NSG120120 Nursing 2 Foundations Of Care


Community nursing is a very important part of nursing practice in Australia. Community nursing is also the integral part of the primary health care system. Nurses working in the health care system of the country make the largest part of the total health care workforce in the country. The major health care problems in a community can impact the life of all the people. Therefore, this paper will discuss the potential health problem in the people of the City of Horizon. Paper will also discuss the role of RN in identifying the problem and providing quality care to the patients.

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The city of Horizon can be considered as a virtual and fictional city, which is significantly considered as the Australian regional centre. This region includes good landscape and many tourists’ destinations. Paper will discuss the various factors and details associated with the City of Horizon, in order to discuss the potential healthcare issue in this small community. Paper will provide the detailed community health assessment that will include demographic details, psychosocial details, details about the infrastructure of the community, goods and services, as well as details about the available health services and resources. The assessment will help to identify a potential health issue in the community; which is affecting the social, mental and emotional well-being of people. 

City Of Horizon Community Assessment
Demographic Profile 

The estimated population in the City of Horizon is the year 2017 is 29,308 and the total land area is 4,248 hectares (43 Km2). According to the data provided, the population density is 6.86 persons per hectare. The median age of the people in the city of horizon is 56. The income of people is very low and the median weekly household income is $751. 6% couples of the city have children and 23% of the older couples do not have children (Unisa, 2017).

The demographic profile shows that there is higher number of people without children in comparison to the families without children. 7.5% of the families are single parent families. This also displays that there is higher proportion of the lone person families. The lone person families comprises of 28.3% of people (Unisa, 2017).

The lone person family states that an individual living alone without any support of family. Loneliness can also impact the mental well-being of individuals and reduces the accessibility to mental health care services (Pate, 2014). The size of the household varies at various levels, which are usually small at the initial stage (early marriage) and the size of the household increases with children. According to the study of  Sliogeris et al (2008), “the idea of affordable housing recognises the needs of households, whose incomes are not sufficient to allow them to access appropriate housing in the market without assistance of the services” (p. 5).

The number of the pre-schoolers is very low in the City of Horizon and the number of retired people is higher in the city. The weekly income of the people is very low in City of Horizon among the people aged 15+. Evidences have strong association between low income and mental health issues like depression and anxiety (World Health Organization, 2014).

Population of the older people is higher in the City of Horizon, which also implies that mental health problems will be higher in region. Old people are more likely to suffer from depression due to age related changes and other social and psychological factors (Fiske, Wetherell and Gatz, 2009). More than 14,000 citizens of the city are above the age of 50, which means that population is rapidly aging and prevalence of depression can increase. 

Psychosocial Profile

The socio-economic status of the people is also affected by the employment opportunities and housing affordability (Rowley and Ong, 2012). 6% of the people belong to non-English speaking background and the University attendance is only 2%. The rate of unemployment is 6.7% and 0% people use public transport. 9% of the people have the bachelor or the higher degree and 23% of people are involved with vocational courses (Unisa, 2016). This data informs that there is a lack of education among the people of City of Horizon.

Rate of unemployment is also higher in the city of Horizon in comparison to Regional SA. Unemployment can be associated with many psychological health problems (Van der Meer, 2014). Unemployment can significantly affect the psychological well-being of the people and can also impact their socio-economic status in the community and housing affordability (Flint et al, 2013). The secure employment is found to be associated with better psychological well-being. The number of people not in labour force is 51.6% in City of Horizon and was 37.7% in Regional SA in the year 2016 (Unisa, 2016).

Education is n important social determinant that impacts the health of people in significant manner. Lack of education can hamper the process of lifelong learning and employment prospects (Titmus, 2014). According o the data obtained in the year 2016, 54.6% of people in the city of Horizon have no qualification. This figure is little more than Regional SA, whcich had 54.1% people with no qualification (Unisa, 2016). This states that socio-economic status of these people is low and will impact their health and well-being. Lack of education and qualification can result in unemployment and negative impact on mental health of people, as it also impacts the people’s ability to perceive and follow health information (van der Heide et al, 2013). Lack of education impacts the level of health literacy and can increase sigma that can on the other hand reduced the access to health care services. 

Community Infrastructure, Goods and Services 

The community of Horizon city includes the people from various cultures and ethnicities. He media age of the people is 56 years and median weekly household income is $751. 23% of the older couples are living without children, which mean that have little or no support from children. 14% of the houses are high density housing arrangements. People living in high density households are more likely to suffer from depression (Haigh, Chok and Harris, 2011). Low household income is also associated with mental health problems in adolescents. The most common mental health problems are anxiety and depression (Lawrence et al, 2015).

The maximum number of the people is from Australians ancestries.

The number of people from overseas is also increasing. The three largest ethnic groups in the City are Australians, English and Scottish. Other then these three ethnicities, people from many different ethnic groups live in the City. Depression can be higher in the people from different ethnicity, because he evidences have shown that depression is higher in the multicultural communities (Gong and Takeuchi, 2014). The dominant language in the City of Horizon is Italian after English. Culture and language barriers can also increase the level of depression among population (Furler et al, 2010). Cultural differences can impact socio-economic status, employment opportunities, educational opportunities and access to healthcare facilities.

It is very important to determine the economic and social status of the people. The level of employment, unemployment, part-time employment and labour workforces is important to understand the social and economic characteristics of the city. It is also important to identify the industry sectors for understanding the goods and services. Maximum numbers of people are involved in the health care industry. The second highest involvement of people is in the retail trade that makes 14% of the people and 10.6% people are involved in Agriculture, forestry and fishing. The city also has the public transport services, which are only used by45 people and the remaining population rely on private vehicles.

Health Services and Resources 

The City of Horizon is provides the important and effective facilities to the residents as well as to the tourists. The region also has the tertiary level hospital that provides the comprehensive healthcare services. The healthcare facilities that are offered to people includes Physiotherapy, medical centre, radiology, pharmacy, pathology, GP clinic and Nutrition and Dietetics.

According to this information, there is a lack of psychiatric health services or the mental health services and care providers in the City of Horizon. According to the evidences the level of depression can be high in the young as well older people of the city, which requires significant consideration from the health care services. Various social determinants impact the physical and mental health of people (World Health Organization, 2014).

Social determinants also impact the social and emotional welfare of people (Zubrick et al, 2010). Due to high rate of unemployment and low individual income, people of the city also lack appropriate resources to receive better health services.

The socio-economic disadvantage is associated with the poor health outcomes. According to the Index of Relative Disadvantage (IRSD), there is large disparity in the socio-economic status of people has been found in the local government are of the City of Horizon. That explains the lack of health care resources, lack of access to health care services and poor mental health of people. 

Potential Health Issue 

The potential health issue identified through this community health assessment is Depression. Depression is considered as the common mental health problem that can significantly impact the social, physical and emotional well-being of an individual. People suffering from depression can suffer from mood swings, low self-esteem, loss of interest, withdrawal from the society, low energy, poor problem solving skills and many more other conditions (Monroe, and Harkness, 2012).  This issues is selected as the potential health for the community of City of Horizon because, it is associated with many social determinant of health that are prevailing in the community. Social factors are specifically associated with population health (Zubrick et al, 2010) Since, the development and health of individuals is shaped by various factors, mental health is also shaped by various factors, such as historical, biological, and environmental.

A large number of populations in the City of Horizon live in the lone person families. The number of lone person family is higher than other household settings. Loneliness is another significant reason of depression (Pulkki-Råback et al, 2012). According to the population data obtained about the City of Horizon also informs that larger part of the population comprises of the ageing population or older people. Lonely and older population are more likely to suffer from depression. Studies have found that in the families with only one inhabitant the prevalence of depression is very high (Lindström, 2008).

Depression in the older people is also called as the late life depression. The reason of depression in older people could be many, such as long term illness, lack of social support; chronic diseases hat significantly affects their quality of life (Lin et al, 2014). Depression may remain under-diagnosed or untreated in the case of older people because of the other chronic conditions and co-morbidities (Rodda, Walker and Carter, 2011).

The data retrieved from the statistics and details of the City of Horizon states that rate of unemployment and lack of educational qualification is also very high among the people. Another reason of high prevalence of the depression could be unemployment, low individual and household income (Brand, 2015), living on government benefits. The psychological impact of unemployment is very severe. Evidences have shown the mental health can deteriorate with persistent unemployment and low income. According to the study of Brand (2015), “unemployment, long-term earnings losses, and lower job quality; declines in psychological and physical well-being; loss of psychosocial assets; social withdrawal; family disruption; and lower levels of children’s attainment and well-being” (p. 359).

Therefore, it can be said that depression is the potential health issue in the community of the City of Horizon. The healthcare care services have to focus on better screening, diagnosis, prevention and treatment of the depression among the population of the city of Horizon. 

Role Of The Registered Nurse 

Role of registered nurses is very important in the primary health care system of Australia. Registered nurses are the professionals, who possess the skills and knowledge to provide evidence bases supportive, curative, preventive, restorative and effective care o the people suffering from range of physical and mental health problems. Registered nurse has to play the therapeutic role in providing care to people suffering from depression. Registered nurses play a significant role in providing care to older patients suffering from late life or geriatric depression (Liebel and Powers, 2015).

Registered nurses practice on the basis of evidence based knowledge. Therefore, they are able to provide evidenced based care and treatment to the patients suffering with depression. Registered nurses are also responsible for coordinating, delegation and providing clinical supervision to enrolled nurses. Registered nurses can significantly improve the quality of mental health nursing through effective clinical supervision (Brunero and Stein-Parbury, 2008). Registered nurses are required to demonstrate the skills and competence and appropriate problem solving skills to provide quality care to the patients suffering from depression (Brown and Crookes, 2016).

Registered nurses in the mental health settings provide care, support and counselling to the people suffering from depression and other mental health issues. Whether registered nurses are providing short term care or the long term care in mental health setting, they are able to offer the safe and supportive care and environment to the patients to heal them completely (Registered Nurse (Mental Health), 2017).  

Registered nurse organize the programs and activities that promote mental well-being and assist people in personal development and improvement (Coombs, 2014). Registered nurses are also responsible for providing patient centred care. Patient centred approach is very significant approach in mental health nursing. Therefore, registered nurses apply the patient centred approach and provide individualized care to every patient (Coombs, 2014). The knowledge and skills that are attributed by the registered nurses include compassionate and caring behaviour, keen interest in the health and well-being of the people, responsibility and accountability of the actions, cultural competence and providing culturally safe care, effective communication skills, care coordination and providing clinical supervision Registered Nurse (Mental Health), 2017).

Registered nurses are able to conduct the detailed and comprehensive health assessment of the people or groups. They are also able to provide comprehensive care to the individuals, groups and communities (Coombs, Curtis, and Crookes, 2013). Therefore, registered nurse can also provide quality mental health care to the community in the City of Horizon. They are also skilled in making empathetic, compassionate and therapeutic relationships with the patient suffering from depression. They are also skilled to apply the strength based recovery approach to help people to overcome their mental health problem and live a meaningful life (Coombs, 2014). 

Conclusion And Recommendations 

This report has been prepared with the intention of preparing a detained health assessment of the community of the City of Horizon. This is a fictional city, which is also considered as the regional centre. Report provides the detailed information about the demographic profile and psychosocial profile of the population. From this report the learning achieved was that identifying the health care issue in a population requires to clearly demonstrating the demographic details and other social and economic details of the people. This because evidences have shown that health of people is significantly affected by their living conditions, social and economic status, and their personal behaviour and attitude.

Report also provides the detailed and comprehensive discussion about the community, infrastructure and health care system of the city of Horizon. The health assessment is a very significant tool for the health care workers to identify the major health problems in the community and for delivering quality services. Without appropriate health assessment, identifying the correct health issue is not possible. Therefore, this report helped to learn many significant aspects of preparing community health assessment and identification of potential health issue. This report identified depression as the potential community health issue in the city of Horizon and discussed the importance of the role of Registered nurse in delivering quality nursing care to patients.

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