Community health case study - Substance use: Nursing

Nurse Stevie is a community health nurse and is running a workshop about substance use for a group of parents and teachers of teenagers. She goes through the steps of the Clinical Judgment Measurement Model to make decisions about the group’s needs by recognizing and analyzing cues, prioritizing hypotheses, generating solutions, taking action, and evaluating outcomes.

First, Nurse Stevie recognizes important cues, including the participants’ responses on a pre-workshop survey, where they submitted a variety of questions regarding concerns about the prevalence of substance use in teenagers and how to support their teenagers to make good choices.

Next, Nurse Stevie analyzes these cues. She reviews the demographic data of the group, which includes a mix of parents and teachers with varying levels of experience and knowledge on substance use. She also reviews recent community data that indicates an increase in substance use among local teenagers.

Nurse Stevie knows substance use includes any substance that threatens an individual’s health or impairs their social or economic functioning. Substances can include alcohol; tobacco, including e-cigarettes, or vapes; and drugs such as prescription, over-the-counter, and illicit drugs. She knows that teenagers are more likely to engage in binge-drinking, and that e-cigarettes are becoming popular and prevalent.

Nurse Stevie recognizes that while risk-taking and experimentation is a normal part of adolescent development, younger individuals are at increased risk of dependence and poor health outcomes when using substances.

She also understands that risks for substance use include family-related factors, such as genetics, family dynamics, and adverse childhood outcomes as well as social, financial, and cultural influences. Whereas protective factors against substance use include having a positive role model and a strong connection with family, friends, and the community; appropriate supervision; and engagement in activities such as sports, clubs, and volunteer opportunities.

Nurse Stevie recognizes the group would benefit from primary prevention strategies focused on developing a healthy lifestyle and resiliency in teenagers and education on how to support teenagers in avoiding use of harmful substances.

Now, using the information she’s gathered, Nurse Stevie chooses a priority hypothesis of knowledge deficit. Then, she generates solutions to address the group’s knowledge deficit, including educational interventions; and she establishes the expected outcome that after intervening, the group will communicate their understanding of the information provided by the end of the workshop.

Then, Nurse Stevie takes action to implement these solutions. First, she goes through her presentation on substance use, which includes the community’s most recent statistics and common misconceptions about substance use.