“Health in the Sustainable Development Goals

and the Role of Local Communities for SGDs”

Community health nurses have always practiced in a wide variety of settings and assumed various roles.
The seven major roles are:
1. Clinician
- 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.

2. Educator
- Facilitate client learning on a broad range of topics.
- 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.

3. Advocate
"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)

- To help clients find out what services are available, which ones they are entitled to, and how to
obtain these services.
- To influence change and make the system more relevant and responsible to clients' needs.

4. Manager
- Facilitate and deliver quality nursing care as well as to coordinate and manage the environment
in which the care is delivered.
- Oversee client care, supervise ancillary staff, and do case management, run clinics and conduct
community health needs assessment projects.
- Engages in four steps of the management process of planning, organizing, leading and controlling
evaluation.
- Specific decision-making behaviours are part of the manager's role as well as human, conceptual
and technical skills.

5. 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.

6. Leader
- Directs, influences, or persuades others to effect change that will positively affect people's health.
 - Act as a change agent and influencing health planning at the local, state and national levels are
elements of the role of the leader.

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

7. Researcher
- 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.

TYPICAL FUNCTIONS:
The functions performed by community health workers will vary by level, but may include the following:
1. Assesses health status of individuals, families, and communities; develops plans and implements
appropriate nursing interventions.
2. Evaluates and determines health resources necessary to meet individual, family and community
health needs.
3. Delivers professional nursing care in an assigned unit, clinic, home, or other setting.
4. Educates individuals, families, communities, and members of the health care team about the
principles of disease prevention and health promotion.
5. Provides supervision to other professional or paraprofessional personnel; collaborates with other
professionals in the management of health care.
6. Delegate’s tasks as may safely be performed by others, consistent with educational preparation
and that do not conflict with the provisions of the Nursing Practice Act.
7. 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.
8. Performs specialized nursing functions as educationally prepared.

The role of the nurse needs to be expanded to include:

1. Protection of women's reproductive potential.
2. Act as primary care providers in providing information on prevention on:
- Infertility increases with age.
- The impact of contraceptive choices on fertility.
- 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,
anddibromochloropropane 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 counselling 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.
3. Act as a preconception counsellor may screen for potential infertility and collect a routine history and
physical examination including testing.
+