nurse burnout

Windshield Survey
Maggie Siler
Ferris State University

Windshield Survey
Community assessment is crucial to planning, implementation, and evaluation of programs to improve the health of a population. A windshield survey is an informal method used by community health nurses to obtain basic knowledge about a given community. It provides a subjective view of the various physical characteristics of a communal area as observed while driving or walking through a neighborhood.
Community
Community assessment is an essential function of community nursing. Understanding the various types of community will help clarify the process. The first type of community described is a “geopolitical community” (Harkness & DeMarco, 2012, p. 177). It is an aggregate of people living or working in a defined geographic area. The second is “phenomenological community” (Harkness & DeMarco, 2012, p. 177), which is a collection of people sharing common interests, or philosophies and inter/intra personal connections. Borders for this type of community are not as clear as a geopolitical community. A phenomenological community can exist within a geopolitical community. An example of this is the homeless. The third is a broader view, encompassing a society, a nation, or the international community of the world as we know it.
Community Health
Community health is usually focused on a specific geographic region. In this way, specific epidemiological data can be obtained, and a precise community “report card” (Harkness & DeMarco, 2012, p. 181) can be created. From there specific interventions, including measurable goals can be planned to address specific risks identified in the community.

Community as client
Community as a client requires collaborative practice among nurses, epidemiologists, genetic counselors, and social workers (Harkness & DeMarco, 2012, p. 180), among others, to achieve health promotion. There are many resources available within our various communities to encourage health. A major nursing role is to assess deficits, and identify community assets for implementation of change to improve community health.
Healthy People 2020 Leading Health Indicator
A leading health indicator that must continue to be addressed is tobacco abuse in the adult population (U.S. Department of Health and Human Services, 2010, p. 3). Nursing has a great role in creating evidence based change for this indicator. In the authors work setting, nurses can provide education toward secondary or tertiary prevention (Harkness & DeMarco, 2012, p. 72) at the point of care for acute cardiac care. Nurses can also become involved in primary prevention by forming collaborative relationships with various community agencies to educate the public about risks and prevention. Nursing’s voice can also be heard through political expression. Membership in professional organizations and exercising our right to vote can also pave the way to primary prevention, and better health for all.
Conclusion
Nursing’s role in community health is crucial. Important skills are; knowledge of various community types, strong assessment skills, and understanding of health risks and vulnerable populations. Utilization of available resources and working collaboratively with other professionals are steps to improving overall health of the population.

Appendix
Housing and zoning
Homes are mainly detached single family dwellings. They are well maintained. Primary construction materials are brick and board. All are modernized with plumbing and central heat. In town homes have smaller yards than township homes. All are well cared for.
Transportation
Transportation is mainly by private car. There are many walkers and cyclists observed. There is also a public bus system available that offers a fixed schedule.
Roads are in good condition, with main highways readily available to serve businesses and residents. A health concern is that some of the busier roads are dangerous for walkers and cyclists due to lack of/inadequate sidewalks/crossings. There is a paved recreational trail for public use.
Race and ethnicity
Mainly Caucasian. There are a few African Americans, and Asians noted. There are no overt indicators of ethnicity observed. A local resident would recognize that many of the nail salons are owned and operated by people of Asian descent.

Open space
There are many parks and open spaces available. Along the bay front there is a large, well maintained park and public boat launch. The streets are tree lined. There is a lush 60+ acre park with many varieties of trees, and streams including public trails. Many homeless people and teens use this area as a place to drink, which poses a potential health concern for all. The physical grounds for this area were a former state psychiatric hospital, which has been reclaimed from decay. The buildings are gradually being renovated and provide space for businesses, condominiums, low income housing, senior housing, and office space.

Service centers
The social security and post offices are within walking distance. There is a large, easily accessible hospital, and many physician and dental offices, also within walking distance. There are several parks that are well used and maintained. There is even a dog park where people can take their pets for exercise. It is fenced in and well used.
Religion and politics
There is religious heterogeneity noted. On one corner there is a large Lutheran church; on another is a Jewish temple. A couple of blocks away a large Catholic church is noted. There are two smaller churches located in the neighborhood. Evidence is observed that they are not used only for Sunday service. There are posters for various community meetings, and shared sponsorship for events such as Safe Harbor, which helps shelter our homeless in the winter.
Boundaries
The boundaries of this neighborhood are mainly natural. On the east is the Boardman Lake, on the north is Grand Traverse Bay, the west is bordered by highway M 72, and the east is bordered by Airport Road. The unofficial description for this neighborhood is the west side, which includes bits of Old Town Traverse City, and Garfield township.
Stores and street people
There are several local grocery stores/meat markets that are accessible by car, bicycle, or foot. The flourishing downtown area offers many fine restaurants and bars, as well as specialty stores.
Most people observed on the streets are walkers/joggers, and pedestrians making their way to a destination. Children are seen walking to/from school. There are occasional homeless people noted. All are dressed accordingly, except the teens that seem to think shorts are O.K. year round. The only stray animals are the occasional cat. Most dogs are either leashed or escorted by owners. A few people do not feel leashes are necessary. Dog’s that are not leashed in a public setting pose a health hazard.
Health and morbidity
The most obvious chronic disease conditions are obesity and tobacco abuse. Both of these conditions are serious health hazards. It is not uncommon to observe severely obese individuals/families in this community. A few compound the issue by smoking. Since Michigan banned smoking in restaurants and bars, this phenomena is much less obvious. It is still noticeable when following the car of a smoker, as one can easily smell the tobacco. Many of the homeless observed have mental health issues, as they are often in conflict with local law enforcement. Both our excellent regional referral hospital and the local Veterans Affairs clinic are within walking distance.
Commons
The major common area for this neighborhood is downtown Traverse City. There are many attractions for all to enjoy. Many interesting specialty stores, coffee shops, theaters, event centers,
Micro-breweries, bars and restaurants make the entire downtown area a strong draw for all. Hours are mainly six A.M. to three A.M. Both locals as well as visitors enjoy the downtown and waterfront year round.

Signs of decay
This neighborhood is very alive and on the way up. Traverse City is a popular place to live and work. The described neighborhood is very desirable for all the reasons described above. Store fronts are occupied and busy, homes and yards are well maintained, and schools/churches are busy and are a vital part of the community.
Media
The most common media has become the smart phone. People are able to review local news, weather, and sports at a moment’s notice, all while on the go. The local newspaper is still a popular way to stay connected, as there is evidence of many regularly used home delivery tubes. Cable television is also popular for sporting events, as well as news and weather. The only outdoor antennas are satellite dishes.

References
Harkness, G. A., & DeMarco, R. F. (2012). Community and public health nursing evidence for practice. Philadelphia, PA: Wolters Kluwer Health/Lippincott, Williams, and Wilkins.
U.S. Department of Health and Human Services. (2010). Healthy people 2020. Retrieved from http://healthypeople.gov/2020/TopicsObjectives2020/pdfs/HP2020_brochure_with_LHI_508.pdf

References: Harkness, G. A., & DeMarco, R. F. (2012). Community and public health nursing evidence for practice. Philadelphia, PA: Wolters Kluwer Health/Lippincott, Williams, and Wilkins. U.S. Department of Health and Human Services. (2010). Healthy people 2020. Retrieved from http://healthypeople.gov/2020/TopicsObjectives2020/pdfs/HP2020_brochure_with_LHI_508.pdf