs, influences, or
persuades others to effect change that will positively affect
people's health. Acting as a change agent and influencing health
planning at the local, state and national levels are elements of the role of the
leader.

Peran pemimpin dibedakan dari peran manajer. Sebagai seorang pemimpin, perawat kesehatan
masyarakat mengarahkan, pengaruh, dan membujuk orang lain untuk mempengaruhi perubahan
yang positif akan mempengaruhi kesehatan masyarakat. Bertindak sebagai agen perubahan dan
mempengaruhi perencanaan kesehatan di tingkat lokal, negara bagian dan nasional adalah elemen
dari peran pemimpin.

Characteristics of an Effective Leader

A good leader must be:

• A lifelong learner

• A good communicator with effective interpersonal skills

• Able to look at the whole picture

• A good teacher

• Able to foster growth in others by mentoring and providing opportunities

• A model for effective change

• Accountable

• A problem-solver

• A promoter of collaboration
 • Knowledgeable in area of expertise

• Goal-oriented

• A person who seeks opportunities for growth

• Open-minded

• A good time manager

• Able to remain calm when everyone else is not

Researcher

In the role of researcher, community health nurses engage in systematic

investigation, collection, and analysis of date to enhance community health
practice Research in community health may range from simple inquiries to
complex agency or organizational studies. Attributes of a nurse researcher
include a questioning attitude, careful observation, open-mindedness, analytical
skills, and tenacity.

Dalam peran peneliti, perawat kesehatan masyarakat terlibat dalam penyelidikan sistematis,
pengumpulan, dan analisis tanggal untuk meningkatkan praktik kesehatan masyarakat Penelitian di
kesehatan masyarakat dapat berkisar dari pertanyaan sederhana kantor kompleks atau studi
organisasi. Atribut seorang peneliti perawat termasuk sikap ingin, pengamatan yang cermat,
keterbukaan pikiran, kemampuan analisis, dan keuletan.

Description: Involves all aspects of working with

 pharmaceutical/medical/nursing research

Practice roles: Clinical data coordinator, clinical research assistant, clinical

research monitor, research assistant

Characteristics: Opportunity to be part of groundbreaking studies, projects

Drawbacks: Some work is temporary or part time, travel may be required,

work can be tedious. Position may rely on availability of grant
money

Desirable skills: Strong observation and analytical skills, detail-oriented. Grant

writing experience helpful in some situations

Education: Varies. BS may be required. Some positions may require MS or

higher. Advanced nursing research usually requires PhD

Employers: Pharmaceutical companies, contract research organizations,

teaching and university hospitals, educational institutions,
temporary technical placement agencies

Keterangan: Melibatkan semua aspek bekerja dengan farmasi / penelitian medis /

keperawatan
peran praktek: koordinator klinis data, asisten penelitian klinis, memantau penelitian klinis,
asisten peneliti
Karakteristik: Kesempatan untuk menjadi bagian dari studi inovatif, proyek
Kekurangan: Beberapa pekerjaan adalah waktu sementara atau bagian, wisata mungkin
diperlukan, pekerjaan dapat membosankan. Posisi mungkin mengandalkan ketersediaan uang
hibah
keterampilan yang diinginkan: pengamatan yang kuat dan kemampuan analisis, berorientasi
pada detail. Hibah menulis pengalaman membantu dalam beberapa situasi
Pendidikan: Bervariasi. BS mungkin diperlukan. Beberapa posisi mungkin memerlukan MS
atau lebih tinggi. penelitian keperawatan maju biasanya membutuhkan PhD
Pengusaha: Perusahaan farmasi, organisasi penelitian kontrak, rumah sakit pendidikan dan
universitas, lembaga pendidikan, lembaga penempatan teknis sementara

TYPICAL FUNCTIONS:
The functions performed by employees in this job family will vary by level, but
may include the following:

 · Assesses health status of individuals, families, and communities; develops

plans and implements appropriate nursing interventions.

 · Evaluates and determines health resources necessary to meet individual,

family and community health needs.

 · Delivers professional nursing care in an assigned unit, clinic, home, or other

setting.

 · Educates individuals, families, communities, and members of the health

care team about the principles of disease prevention and health promotion.

 ·Provides supervision to other professional or paraprofessional personnel;

collaborates with other professionals in the management of health care.

 · Delegates tasks as may safely be performed by others, consistent with

educational preparation and that do not conflict with the provisions of the
Oklahoma Nursing Practice Act.

 · Assures quality health care through use of various measures such as record
review, peer review, direct observation, and assessment of individual, family,
and community for the desired outcome.

 · Performs specialized nursing functions as educationally prepared.

 The role of the nurse needs to be expanded to include protection of women's
reproductive potential. Nursing has adjusted to the change in medical care
through assistance in regaining of health in acute and extended care facilities, in
health maintenance, and in acting as primary care providers in providing
information on prevention. Infertility increases with age. The impact of
contraceptive choices on fertility is reviewed for barrier contraception, oral
contraception, IUDs, sterilization, and new contraceptive methods. At different
stages in the life cycle there are methods of contraception that are more
appropriate than others. The environmental effects on fertility are noted for
diethylstilbestrol (DES), which may result in cell carcinoma and changes in the
cervical ectropion, uterine, and tubal anomalies; these effects in turn may lead
to decreased fertility or fetal loss. DES may also affect male fertility. Chemicals
in the workplace such as lead, ionizing radiation, ethylene oxide, and
dibromochloropropane are federally regulated because of deleterious effects on
reproduction. Other metals and chemicals that may affect fertility are indicated.
The prevention of sexually transmitted diseases has a significant impact on
preservation of fertility. Life style choices and counseling at early stages of
disease are important considerations. Women who smoke have an earlier
menopause, have reduced estrogen levels, and increased vaginal bleeding.
Infant mortality is higher among women who smoke. Fetal alcohol syndrome is
known, but alcohol's effect on fertility is not well documented. Adolescent drug
use may lead to later dysfunction. Marijuana use in adults has been related to
decreased levels of follicle stimulating hormone, luteinizing hormone, and
prolactin, which appears to be reversible in adults. Exposure to high levels of
heat is related to male infertility (sperm quality and number); increased scrotal
temperature may be caused by febrile illness, varicocele, hot tub usage, and
tight jockey shorts. Fertility impairment may be related to a previous medical or
surgical intervention. Options are available for organ preservation rather than
outright removal. General health conditions related to infertility are identified.
The nurse practitioner as a preconception counselor may screen for potential
infertility and collect a routine history and physical examination including
testing.

Peran perawat perlu diperluas untuk mencakup perlindungan dari potensi reproduksi perempuan.
Keperawatan telah disesuaikan dengan perubahan dalam perawatan medis melalui bantuan dalam
mendapatkan kembali kesehatan di fasilitas perawatan akut dan diperpanjang, dalam pemeliharaan
kesehatan, dan dalam bertindak penyedia perawatan primer dalam memberikan informasi tentang
pencegahan. Infertilitas meningkat dengan usia. Dampak pilihan kontrasepsi pada kesuburan ditinjau
untuk kontrasepsi penghalang, kontrasepsi oral IUD, sterilisasi, dan metode kontrasepsi baru. Pada
berbagai tahap dalam siklus hidup ada metode kontrasepsi yang lebih tepat daripada yang lain.
Dampak lingkungan pada kesuburan dicatat untuk dietilstilbestrol (DES), yang dapat mengakibatkan
karsinoma sel dan perubahan dalam ektropion serviks, uterus, dan anomali tuba; efek ini pada
gilirannya dapat menyebabkan kesuburan berkurang atau hilangnya janin. DES juga dapat
mempengaruhi kesuburan pria. Bahan kimia di tempat kerja seperti timah, radiasi pengion, etilen
oksida, dan dibromochloropropane yang diatur pemerintah federal karena efek merusak pada
reproduksi. logam dan bahan kimia lainnya yang dapat mempengaruhi kesuburan ditunjukkan.
Pencegahan penyakit menular seksual memiliki dampak yang signifikan terhadap pelestarian
kesuburan. pilihan gaya hidup dan konseling di tahap awal penyakit pertimbangan penting. Wanita
yang merokok memiliki menopause sebelumnya, telah mengurangi tingkat estrogen, dan
peningkatan perdarahan vagina. kematian bayi lebih tinggi pada wanita yang merokok. sindrom
alkohol janin diketahui, tetapi efek alkohol pada kesuburan tidak terdokumentasi dengan baik.
penggunaan narkoba remaja dapat menyebabkan disfungsi kemudian. menggunakan ganja pada
orang dewasa telah terkait dengan penurunan kadar hormon perangsang folikel, hormon luteinizing,
prolaktin dan, yang tampaknya reversibel pada orang dewasa. Paparan tingkat tinggi panas
berhubungan dengan infertilitas pria (kualitas sperma dan jumlah); peningkatan suhu skrotum dapat
disebabkan oleh penyakit demam, varikokel, penggunaan bak mandi air panas, dan celana pendek
joki ketat. penurunan kesuburan mungkin terkait dengan intervensi medis atau bedah sebelumnya.
Pilihan yang tersedia untuk pelestarian organ daripada penghapusan langsung. kondisi kesehatan
umum yang berhubungan dengan infertilitas diidentifikasi. Perawat praktisi sebagai konselor
prasangka mungkin menyaring potensi kemandulan dan mengumpulkan sejarah rutin dan
pemeriksaan fisik termasuk pengujian.
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