Learn about counselling, its types, processes, tools, techniques, and the qualities of a good counselor. Explore the role of health education in effective counselling strategies.

COUNSELLING

Introduction

• Definition: Counselling is a helping process aimed at assisting clients in identifying solutions, managing stress, and improving interpersonal relationships.
• Purpose:
  • Address normal developmental problems in adolescents.
  • Assist individuals during temporary crises.
  • Early identification of disturbed or problematic behavior.
  • Refer cases requiring specialist treatment.
  • Facilitate communication between nursing schools, homes, communities, and resources.
  • Support tutors needing guidance and reassurance.

---

Principles of Counselling

• Tailored to individual needs.
• Encourages collaborative thinking with the client.
• Avoids a dictatorial approach.
• Builds trust and confidence with the client.
• Prioritizes the client’s needs.
• Includes family and significant others in the process.
• Demonstrates warmth, friendliness, openness, and empathy.
• Active listening and objective responses.
• Encourages voluntary, informed decisions by the client.
• Respects the dignity of the individual.

---

Scope of Counselling

• Covers various aspects of life as challenges grow more complex.
• Educational Guidance:
  • Course selection and study habits improvement.
  • Career planning and higher education advice.
• Personal and Social Support:
  • Mental health maintenance.
  • Family, moral, marital, and financial problem resolution.
• Vocational and Developmental:
  • Job placement and vocational objectives selection.
  • Addressing discipline and interpersonal issues.
• Includes advising on students’ activities and program planning.

---

TYPES OF COUNSELLING

1.Directive Counselling (Counsellor-Centered):

• Counsellor plays a major role in solving problems and guiding the client.
• Advantages:
  • Effective for anxious clients, young children, or disturbed individuals.
  • Less time-consuming.
• Limitations:
  • Limits the client’s self-insight.
  • Not suitable for all clients.

2. Non-Directive Counselling (Client-Centered):

• Client takes the lead; the counsellor offers support and guidance.
• Advantages:
  • Promotes client’s self-insight and decision-making skills.
• Limitations:
  • Time-consuming and may irritate some clients.
  • Not suitable for low IQ or severely disturbed individuals.

3. Eclectic Counselling:

Combines directive and non-directive approaches for a collaborative effort.

---

1. Educational Counselling:
   • Guides in course selection, study habits, specialization, and higher education.
   • Supports clinical learning and career planning.
2. Vocational Counselling:
   • Assists in understanding abilities, values, and career goals.
   • Provides information about occupations, scholarships, and skill development.
3. Health and Living Counselling:
   • Promotes health awareness, hygiene, and proper living conditions.
   • Includes sex education and recreational activities.
4. Personal Counselling:
   • Helps in self-acceptance, interpersonal skills, and appearance improvement.
   • Provides guidance for personal problems.
5. Moral and Social Counselling:
   • Encourages ethical conduct and social values.
   • Trains in prioritizing values for societal benefit.
6. Leisure Counselling:
   • Guides creative use of free time.

---

4. Short-Term Counselling:

• Addresses situational crises or immediate concerns.

5. Long-Term Counselling:

• Focuses on developmental crises (e.g., menopause, breastfeeding).
• May involve group support.

6. Clinical Counselling:

• Diagnoses and treats maladjustments through face-to-face interaction.

7. Psychological Counselling:

• Relies on conversation to address repressed emotions and mental challenges.

8. Psychotherapeutic Counselling:

• Facilitates emotional and personality reorganization for personal growth.

9. Student Counselling:

• Assists in educational and vocational planning, study methods, and adjustment.

10. Placement Counselling:

• Matches clients with suitable jobs based on skills and interests.

11. Marriage Counselling:

• Resolves marital issues and enhances understanding between partners.

12. Vocational Counselling:

• Focuses on career preparation, problem-solving, and skill enhancement.

13. Individual Counselling:

• One-on-one sessions to boost personal growth and effective skill utilization.

---

Key Areas of Counselling

• Vocational
• Educational
• Health and Living Conditions
• Personal and Social Development
• Moral Guidance
• Leisure Activities

COUNSELING PROCESS: STEPS AND TECHNIQUES

Introduction

The counseling process involves interconnected and overlapping phases, much like the nursing process. These steps are flexible and can be adjusted based on the nature of the issue and the individual being counseled.

---

Steps in the Counseling Process

1. Appointment and Establishing Relationship
   • A trusting relationship is key in counseling. The counselor schedules an appointment with the counselee at a mutually convenient time. Building rapport may take several sessions.
2. Assessment
   • This phase involves collecting and analyzing data. The counselor encourages the counselee to express their feelings and expectations while observing and clarifying the problem.
3. Diagnosis
   • The counselor identifies the core issues and determines the area of intervention based on the information collected.
4. Setting Goals
   • The counselor collaborates with the counselee to set short-term and long-term goals, providing direction and purpose to the process.
5. Intervention
   • Strategies are implemented to achieve the goals. The methods depend on the counselor’s approach, the problem, and the counselee’s needs.
6. Termination and Follow-up
   • Counseling concludes once the goals are achieved, with a phased-out process to ensure the counselee maintains progress. Follow-up sessions are scheduled as necessary.

---

Tools and Techniques in Counseling

1. Standardized Tools and Techniques

These are objective and reliable tools developed by specialized agencies to evaluate various aspects of an individual:

• Intelligence Tests: Measure intellectual capacity.
• Achievement Tests: Assess performance in specific subjects.
• Aptitude Tests: Evaluate potential skills in particular fields.
• Interest Tests: Identify individual preferences and inclinations.
• Personality Tests: Analyze traits, interests, and behaviors.

2. Non-Standardized Techniques

These informal methods collect qualitative data and offer insights into personal characteristics:

• Autobiography: The counselee shares personal experiences through guided questions.
• Anecdotal Records: Document specific behaviors and their interpretation for action planning.
• Questionnaire: A structured set of questions about the individual’s background, habits, and aspirations.
• Interview: Face-to-face interaction for gathering direct information.
• Observation: Monitoring the individual’s natural behavior in various settings.
• Cumulative Record Chart: Detailed documentation of academic, health, and extracurricular activities.
• Case Study: Comprehensive analysis of an individual’s life, including family and development history.
• Rating Scales: Evaluate traits such as honesty, leadership, and reliability, though they can be subjective.
• Sociometric Techniques: Assess social dynamics and interpersonal relationships within a group.
• Informal Data Collection: Observing the individual during social and cultural events.

---

QUALITIES OF A GOOD COUNSELLOR

Effective counselling requires a blend of interpersonal skills, personal maturity, educational expertise, and professional dedication. The qualities of a good counsellor can be grouped into the following key areas:

---

1. Interpersonal Relationship Skills

• Friendly, approachable, and capable of building rapport.
• Displays sympathy, empathy, and sensitivity toward others’ attitudes.
• Exhibits fairness, sincerity, and tactfulness in interactions.
• Demonstrates patience and respects the client’s abilities and needs.
• Maintains confidentiality and communicates in the client’s language.
• Listens attentively, shows genuine concern, and responds in a facilitative manner.
• Inspires trust, tolerance, openness, and demonstrates a humanistic philosophy.

---

2. Personal Adjustment

• Possesses mature behavior and an integrated personality.
• Maintains emotional stability, flexibility, and adaptability.
• Aware of personal limitations and demonstrates unbiased coping mechanisms.
• Shows self-respect, self-reliance, and confidence.
• Accepts criticism constructively and exhibits self-awareness.
• Has a sense of humor, personal magnetism, and tolerance for ambiguity.

---

3. Scholastic Potential and Educational Background

• Possesses broad knowledge and efficient counselling skills.
• Motivated and committed to the counselling process.
• Understands community policies, beliefs, and misconceptions.
• Capable of effective problem-solving and decision-making.
• Possesses a Master’s Degree in counselling or related areas with training in:
  • Counselling process and understanding individuals.
  • Educational, occupational, and vocational guidance.
  • Behavioural sciences like psychology and sociology.
  • Research and evaluation methods.
• Experienced in teaching and follow-up services.

---

4. Health and Personal Appearance

• Has a pleasing voice and appearance, with freedom from annoying mannerisms.
• Maintains poise, neatness, vitality, and endurance.

---

5. Leadership Skills

• Ability to stimulate and lead others.
• Reinforces key information and directs counselees toward solutions.
• Guides counselees to make independent decisions in a voluntary manner.

---

6. Philosophy of Life

• Demonstrates good character and a wholesome outlook on life.
• Respects human values, civic sense, and exhibits an integrated personality.
• Holds spiritual and religious values while respecting universal principles.

---

7. Professional Dedication

• Strong vocational interest and commitment to guidance work.
• Displays a professional attitude, loyalty, and enthusiasm.
• Maintains professional ethics and a focus on growth and research.
• Willing to work beyond expectations to provide support.
• Uses psychotherapy when needed and fosters a helping relationship.

---

8. Spiritual Faith and Universal Principles

• Holds a belief in the spiritual quality of the world.
• Respects universal principles of religion and exhibits moral conviction.

---

9. High Sense of Morality

• Upholds moral values and maintains integrity in all professional and personal endeavors.

---

Difference Between Health Education and Counseling

Aspect	Health Education	Counseling
Scope	Related to groups or individuals.	Primarily focuses on one-on-one interactions.
Interaction	Often delivered in group settings, though it can be individual.	Always involves face-to-face interaction between counselor and client.
Focus	Emphasizes increasing awareness of health risks and promoting protective behaviors.	Helps individuals solve personal problems through mutual discussion.
Nature	Research-based, theory-driven, and provides functional health knowledge.	A learning-oriented process aiming to remove barriers to personal growth.
Purpose	Provides information to support informed health decisions.	Encourages self-reflection and personal problem-solving.
Environment	Can be conducted in various settings like schools, clinics, or community centers.	Requires a cooperative and supportive environment for effective engagement.
Outcome	Enhances general awareness and promotes collective health behavior change.	Empowers individuals to make decisions and solve problems independently.
Process	Focuses on delivering health messages and information.	Aims to help individuals explore and resolve personal challenges.

---

Role of Nurses in Counseling

Nurses play a vital role in counseling, encompassing several functions critical to patient care and support:

1. Caregiver:
   • Provides physical and psychological assistance while preserving the client’s dignity.
   • Offers full, partial, or supportive-educative care based on client needs.
2. Communicator:
   • Identifies client problems and communicates effectively with the health care team.
   • Ensures clear and accurate communication to meet client needs.
3. Teacher:
   • Educates clients about health conditions and procedures to restore or maintain health.
   • Assesses learning needs, sets goals, and measures progress.
4. Client Advocate:
   • Protects client rights and communicates their needs to other health professionals.
   • Helps clients exercise autonomy and speak up for themselves.
5. Counselor:
   • Supports clients in coping with psychological and social stressors.
   • Encourages new attitudes, feelings, and behaviors for personal growth.
   • Promotes decision-making and problem-solving through reflection.
6. Change Agent:
   • Helps clients modify behaviors and facilitates systemic changes in health care.
7. Leader:
   • Guides individuals or groups toward achieving specific health goals.
   • Utilizes interpersonal and motivational skills to influence positive outcomes.
8. Manager:
   • Coordinates nursing care for individuals, families, and communities.
   • Delegates, supervises, and evaluates care delivery.
9. Case Manager:
   • Collaborates with multidisciplinary teams to ensure client-centered and cost-effective care.
   • Oversees care plans and monitors outcomes.
10. Research Consumer:
    • Engages in research to improve client care.
    • Identifies significant problems, protects rights, and applies findings effectively.
11. Expanded Career Roles:
    • Functions in advanced roles like Nurse Practitioner, Nurse Educator, and Clinical Nurse Specialist.
    • Contributes to specialized care and greater autonomy in health care delivery.

---

COURSES

GNM

BSC NURSING

“Discover the key principles of communication, its process, types, barriers, and the art of observing and listening skills. Learn how effective communication can transform your interactions.”

Introduction

• Communication originates from the Latin word “communicare,” meaning to participate, inform, or impart.
• It involves the exchange of thoughts, experiences, views, opinions, information, and facts among individuals or groups.
• Effective communication in health education can motivate individuals and groups toward health protection.

---

Definition of Communication

1. General Definition:
   The process of exchanging information, thoughts, ideas, and feelings between individuals.
2. Detailed Definition:
   • Includes all actions taken to create understanding in another person’s mind.
   • Ensures information, purpose, and attitudes are shared to achieve a common goal.
   • Aims for the message to be received and understood as intended.

---

Process of Communication

The communication process consists of seven stages, involving a sender, message, channel, receiver, and feedback.

1. Source/Sender: The individual or medium delivering the information.
2. Ideas: The message’s content or subject matter.
3. Encoding: Converting ideas into codes like words, actions, or images.
4. Channel: The medium through which the message is sent (e.g., radio, phone, speech, TV).
5. Receiver: The person for whom the message is intended.
6. Decoding: Interpreting the codes to understand the message.
7. Feedback: The receiver’s response, confirming if the message was understood as intended.

S-M-C-R Model:

• S = Source
• M = Message
• C = Channel
• R = Receiver

---

Diagram of the Communication Process

Stages:

• Sender → Encoding → Message → Channel → Receiver → Decoding → Feedback

---

Purpose of Communication

• Information Sharing: Facilitate understanding among all levels of employees.
• Policy Interpretation: Help adopt and implement organizational policies.
• Motivation and Cooperation: Inspire teamwork and coordination among employees.
• Employee Relations: Strengthen employer-employee relationships.
• Personnel Development: Assist in recruitment, training, and development.
• Participation: Encourage decision-making involvement.
• Delegation: Enable decentralization of authority.
• Morale Boosting: Enhance group morale among workers.
• Job Satisfaction: Ensure contentment in the workplace.
• Problem-Solving: Aid in grievance handling and disciplinary actions.
• Community Engagement: Inform the public about available services.
• Change Management: Prepare personnel and the public for transitions.

---

Principles of Communication

Effective communication follows these core principles:

1. Clarity
   • Focuses on specific goals or messages.
   • Promotes easier understanding through exact and appropriate words.
2. Completeness
   • Ensures all necessary information is conveyed.
   • Addresses audience needs with relevant facts and figures.
3. Conciseness
   • Communicates with minimal words while retaining the essence.
   • Saves time and emphasizes the core message.
4. Consideration
   • Adapts to the audience’s mindset, emotions, and educational level.
   • Respects the audience’s self-esteem and avoids harm to feelings.
5. Correctness
   • Avoids grammatical errors and ensures precision in facts.
   • Uses appropriate language to boost confidence and impact.
6. Concreteness
   • Relies on specific facts to avoid ambiguity.
   • Builds reputation and strengthens confidence through clear messaging.
7. Courtesy
   • Reflects politeness and respect for the receiver.
   • Maintains a positive tone and avoids bias.

---

Types of Communication

1. One-Way Communication
   • Information flows only from the sender to the receiver (e.g., lecture method).
   • Drawbacks:
     • Imposes knowledge and lacks audience participation.
     • No feedback, limiting behavior influence.
2. Two-Way Communication
   • Interactive communication involving both sender and receiver (e.g., Socratic method).
   • Advantages:
     • Encourages active participation and democratic learning.
     • More effective in influencing behavior.
3. Verbal Communication
   • Involves spoken or written words.
   • Features:
     • Spoken words can be persuasive with hidden meanings.
     • Written communication is less persuasive but precise.
4. Non-Verbal Communication
   • Uses gestures, facial expressions, posture, and silence.
   • Examples: Smiles, frowns, raised eyebrows, and body language.
   • Can often convey more than words.
5. Formal and Informal Communication
   • Formal: Follows structured lines of authority.
   • Informal: Exists as social networks like gossip circles.
6. Visual Communication
   • Includes charts, graphs, pictograms, maps, posters, and tables.
7. Telecommunication
   • Uses mass communication media (e.g., radio, TV, internet) and point-to-point systems (e.g., telephone, telegraph).

---

Importance of Communication

• Nursing: Facilitates understanding between nurses, patients, relatives, and the healthcare team.
• Interpersonal Relations: Reduces tensions and improves relationships.
• Patient Care: Poor communication can lead to inadequate care.
• Behavioral Influence: Enables nurses to modify their behavior and influence others effectively.
• Organizational Efficiency: Prevents disorder and facilitates policy interpretation in hospitals.

---

Barriers to Communication

1. Physiological
   • Hearing difficulties or inability to express thoughts.
2. Psychological
   • Emotional disturbances, neurosis, language comprehension issues, or varying intelligence levels.
3. Environmental
   • External factors like noise, congestion, and invisibility hinder effective communication.
4. Cultural
   • Differences in literacy, customs, beliefs, religion, language, and socioeconomic status.
   • Social and cultural barriers can obstruct health behavior changes, even when services are accessible.
   • Solution: Identify and address these barriers for effective communication.

---

Establishment of Successful Communication: Key Aspects

Successful health communication is essential for improving public health, promoting positive behaviors, and enhancing the effectiveness of healthcare services. Below are the key elements and principles for establishing effective communication:

---

Primary Needs Addressed by Health Communication

1. Information
   • Provides factual, scientific knowledge to the public about health issues and methods to maintain and promote health.
   • Key Factors:
     • Eliminating ignorance, prejudice, and misconceptions.
     • Collaboration of the government, media, and health providers to disseminate accurate information.
2. Education
   • Education is rooted in communication, forming the foundation for health literacy and awareness.
3. Motivation
   • Encourages individuals to progress through:
     • Awareness → Interest → Decision-Making → Adoption of Behaviors.
4. Persuasion
   • Influences beliefs, values, and behaviors through targeted messaging.
   • Benefits:
     • Lifestyle changes.
     • Reduction of risk factors for diseases.
5. Counseling
   • Assists individuals in understanding and managing their problems.
   • Relies heavily on relationship-building and communication skills.
6. Raising Morals
   • Enhances team spirit and cohesion among healthcare teams.
   • Communication fosters collective determination and resilience.
7. Health Development
   • Spreads knowledge about health goals, facilitating progress in public health initiatives.
8. Health Organization
   • Communication serves as the backbone of organizational operations.
   • Types of Communication:
     • Vertical Communication:
       • Downward: From administrators to staff and beneficiaries.
       • Upward: From staff to higher management.
     • Horizontal Communication: Between peers at the same organizational level.
   • Facilitates intersectoral coordination within healthcare organizations.

---

Observing and Listening Skills in Communication

Effective communication relies heavily on listening and observation skills. These abilities enhance understanding, foster empathy, and facilitate meaningful interactions, especially in health education. Below is a detailed exploration of these skills:

---

Art of Listening in Communication

Listening is a critical yet often overlooked component of communication. While speaking might seem more impactful, being an attentive listener is a hallmark of effective communicators, particularly in health education.

Characteristics of a Good Listener

1. Active Listening: Listening attentively, with focus and patience, rather than passively remaining silent.
2. Understanding: Fully comprehending the speaker’s concerns, emotions, and messages.
3. Evaluating: Assessing the information for accuracy and relevance to health education.

The LADDER Approach to Effective Listening

• L: Look at others and maintain good eye contact.
• A: Ask appropriate and relevant questions.
• D: Do not interrupt the speaker.
• D: Do not change the subject.
• E: Express emotions with control.
• R: Responsively listen, providing feedback and encouragement.

Benefits of Good Listening Skills

• Enhances personal development and relationships.
• Saves time by identifying the root of problems.
• Clarifies objectives and facilitates effective feedback.

---

Observation in Communication

Observation involves gathering information about people, events, and situations through careful inspection. In health education, observation is crucial for understanding community dynamics and individual needs.

Definition

“Observation means to see events in the right perspective and record them to understand the relationship between causes and effects.”

Characteristics of Effective Observation

1. Use of Special Senses: Utilizing sight, hearing, and speech for detailed inspection.
2. Minuteness: Paying attention to even the smallest details.
3. Cause-Effect Analysis: Identifying relationships between actions and outcomes.
4. Impartiality: Remaining unbiased and objective during observation.
5. Empirical Study: Observations should be based on real-world evidence.

Types of Observation

1. Participatory Observation: Observer actively participates in activities.
2. Non-Participatory Observation: Observer remains a passive onlooker.
3. Semi-Participatory Observation: Combines elements of active and passive participation.
4. Controlled Observation: Conducted under predefined conditions.
5. Uncontrolled Observation: Occurs in natural, uncontrolled environments.

Guidelines for Health Education Observation

1. Clarity: Observations must align with the subject matter.
2. Focus: Target observations to immediate issues, e.g., checking dietary habits for anemia.
3. Objective-Oriented: Clear goals for the observation process.
4. Techniques and Methods: Observers should be trained and experienced.
5. Communication Expertise: Strong communication skills enhance observational accuracy.

Limitations of Observation

• Potential biases or favoritism from the observer.
• Limited ability to cover all events or scenarios.
• Subjectivity in interpreting reactions and behaviors.

---

COURSES

GNM

BSC NURSING

(more…)

Learn how standing orders guide community health nurses in managing minor ailments like fever and diarrhea. Explore their role in MCH care, referrals, and health education.

Standing Orders for Treatment of Minor Ailments

1. Fever:

• Record vital signs (temperature, pulse, respiration, BP).
• Identify accompanying symptoms (e.g., headache, nausea, shivering).
• Provide rest, light meals, and hydration.
• Administer paracetamol for high fever and perform cold sponging if >39°C.
• Prepare blood slide for malaria parasite test.
• Refer for severe symptoms (delirium, convulsions, unconsciousness).

---

2. Heat Stroke:

• Place patient in a shaded, ventilated area; wrap in a wet sheet.
• Monitor temperature; give salted cool water if conscious.
• Refer to the hospital once stabilized.

---

3. Diarrhea:

• Monitor dehydration signs.
• Provide ORS, coconut water, lemon juice, or light meals.
• Refer severe dehydration cases to the hospital.
• Ensure proper hygiene, and report epidemic cases promptly.

---

4. Burns:

• Cool the burn with water; do not touch blisters.
• Cover with a clean cloth, and remove tight items like rings or belts.
• Administer analgesics if needed and refer for severe cases.

---

5. Drowning:

• Clear lungs by laying the person on the abdomen.
• Perform resuscitation and refer to the hospital.

---

6. Dog Bite:

• Wash the wound thoroughly with soap and running water.
• Apply antiseptics (betadine/tincture iodine).
• Administer tetanus toxoid and refer for ARV therapy.

---

7. Snake Bite:

• Immobilize the patient and tie a tourniquet above the bite (loosen every 30 mins).
• Suction the venom carefully or use a vacuum syringe.
• Clean with saline; provide fluids like tea/coffee and refer for ASV therapy.

---

8. Scorpion Bite:

• Remove sting, apply ice, and clean thoroughly.
• Use tourniquet and give analgesics or sweetened milk.

---

9. Fainting:

• Lay the person down with feet elevated.
• Ensure fresh air; help them take deep breaths upon regaining consciousness.
• Refer if unconsciousness persists.

---

10. Injuries and Fractures:

• Clean wound with soap and antiseptic; apply sterile dressing.
• Immobilize fractured parts with a splint.
• Administer analgesics and tetanus toxoid, and refer for further care.

---

11. Wounds:

• Wash with clean water and antiseptic.
• Remove foreign bodies and apply sterile bandage with betadine.
• Administer tetanus toxoid and manage bleeding.
• Refer large or severe wounds for sutures.

Standing Orders for Maternal and Child Health (MCH) Care

Maternal Care

• Provide tablets for morning sickness during early pregnancy.
• For pregnancy-induced toxaemia:
• Advise restricted salt intake and complete rest.
• Refer to the hospital immediately if edema develops.
• In cases of Antepartum Hemorrhage (APH) or Postpartum Hemorrhage (PPH), refer the mother to a hospital.
• Manage fever post-delivery with antipyretics and refer for further treatment if necessary.
• Support mothers with perineal care, excess breast milk, or stillbirth issues, and guide them for further treatment.

Newborn Care

• Observe for abnormalities and refer if needed.
• Ensure the newborn is kept warm.
• Initiate breastfeeding as early as possible.

---

Common Pediatric Issues

Convulsions in Children

• Place the child safely on a bed and loosen tight clothing.
• Clear mouth secretions to ensure proper breathing.
• Use cold sponging if fever is present.
• Identify possible causes and refer for treatment.

---

Emergency Conditions

Hemorrhage

• Lie the patient flat on their back.
• Press a pad on the bleeding site until it stops, then bandage.
• Monitor for shock and provide liquids.
• Refer to the hospital if bleeding or shock persists.

Unconsciousness

• Ensure the patient is in a well-ventilated position to support breathing.
• Remove dentures and loosen tight clothing.
• Clear mouth secretions and provide artificial respiration if needed.
• Refer to the hospital urgently.

---

Minor Ailments

Sore Throat

• Inspect for redness or white patches and take swabs if needed.
• Advise saline gargles and fluid intake.
• Refer recurrent cases to the hospital.

Cough

• Determine duration and type; check for associated symptoms.
• Provide cough mixtures and steam inhalation as required.
• Collect sputum samples if tuberculosis is suspected.

Conjunctivitis

• Irrigate eyes with saline and clean with cotton.
• Apply drops/ointments and refer if severe.

Toothache

• Provide aspirin for pain relief.
• Refer to a dentist for further care.

Earache and Discharge

• Clean ears carefully without probing.
• Use hydrogen peroxide for discharge and administer ear drops.
• Refer complex cases to the hospital.

Foreign Bodies in Nose/Ears

• Avoid pouring water on seeds; refer immediately for removal.

Constipation

• Advise fluids, fruits, and leafy vegetables.
• Use mild laxatives as per protocol.

---

Chronic Cases

Chronic Ulcers

• Clean with soap and water and apply prescribed ointments.

Pediculosis (Lice Infestation)

• Apply 5% DDT, Benzyl Benzoate, or kerosene-oil mixtures.
• Use fine-toothed combs for removal.

Scabies

• Scrub, bathe, and apply Benzyl Benzoate or neem-based treatments.
• Wash clothes in boiling water and dry in sunlight.
• Repeat treatment if required.

Role of a Community Health Nurse in Implementing Standing Orders

The Community Health Nurse (CHN) plays a pivotal role in executing standing orders effectively within the scope of their practice. Their responsibilities include the following:

Assessment and Data Collection

• Patient History: Collect comprehensive information about:
• General health status.
• Onset, intensity, and symptoms of the disease.
• Family history of illnesses.
• Past medical history and any prior treatments.
• Vital Signs: Measure and document temperature, pulse, respiration, and blood pressure. Conduct urine tests as necessary.
• Problem Identification: Recognize patient problems and determine personal needs.

Nursing Services

• Provide nursing care as outlined in the standing orders.
• Offer emotional support and reassurance to the patient and their family.

Referral and Follow-Up

• Referral System: Facilitate referrals to higher healthcare facilities when required.
• Health Education: Explain the causes of illness, possible complications, follow-up care, and preventive measures to the patient and their family.

Documentation and Review

• Assess the outcomes of nursing care provided.
• Regularly review and stay updated on standing orders and health manuals.
• Document and inform the health officer about communicable diseases promptly.

Communication and Advocacy

• Represent the nurse’s perspective during the review of standing orders.
• Clarify doubts about standing orders by gathering relevant information promptly.

Professional Conduct

• Be mindful of the scope of practice and maintain professional boundaries.
• Foster trust and collaboration with doctors and health administrators.

Environmental Safety

• Ensure a safe and healthy environment conducive to patient well-being.

---

COURSES

GNM

BSC NURSING

(more…)