NURSING may help in the evaluation of

MANAGEMENT
applicants.
AND LEADERSHIP-BSN
Chapte7 PERSONAL AND • Age and physical condition
• Emotional stability and goals in
PROFESSIONAL
life- most employees prefer young
DEVELOPMENT nurses for beginning positions;
A. administrative positions will
POSITIVE IMAGE OF A NURSE , SELF require nurses who are mature in
ASSESSMENT. SELF AWARENESS judgment.
• Emotional stability and goals in
PROFESSIONAL ACCOUNTABILITY life- can you be calm under
Profession – a calling, occupation stress; be rather alone than in a
Professional adjustment – growth of crowd?
the whole person in the development of
his capabilities to make him/her fit to Factors in selecting a field of
assume a new position. nursing
Criteria for a profession – 1. Kind of work to be performed
 Specialized education (school) 2. Availability of the work
 Body of knowledge- theoretical 3. Hours of work
framework that contribute to the 4. Qualifications
knowledge base of nursing 5. Opportunities for advancement
 Service oriented- hallmark of 6. Method of entering- examination ?
nursing – altruism (selfless Recommendation ?
concern for the welfare of others) 7. Earning
Professional organization- for 8. Fringe benefits/Other benefits
nursing - PNA Sept. 2, 1922 -
founder- Anastacia Giron Tupas [Link] OF NURSING PRACTICE
Characteristics of a profession Review- History of Nursing
 Altruism- selfless concern for the • Florence Nightingale –
welfare of others • Matriarch of modern nursing-
 Accountability – answerable for worked not only for the
one’s action advancement of nursing ; also
 Responsibility – obligation to fulfill contributed to the improved
a task sanitation in India and Public
 Autonomy – self governance Health in great Britain
 Authority – power to direct the • “The lady with a Lamp during the
work of others. Crimean war she wrote:
Choosing, Retaining, Resigning and  Notes on Matters affecting health
Dismissal from Job  Efficiency and hospital
Self evaluation when selecting a Job: administration of the British army
• Qualifications- educational, does  Notes on hospitals and Notes on
it fit the job you are applying for? Nursing : What is it, what it is not
(Minimum qualification for the “ Nature alone cures what nursing
job) has to do… is to put the patient in
• Years of experience and training- the best condition for nature to
staff nurses do not require any act on him”
experience and training but such Highlights in Nightingale’s
career
• Experience at Kaiserwerth- she
realized the need for nursing
1
 reform to train reliable and the modern concept of the visiting
qualified nurses. nurse
• Crimean War- she was able to • Early 1990’s- Lilian Wald and
demonstrate what nurses could Mary Brewster- began a program
do to improve the health of for visiting nurses
people; particularly the wounded • 1922 – The Filipino Nurses
soldiers. Association was born (became
• Nightingale school for Nurses (St. PNA in 1966) was admitted to the
Thomas Hospital) – established International Council for Nurses
1860- the first school – this (ICN) 1929
became the prototype for others. • 1937- first time the board of
The Nightingale Pledge- Examiners for nurses was headed
formulated in 1893- by a by a nurse
committee headed by Mrs. • Post world war II – colleges of
Gretter nursing came into being
Important historical events /social • 1973- President Quirino signed
developments influencing the the Bill that became the Phil
evolution of nursing Nursing Law (RA 877) amended
• Historical developments- by RA 4704; later Phil Nursing act
 Crusades of 1991 ( RA7164) and the Phil
 The renaissance Nursing Act of 2002- (RA9173
 The Reformation • 1958 – Pres. Garcia issued
 The Industrial revolution Proclamation 539 declaring
• Technological – modern science October as Phil. Nurses week
and facilities • 1990’s- Continuing Professional
Social changes – liberation of women education (CPE) was mandated as
requirement for re licensure
Some significant events and Oldest Nursing schools in the
developments in the history of country
nursing in the Philippines • Iloilo Mission Hospital (1906)
• Seems to have started by Fray • Philippine General Hospital (1907)
Juan Clemente- founded the San • St. Luke’s Hospital, School of
Lazaro Hospital in 1378- was Nursing (1907)
devoted to his nursing work • Mary Johnston Hospital School of
• 1879- UST started classes in Nursing (1907)
Practica medica – 2 year course • San Juan de Dios Hospital School
• Dr. Bacala- 1961- wrote that of Nursing – 1913
“graduates had to pass a revalida • Emmanuel Hospital school of
before they were given Nursing (1913)
certificates – these graduates
could do minor surgery in town s • Southern islands Hospital, School
without doctors and treat minor of Nursing (1918)
ailments. • Zamboanga General Hospital
• 1906- Iloilo Mission Hospital – school of Nursing (1921)
graduated the first trained nurses • Chinese General Hospital School
in the hospital of Nursing –(1921)
• 1912- visiting nurses were fielded • Baguio General Hospital, school of
by the Bureau of Health to give Nursing (1923)
home care to newborns and • Manila sanitarium, School of
mothers Nursing ( 1930)
• 1850’s -William Rathbone • Saint Paul’s School of Nursing
(Liverpool, England) – established (1946)

2
 • Quezon Memorial Hospital, School • Observe the code of technical
of Nursing – 1957) standards for nurses
First Colleges of Nursing • Uphold the standards for safe
• UST College of Nursing – 1946 nursing practice
• Southwestern Colleges of Nursing • Maintain competence by continual
– 1947 learning through professional
• Manila Central University, College continuing education to be
of Nursing- 1947 provided by the accredited
• Philippine Union College- 1947 professional organization or any
• Central Philippine College- 1947 recognized professional nursing
• Silliman University – 1947 education.
• University of the Philippines- 1948 • Career Planning
• Philippine Women’s University-
1951 A. CAREERE PLANNING
• Far Eastern University Institute of 1. Choosing a field of nursing
Nursing- 1955 2. Locating job openings
• University of the East, College of 3. Resume- summary about one’s
Nursing - 1958 education, employment,
Members of the first Board of profession, personal history
Examiners March, 1919 Pre-requisite for an interview
1. Dr. Juan Cabarrus – President • Printed on high quality 81/2 – 11
2. Mrs. Belen del Rosario- member typing paper (never handwritten)
3. Anastacia Giron- member • Contents- concise, complete but
• First Nurses Board exam – given not crowded
by the board of examiners – June Contents of a resume:
14, 21,25, 1920; Theory- at UP;  identification, full name, address,
Practical at PGH Tel. no. (appears at the beginning
• Number of candidates – 93 of the resume)
• 68 passed; 25 failed  Job objective
 Highest – 93.5 – Anne Dahlgan  Education – reverse chronological
 Second – 93.4 – Pamintuan (PGH) order- name and location of
 Third- 84.6 – Zabalo (PGH) school
 Work experience- reverse
Stages Of Nursing Practice chronological order- name,
location of each agency, position
and dates of employment
• Novice- no experience, beginner
 Military (if any)
• Advanced beginner- experience- 2
 Affiliations – membership in
years, performance- acceptable
offices, organizations, societies
• Competent- 2-3 years; can cope  Honors and awards
with and manage contingencies;  References
organizational ability a little lack 4. Cover letter- to accompany
of speed) resume
• Proficient – perceives situation as 5. Job procurement- once a position
a whole, performance guided by has been accepted, other agencies
maxim; 5 years experience ; where you applied should be notified
confidence Factors in selecting a field of
• Expert- enormous experience nursing
In addition to their duties, what 1. Kind of work to be performed
are expected of nurses in the 2. Availability of the work
practice of their profession? 3. Hours of work
4. Qualifications
5. Opportunities for advancement
3
 6. Method of entering- examination ? Useful Pointers in writing
Recommendation ? application letters
7. Earning • Use clean, white, unlined paper.
8. Fringe benefits/Other benefits • Use ink or ball pen in writing- you
Writing a letter of application may want to type the letter if you
ABCD of good writing: want.
• Accuracy – data well researched • Use proper salutation
• Brevity- putting as much, no • Observe proper margin and
more, no less paragraphing
• Clarity- simple, logical, clear, • Write in a courteous manner
correct grammar, punctuation • Enclose return postage.
• Dignity – professional, command Contents:
respect, polite but not heavy, 1. 1st paragraph- Source and
purpose- source of info re
4 P’s of a business letter vacancy, intent to apply for the
1. Personal- like a conversation, not position
communicating to a paper, use 2. 2nd and 3rd paragraphs -
personal pronouns active voice. Qualifications- school or college
Use You, instead of we attitude. where graduated, year of
Ex: we attitude- I believe your graduation, experience
company could use an efficient 3. Reference- at least 3 persons who
program like me. I enclose my gave consent to the use of their
resume. names- former principals or
You Attitude- If your company is deans, parish priest, professional
looking for an efficient programmer, nurse or one’s former instructor
please consider the enclosed Contents of a letter of application(cont)
resume. 4. Request for personal interview-
2. Positive- Ex: half ,instead of half last paragraph
empty
3. Polite- please, kindly Personal Interview
4. Professional- not heavy language Interview- a face to face conference
Steps in writing a letter between 2 people about something.
1. Determine the ff: who are you • For the employer- gives him/her a
writing to; your objective, message chance to assess the applicant’s
you want to deliver personality, poise in answering
2. Outline questions
3. Put in transition • For the applicant- gives him/her a
4. Read aloud, review, revise background of the institution
3 main parts of a business potential as a working place
letter: • A two way process – employer
1. Introduction- opening statement, and applicant discuss conditions
single statement states first major of work and other related topics.
idea, single statement states • An applicant sells herself/himself ;
second major idea wants to convince the employer
2. Body – first major idea – explain, that he/she is the best applicant
support and conclude first major for the job.
idea – (transition statement) Pointers in preparing for an
second major idea – transition interview
statement; third major idea; 1. Make an appointment either by mail
transition statement or telephone.
3. Conclusion – summary if letter is 2. Be at the place at the appointed
lengthy; closing statement time.

4
3. Know something about the
institution where you will apply, Policies
4. Be at your best. Policies- rules that govern all actions
5. Knock before you enter. at all organizational levels.
6. Bring the necessary credentials. Ex. Of Policies
7. 6. Ask questions about the job. • Personnel policies – absences,
8. 7. Thank the interviewer for giving accidents, addresses,
you some of his/her time. assignments, meal breaks
9. 8. Give yourself time to think about confidential information,
the position. employee benefits, health
10. 9. If the prospective employer programs, hospitalization,
does not answer, you may write a holidays, Performance evaluation,
follow up letter stating your interest designation, leaves membership
in the position. in GSIS, promotion, recognition of
What nurses should know about employees performance,
the institution/agency where they achievements
work: • Nursing service policies-
• Mission, vision, goals Professional and ethical
• Benefits they receive- standards, staffing, assignments,
• Personnel policies, job description, nursing audit,
• conditions of employment nursing committees, nursing
• Provision for career or upward records, continuing education,
movement patient care, infection control and
Conditions of employment: fire safety
Tenure- nursing personnel (govt.) with Retaining a position
civil service eligibility are given 1. Adequate knowledge and
permanent positions after 6 months of preparation for the job.
satisfactory service to the institution, 2. Well developed personality;
they hold their position until such time cultivate a pleasing appearance.
that they are either promoted to higher This gives a good first impression.
office, reassigned or separated from the 3. Develop good interpersonal
service. relationship with co workers by:
Effectivity of appointment- upon 4. Develop proficiency in
assumption to duty entitling them to communication
receive all corresponding benefits. (oral/written)
Employee Benefits and 5. Be able to adjust to working
Requirements conditions and to life patterns
• Subsistence, quarters and laundry characteristic of particular
allowance occupations and communities.
• Salaries – established on the basis 6. Keep abreast with the advances
of equal pay for equal work in
• GSIS- membership is compulsory medicine, nursing and related
• Retirement Insurance- all sciences
personnel covered by compulsory Causes of failure
insurance 1. Incompetence or lack of the
Termination of employment- required ability and knowledge
(Resignation or transfer)- employee for the particular job.
should notify in writing at least one 2. Poor interpersonal relationship,
month prior to effectivity of resignation lack of cooperation with co
or transfer, an exit interview is workers, dishonesty, boastfulness
desirable and inability to get along with
Leave of absence- a privilege, not a people.
right. (governed by CSC rules
5
 3. Personality defects- imprudence • Hospitals and homes as private
in choosing friends, insincerity, duty nurses
conceit, sarcasm, lack of tact, • Independent practice – self
envy employed
• Entrepreneurs- day care centers,
Causes of failure (cont) nursing home , review centers
4. Inadequate knowledge in social • Educational institutions
conduct, too little time for Expanded Career roles for Nurses
relaxation and recreation • Clinical Nurse specialist- Expert in
5. Indifference to need fo a special field (oncologist, ostomy
professional growth, always nurse)
finding reason for not attending • Nurse Practitioner- deals with non
professional meetings or joining emergency acute or chronic
professional organizations. illness
• Nurse educator- CI, teacher
Resigning from a position • Nurse researcher- investigates
Reasons: issues
• To seek better positions • Nurse Administrator- HN, Sup, CN
• Inability to adjust to the work etc.
situation • Nurse Midwife- RA 7392- Phi.
If offered a better position, talk it over Midwife Act of ’92 with 20 actual
with employer. Leave a friendly feeling deliveries
towards supervisors and co workers.
Use prudence in accepting better • Nurse entrepreneuer – manage
positions. health care related business,
Give advance notice; leave with a clean consultation services
record. • Nurse anesthetist- Can give GA
Write a letter of resignation and under supervision of the
observe the ff: Anesthesiologist
1. Date of resignation. Different Fields In Nursing
2. State the reason for resigning 1. School Nursing – responsibility:
3. Express gratitude health teaching; PE; eye
4. Attach clearance for money, work screening
and property responsibilities. 2. Institutional Nursing – Hospital
Dismissal from a position (Seldom) and Nursing homes; should be
Reasons: updated in the current trends;
• negligence, presence of supervisor;
• malpractice, disadvantage- overworked;
• incompetence, understaffed
• unprofessional behavior or breach  Staff nurse –RN, BSN
of contract  Head Nurse- RN, BSN ; 2 yrs
experience in general nursing
EMERGING OPPORTUNITIES service; 9 units Management and
Administration course
Where do nurse work?  Chief Nurse- RN, BSN, Master in
Nursing
• Industries (occupational health
3. Military Nursing- deals with the
nurse)
health of soldiers-
• Local health agencies ( PHN,
Elvegia Mendoza- first Brigadier
school nurse)
General
• Clinics and hospitals (staff nurse,
 Male or female- single
N2,N3 etc.)
 With hazard and clothing
allowance
6
  Glamour and prestige of nurses and nursing in
 Lowest rank- 2nd lieutenant government agencies.
4. Occupational Health Nursing- 4. Association of Nursing Service
Industrial Nursing – Administrators of the Philippines
 Provision of personal protective (ANSAP)- founded in St. Luke’s
device Hospital – 1963 . First President-
5. Nursing Education Rosita Furia
 faculty – 1 yr. clinical experience; 5. Association of Deans of Philippine
Masters in Nursing Colleges of Nursing- (ADPCN)
 Dean – 5 years teaching 6. . Military Nurses Association of the
experience. MD or Master’s in Philippines- MNAP- Organized
Nursing 1965- V Luna Hospital AFP- first
6. Private duty Nursing- Military general – Brigadier
independent, contractual; General Elvegia Mendoza
comprehensive nursing care; one Academy of Nursing in the
on one Philippines
7. Clinic Nursing – Secretariat ; 7. Association of Diabetic Nurse
primary responsibility- assist the Educators of the Philippines
doctor during examination; acts (ADNEP)
as receptionist, answers the 8. 7. Association of Private Duty
phone; taking diagnostic result Nurse Practitioners of the
8. Community Health Nursing- learn Philippines (APDNPP)
to maximize community health 9. [Link] Nurses Guild of the
resources; Philippines (CGNP)
Disadvantages: exposure to 10. 9. Critical Care Nurses Association
chronic communicable disease; of the Philippines (CCNAP)
elements of dog bite, snake bite 11. 10. Graduate Nurses Christian
Fellowship (NCF) Occupational
NURSING ASSOCIATIONS Health Nurses Association of the
Philippines
Nursing Associations in the 12. Operating Room Nurses
Philippines Association of the Philippines
• Alumni association – the first (ORNAP)- founder Magdalena
association a nurse joins upon Valenzuela
graduation 13. 12. Maternal Child Nurses
• Professional Associations. Association of the Philippines
1. The Philippine Nurses Association – (MCNAP)
(PNA) organized Oct. 22, 1922 14. 13. Philippine Oncology Nurses
upon initiation of Mrs. Anastacia Association (PONA)
Giron Tupas. Office Kansas Ave. 15. 14. Philippine Orthopedic Nurses
Malate Society (PONS)
Nursing Associations in the Phil 16. . Catholic Nurses Guild of the
(cont) Philippines (CGNP)
2. National League of Phil. 17. Psychiatric Nursing Specialist
Government Nurses (NLPGN) foundation of the Philippines
formerly Department of Health (PNSI)
National League of Nurses 18. 16. Integrated registered Nurses
(DHNLN)- of the Philippines (IRNUP)
3. founded Jan. 16, 1961 by Annie 19. 17. International Nursing
Sand – Office DOH, Manila Annie foundation of Japan Scholars
Sand Leadership Award – given to Association- initiated by Mrs. Linda
an outstanding nurse or retiree Buha
who contributed to improvement
7
 What Nurses should know about
the PNA Awards given to Outstanding
Filipino Nurses
PNA – the only nursing organization 1. Anastacia Giron Tupas award –
accredited by the PRC given by the PNA
• Anastacia Giron Tupas- Founder 2. Outstanding Professional Award-
Sept. 1922 given by PRC
• Francisca Delgado –first President
• Marco Antonio Santo Tomas –
first male president ISSUES AND TRENDS IN
Purposes:
• To attain optimal level of
NURSING PRACTICE/
professional standards EDUCATION
• To work fro the welfare of nurses
• To respond to the changing health 1. Migration
needs of Philippine society 2. Aging Population Changing
• To establish linkages with demographics. The rapid growth
government , non government, in older population is one of the
local, national and international most influential forces shaping the
agencies in the attainment of health care delivery system as a
whole now and in the next century.
goals.
Majority of older people are active
ANA – 1986- National Professional individuals who prefer to live at
org. for nurses in the US home in apartments, mobile
Philippine National Red Cross (PNRC) houses .
• Candidates for Florence Assistive Technology- Abundance of
Nightingale award are processed innovations and uses of variety of
by the PNRC and forwarded to the equipment –have a direct application in
International Committee in nursing- aim is to increase patient’s
Geneva for final selection independence and thereby decrease
• Nursing service the workload of caretakers. Nursing
domains: mobility, special senses and
• Primary health care
communication, maintaining skin
• Nursing affiliation- strong linkages integrity , comfort, cognition,
with many colleges of nursing elimination and respiratory.
• Helping disaster victims Personal assistive devices:
• Disaster nursing Smart houses
• Disaster response Personal computers
• Tele health systems – (also known
International Nursing And Allied as telemedicine) – transmission of
Organizations audio, video, vital signs and data
1. International Council for Nurses suing a client computer terminal
connected through a single
(ICN)- composed of national
telephone line.
nursing association from each
• Technology will affect all health
member country. PNA is the professionals. Nursing will be done
member association for the Phil. differently in the 21st century and
(1929 at the ICN congress in nurse executives who can not
Montreal Canada. expand their thinking will be
2. International Committee of replaced by other health
Catholic Nurses- (ICCN) professionals who perceive that
3. World Health Organization (WHO) personal health devices can be used
4. International Red Cross- The by both care givers and care
International committee awards recipients.
the Florence Nightingale Medal to
Nurses
8
 Beyond Managed Care: Person-Centered served. There was much confusion as to
Care their purpose: service or nursing education
Effects Of Managed Care: These are _ 1923- need for self directed , independent
systems that integrate the financial and schools of nursing identified- Goldmark
delivery of health care services to report stressed the need to establish
enrollees by means of one or more of university based schools of nursing
the following: Arrangements with _ Next 4 decades- transition from hospital
selected providers to provide a based to university and college based
comprehensive set of health care schools of nursing- as faculty moved away
services; Explicit standards for the from practice, nursing service personnel
selection of health care providers. etc. moved away from education
• Nurse Practitioners NP’s – RN’s _ Early 1960’s- reintegrating nursing
whose formal education and training practice and nursing education
extend beyond the basic nursing The Shift To Community- The group of
 frequently case managers whose nurses affected most will be those in
central roles is to obtain and current leadership roles. As the concept of
negotiate the most cost effective leadership changes and becomes
treatment for the patient. integrated in all levels in the system,
 trained to diagnose and recommend traditional command and control positions
treatment for common acute are likely to disappear.
illnesses , disease prevention, Continued development of staff in a
management of chronic illnesses learning environment will be a top priority.
etc. Nurse executives will be expected to
4. managing a culturally diverse workforce design and implement entrepreneurship
Key employment Trends- and intrapreneurship. Tele-health
 changing demographics brought businesses in home practice will be
influences: from manufacturing – common; nurses in general will recognize
based economy to globalization of media as a powerful influence in patient
the workplace, immigration patterns and health education.
 With nursing being a predominantly
female profession ; nurse executives NURSING -SENSITIVE OUTCOMES
have special challenges in women’s _ Key is patient involvement; as self
health assessment of functional abilities will
 We are also aging- next 10 years become standard for all patients health
40% will be more than 45 years of relate quality of life will become as
age important as drug or gene therapies.;
health professionals will be able to monitor
Culturally Sensitive Awareness- clinical outcomes (medical or nursing); we
Nurse executives need to instill in their have moved from understanding process
staff the need for culturally sensitive to fully appreciating the importance of
awareness for an effective and outcomes.
competent work force. All individuals _ Patient satisfaction is considered an
are shaped by their cultural , societal outcome in its own right and can be
and familial experiences during lifetime; viewed as an objective of care representing
however it is not assumed that a the patient’s judgment of quality of care.
because someone is of certain cultural _ Nursing research on outcomes focuses
heritage that he or she has the most on the measurement of positive
characteristic reactions to all given aspects of health such as status of
situations physiologic, physical, emotional and
functional health and patient satisfaction
5. Beyond Integrating Practice rather than death, disease and disability to
Education and Research determine effectiveness of care.
Historical perspective: _ Technological explosion of genetic
_ Early schools of nursing were hospital knowledge through the Human Genome
based nurses were trained through Project (Collins and Jenkins,1997) has
apprenticeship with little emphasis on created enormous opportunity for nurses to
formal education. Nearly all schools were share leadership in the 21st century. Health
owned and controlled by the hospitals they professionals may think that genetic
9
disorders are infrequent , it has become Summary:
obvious that almost every identified • there will be an increased emphasis
disease has a genetic component, even on research that has relevance for
trauma may have elements of genetic both nursing practice and education
disposition to accidents. • Faculty members will be increasingly
_ Genetic education will be important for criticized for their lack of practice
nurses in all types practice and for health based research
consumers. In every health care setting, • Nursing service personnel will be
nurses will be involved with the care of expected to provide sophisticated,
patients who have genetic disorders, are cost effective evidence based patient
members of families with genetic care;
disorders , or undergoing genetic testing or • Research is the primary means of
gene therapy The prevention, diagnosis documenting effectiveness and
and treatment of a variety of health efficiency of nursing education and
problems is changing significantly in the practice
genetic age. • Nurses in the near future will be
expected to provide data to justify
GLOBALIZATION OF NURSING- Global nursing’s portion of education and
economy health care costs.
 influenced nursing education and
practice. There is a need for
students, nurses and faculty to have
multi-cultural experiences;
 Increased the availability electronic
communication and nurses in less
developed countries can now access
health info without traveling
distances
 Knowledge of health statistics in
other countries made US
professionals aware that the US no
longer ranks top for common health
data.
 Models of international exchange CHAPTER 8 - LEADERSHIP IN
should go beyond student and
faculty educational programs, COMMUNITY DEVELOPMENT
serious attention to be given to
clinical exchanges. Community Development
Concepts
THE NEXT 100 YEARS-Regardless of • What is a community? - a
program, degree Tebbitt (1997) suggests group of people with common
that job dimensions for nurse executive characteristics or interests living
over the next 10 years will require a clinical together
base and knowledge, skill and experience
within a territory or geographical
on the ff:
 Business acumen
boundary place
 Strategic and financial planning where people under usual
 Program development and conditions are found
implementation • What is health?
 Rapid problem solving 1. Health-illness continuum
and decision making 2. High-level wellness
 Teamwork and team building 3. Agent-host-environment
 Interpersonal and intergroup 4. Health belief
communication 5. Evolutionary-based
 Resource allocation 6. Health promotion
 Negotiation, Developing employee
7. WHO definition
potential
 Community organization relations.
10
 What is community health? - part
of paramedical and medical HEALTH PROMOTION -Primary focus
intervention/ approach which is of community health nursing
concerned on the health of the whole • Community health nurses are
population generalists in terms of practice
Aims: • Based on the recognized needs of
1. health promotion • communities families, groups and
2. disease prevention individuals
[Link] of factors affecting • FAMILY – unit of service
health • HEALTH TEACHING- primary
What is nursing? -assisting sick responsibility of the CHN
individuals to become healthy and
healthy individuals achieve optimum CHN ROLES OF THE NURSE
wellness • Clinician- focus on the health of
• The World Health individuals in the larger context of
Organization defines public the community.
health as the art of applying • Advocate- advocates self care,
science in the context of politics peoples ability to be active
so as to reduce inequalities in participants in their own health
health while ensuring the best and self determination, the right
health for the greatest number. to make their own decisions.
• • Collaborator- brings together
• A. Winslow- defined public strengths and resources of the
health as the science and art of people involved toward a goal.
preventing disease, prolonging • Counselor- key tasks include
life, promoting health and listening and providing feedback
efficiency through organized and information.
community effort. • Educator- provides skills,
What is Community Health knowledge and attitudes that the
Nursing? people need to make appropriate
• “The utilization of the nursing choice or decision
process in the different levels of • Hospice care- providing care skills
clientele-individuals, families, in a home or other setting and
population groups and balancing the client’s needs.
communities, concerned with the
promotion of health, prevention of
disease and disability and
rehabilitation.” Maglaya, et al
Basic Principles of CHN
• FACTS OF CHN
1. The community is the patient in CHN,
Focus- Promotion and preservation of the family is the unit of care and there
health are four levels of clientele:
• individual,
_Area of Content: Skills and • family,
knowledge relevant to both nursing and • population group (those who
PHN share common characteristics,
developmental stages and
Clients : Patient, general population common exposure to health
individuals and community problems – e.g. children, elderly),
_ Time Continual not episodal and
_ Scope- Comprehensive and General • the community.
not limited to a certain group
11
2. In CHN, the client is considered as an • Dec. 8, 1941 Victims of World
ACTIVE partner NOT War II were treated by the nurses
PASSIVE recipient of care of Manila.
3. CHN practice is affected by • July 1942 Nursing Office was
developments in health technology, in created; Dr. Eusebio Aguilar
particular, changes in society, in helped in the release of 31
general Filipino nurses in Bilibid Prison as
[Link] goal of CHN is achieved through prisoners of war by the Japanese.
multi-sectoral efforts • 1946 Number of nurses
5. CHN is a part of health care system decreased from 556 – 308.
and the larger human services system. • 1948 First training center of the
Bureau of Health was organized
History of Community Health by the Pasay City Health
Nursing Department. Trinidad Gomez,
• 1901 Act # 157 (Board of Health Marcela Gabatin, Costancia
of the Philippines); Act # 309 Tuazon, Ms. Bugarin, Ms. Ramos,
(Provincial and Municipal Boards and Zenaida Nisce composed the
of Health) were created. training staff.
• 1905 Board of Health was • 1950 Rural Health Demonstration
abolished; functions were and Training Center was created.
transferred to the Bureau of • 1953 The first 81 rural health
Health. units were organized.
• 1912Act # 2156 or Fajardo Act • 1957 RA 1891 amended some
created the Sanitary Divisions, sections of RA 1082 and created
the forerunners of present MHOs; the eight categories of rural
male nurses performs the health unit causing an increase in
functions of doctors the demand for the community
• 1919 Act # 2808 (Nurses Law health personnel.
was created) – Carmen del • 1958-1965 Division of Nursing
Rosario, 1st Filipino Nurse was abolished (RA 977) and
supervisor under Bureau of Health Reorganization Act (EO 288)
• Oct. 22, 1922 Filipino Nurses • 1961 Annie Sand organized the
Organization (Philippine Nurses’ National League of Nurses of
Organization) was organized. DOH.
• 1923 Zamboanga General • 1967 Zenaida Nisce became the
Hospital School of Nursing & nursing program supervisor and
Baguio General Hospital were consultant on the six special
established; other government diseases (TB, leprosy, V.D.,
schools of nursing were organized cancer, filariasis, and mental
several years after. health illness).
• 1928 1st Nursing convention • 1975 Scope of responsibility of
was held nurses and midwives became
• 1940 Manila Health Department wider due to restructuring of the
was created. health care delivery system.
• 1941 Dr. Mariano Icasiano • 1976-1986 The need for Rural
became the first city health Health Practice Program was
officer; Office of Nursing was implemented.
created through the effort of • 1990- 1992 Local Government
Vicenta Ponce (chief nurse) and Code of 1991 (RA 7160)
Rosario Ordiz (assistant chief • 1993-1998- Office of Nursing did
nurse) not materialize in spite of
persistent recommendation of the
officers, board members, and
12
 advisers of the National League of psychological and educational
Nurses Inc. needs, policy of given agency,
• Jan. 1999- Nelia Hizon was evaluation of past services given
positioned as the nursing adviser to the family
at the Office of Public Health TYPOLOGY OF FAMILY
Services through Department NURSING PROBLEMS USED IN
Order # 29. THE STATEMENT OF NURSING
• May 24, 1999- EO # 102, which DIAGNOSIS IN THE CARE OF
redirects the functions and FAMILIES
operations of DOH, was signed by
former President Joseph Estrada. • Health deficits are gaps
between actual and achievable
HOME VISIT health status such as no regular
• A professional face to face checkup and history of repeated
contact made by a nurse to a infections.
patient or to a family to provide • A health threat is a condition
necessary health care activities that promotes disease or injury
and to further attain an objective and prevents the people from
of the agency. realizing their health potential.
• Should have a purpose or Examples include, lack of
objective immunization and inappropriate
• Planning of home visit should role assumption.
make use of all available • Foreseeable crises are stressful
information about the patient and events such as death or illness of
his/her family. a family member.
• Frequency of home visit takes • A health problem is a situation
into consideration: acceptance of in which there is a demonstrated
the family and ability to recognize health need combined with actual
their needs, physical, or potential resources to apply
psychological and educational remedial measures.
needs, policy of given agency,
evaluation of past services given COMMUNITY
to the family DIAGNOSIS(community assessment
or situational analysis).
Steps: = process which involves the collection
of data about the community to identify
• greet client, explain procedure the different factors that may directly or
• A professional face to face indirectly affect the health of the people
contact made by a nurse to a and analyzing and seeking explanations
patient or to a family to provide for the occurrence of health needs or
necessary health care activities problems of the country.
and to further attain an objective
of the agency. Two types of Community Diagnosis-
• Should have a purpose or
objective 1. Comprehensive Community
• Planning of home visit should Diagnosis
make use of all available 2. Problem-oriented Community
information about the patient and Diagnosis.
his/her family. -.
• Frequency of home visit takes The Comprehensive Community
into consideration: acceptance of Diagnosis
the family and ability to recognize • more focused on obtaining
their needs, physical, general information about the
13
 community, takes the takes the 5. Developing the instrument
community as a whole and gives 6. . Actual data gathering
emphasis on all of its aspects, its 7. 7. Data collation
strengths and weaknesses 8. 8. Data presentation
• You will research :demographical 9. 9. Data analysis
data, socio-economic and cultural 10. 10. Identifying community
variables affecting health, health nursing problems
economic status ,status of the 11. 11. Priority setting
environment,
health and illness patterns, health
resources health manpower and
material resources, and the political Types of community nursing
and leadership patterns. problems
1. Health Status Problems —
• The prioritizing of the health problems that are directly related
problems will just come later on in to the community’s health (e.g.
the process. too many breeding grounds for
• You’ll have to look at a whole vectors, epidemics,
bunch of factors and see how malnourishment), increased or
they figure into the health status decreased morbidity
of the people. 2. Health Resources Problems —
• You’ll have relate everything — problems that concern a
from how politics affect the community’s health resources
people’s health to how their (e.g. understaffing in the
culture affects their health. barangay health center, lack of
• It encompasses all the aspects of hospitals, lack of health
the community’s health and looks transportation)
at it from all possible perspectives 3. Health - related problems —
problems that indirectly influence
The Problem-Oriented Community health (e.g. lack of funding from
Diagnosis the government, indifference of
• deals with problems that are the people)
readily seen and should be acted
upon immediately. For example, Prioritizing health problems
if there’s an epidemic in the
community, what you should Now, if you’re going to set your
make is a problem-oriented priorities, you must consider these
diagnosis. After all, it would be things:
quite unwise to use a 1. Nature of the condition or
comprehensive community problem presented- problems are
diagnosis when people are classified by the nurse as health
already dying and suffering. status, health resources or health
related problems.
Steps in conducting community 2. Magnitude of the Problem-
diagnosis severity of the problem measured in
1. Determining the objectives by terms of the proportion of the
deciding on the depth and scope population affected by the problem.
of data needed. 3. Modifiability of the Problem-
2. Defining the study population- probability of reducing, controlling or
maybe the entire population or eradicating the problem.
specific population group. 4. Preventive Potential- probability of
3. Determine data to be collected reducing the effects posed by the
4. Collecting the data problem.
14
 5. Social Concern- perception of the - Dengue Control
population or the community as they Program
are affected by the problem.
- Dental Health Program
- Doctors to the Barrios
(DttB) Program
Emerging Disease Control
Program
- Environmental Health
- Expanded Program on
Immunization
- Family Planning
- Food and Waterborne
Diseases Prevention and
Control Program
Food Fortification
Program
- FOURmula One
- Garantisadong Pambata
- GMA 50 / Parallel Drug
Importation (PDI)
- Human Resource Health
Network
- Healthy Lifestyle
Program
Health Sector
Development Program
- Knock-Out Tigdas
- Leprosy Control
Program
- Malaria Control
Program
DOH PROGRAMS - Measles Elimination
• Adolescent and Youth Campaign (Ligtas Tigdas)
Health and Development - National Cardiovascular
Program Disease Prevention and
- Botika Ng Barangay Control Program
- Breastfeeding Program / • National Filariasis
Mother and Baby Friendly Elimination Program
Hospital Initiative - National Mental Health
- BreastfeedingTSEK Program
- Blood Donation Program - Natural Family Planning
Cancer Control Program - Newborn Screening
- Child Health - Nutrition
- Diabetes Mellitus • - Occupational Health
Prevention Program Program
15
 - Health Development •
Program for Older
Persons (Elderly Health)
- Pinoy MD
- Persons with Disabilities
Program
- Pnuemonia and Other
Acute Respiratory
Infections (ARI's)
- Prevention of Blindness
Program
• - Rabies Control Program
- Safe Motherhood and
Women's Health
- Schistosomiasis Control
Program
- Smoking Cessation
Program
- Soil Transmitted
Helmenthiasis
- TB Control Program
- Unang Yakap

EPI
• Aim: To reduce morbidity and
mortality among infants & • Clean the skin with moistened
children caused by the 6 with boiled water and let dry
immunizable childhood diseases before injecting vaccine.
• Launched July 1976- • Fever, ,local soreness and rash
• PD996 – Sept. 16, 1976- provides are common side effects .
for the compulsory immunization Reassure mother that these are
for infants and children below 8 normal and needs no treatment
years old. and to give antipyretic for fever.
• RA 7846-Dec. 30, 1994- • If convulsions occur, this is
compulsory immunization against attributed to the Pertussis
Hepatitis B for infants and component of DPT. Next DPT dose
children below 8 years old. is not given or the pertussis
component will be removed.
• Opened vaccines should be
discarded properly: BCG after 4
hours discard DPT, OPV mealses
vaccine and Hepa B at the end of
working day.
• OPV and measles vaccine are
most sensitive to heat with
storage temp of -15 oC to -25 o C

16
 •

COMMUNITY ORGANIZING-
COPAR

17
 needs towards solving their long-
term problems (CO: A manual of
experience, PCPD)

Importance of COPAR
• COPAR is an important tool for
community development and
people empowerment as this
helps the community workers to
generate community participation
in development activities.
• COPAR prepares people/clients to
eventually take over the
management of a development
Definitions of COPAR programs in the future.
• A social development approach • COPAR maximizes community
that aims to transform the participation and involvement;
apathetic, individualistic and community resources are
voiceless poor into dynamic, mobilized for community services.
participatory and politically
responsive community. Principles of COPAR
• A collective, participatory, • People, especially the most
transformative, liberative, oppressed, exploited and
sustained and systematic process deprived sectors are open to
of building people’s organizations change, have the capacity to
by mobilizing and enhancing the change and are able to bring
capabilities and resources of the about change.
people for the resolution of their • COPAR should be based on the
issues and concerns towards interest of the poorest sectors of
effecting change in their existing society
oppressive and exploitative • COPAR should lead to a self-
conditions (1994 National Rural reliant community and society.
ConferenceA process by which a • COPAR Process
community identifies its needs A progressive cycle of action-
and objectives, develops reflection action which begins
confidence to take action in with small, local and concrete
respect to them and in doing so, issues identified by the people
extends and develops cooperative and the evaluation and the
and collaborative attitudes and reflection of and on the action
practices in the community (Ross taken by them.
1967) • Consciousness through
• A continuous and sustained experimental learning central to
process of educating the people the COPAR process because it
to understand and develop their places emphasis on learning that
critical awareness of their existing emerges from concrete action
condition, working with the and which enriches succeeding
people collectively and efficiently action.
on their immediate and long-term • COPAR is participatory and mass-
problems, and mobilizing the based because it is primarily
people to develop their capability directed towards and biased in
and readiness to respond and favor of the poor, the powerless
take action on their immediate and oppressed.

18
 • COPAR is group-centered and not disregard of their being role
leader-oriented. Leaders are models.
identified, emerge and are tested • Avoid raising the consciousness of
through action rather than the community residents; adopt a
appointed or selected by some low-key profile.
external force or entity. 3. Organization Building
PHASES OF THE PROCESS Phase
(COPAR) • Entails the formation of more
formal structures and the
1. Pre-entry phase inclusion of more formal
Is the initial phase of the organizing procedures of planning,
process where the implementation, and evaluating
community/organizer looks for community-wide activities. It is at
communities to serve/help. this phase where the organized
• It is considered the simplest leaders or groups are being given
phase in terms of actual outputs, trainings (formal, informal, OJT) to
activities and strategies and time develop their skills and in
spent for it managing their own
Activities include: concerns/programs
– Designing a plan for 4. Sustenance and
community development Strengthening Phase
including all its activities • Occurs when the community
and strategies for care organization has already been
development. established and the community
– Designing criteria for the members are already actively
selection of site participating in community-wide
– Actually selecting the site undertakings. At this point, the
for community care different communities setup in
2. Entry Phase the organization building phase
• Sometimes called the social are already expected to be
preparation phase as to the functioning by way of planning,
activities done here includes the implementing and evaluating
sensitization of the people on the their own programs with the
critical events in their life, overall guidance from the
innovating them to share their community-wide organization
dreams and ideas on how to • Strategies used may include:
manage their concerns and • Education and training
eventually mobilizing them to • Networking and linkaging
take collective action on these. • Conduct of mobilization on health
• This phase signals the actual and development concerns
entry of the community • Implementing of livelihood
worker/organizer into the projects
community. She must be guided • Developing secondary leaders
by the following guidelines
however.
• Recognizes the role of local
authorities by paying them visits
to inform them of their presence
and activities.
• The appearance, speech,
behavior and lifestyle should be in
keeping with those of the
community residents without
19
 Steps
conduc
g

comm

EPIunit
diagno
NatiEm
g
ing
opport
COMMU iesona
allied
NITY Organi
ORGANI onsper
ZING Stages
copC nursin
unity practic
orPhilipp ages o
ine
Health
Care
Delivery
System
anizing-
coparar

20
 f nursing Nursin
practiceSt Profes
ages of F
nursing DISCH
practiceal E, AND
/professio INCREA
OF SAL
nal
1.
developm
2. ARY
ent- 3. MAN
EME
gui
in
emp
ee
cou
ling
and
disc
ne.

1. Pro
es
fee
ck o
L emp
ee
per
man
2. Bas
for
per
nel
act
tran
r,
dem
on,
off
disc
ge,
EGAL and
ASPECTS incr
AND THE e of
NURSE sala
3. Man
eme
gui
in
OLEGAL emp
aspects ee
and the cou
Nursether ling
Laws and
Affecting disc
The ne.

21
 4. Promot
ion of
better
employ
ee-
employ
er
relatio
nship .

1. Provid
es
feedba
ck on
employ
ee
perfor
mance.
2. Basis
for
person
nel
action,
transfe
r,
demoti
on, lay
off
dischar
ge,
and
increas
e of
salary.
3. Manag
ement
guide
in
employ
ee
counse
ling
and
discipli
ne.
4. Promot
ion of
better
employ
ee-
employ
er
relatio
nship .

22