Nursing leadership in healthcare partnerships: barriers and strategies for community care

Healthcare Partnership in the Community

Discuss an example of healthcare partnership in your community and specifically cite examples that show how nurses, both individually and collectively, influenced the care provided. What obstacles were confronted and what strategies were employed in order to effectively overcome them.

One community healthcare partnership that is salient in my mind is Texas Department of State Health Services' program on tuberculosis or TB. This group of projects is specifically handled by the Office of Border Health, specifically because communicable diseases transmitted over the Texas-Mexico border will inadvertently affect the state of community health of both countries (i.e., the U.S. And Mexico). Under the program, two projects have been successful and known for its accomplishment in helping decrease TB prevalence in communities near the Texas-Mexico border: Proyecto Juntos and TBNet.

Proyecto Juntos specifically centers on "bilateral TB control," centering its efforts to curbing TB prevalence by monitoring the health of individuals crossing the border daily. Most especially, the project centers its efforts in monitoring the health north-bound travelers, as TB prevalence is higher in Mexico compared to the U.S. The specific service/implementation sites for the project are the towns/cities of El Paso, Ciudad Juarez and Chihuahua. TBNet, meanwhile, is another initiative under the TB program of the Office of Border Health, wherein TB patients are monitored and treatment is facilitated efficiently through process improvements in TB treatment, through improved monitoring and documentation systems and implementation of new technologies. The TBNet project makes use of a "wallet-sized portable treatment records," central storehouse system of patient records, and toll-free helpline, which make TB treatment and follow-through more accessible, available and more convenient for patients (OBH, 2010).

Nurses for this TB program have critical roles in ensuring that spread of this communicable disease is controlled and does not spread across the border. Despite the innovations developed and implemented for the program, coordination among healthcare professionals and cooperation of TB patients remain critical factors that determine the success of the Office of Border Health's TB program. Achievement of the program's success through the years did not happen without the challenges that the nurses, the frontliners of these projects, experience everyday.

Individually, nurses are constantly confronted with the fact that they will always encounter patients who will not follow through on their treatment, only to find out later that their TB has escalated to MDR-TB (multi-drug resistant TB). Establishing personal relations with the TB patient is critical, as this is an effective way to increase compliance during the treatment period. Nurses have inevitably became 'treatment partners' as well, constantly reminding patients about their treatment and establishing himself/herself as an authority figure in the community when it comes to TB.

As a group, nurses are also expected to accomplish other tasks apart from these TB projects. Thus, what happens is that as a group, nurses tend to take on more workload because of limited staffing, not to mention difficulties in addressing patient needs and concerns. As a result, they become demoralized and eventually become dissatisfied with their roles in the healthcare institution/organization. These issues concerning nurses have not been entirely resolved by the institution, but healthcare institutions are aware of these issues and are actively developing resolutions on how to prevent work dissatisfaction among nurses who do not only handle basic healthcare functions, but also have critical roles in the implementation of the Department's TB program in the Texas-Mexico border.

Q2: Describe the purpose and effectiveness of a nursing organization to which you belong or with which you are familiar. What leadership role are you currently performing or would you like to perform in this organization? What is your next step within the organization or its partners to enhance professional development?

The Texas Organization of Nurse Executives (TONE) is one of the nursing organizations I have aspired to be a part of, mainly because of their excellent program for nurses, developing them as professionals and leaders in the healthcare settings. I became familiar with TONE early on in my chosen career path as a nurse. As a healthcare professional, I considered moving up from being a technical staff member to manager as the natural career movement for me, especially since I have always considered myself as an individual who can incite change and development in the nursing profession in the healthcare institution/organization I work for.

As a nurse assuming the role of a team member in the organization I currently work in, I know that I need both the technical and managerial expertise in order to achieve my goal of becoming a nurse executive someday. TONE would give me the "leverage" I need to achieve this goal, since its program is geared towards providing "innovative nursing leadership," a promise that I believe best reflects the future of nursing, especially for my generation of nurses and healthcare professionals.