Community Nursing Generally, in any Hospital or Health Care Center, the patient would be looked after and taken care of by the Primary Care team, comprised of General Practitioners, Health Visitors, Practice Nurses, Physiotherapists, Podiatrists, Dieticians, and a team of Nurses, of which District Nurses or Community Nurses play a major part. Community Nurses or District Nurses usually work in a partnership with Acute Trusts, Hospices, as well as with Social Services, in order to provide a complete package of Health Care for those patients who would want to or prefer to stay at home and avail of these services. The so-called 'Joint Futures Agenda' is responsible for promoting a sort of collaborative working within the health care sector and thereby dramatically improve the service so that there may be a more holistic type of care given to the patients of today. Community Nurses provide highly skilled health care for those patients who would stay at home and be cared for, and they also offer firm and good advice on a wide range of issues, and also critical support wherever and whenever needed. (Community Nursing: Glasgow Palliative Care Information Network)

Some of the chronic illnesses that the Community Nurses are trained to handle are: heart disease and failure, multiple sclerosis, mental illness, or dementia, chronic obstructive pulmonary disease, post hospital care after any type of surgery, care of the elderly, and palliative care. When a patient feels that he needs to be looked after by a District or a Community Nurses, then he must get in touch with the District Nurse Team, who is headed by a senior District Nurse, who would send a District Nurse to visit the patient and assess the type of care that he actually needs. After the initial assessment, the patient would be given a care plan, along with the contact numbers and other details that the patient or his family members may need. When a patient needs the services of the Community Nurse, all he has to do is to contact his own GP or call his local Clinic or the Local Health Center. (Community Nursing: Glasgow Palliative Care Information Network)

It is a fact that over the past thirty years or so, palliative care services or the home care of patients through the system of Community Nurses has been developing all over the world. Today, not only is the patient more aware of health care issues, but he also knows the type of care that he can avail of, and he is also knowledgeable about the various types of health care services that are available to a patient suffering from any type of disease, and the concept of Community Nursing is a choice that he may be able to make after a thorough research and investigation into it. Community expectations of the patient, especially in relation to palliative care has been growing steadily, over the past thirty years, and as the evolution of he issue of palliative care has been taking place, so has the evolution of the very definition of palliative care by the World Health Organization. These changes have been proving to be a challenge to the planners and the funders of the providers of palliative care, and it is noticed that many services have not been able to attract the proper and the adequate amount of nursing and the various other related services like medical and health resources in order to provide the proper amount of inter-disciplinary palliative health care for any patient. (A planning guide: developing a consensus document for palliative care service provision)

This has led to the development of a 'Planning Guide' or what is otherwise a virtual national consensus that outlines the minimum needs for the provision of services to a patient needing it, and this would be independent of the various fund holders and the various models of service delivery. The Plan or the Guide that was released by the PCA or the 'Palliative...

The aim of the Guide is to make sure that a network of health care professionals who are all well versed and experienced in providing acute care and other services to the needy are available to the patients when they actually need them. In this context, palliative care does not merely mean the treatment of those patients who are suffering form cancer, but it also includes the sufferers of various other diseases who may need interdisciplinary and acute care from the physicians and Community Nurses attending to them. (A planning guide: developing a consensus document for palliative care service provision)
Nursing, and especially Community Nursing, is one of the fastest growing fields of opportunities for the Nurses who give health care of any type for the patient. In fact, the Bureau of Labor Statistics, 2001, states that nursing as a profession, is one of the fastest growing in the United States of America. The number of positions that are available to nurses are growing everyday, and the growth has in fact remained steady over the past few decades, and it has been predicted that at the end of the year 2008, there would be about 2.5 million nursing positions available in the United States of America alone, while at the same time, more than half of the registered nurses of today would retire in the next fifteen years. If the situation were ideal, then the number of nurses entering the profession would be the same as the number of nurses who are leaving the position, but it is not the case today. The number of registrations of nurses has been steadily declining over the past few years, and what is even more alarming is the fact that today, there is a vital need for more and more nurses in the profession. This is because of the fact that in addition to the traditional nurses, there is an additional requirement of nurses in several new positions, like for example, in the field of home care, long-term health care, as well as palliative care, and ambulatory care. (Window of Opportunity for Home Care Nurses: Tele-health Technologies)

The situation today is that, since there is a paucity of the number of nurses, and then technology would have to intervene and make up for the lack of numbers of nurses. When the fact that American society is elderly or ageing, and the number of elderly, who have grown in the number of the population almost twice as rapidly as the younger population, who need long-term health care or palliative care, and so on has also increased simultaneously, most of the nurses of today would be required to perform and meet efficiently the health care needs of the ageing or the elderly population of America. It is also a fact that technology would help these nurses meet and perform their duties with relative ease. Patient care decisions, the various decision support systems, the management protocols that are assisted in their maintenance by the computerized technology that is available today are all part of the facilities that are provided by the improvement in technology for Nurses. (Window of Opportunity for Home Care Nurses: Tele-health Technologies)

The population in the United States of America has been growing by leaps and bounds over the past few decades, and the health problems that are associated with such increases of population have been a cause for great concern for the Health Care Authorities of the country. For example, there are more than 22,000 per square mile in NYC alone, and strict measures must be taken immediately and urgently in order to counteract the effects of such huge numbers of people on the environment and on the health of the people living in such over crowded areas. The several types of health problems that generally arise from a density of population are asthma, PCBs, and lead poisoning. Illegal dumping forms a major problem and this causes quite a few respiratory problems and infections. For example, in Staten Island, America, there was quite a great fuss about the Fresh Kills Landfills, across the harbor. However, in Staten Island itself, there is no dearth of dumpers of trash and rubbish all over the place. Council Member James Oddo states that people do dump trash on the sidewalk; people do drop a cigarette butt wherever and whenever they want to, completely without thinking about the long-term consequences of such actions.

The population on Staten Island, according to the U.S. Census, has grown from a mere 380,000 residents in the year 1990, to a 445,000 in the year 2000, thus demonstrating a stupendous 17 percentage of growth rate of population, a figure that was not seen in any other borough in the city, or in any other county in any other state. Though Staten Island is larger than…