Chapter 3: Community Nursing Roles & Practice Settings

Community Nursing Roles & Practice Settings overview examines the dynamic landscape of community health nursing (CHN) in Canada, detailing the essential roles, functions, and diverse practice settings that define this specialized field. It begins by exploring the Blueprint for Action, a strategic framework released by the Community Health Nurses of Canada (CHNC) to guide the profession toward full scope of practice, strengthened leadership, and system-wide transformation. The chapter establishes a professional practice model centered on the client—ranging from individuals to entire populations—underpinned by a code of ethics and core standards of practice, including health promotion, capacity building, and health equity. Nursing care is presented as a continuum spanning primordial prevention, which addresses social policies, through to primary, secondary, tertiary, and quaternary levels to prevent over-medicalization. A significant portion of the discussion is dedicated to the vast array of nursing roles, such as public health nurses (PHNs) who manage population health and disease surveillance, home health nurses (HHNs) delivering clinical care in private residences, and primary care nurses who serve as the first point of contact within the healthcare system. Specialized areas such as forensic nursing, sexual assault nurse examiners (SANE), street and outreach nursing for marginalized populations, and parish nursing within faith communities are analyzed alongside the unique autonomy required for rural and northern outpost nursing. The chapter further differentiates the regulated nursing groups in Canada, highlighting the expanded scopes of Nurse Practitioners (NPs) in diagnosis and prescribing, as well as the increasing presence of Licensed/Registered Practical Nurses (L/RPNs) in community sectors. Finally, it addresses critical emerging trends, emphasizing the necessity of cultural safety and humility in response to the Truth and Reconciliation Commission's Calls to Action for Indigenous health, the integration of information communication technology (ICT) and telehealth to bridge geographic barriers, and the systemic shift toward home-based care for an aging population.