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16.1 The Community as the Client

When the community is the client, nurses address the community’s collective health instead of the acute and chronic health needs of individual clients. Community health nurses focus on promoting health, reducing risk, ameliorating disparities, and increasing equity. Communities may consist of groups of residents in a geographic area or groups of people sharing common characteristics. Nurses use many approaches, such as windshield surveys, to identify community health risks. Nurses should also consult public reports and other open information sources and interview community partners, decision-makers, and community members to ensure accurate assessments and meaningful data and to facilitate ethical practice. Partnerships with community members build trust, convey respect, minimize risk, and contribute to positive health outcomes. Inclusive practices in community-based work align with the concept of decolonization in nursing.

16.2 What Is a Healthy Community?

Communities can work together to support acheivement of full health potential in terms of physical health, mental health, education, community access, employment, and other aspects essential to wellness. The Robert Wood Johnson Foundation (RWJF) supports community health, health equity, and eliminating disparities. The RWJF Culture of Health initiative focuses on community-based health determinants such as access to care, housing, food, and economic stability. While clinical interventions and condition-specific nursing care are important, this kind of care is insufficient to achieve health equity. Focusing on social, economic, and environmental factors is imperative to creating healthy communities.

16.3 The Nursing Process as a Framework

The stages of the nursing process as a framework are assessment, diagnosis, planning, implementation, and evaluation. Nurses can use this framework in community health to guide scientific reasoning, problem-solving, and critical thinking when determining the need for community-level interventions. Holistic approaches to community health practices are based on recognizing that the dimensions of community health are interconnected and interact in complex ways.

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