A different skill set for nurses in the community discussion postings

I am listing three discussion postings and i need you to respond to them individually and number each response. In your responses i need you to provide constructive and insightful comments that go beyond that of agree or disagree. 1) This is a posting from Nash: I believe the skill sets and competencies of the RN in a community setting vice acute care are extremely different. The basics are the same but the community RN needs to be aware the resources available to patients, whether they are support groups or alternative treatment plans. The acute care RN usually treats acute issues that will not require continuous follow ups or the need for support groups. The community RN needs to be able to assess whether a dissease warrents infection control practices, whether on a large scale or small scale. This can be as simple wear PPE or as complex as calling CDC to implementing full scale containment. This RN would need to utilize many resources to complete all the tasks needed. The quick actions of RN are needed to prevent the spread of a range of diseases from the common cold to a number of airborne illnesses. 2)This posting is from Rachel: The required skills and competencies of the RN in a community setting are different than those of an RN in a hospital or hospital like setting. The RN in a community care setting must work more independently and work more hands on with the patients personal life including making home accomodations, resources, family concerns and sometimes even assistance with information on transportation and on help scheduling follow up appointments. The RN in a community setting will face the challenge of maintaining patient and family privacy at all times. The RN could only speak of the patients personal and medical information in front of family memebers that the patient gave approval to get full information. If there are other family members or friends present, the RN could move the patient to a more private place and speak in a lower tone, if the patient is not hard of hearing. There are many options for this situation, the RN must possess the ability to put the correct one in place to maintain privacy. 3)This posting is from Carolyn: The required competencies of acute vs. community based nurse are the same. Although the community based nurse must have a greater knowledge of community resources, and home care nursing is often based on psychosocial and learning needs. In the acute care setting you are in control of the environment and patient's needs are usually acute and require more skill by the nurse rather than patient skill. In the community setting you often develop a patient client relationship vs. acute setting where you basically treat and release. In a community setting you must be able to work well independently as you do not have coworkers or physicians readily available at your side. Both settings would require a significant orientation period to evaluate personal and techinical compentencies. Personal safety is a serious challange in the community setting for nurses, especially in the home care field. Many times a nurse is sent into areas that are unknown and often can be in neighborhoods that one would normally choose to stay away from. A nurse does have options to help ensure personal safety. Taking self-defense classes in my opinion should be mandatory. Dressing in simple clothes, casual comfortable shoes, and leaving expensive jewelry at home. Having a working cell phone, reliable car, and personal self defense weapon of some sort available. (opening a can of worms with that one). Knowing your policies and procedures is also very important to ensure safety of knowing when you can refuse a visit.