Chapter 2: The Evolution of Community Health Nursing in Canada Flashcards
- Which one of the following is a reason to study nursing history?
a. To fulfill provincial/territorial nursing requirements
b. To help fill up the necessary credit hours for graduation
c. To meet accreditation requirements
d. To understand the present and plan for tomorrow
ANS: D
One of the best ways to make plans for today and tomorrow is to look at the past to see what
did or did not work. Lessons learned through history provide direction for current and future
community health nursing practice.
- Which group was the first to establish hospitals?
a. Feudal lords, to keep their peons working
b. Small towns, to care for their own citizens
c. The military, to enable soldiers to keep fighting
d. Religious orders, to care for the sick, poor, and neglected
ANS: D
Historically, most people were responsible for their own health care services. However, during
the Middles Ages, religious convents and monasteries established hospitals to care for the
aged, disabled, orphaned, sick, poor, and neglected.
- The Industrial Revolution caused earlier caregiving approaches—where care was provided by
families, friends, and neighbours—to become inadequate because of constantly increasing
demand. Which situation also contributed to the inadequacy of caregiving approaches at this
time?
a. Ongoing wars, which caused frequent deaths and injuries
b. Horrific plagues that swept through Europe
c. Migration and urbanization
d. The need to pay caregivers
ANS: C
Older forms of care became inadequate because of the social changes in Europe, with great
advances in transportation, communication, and other technologies. Increased mobility led to
increased demand for health care, migration, and urbanization.
- Which event most notably changed health care?
a. The creation of the discipline of nursing by Florence Nightingale
b. The formation of sisterhoods by nuns who gave care
c. The establishment of the Sisters of Mercy in Dublin
d. The formation of the Dames de la Charité by Saint Vincent de Paul
ANS: A
Many innovations in health care led to improvements in care, but Florence Nightingale
revolutionized health care by establishing the discipline of nursing.
- Which was a very important factor in the success of early visiting nurses?
a. The care they provided that served as a model for all later hospitals
b. The more economical care they provided to families
c. Their role model, Edna Moore
d. The superb publicity campaign that was created by the health departments
ANS: B
Visiting nurses, who provided care wherever the client was located—at home, work, or school
—took care of several families in one day (rather than taking care of only one patient or
family as the private duty nurse did), which made their care more economical.
- Eunice Dyke was a public health nursing pioneer in Canada. In which area did she play a key
role at the beginning of the twentieth century?
a. Decentralization of public health nursing
b. Specialization of public health nursing
c. Inclusion of powerful citizens on health department boards to ensure adequate
funds to pay for care
d. Development of a system for accurate records of births and deaths
ANS: A
Eunice Dyke played a key role in the decentralization of public health nursing in 1914. Before
this time, public health nurses (PHNs) had been working in specialized areas of nursing, such
as tuberculosis (TB) care, but now they became generalists (though they did not provide
bedside nursing care in the home as community health nurses [CHNs] or visiting nurses
would).
- Which public health nurse leader was instrumental in establishing the first integrated basic
nursing degree program in Canada?
a. Florence Nightingale
b. Kathleen Russell
c. Edna Moore
d. Lillian Wald
ANS: B
In 1920, Kathleen Russell, Director of the Department of Public Health Nursing at the
University of Toronto, was instrumental in establishing the first integrated basic degree
nursing program, a major milestone in nursing education, including public health nursing
education.
- Which argument was used to convince the Metropolitan Life Insurance Company to establish
the first community health nursing program for workers in 1909?
a. Creating such a service was the morally right thing to do.
b. Employing nurses directly would be less expensive than paying taxes to the city to
provide nursing services.
c. Having the company’s nurses make home visits would increase morale among
workers.
d. Using PHNs would keep workers healthier, which would increase worker
productivity.
ANS: D
Lillian Wald argued that it would be more economical to use the services of a PHN than to
employ the company’s own nurses and that keeping workers healthier would increase their
productivity.
- What is the main achievement of the Community Health Nurses Association of Canada
(CHNAC)?
a. Licensed practical nurses (LPNs) as well as registered nurses (RNs) were allowed
to join the association.
b. Nurses who were not PHNs were encouraged to join.
c. National standards of practice were developed.
d. A process was developed to choose the organization’s leaders and officers
ANS: C
In 1987, the CHNAC, an interest group of the Canadian Nurses Association (CNA), was
formed. This association developed the national standards of practice (published in 2003) for
CHNs. These standards of practice have helped establish the term community health nursing
as the umbrella term for all nurses working in and with communities and defined the
minimum scope of practice for CHNs.
- Following the release of the Romanow Report in 2002, which type of care was identified as
the most rapidly growing area of community health care?
a. Home care
b. Community problems
c. Immunization
d. Women’s issues
ANS: A
The Romanow Report (2002) identified home care as the most rapidly growing area of
community health care.
- In which practice area were the first PHNs in Canada employed?
a. Healthy baby clinics
b. Outpost nursing
c. School health programs
d. Tuberculosis education, prevention, and treatment
ANS: D
From the 1920s to the 1940s, nurses specializing in TB care were replaced by PHNs, as it was
believed that visiting nurses would be more effective and efficient if they moved to general
nursing care. Therefore, PHNs became specialists in TB education, prevention, and treatment.
- What was the main reason for the brief existence of the nurse practitioner–model educational
program?
a. Inadequate assessment and planning in the local area
b. Insufficient provincial/territorial funding
c. The large number of primary care physicians practicing in urban areas
d. The need for nursing expertise and skills in other practice settings
ANS: C
In Ontario, the nurse practitioner model for alternative health care delivery was initiated with
the educational program offered by McMaster University. However, its existence was shortlived because of a perceived duplication of services and a lack of career opportunities for
nurse practitioners, partly because there were too many primary care physicians practising in
urban areas.
