Community health nursing means giving health care to the public or community in settings such as state health departments, visiting nurse services, community or neighborhood health centers, day care centers, and hospices (Kovner et al, 2001). Community health nursing bring health care to the communities, especially impoverished areas without the option to seek costly medical help. This implies that majority of the patients treated by community health nurses have difficulties in paying for medical bills and medicine. This further implies that there is a need to support these people in managing and taking control their finances and learning about health care opportunities. The community health nurse is in the best position to provide this support because he or she has the capacity to foresee and approximate the expected health care cost and the knowledge to suggest financial support services.


Supporting patients to manage their finances involves two aspects, which are actual and preventive support. Actual financial support refers to the process of providing information to the patient about the expected medical expenses, upon the patient’s inquiry and when the community nurse deems it appropriate to volunteer the information. The community nurse has to be receptive to determine whether the patient is open to discussions about his or her financial standing or if the patient prefers to deal with it on his or her own or with the help of other people. In this case, the community nurse may recommend people such as the local social worker who can provide information support or recommend the patient for available medical welfare services.


            Apart from providing information, the community nurse should also elicit information to be able to evaluate the financial status of the patient to provide the necessary financial information and other forms of support. There are two ways of gathering information, which are formal and informal determination of financial need. Formal determination of need pertains to the filling up of medical forms by the patient including questions about the patient’s financial needs. However, this is problematic because most of the time patients are only made to sign forms at the beginning of the medical treatment when they may not have a complete view of their medical expenses in the long run. Again, offering information at this stage is crucial to the patient’s decision making. There are informal ways of determining patient’s financial needs through direct conversations, patient advocacy and indirect need triggers. Direct conversations cover the exchange of information on the financial cost of medical treatment and the financial condition of the patient in an engaging conversation so that building a fiduciary relationship with the patient is necessary. Indirect need triggers showing financial need are perceived by the community nurse through statements by the patient such as canceling or being late to medical sessions due to lack of transportation or the need to work despite the medical condition. Patient advocacy involves the proactive action of community nurses to inform the patient about support groups and recommend or contact the group for the patient. (Gould, 2005)


Preventive support refers to the information dissemination drive that may be given by community nurses to apprise households and individuals about the medical cost of certain unhealthy habits such as excessive intake of junk food, smoking and drinking to prevent people from incurring the higher cost of health care treatment.


References


 


Gould, J., Peng, I., Cameron, C., Bowes, P., Chauvette, L., Fitzgerald, B., et al. (2005).


Cancer Professionals’ Views on the Financial Issues of Lower-Income Women       with Breast Cancer The Generating Dialogue with Cancer Health Professionals  Advisory Committee. Ontario, Canada: Ontario Breast Cancer Community         Research Initiative.


 


Kovner, C. & Harrington, C. (2001). ‘Counting Nurses: What is Community     Health-Public Health Nursing?’. American Journal of Nursing, 101(1): 59-60.


 


 



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