Nurses Role in Health Promotion
Health promotion is one of the important aspects which the World Health Organization or WHO addresses in every meeting. Though it is not possible to completely define this term to perfection, the WHO attempts to revise the definition every time to cover all aspects of health promotion.
According to the Bangkok Charter of WHO (2005), health promotion is be defined as “the process of enabling people to increase control over their health and its determinants, and thereby improve their health.” This definition has been modified from the previous definition as per Ottawa Charter (WHO, 1998) which states that “health promotion is the process of enabling people to increase control over, and to improve their health.”
The responsibility of health promotion vests not only with the government and health authorities, but also with the health professionals like nurses and physicians. This essay explores the role of nurses at all levels of health promotion.
Levels of health promotion and the role of nurses
Nurses play an important role in the health promotion of an individual due to their direct contact and proximity with the patients. The 3 basic roles of a nurse are that of a practitioner, leader and researcher.
As a practitioner, the nurse attends to all the medical needs of the patient and as a leader she takes decisions which relate to, influence and facilitate the actions of others with an aim to achieve a particular goal. As a researcher, the nurse aims to implement studies to determine the actual effects of nursing care and to work towards further improvement in nursing care (Nettina, 2006).
The steps in the nursing process are assessment, nursing diagnosis, planning, implementation and evaluation (Baillie, 2005; Nettina, 2006). Assessment is the systematic collection of data which are markers of the health status of the individual and help in identifying any health related problems.
Nursing diagnosis is the actual identification of the disease process which needs to be dealt with. Planning is a process of setting health related goals that are aimed to resolve the potential health problems identified by means of nursing diagnosis. Implementation is the means of delivering the plan to achieve the set goals. Evaluation is determination of patient’s response to the interventions made towards the achievement of goal (Nettina, 2006).
There are basically 3 levels of health promotion. They are primary level, secondary level and tertiary level. Majority of people receive primary health care. According to WHO, “Primary health care seeks to extend the first level of the health system from sick care to the development of health.
It seeks to protect and treat the problems at an early stage. Primary health care services involve continuity of care, health promotion and education, integration of prevention with sick care, a concern for population as well as individual health, community involvement and the use of appropriate technology.”
The approach to primary health care is characterized by “holistic understanding of health as wellbeing, rather than the absence of disease” (WHO, 2005). An extension to primary health care is community health services which provide acute care, care of the elderly, drug and alcohol-related services, services for those who are sexually assaulted and also mental health services (PHC Connect, 2006).
Nurses involved in the primary health care work collaboratively and autonomously to improve, promote and restore health. Primary health care nurses play an important role in health promotion, population health, prevention of diseases, care of wellness, first point of contact care and disease management across the lifespan (Ministry of Health, 2005).
People who cannot be dealt with in a primary care center are referred to secondary health care. Secondary health care involves a consultant or a specialist in a hospital or a clinic setting with suitable equipment with certain technology like X-rays and laboratory tests (WHO, 2005). In secondary care centers, nurses play an important role in the history taking and assessment of the patients. They collaborate with the consultant and the diagnostic services to enhance health promotion.
People who need health care beyond secondary care are managed in tertiary care centers which are mainly institutions like teaching hospitals or superspeciality hospitals which house many specialist and superspecialists and have advanced technology for adequate investigations and tests (WHO, 2005). In tertiary health care set up, nurses provide health promotion by working in collaboration with physicians and other health professionals (Kotzer, 2005).
Nurses play an important role in the health promotion of people at all levels of health care. Nurses are not only involved in the initial assessment and history taking of the patients but also in coordination with specialists, diagnostics and other health professionals.
Nurses also have an important role in decision making and organization of the treatment plans of the patient. Due to their crucial role, health promotion becomes impossible without the involvement of nurses.