As a community Nurse working with a specific population, one must be aware of different risk factors that can affect a community. As members, we should talk about risks and about protective factors that evolve promotion or community development. One of the goals here is to give the community members the tools they need to be able to prevent any risks or threats that may affect them and keep it from happening. It is important that we educate community members with safety measures that will keep them from having adverse effects. In the following findings, we will learn and discuss problems, issues, concerns and results to assist the members to act appropriately and better their way of life.
Holden Beach, North Carolina is located on a nine-mile stretch of land along the Atlantic Ocean coastline (NCBeaches.com, 2006-2007). The average age level for the county is the mid to upper 30’s averaging around 36 years old. The community holds concerts and events in order to keep up with community spirit and support. As far as a little history on the county, it has been around since 1664. The county was officially made from New Hanover and Bladen Counties back in 1764 but until the 1950’s most of the land was considered commercial forest. The county is very proud and that is evident by the web sites they have available and the way they present themselves on line. There are two major websites for the county and that is www.brunsco.net and www.ncbrunswick.com. Holden Beach, North Carolina is a small, family oriented quiet community that becomes popular within the summer months with tourists. Only 18.4 % of the housing is occupied year round but more than doubles during the summer months (Fischer & Imperial, 2007). As far as vulnerability goes, Holden Beach has high rent and property values so there is not really any poverty seen in this community. The community consists of 900 permanent residents, but during the months of May through August, an additional 15,000 people can be expected to vacation here with their families each year (NCBeaches.com, 2006-2007). Therefore, community nurses must prioritize and focus on water safety and sun exposure the main reason is due to the locals as well as the tourists are brought together by their common interests and love for sunbathing, swimming, fishing, and boating. The beach environment poses specific threats to the community, particularly during the summer months. Examples of these threats are sunburns, stings from jellyfish, shark bites, dangerous rip currents, boating accidents, and severe weather, including hurricanes. These challenges must be addressed by educating the community about water safety, sunburn prevention, and hurricane preparedness. Areas for concern in Holden Beach would be hurricanes, flooding, rip currents as well as boating accidents. Residents have stressors during hurricane season, which begins on June 1, and lasts until November 30. It’s important for locals as well as tourists to know the evacuation routes and to be able to locate local emergency shelters. Nursing Diagnosis: Powerlessness related to the threat of a hurricane and flooding in the community. Rip tides cause nearly 100 drownings each year. There are three categories for rip tide risks, low, moderate and high. Even in low risk categories, this can be dangerous to weak swimmers and toddlers. This can be of major concern when the town is flooded with families visiting on vacation. If ever caught in a rip tide, it is encouraged to swim parallel to the current then as it dies down to swim diagonally backing to shore. This would lead to the nursing diagnosis of Knowledge Deficit. Holden Beach, North Carolina believes in healthy and safe fun family values. It keeps the beaches and local areas alcohol free and keeps the beaches free from glass containers. People that live there or visit there are not allowed to drive up onto the beaches or walk along the dunes. The dunes help protect the community in case of a hurricane. There are special walkways that are taken to access the beach. All personal items must be removed from the beach by 7 pm. The community also values wildlife by having active turtle watching to ensure their continued survival. The community also marks off areas where the sea turtles are to keep people away from them. Only about 1/3 of the population belongs to a religious congregation. (http://www.city-data.com/city/Holden-Beach-North-Carolina.html). This could lead to a Risk for ineffective coping, spiritual, related to lack of religious affiliation, belief and support group. For this community, environmental concerns include the protection of sand dunes and the sea turtles. The Holden Beach Turtle Watch Patrol was founded in 1989 and consists of 65 volunteers (Town of Holden beach, n.d.). It is a nonprofit conservation organization and operates under the authority of NC Wildlife Resources Commission (Town of Holden beach, n.d.). Volunteers starting in May patrol the beaches looking for crawling turtles or nests. If a nest is found to be located in an unsafe place, it will be carefully moved to a safer location on the beach (Town of Holden beach, n.d.). Sites are marked with stakes, ribbons, and a warning signs to alert beachcombers to not disturb the area (Town of Holden beach, n.d.). Nests are patrolled nightly to ensure hatchlings are released from their nests and make it safely to the ocean (Town of Holden beach, n.d.). Turtle Watch meetings are held at Town Hall on Wednesday evenings to update the community on nests and turtle counts. Currently, Holden Beach has 31 nests; the first is scheduled to hatch July 6th (Town of Holden beach, n.d.). Tri Beach Fire Department provides services to the community of Holden Beach. There are 35 volunteers and 8 paid staff members. The response to calls averages around less than 8 minutes during off-season and can be much longer during the summer months due to high traffic. Coastline Rescue and Brunswick county EMT provide emergency medical services in this area (Fischer & Imperial, 2007). During the summer months Civilian bench Ambassadors are hired to assist police officers on beach patrol. Nursing Diagnosis: Risk for other directed Violence related to increased theft and burglaries. Due to the higher education level and older population in Holden Beach, STD’s are not prevalent within the community. Because there are such a small percentage of school-aged children and teens in Holden Beach, statistics on teen pregnancy could not be found but showed up for Brunswick County. Sexual Education in Brunswick County focuses on abstinence only curricula and do not educate school-aged children and teenagers on birth-control options (Pro-Choice North Carolina, 2009). According to 2008 data, Brunswick County abortion rates were 14.7%, teen pregnancies 43.3 per 1,000 teens, Syphilis 2 per 100,000, Gonorrhea 69.5 per 100,000 and Chlamydia 206.6 per 100,000 (Brunswick County, NC 2008). Nursing Diagnosis: Ineffective Protection related to lack of education on birth control and STD’s. Another health issue present for this community is adult diabetes with a rate of 9.3% and the adult obesity rate is 27.5%. This could lead to a nursing diagnosis of Potential for Obesity related to inactive lifestyle and/or poor eating habits. The county of Brunswick, NC has a few options available as far as community fitness. There are a total of 5 gyms in the county in which are open for members to participate and the Community College also offers fitness as well as aquatic fitness programs for its community members. There is a local YMCA called the South Brunswick Family YMCA in which young kids can sign up for fitness and sports if they so choose to do so. As far as recreational activities the county offers vast beaches, plenty of golfing spots, public playgrounds and trails in which for people to partake of why they are there. Brunswick’s most common reason for ED visits and injury is actually unintentional falls. The leading cause of death in the county is by MVA’s. Sedentary leisure activities are about average for the rest of the US when you consider the following statistics. For adult obesity Brunswick is at about 30% when the national average is 29%. This leads us to believe that they are no more sedentary then the rest of the nation, which would make the county average. With it being a smaller county it is expected that adults and children both probably watch TV and play on the computer as much as the rest of us but as far as outdoor activity, since there are beaches, it would be better to be compared to places like California and Florida where people spend a lot of time outdoors. The average mileage to work is between 10 to 26 miles and most people commute by means of their own vehicle. There was a small percentage that carpool or even walk to work. The rest in this county is average to the rest of the nation. There are those that work night shifts that sleep less just like the rest of the nation. Nurses, of course, are the most common type of night shift workers. The county has a calming atmosphere that almost seems peaceful and relaxing without all the hustle and bustle of big city life with too much light and sound around where there is no time for a moment of peace. In the county approximately 24% smoke and 14% drink which are both higher than the national average. As far as health issues there are no major ones reported for the county and the amount of uninsured people stays average with the rest of the country around 19%. The primary language in Brunswick is English, which is written and spoken. On average 65.2% of the population has a high school diploma when the national average is 85.3%. As far as Bachelor degrees there is only 5.7% compared to 27.9% for the US and Masters degrees are around 1.7% compared to 10.3%. Surprisingly though, the average community member to graduate from high school is pretty high in Brunswick, they just don’t stay in the county after graduation. One issue with the college degrees is that there is only 1 community college in the county and the nearest university is 36 miles away. As far as special education programs those are run through the Brunswick Department of Special Education in order to accommodate those in need. In closing the community will be aware of all the risk factors that expose them to water dangers, sun exposure, health issues and crime. Once the community nurses educate and prepare them, the members will have better knowledge and understanding their surroundings and what they need to do to keep healthy and safe. The community nurse will provide the proper resources to all members.
References

Brunswick County, North Caroline. (n.d.). Retrieved July 5, 2012 from http://www.nchealthystart.org/RICHES/NC%20counties/Brunswick.htm City-Data. (2012). Retrieved July 5, 2012 from http://www.city-data.com/city/Holden-Beach-NC.html County Health Rankings & Roadmaps http://www.countyhealthrankings.org/app/north-carolina/2012/brunswick/county/1/overall

Fischer, Kristina & Imperial, Mark T. (2007). Town of Holden Beach Phase I Report on Land use & Future Development. Retrieved July 5, 2012, from http://Idcm2.enr.state.nc.us/planning/Holden%20/Beach/Phase%201%20report.pdf Holdenbeach.me (2012). NC festival by the sea event schedule (Oct. 29 & 30). Retrieved July 1, 2012, from http://holdenbeach.me/2011-nc-festival-by-the-sea-event-schedule-oct-39-30/

http://www.brunsco.net/Portals/0/bcfiles/planning/plan_Final_Report_-_Brunswick_County_Comprehensive_Historical_Architectural_Site_Survey.pdf

NARL Pro-Choice North Carolina. (2009). Retrieved July 5, 2012 from http://www.prochoicenc.org/media/news/20090109.html NCBeaches.com (2006-2007). Come as guests leave as family, welcome to Holden beach. Retrieved July 1, 2012, from http://www.ncbeaches.com/brunswickbeaches/holdenbeach/

Onboard Informatics, 2012 http://www.city-data.com/city/Brunswick-North-Carolina.html

Town of Holden Beach, NC (n.d.). Holden beach turtle watch program. Retrieved July 4th, 2012, from http://hbturtlewatch.org/