Health Promotion, Education, Counseling, and Coordination in Primary Health Care Nursing

The evolution of advanced nursing practice over the past several decades has stimulated a number of studies of the activities of nurses specializing in the area of primary health care. These studies have ignored the nursing component of nurse practitioners' role in the areas of health care coordination, health promotion, health education, and counseling. We examined the extent to which nurse practitioners reported involvement in these areas in their practices. Study findings pointed to a high frequency of health-promotion activities, with 98 percent of the respondents reporting this type of care delivered during the reporting day, including health screening, nutrition information, exercise counseling, family planning, education, and risk factor analysis. The most common coordination activities were referrals for mental health, social work or drug rehabilitation, vision services, alcohol problems, and hearing services. Overall, study results supported the assertion that nurse practitioners considered that they provide their clients with a wide array of coordination, health-promotion, health-education, and counseling services within a nursing framework.     

Maternal Health Care

The author suggests a plan for maternal health care involving a family practitioner, a family practice nurse, and a regional high risk neonatal unit.     

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.     

Stigma, Health Beliefs and Experiences with Health Care in Lesbian Women

Twenty-jive Midwestern self-identified lesbian women were recruited through a snowball design to participate in a semistructured interview. Data were analyzed qualitatively for themes and consensus. Stigma and identifiability in lesbian women are complex issues that affect their cultural and social experience, health beliefs, interaction with health care providers and use of health care systems. The results suggest that lesbian women often do not feel comfortable seeking health care, experience nonempathetic responses when they do and even feel at risk of harm in some health care situations. Nurses are challenged to evaluate the adequacy of knowledge and reassess the quality of health care offered to lesbians.     

The Evercare Story: Reshaping the Health Care Model,Revolutionizing Long-Term Care

Clinicians struggle with how to deliver effective care to the growing geriatric and chronically ill population. This article describes one nurse practitioner–developed model and the elements that have contributed to its success. Not only did 2 innovative nurse practitioners leverage collaborative practice techniques to change care management for frail and elderly nursing home residents, but they also replicate and externally validated that care approach nationally and internationally, while helping to launch a public policy revolution.