Application of the Salmon Model: A Tale of Two Cities

This report demonstrates the application of a recently developed conceptual model of public health nursing practice to a specific community problem. The nurse was able to assist one community group and lead another in identifying their needs, developing a plan to meet those needs, implementing the plan, and evaluating the results. The model provided a structure for the nurse to use in determining scope of practice, the importance of values, practice priorities and interventions, and the relevant determinants of health. This project also served to demonstrate faculty practice. Graduate students in community health nursing attended the nonsmokers' group meetings and city council hearings. They participated at various levels, but primarily they observed their instructor putting into practice the role of the public health nurse specialist as described in the classroom. Discussions regarding group dynamics and community action strategies often occurred in the classroom as a direct result of faculty and student involvement. The Salmon model for public health nursing practice has significant potential for application in numerous areas. It can serve as a unifying force in considering the many variables that influence community action. Being specifically designed for public health nursing, it holds great promise for optimizing the practice of the nurse in community settings.     

Developing community partnerships in nursing education for children's health

Community partnerships are central to educating nurses and providing much-needed services to underserved children in Baltimore City. Johns Hopkins University School of Nursing (JHUSON) collaborates with Head Start programs and a local elementary school for faculty practice and child-health clinical Service Learning experiences. At local Head Start programs, undergraduate nursing students annually screen > 1000 children for height, weight, hearing, vision, and blood pressure. Results are sent to parents with referral information if indicated. In addition, graduate and baccalaureate nursing students implement skills and knowledge learned in the classroom in a nurse-run clinic in a local elementary school, a faculty practice site. The Service Learning community partnerships benefit nursing students because they can apply principles of growth and development while providing important health screening to children in underserved populations. All students gain from practicing in the community and applying their classroom instruction to the care of children.     

Academic nursing practice in rural West Virginia

This exemplar highlights how a rural academic nursing practice has been effective in facilitating the integration of the tripartite academic role of education, research, and service for one university faculty member. The integration of students into the practice is described. The experience provided them with critical insights into rural academic practice during their delivery of prenatal care services to a vulnerable population of women in rural Appalachia. This exemplar also describes the use of the academic nursing practice as a laboratory both for studying the specific problems of this vulnerable population of women and their families, and testing interventions tailored to the needs of the community. Finally, the other ways the academic nursing practice benefits faculty and students, including integration of educational technology into the practice setting and opportunities for faculty leadership in rural community development, are discussed.     

Associate degree nursing in a community-based health center network: lessons in collaboration

This exemplar highlights the ability of community experiences to enhance nursing students' understanding of the principles of community-based care: advocating self-care; focusing on prevention, family, culture, and community; providing continuity of care; and collaborating. An innovative teaching-practice model (i.e., a nurse-managed "network" of clinics), incorporating service-learning, was created. The Network's purposes are to provide practice sites in community-based primary care settings for student clinical rotations, increasing the awareness of the civic and social responsibility to provide quality health care for disadvantaged populations; and to reduce health disparities by increasing access to free primary health care, including health promotion and disease prevention, for disadvantaged individuals. Network clients receive free health care, referrals, and guidance to effectively obtain additional health care resources for themselves and their families. The Network is a national pioneer in modeling the delivery of primary care services through a faculty-student practice plan, with leadership emanating from a community college.     

Celebrating a commitment to care: building concernful practices among practitioners

Caring can be discussed and achieved in a variety of ways within various professional nursing settings. The purpose of our Commitment to Care Celebration was to share common experiences of caring among students, faculty, and staff to build community at a small midwestern college of nursing. The concernful practices of schooling learning teaching were the backbone of designing this caring experience. Narrative pedagogy invited stories of caring among participants in small circular groups to discover what was most important in caring for self and others. This event revealed a true caring experience for students, faculty, and staff, and supported how concernful practices engendered a community of learners.     

The University of Iowa Nursing Collaboratory: a partnership for creative education and practice.

This article describes a comprehensive partnership between a college of nursing and its corresponding department of nursing services. The Nursing Collaboratory was created to provide an infrastructure for the generation, dissemination, and application of knowledge to improve nursing practice and patient outcomes. In addition to creative problem solving, the Collaboratory serves as an "incubator" of ideas and innovation, engaging nursing staff, faculty, and students in the development of new products and services to enhance nursing education and practice. J Prof Nurs 17:114-120, 2001.     

Enhancing cultural competencies of advanced practice nurses: health care challenges in the twenty-first century

Shifting population demographics will have a major impact on the practice of advanced practice nurses (APNs). The ethnic composition of people in this country is becoming increasingly diverse. Massachusetts and, in particular, the city of Worcester is also experiencing changes in the diversity of its population. These trends testify to the great need for APNs who are sensitive to and competent to care for culturally diverse populations. To address these changes, specific curricula enhancements focused on ethnically diverse populations were implemented for the nurse practitioner specialties at the Graduate School of Nursing (GSN), University of Massachusetts Worcester. The processes used for this project included visiting community and clinical sites, identifying key curricular components, and evaluating existing didactic and clinical learning experiences. The GSN faculty developed a systematic plan for integrating these components into the graduate nursing core, advanced practice core, and specialty courses of the respective curricula. A major outcome of this project was the enhanced preparation of APN students to meet the multifaceted needs of ethnically diverse patients, families, and communities.     

A study of nurse faculty job satisfaction in community colleges in Florida

There are many factors that influence nurse faculty job satisfaction including professional achievement and growth, interpersonal relations, leadership, recognition, responsibility, salary, and working conditions. However, much of the research in this area is limited to the clinical nurse setting. There are few studies that focus on nurse faculty job satisfaction in the community college setting. One of the primary drivers for the current nursing shortage in the United States is a shortage of faculty. Better understanding of the factors influencing job satisfaction among faculty may be helpful in addressing the faculty shortage. The purpose of this study was to explore the constructs of job satisfaction and intent to stay. Community college nursing faculty was chosen given that all of the authors were nursing faculty in this type of setting. Examining the relationship between job satisfaction and intent to stay of nurse faculty in community colleges in Florida could provide information for deans and administrators of nursing programs to address the nurse faculty shortage. The sample was drawn from Associate in Science Programs faculty from the 23 community colleges in Florida that offer a nursing program. The qualitative part of this study focused on the perceptions or feelings of nurse faculty. The open-ended questions were based on the subscales of Herzberg's Motivation to Work Theory. The findings revealed that nurse faculty were most passionate about the salary and the work itself. The overwhelming majority response was that the faculty loved their jobs. This study found that overall job satisfaction can be used as a predictor for intent to stay. Findings further revealed that nurse faculty in community colleges in Florida are generally satisfied with their jobs and have intent to stay.     

Innovations in community health nursing: Examples from practice

Cusack L, Smith M, Byrnes T. International Journal of Nursing Practice 1997; 3: 133–136
Innovations in community health nursing: Examples from practice
The Ottawa Charter for Health Promotion is cited internationally as an appropriate conceptual framework for healthcare service delivery yet the literature reveals minimal evidence of nursing services interpreting and applying the Ottawa Charter strategies into nursing practice. Nurses with the community services of Noarlunga Health Services and the Drug and Alcohol Services Council of South Australia, however, do use the strategies to plan and implement their services. The Ottawa Charter strategies of developing personal skills; creating supportive environments; strengthening community action; building healthy public policy; and re-orienting services in the interest of health can be used as a tool to assist nurses to identify the purpose of their interventions and select a comprehensive range of nursing actions which address the needs of individuals while acknowledging the broader determinants of health. This article presents a nursing analysis of the Charter and provides examples of how the strategies are used to influence nursing practice in both organizations. The examples provided from the two different nursing services also demonstrate the adaptability and relevance of the strategies to diverse community nursing practice settings.     

Nurse-managed primary care: outcomes of a faculty practice network

PURPOSE: To describe selected outcomes of nurse-managed primary care in a large faculty practice network (FPN) and to use guidelines proposed by the National Organization of Nurse Practitioner Faculties (NONPF) to evaluate those outcomes. DATA SOURCES: Mission and goals, nursing control, fiscal stability, health care outcomes, and faculty role integration were examined. CONCLUSIONS: Outcomes show that the FPN directly supports the mission and goals of the East Tennessee State University College of Nursing and is managed by nurse faculty members. The FPN uses earned revenue, grants, and contracts to maintain fiscal stability. Patients are highly satisfied with services, and external and internal audits find the quality of care to be excellent. Students are educated in the centers. Faculty members publish and present research and other scholarly work derived from the FPN. IMPLICATIONS FOR PRACTICE: This model demonstrates that faculty practice can work, can meet the evaluation components of guidelines of a major national organization, and can contribute to the improvement of health for vulnerable populations.     

Building skills in pediatric nursing: using a child care center as a learning laboratory

The collaborative efforts of faculty in nursing and early childhood education resulted in opportunities for nursing students to enhance their skills in the observation and assessment of preschool-age children, as well as to plan for and interact with young children in the context of health-related learning activities. A community child care center served as the field laboratory for these learning experiences. Through these activities, nursing students were able to gain valuable insights into the development and learning of young children and to clearly relate textbook material to actual child behavior. Opportunities to observe differences within a group of children of similar ages strengthened students' abilities to recognize the nature of individual differences and the implications of various developmental characteristics for nursing practice. Finally, students gained valuable experience using their observations to plan for the children's learning through play and interactions that matched their unique developmental needs.     

A community-oriented primary care nursing model in an international setting that emphasizes partnerships

PURPOSE: To present an interdisciplinary, community-oriented primary care nursing model that effectively draws upon the strengths of advanced practice nurses (APNs), both nurse practitioners and community health nurses. DATA SOURCES: Articles in professional nursing journals, international data sources, and the clinical experiences of the authors, both domestic and international. CONCLUSIONS: The model, developed domestically, was utilized successfully by APNs internationally in a medical mission endeavor in rural Haiti. Many partners, domestic and Haitian, worked as an interdisciplinary team to deliver quality health care to an impoverished population. Graduate nursing students participated in the program, which offered opportunities and challenges for both novice and expert nurses. IMPLICATIONS FOR PRACTICE: Nurse practitioners, community health nurses, and nursing faculty members can use this model to enhance their professional practice. They can learn that clients can be optimally cared for whether the community served is domestic or international. Nursing faculty can teach graduate nursing students about the value of partnerships and collaboration.     

Interprofessional Education for Undergraduate Students

Collaborative practice is an essential component of public health nursing. Using an interprofessional collaboration process, community health nursing and social work faculty developed joint classroom instruction and clinical experiences for their students. In partnership with a neighborhood organization, the undergraduate nursing and social work students conducted a community assessment and recommended a plan of action. Analysis of the student collaborative practice revealed both similarities and differences in role perceptions, group process, problem solving, and discipline-specific values and attitudes. Logistical concerns revolved around student scheduling and communications. Based on the analysis, specific recommendations are provided for faculty in developing student collaborative experiences across disciplines.     

Of Lillian Wald, Community Health Nursing Education, and Health Care Reform

Abstract A pilot project is described that was initiated to provide a comprehensive clinical experience for community health nursing (CHN) students despite local cutbacks in field nursing services. The project, entitled the Nursing Elementary Education Outreach Project (NEEOP), is used as a basis for discussion on the CHN role in community-focused health care reform. One-third of the CHN students in one school of nursing during one academic year ( n = 16) participated in the NEEOP. One salaried CHN faculty member assumed primary responsibility, and equipment funding was granted by a local corporation. Collaboration was established with the county's proactive school nurses' association. CHN students developed and conducted health education presentations in elementary schools, worked with school nurses, and participated in other community health activities. Three levels of evaluation were utilized: elementary students to nursing students, nursing students to nursing faculty, and school nurses to nursing faculty. The NEEOP was a success by all evaluation criteria, and plans are currently in progress to expand its focus. Innovative clinical placements such as the one described can promote student understanding of CHN practice with its broad-based emphasis on the promotion of healthier communities.     

Nursing faculty practice: challenges for the future

Just as artists need to create their own art, so nursing instructors need to practise nursing However, traditional educational settings and clinical placements limit the capacity of nursing instructors to practise nursing directly with clients The creation of a nursing faculty practice model in Canada, whereby teaching roles and responsibilities are combined with clinical practice, is discussed within the context of a community college environment A nurse-managed health centre is suggested as an innovative practice arena which is more in line with the changes in the health care system     

Using an Academic‐Community Partnership Model and Blended Learning to Advance Community Health Nursing Pedagogy

This article describes a model of teaching community health nursing that evolved from a long‐term partnership with a community with limited existing health programs. The partnership supported RN–BSN students' integration in the community and resulted in reciprocal gains for faculty, students and community members. Community clients accessed public health services as a result of the partnership. A blended learning approach that combines face‐to‐face interactions, service learning and online activities was utilized to enhance students' learning. Following classroom sessions, students actively participated in community‐based educational process through comprehensive health needs assessments, planning and implementation of disease prevention and health promotion activities for community clients. Such active involvement in an underserved community deepened students' awareness of the fundamentals of community health practice. Students were challenged to view public health from a broader perspective while analyzing the impacts of social determinants of health on underserved populations. Through asynchronous online interactions, students synthesized classroom and community activities through critical thinking. This paper describes a model for teaching community health nursing that informs students' learning through blended learning, and meets the demands for community health nursing services delivery.     

School nursing in an underserved multiethnic Asian community: experiences and outcomes

Based on an Asian faculty's previous work, University of South Alabama College of Nursing conducted a project targeting the Asian population in Bayou La Batre, Alabama. The Helene Fuld Health Trust, HSBC, Trustee funded the project to demonstrate effective models for involving nursing students and faculty members in community-based practice. This project provided health services and developed educational programs for this underserved population. To facilitate entry into the Asian community, the College established clinical sites at 2 schools in Bayou La Batre that had the highest concentration of Asians in Mobile County's public school system. The purpose of the project was to develop a new curriculum, to involve nursing students in community-based practice, and to provide health care services in the community. The health services, educational programs, and community instructional activities generated substantial outcomes for the targeted population as well as nursing students. Nursing students learned to assess aggregates, plan, and evaluate interventions. The learning outcomes of the nursing students were evaluated using objectives developed in accordance with Bloom's (1956) Taxonomy. The project not only complemented and expanded existing school health services and programs but also filled the void in some health service and program areas. Preliminary evaluation of the project revealed overwhelmingly positive feedback from both the nursing students and Bayou La Batre school teachers. This article also explores the implications of the newly issued "National Standards for Culturally and Linguistically Appropriate Services in Health Care" for nursing education in the contexts of the Census 2000 and the megatrend of globalization.     

Cudahy high school survey and focus groups: assessment of the needs of a teen population. A community-campus collaboration

Collaboration between local public health agencies and university schools of nursing can be advantageous to both parties. Students need opportunities to learn aggregate-based care; health officers need community partnerships that expand their potential to accomplish core functions. This article offers a case study to illustrate a collaborative relationship. A high school survey and a plan for teen services were the focus of the joint endeavor. With guidance from faculty, students offered labor and expertise; the agency offered a real world laboratory for learning.     

An academic-community partnership: a model of service and education.

To meet the challenge of preparing nurses for delivery of health care that is directed toward health promotion and focused on populations at the community level, it is critical that academicians develop new methods to educate their students. In this article, I describe an innovative clinical practice model in which an academic-community partnership was created between a college of nursing and a neighborhood grade school and parish. The purpose of the partnership is to provide needed health services to clients, at the same time giving students the opportunity to practice population-focused care in the community. The benefits of the partnership are numerous, including improved client health status, increased access to health promotion services, and enhanced student learning.     

New nurse faculty: core competencies for role development.

This study originated from the need to define the role competencies for a beginning nurse educator. A survey of full-time faculty and heads of university and community college nursing programs in Ontario showed a high degree of agreement between the two sets of faculty for teacher role, practice, service, personal and professional growth competencies. Significant differences were noted on competencies involving student evaluation, facilitating student's practice, acting as student's advocate, and research. Agreement was noted on the problems created by role ambiguity and role incompetence, particularly for new faculty. This suggests the need for educational preparation and socialization of nurse faculty.