Community health nurses treat communities through the application of the nursing process. The process is community focused rather than treating the individual. Phase one begins with identifying a community. Phase two is the assessment phase consisting of data collection, interpretation, and analysis. The collection of direct data may be done through focus groups, interviews, observation, and windshield surveys.
Denver, Colorado was the focus of my windshield survey, and I saw more in one day than I ever noticed as a resident for four years. I recognized that drug use is prevalent, there are a large number of medical marijuana dispensaries, and the homeless population is greater than I thought previously. Each of these issues in Denver warrants their own community nursing diagnosis. Three priority nursing diagnoses, based solely on the windshield survey, are risk of violence among the businesses of Denver related to neighboring medical marijuana dispensaries, risk of crime among the residents of Denver related to prevalent drug use and sales, and risk of malnutrition among the homeless population of Denver related to lack of access to adequate nutrition.
Medical marijuana dispensaries are popping up in every neighborhood of Colorado, but in Denver alone there are sometimes two dispensaries per block. This puts people in the area at risk for increased violence, such as beatings, murder, and violent burglary. If the state regulators limited the number of dispensaries per city based on population and the police increased the patrolling in these areas, the risk for violence may decrease. This would require the community nurse to become politically active and fight for these goals through the government leaders in Colorado. The nurse could interview residents of the area and get signatures on a petition to present to the city.
Drug sales and use is visible throughout the Denver area, and the types of illicit drugs used goes well beyond medical marijuana. As I drove around performing my windshield survey, I witnessed people on the street handing money to another person and orally taking what they were given in exchange, and others would put what they were given into their pockets. Marijuana is openly used and rarely questioned. According to the National Drug Intelligence Center (2007), much of the drug-related crime consists of “assaults, home invasions, homicides, and robberies” (para. 1). The community health nurse could decrease the amount of drug use and sales in the area by educating the residents of the area and organizing neighborhood watch groups. This can empower the residents of the area to take a stand and work with law enforcement to decrease the drug activity in the area.
The homeless rate in Denver is increasing because of loss of jobs, and the moderate weather draws homeless people from other areas to reside in Denver. There are shelters and food resources available, but during my windshield survey I witnessed the astronomical number of homeless waiting in line only to get turned down when the resources were exhausted. The community health nurse can impact this area through hosting walks and fundraisers to help meet the demands of the homeless.
The community health nurse must collaborate with others to make an impact on the aggregate level. To assist in decreasing crime, violence, and homelessness in Denver, the community health nurse should partner with government officials to gain support and funds. The nurse may also collaborate with local organizations with the same cause in mind, or residents of the community through hosting walks or representing booths at fairs or events to increase awareness and support. The Metro Denver Homeless Initiative is an organization well known to the area with the common goal of decreasing homelessness, and helping those in need.
Cultural diversity is important for the community health nurse, and the nurse must be culturally competent to serve all members of a community effectively. Denver is a mixed community and there is no segregation. The nurse who is culturally competent is knowledgeable, committed to change, highly skilled, and constructive (Stanhope & Lancaster, 2008). Providing educational materials in multiple languages that fit the community is an example of providing culturally competent care.
The Office of Minority Health hosts an informative website offering information to health care providers and people in the community regarding efforts to combat racial and ethnic disparities. There are links providing research and funding sources, calendar of events, guides to cultural competency, and health topics of concern (United States Department of Health and Human Services, n.d.).
Injury, violence, and substance abuse, are leading health indicators of Healthy People 2020 (Healthy People 2020, 2012). The nurse educator role would positively affect these initiatives. By creating awareness of available resources and educating the public on these issues, the nurse can lead the future population in the right direction. As a resident of the Denver area, I was unaware how prevalent these issues are in my area until I completed the windshield survey and opened my eyes enough to see the big picture.
The public health nurse could partner with the Metro Denver Homeless Initiative (MDHI) in an effort to meet the objective of meeting the needs of Denver’s homeless and to prevent the homeless rates from escalating. The MDHI assists those at risk of losing their homes by providing case managers to assist in finding households or services as well as providing financial assistance ("Metro Denver Homeless Initiative", 2012). The nurse can create a program, such as a walk or festival, to raise money for the Cold Weather Care program, a program designed to provide shelter or warm supplies to those in need when cold weather arrives ("Metro Denver Homeless Initiative", 2012).
The windshield survey was an opportunity to view my area in a whole new light. I could recognize the severity of homelessness and drug abuse in my area. Although I previously knew these issues were present, I had not deeply thought of how this could impact me or the community as a client. This new perspective gives me the inspiration needed to make a difference in my community.