Windshield Survey Reflection
Sherry Roy
NUR/405
9/4/2011

Reflecting on the area of daily influence opens the eyes to a new perspective. Looking at communities through the eyes of a nurse creates an assessment all its’ own. Analyzing the events and conditions people live in tells a lot about the person. The nurse can reflect on the surroundings and develop an opinion regarding the patient. The difficulties the community can impose create negative outcomes and or can be productive for the patient; this is revealed in the assessment surrounding the patient. The historical area of the community does have down falls. The paint that was used in the era of older homes and apartments contain lead. Lead, a contaminate to children in the home, school or business is a concern for the community and the nurse. The lead would give the nursing diagnosis of, Risk for Contamination (Household Lead Exposure). Lead exposure in apartments, schools and playground equipment are primary sites for exposure. Nursing interventions would consist of ongoing screening program for lead levels of individuals, agency notification of levels, decrease the exposure to minimize the risk, relocate families to a safe environment, and educate the high-risk people about lead exposure (Polk & Green, 2007). OSHA has standards set in place to regulate the levels of lead exposure. They mandate that areas of lead paint must be removed and for a cleaner environment of the community. The city and state enforce the regulations in communities. Groups within the community organize individuals from the community to provide free help in removing paint that is found to be contaminated. Child Advocacy is one group that supports cleanup efforts. It does seem that the lower income area of the city is ignored, leaving the minority groups to live in less than standard housing. Community areas abound with life for the families to enjoy during the warmer times of the year. The community pool, park, and public events open the door to contamination of the community. Nursing recognizes these areas of contamination to the public. Ineffective hand washing can be a real issue. The nursing diagnosis of Potential/risk for Infection (Hand Washing) is a great area to educate the community on infection. The community must be educated on the types of infections that can be passed from person to person. The types need to include the air-borne, blood-borne, food-borne, and water-borne infections (Polk & Green, 2007). Educating the community where contaminate is also found; home, school, and social events. Nursing interventions should include the proper way to wash hands, care for food, and signs/symptoms of potential exposure of infection. Being aware of the surroundings for an individual does empower the person to decrease chances for the risk of infection. The community health department addresses these issues on TV, radio, billboards, personal education, and schools for free. The community health nurse is available for educating the community with several types of tools. Within all communities there is violence noted more so in the lower income portion. Living in the middle of a city breeds violence due to unemployment rate, education level, and lack of guidance of some children. Communities should employ a program to decrease violence in the community. Educating the young on ways to be part of the community not a gang or group of individuals that cause harm. The Nursing Diagnosis of, Potential for injury due to violence, would support the people of all ages in the community of down town. Nursing interventions would include; facts to recognize gangs or affiliates, home safety measures, provide education to the children regarding safety in the community, and recognizing violence in the home/community. The Boys and Girls Club is a Christian based program for children to keep them off the street with parents at work. Local churches also provide help to the community when asked to help. Being poor in most cities can be difficult, but the silent epidemics are devastating to the community. Oral health is a growing issue for the population. According to the Health and Human Services, dental caries is the single most common chronic childhood disease (Office of Minority Health). The disadvantaged population that does not have access to dental care or treatment increasing the chronic disease process for their personal culture. The poor, unemployed, and insurance less people are the affected in this category. Healthy People 2020 indicate oral hygiene, preventative care, and oral disease are hand in hand. The school nurse along with the community nurse can provide education to the students in the schools during the academic year. The school nurse can assess the students and report to the community nurse the type of care that is needed for the children. The nurse can help reduce the conflict of receiving care and find measures that will fit the community and family. The community supports a large bus that travels to the schools during the school year to provide options for the students and the family. The bus has a dental hygienist and a dentist aboard to diagnosis and treats some dental concerns. Dental plans for everyone are greatly needed in this area of medical treatment. Watson would be very proud to think that nursing has covered an area of oral health. As nurses broaden the aspects of nursing to include other areas of health they will align with the Healthy People 2020 for the future. The objective is to create a healthier society through assessment and objective care of the patient. Assessment of oral hygiene of the school age children will give a start to the community on how to approach the dental epidemic. This will not reach every child, but a majority will be seen.

Reference
Polk, L. V., & Green, P. M. (2007). Contamination: Nursing Diagnoses with Outcome and Intervention Linkages. International Journal of Nursing Terminologies & Classifications, 18(2), 37-44. doi:10.1111/j.1744-618X.2007.00048.x
Stanhope, M., & Lancaster, J. (2008). Population-centered health care in the community (7thed.). St. Louis, MO: Mosby Elsevier
US Department of Health and Human Services, Centers for Disease Control and Prevention (CDC). Oral health: Preventing cavities, gum disease, tooth loss, and oral cancers: At a glance 2010 [Internet]. Atlanta: CDC; c2010 [cited 2010 March 8]. Available from: http://www.cdc.gov/chronicdisease/resources/publications/AAG/doh.htm#aag
http://www.minorityhelth.hhs.gov