The public health system in the Philippines has undergone several transformations since established by the Americans more than a century ago. The concepts and principles may still be the same, but the face and the structure have to change in order to address the changing needs of the society. (Preface, Public Health Nursing in the Philippines-NLPGN, 10th Edition)
Even in the practice of public health nursing where the main concerns are on the promotive-preventive, aspects of care, Henderson’s unique definition of nursing still stands true---the need-based assistance of individuals for the achievement/maintenance of health and of gaining independence.
My functions and goals as a public health nurse can also be correlated to the 14 Basic Needs cited by Henderson.
The only difference is that while she focused on the care of individuals, ours is to take care of families and the community as whole. The programs that we implement also respond to the same needs she identified, like the programs on environmental sanitation, healthy lifestyle, dental, maternal and child care, and on gender and development. The focus of care may be different, but public health is one with Henderson’s view point on individuals as holistic beings, giving importance not only on the physical aspect of one’s being, but of the social, spiritual, emotional, and psychological as well.
Henderson also saw the importance the nursing process, emphasizing on the significance of assessment, nurse-patient collaboration and the principle of empathy in the entire nursing process. This, too, is very true with public health. Various assessment tools were formulated and are being used to guide the workers in the field. Like the Integrated Management of Childhood Illnesses (IMCI) manual and the manual on Family Planning and Reproductive Health which focuses not only on critical assessment, but appropriate diagnosis, interventions, evaluation and follow-up as well. Seminars on therapeutic communication, among others, are also conducted to significantly improve the care given by public health workers through effective nurse-patient relationships.
Henderson was also the one who promulgated the use of individualized plan of care for every patient, highlighting the importance of proper documentation. We strongly put emphasis on this as well. Different types of tools are being utilized in the area, such as the Individualized Treatment Record (ITR), Target Client List (TCL), Early Childhood Care and Development (ECCD) card, and others, to ensure that the care given is at the optimum and that appropriate follow-up of clients are done in their households.
Of all the varying flagship programs of the Department of Health (DOH) and the services that we offer in the community, all these we do with one objective in mind---self-reliance of the family and of the entire community.
Primary Health Care is the essential health care based on practical, scientifically sound and socially acceptable methods and technology made universally accessible to individuals and families in the community through their full participation and at a cost that the community can afford to maintain every stage of their development in the spirit of self reliance and self determination. (WHO/UNICEF)