Building a Community Nurse Program:
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​A Framework for Success

Community Nurse Connection is a convening organization bringing together people, ideas and resources to improve the quality of life for older adults.

• We partner with communities to create a roadmap for the development of Community Nursing projects 
• We provide access to a confidential electronic documentation system
• We provide outcome data in the form on monthly, quarterly and annual reports
• We host virtual monthly nursing peer support meetings
• We provide grants to start and sustain Community Nursing programs and assist in searching for additional funding.

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Phase 1 Exploration and Discussion:
Organize a small group (3-5)of like minded people.  Plan to meet for coffee once a month or a zoom call. We are happy to have a representative attend these meetings. Think about inviting police, fire, welfare officers and other key community organizations.

Define your community.  The community could be a town, a village, a parish, a religious organization, or an aging in place organization.

Define the problem or need. The need may be to reduce non urgent ambulance calls, care is needed for the older adults to keep them safe at home, the minister or parish members may need more healthcare support, community members need assistance navigating healthcare needs. 

Community Nurse Connection has examples of Community Nurse models. 

Community Nurse Connection would be happy to join these meetings.


Phase 2 Planning for infrastructure or modeling:
Identify possible sources of funding.  Are you an established non-profit? Do you need a fiscal sponsor? If this is a municipality position how will it fit in the budget? 
Will the nurse be an independent contractor or an employee?
If an employee of a municipality will there be an official nursing advisory committee? How to organize your committee?
Start a budget outline. Community Nurse Connection has samples to get you started.
      
Phase 3 Planning for implementation
Outline  roles and responsibilities for the nurse role-Community Nurse Connection has samples of job descriptions and contracts.
On average how many hours a week will the nurse work?
Let community members know about the position
Let  health care providers know about the position
Advertise in local media, social media, and word of mouth
Community Nurse Connection will list the position on our website and explore with you other recruitment strategies
Do you need a website or to update your existing website

Hiring
Clarify expectations such as office hours, meeting expectations, and community engagement. Every community is different with unique needs. 
How will the nurse apply, online, by mail, phone call? 
Make a screening and  interview plan-who does initial screening, what is your response to applicants expectations,  Community Nurse Connection can help interview.
What is the hiring process. Who makes the decision. What is the offer including salary, mileage, insurance and education stipends? 
When is the start date?

Orientation
Work with Community Nurse Connection on an orientation outline including for the first month

• joint visits with other community nurses
• documentation and resource training sessions from Community  Nurse Connection  2-3 hours
• infection control         
• home visit safety
• confidentiality
• getting to know your community, police, fire, welfare, community groups
• plan on when to accept first client
• Managing the caseload of clients-start slow and build

How to get the word out to the community that nursing services are available
ListServe
Nursing meet & greet at community events such as the library, farmers market or town holiday events.
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FREQUENTLY ASKED QUESTIONS 

 What is a Community Nurse? 
​Community Nurses work to improve the health and well-being of the communities they serve by educating them about illness, disease prevention, safe health practices, and how to obtain health care services. They also facilitate communication between people, their families, and the medical community in order to improve health outcomes.

 Why have a nurse in this role?  
Nurses are accustomed to viewing the individual and the community in a holistic manner.  Their assessment ability and knowledge about options for appropriate interventions will assist them in addressing complex problems. They are familiar with health care systems and have experience in working as part of a team.  They understand the course of an illness, the functional consequences of that illness and the impact on the individual and the family. They also have a global familiarity with community resources that are necessary to support the individual during a crisis.  Community Nurses have the capacity to initiate interventions for the larger community based on needs that arise.

 Does the nurse need to be currently licensed?
Yes, a current RN license in the State where they will provide care is necessary for individuals in this position. A nursing license indicates that the nurse does not have a criminal record and has been “active in practice” and has maintained a level of professional accountability related to continuing education

 What does a Community Nurse do?
The nurse can do any of the following:

• health education
• health counseling
• referral agent/care coordination for vulnerable members of the congregation and their families
• health advocacy
• volunteer education/facilitation
• facilitate support groups
• care management
• medication reconciliation
• initiate advanced directives

The nurse does not do direct care (e.g., wound care, IV administration). Direct care needs for homebound individuals can be referred to the area home care agencies. Assessing the needs of the  frail older adults in the community setting is a good way to begin a practice.

How many hours a week do they work?
Nurses work anywhere from 8-40 hours/week. with an average of about 12

How much should a Community Nurse get paid?
Community Nurses hourly rates should start at $30-$55per hour depending on their experience.

Can several communities “share” a nurse?
Yes, especially if the groups are in close proximity to one and other. However covering large areas can mean more travel and less time with members of the community.

Should a Community Nurse have Liability Insurance?
Yes. Community Nurse Connection can assist with finding a low cost high coverage option. 

What is the difference between the services offered by visiting nurse associations (VNAs) and the services provided by a community nurse?  
Home care and hospice services are skilled direct care nursing or rehab services provided to an eligible individual by a licensed professional under the orders of a medical provider. These services are paid for  by Medicare, Medicaid, or private insurance. Community Nurse services do not require a physician’s orders nor are the services direct hands-on care. These services are not reimbursable by Medicare, Medicaid or private insurance at this time.  


How do we evaluate the performance of the nurse?
A performance review should be done annually. The review should consider each of the different roles of the nurse. Feedback can be obtained from the many individuals and groups with whom the nurse works. Community Nurse Connection can help you prepare an performance review tool. 

How do we know this is a good investment for our community?
Evaluation can be obtained via satisfaction surveys. Specific questions can be asked about educational events and activities. Individuals who have used the services of the nurse can also be asked to comment on the value of the services.  

What about continuing education for the nurse?
Continuing education is critical for professional growth. Local conferences should be pursued, but a regional or out-of-state conference should be encouraged once a year. Educational opportunities could be included in the benefit package.