Developing Leadership in Advanced Practice Nursing (APN)

Community Group Meeting Observation

Health Planning and Policy Development: Leadership Issues

• Jinyi Kim

Hypertension is a major public health problem among Korean population. According to a survey of Korean Centers for Diseases Control and Prevention in 2012, almost 30% of adult Koreans have hypertension. In addition, a stroke triggered by hypertension is one of leading causes of death in Korean population. When I worked as a staff nurse at coronary care unit (CCU) in Korea, I saw a lot of patient suffering with severe cardiovascular disease triggered by poorly controlled hypertension. A study by Kim (2009) indicates that hypertension contributed nearly 70% of deaths from all cardiovascular disease in Korean. Many studies argue that blood pressure is related with life styles of exercise, diet, drinking, and smoking. In general, healthy food consumption for preventing hypertension included vegetables, fruits, and whole grains. However, Koreans dietary patterns differ from other culture, the specific hypertension dietary guideline is necessary.

I attended a community group meeting about hypertension prevention program focusing on Korean community in New York. The Korean Community Services (KCS) bring issues to light of heart disease and hypertension within Korean population in New York. This community group is established in 1973 as the first community-based social service organization focusing on the Korean population in New York. The group is a voluntary, nonprofit community service agency with the objective to develop and deliver a wide scope of community service programs to meet the various needs of the community. In order to accomplish these goals, KCS provides various professional community service programs in the areas of Aging, Community, Workforce Development, and Public Health. This group serves over a thousand people day by day with the assistance of 10 board members, over 50 staff, and about 100 volunteers who are all working to improve Korean community around the New York area. These staff members comprise of doctors, nurses, and social workers.

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Leadership which is a core competency of advanced practice nursing (APN) has been defined as moving a group of persons toward a common goal (Hamric, Hanson, Tracym, & O’Grady 2013). In the community meeting, the official leadership is given to the director of public health and research department at KCS who started this group meeting and the type of team leadership is transformational leadership. According to Hamric et al (2013), the transformational leadership is pointed at change because the leader has a vision or mission to achieve certain goals. In order to reach those objectives the assistance of others is needed. Such leaders energize and motivate their supporters to accomplish their goals, share their visions, and embrace empowerment (Hamric et al., 2013). In the meeting, the leader determined the vision of the community program and others group members agreed in the value of the leader’s goals.

The agenda consists of short term goals, long term goals, and strategies in this meeting. The agenda is decided through the meeting with all members of the group members by a show of hands. The key strategies to prevent or manage high blood pressure and cardiovascular disease in Korean community, the group working closely with Korean restaurants to offer healthy menu options to their customers, religious associations (e.g. Korean Churches) to improve nutrition of client by serving healthier food during communal meals, and ‘Keep on Track’ program to improve blood pressure control in the Korean community. The goal of this program is to lower mortality and morbidity due to cardiovascular disease among Koreans in New York. At this meeting, it is thought that the community group’s vested interesting is faith-based organizations. During the most recent grant period, KCS secured commitments from over 40 churches in Queens to adopt these standards for communal meals they serve.

Many studies have been indicated that high blood pressure as ‘silent killer’ that causes problems with the heart and blood vessels, leading to heart attack, aneurysm, atherosclerosis, kidney failure and other complications (Kim, 2009). Therefore, KCS seeks to raise awareness of the danger of the high blood pressure and its complications by implementing policy, system, and environmental approaches in collaboration with community groups such as churches, ethnic markets, health care providers and pharmacists with linguistically and culturally competent, tailored programs. Client can participant in health educational programs and share their idea to improve Korean community and the programs. Responding to community needs for chronic disease prevention and intervention, KCS offers healthy eating projects to encourage the community to make their environment healthier and to adopt health nutrition policies. Nurses have been major impact on this community group as an educator, collaborator, and advocator in this group. This group is dedicated to encouraging people who have of are at risk of hypertension to adopt a healthier diet and lifestyle. Traditionally, Koreans enjoy salty food. Therefore, this community group offer less salt project, it is a restaurant initiative project designed to prevent the high blood pressure that is prevalent in the Korean community. It promoted the reduction of sodium used by Korean ethnic restaurants by offering alternative, lower-sodium methods of preparing traditional foods at their venues and raising awareness among the public in general.

This group plays a crucial role in the improvement of local, state, national health planning and policy development. Since 2001, KCS sends their representative to collaborative meetings and annually takes part in a trip to Albany, NY, to speak with elected officials to address the educational and health needs of minors and increasing funding for immigrant services such as Community Health Advocate funds, which help Koreans Americans obtain public health insurance, information about hospital billing practices, and more. As a future APN, it is thought that APNs can play a crucial role in helping KCS promote chronic disease prevention and management by educating and advocating patient as primary health care providers. In order to do this appropriately APNs should achieve analytic assessment skills, community skills and cultural competency. An analytic assessment is needed to promote health promotion and prevention with community that is faced with complex challenges (Hamric et al., 2013). Communication skills are also needed for the comprehensive and appropriate exchange of information, and mediation skills are needed to counterbalance conflicts caused by individual personality and viewpoint diversity within a group (Hamric et al., 2013). By utilizing this skill, APNs can organize evidence-based programs and can catch the requirements of the community effectively. In addition, the cultural competency is one of aspects of public health nursing. Through this competency, APN can understand the issues within the community accurately without ethical disparities and can enhance their strategies to prevent disease (Hamric et al, 2013). I would seek to be involved in meetings to discuss important issues like chronic disease prevention and reducing health care disparities. It is believed that as one of future APNs, I can become involved in this group though participation in their programs as educator, primary health care provider, and policy maker to achieve the goals of the community group.

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In conclusion, the nursing profession should encourage all APNs to be leaders. APNs can define the scope of their leadership influence in an individual patient, group, and society. As a future APN, it is thought that APN can be the leader of this community group. In order to this, graduates are encouraged to seek additional opportunities for leadership development commensurate with their practice setting and associated leadership needs. APNs should continue to involve themselves in contemporary healthcare debates and equip themselves to provide leadership for change.

References

Hamric, A. B., Hanson, C. M., Tracy, M. F., & O’Grady, E. T. (2013). Advanced practice nursing: An integrative approach. St, Louis, MI: Elsevier Health Sciences.

Kim, Y. O. (2009). Dietary patterns associated with hypertension among Korean males. Nutrition research and practice, 3(2), 162-166. doi: 10.4162/nrp.2009.3.2.162

Korean Centers for Diseases Control and Prevention. (2012). Health Statistics 2012: Korean National Health and Nutrition. Retrieved from http://kostat.go.kr/wnsearch/search.jsp