| Course | NUR-4420 Nursing Care in the Community |
|---|---|
| Module | Module 4 |
| Paper type | Community care settings analysis |
| Length | About 1,078 words, 6 pages |
| Format | APA 7 student paper |
| School | Thomas Edison State University |
| Program | Accelerated B.S.N. Program |
| Updated | October 2026 |
Free sample paper for NUR 4420 Module 4
Asthma in Three Places: How School, Home and Workplace Nursing Reach One Trenton Family
Student Name
Accelerated B.S.N. Program, Thomas Edison State University
NUR-4420: Nursing Care in the Community
Mentor Name
Month Day, Year
Asthma in Three Places: How School, Home and Workplace Nursing Reach One Trenton Family
Community health nursing happens in many places that are not clinics: schools, homes and workplaces among them. This module asks how care differs in those settings. Rather than describe each setting in general, this paper follows one composite family from my Trenton placement through all three. The family has two children, one of whom, a nine-year-old, has persistent asthma with frequent symptom nights and two emergency visits in the past year. One parent works nights for a commercial cleaning company. The family rents an older apartment near the food pantry where I spend my clinical days. The same health problem looks different, and calls for different nursing, in each setting.
The School Setting
The school nurse is often the health professional who sees a child with asthma most often. In Trenton's public schools, a school nurse may be responsible for several hundred students, keeps the child's asthma action plan and rescue inhaler, sees the child when symptoms start in class, and communicates with parents who may work hours that make daytime calls difficult. The strengths of the school setting are presence and routine: the nurse sees the child every school day and can supervise a daily controller medication when a family struggles to give it at home.
Evidence supports building on that routine. Halterman et al. (2018) randomized 400 urban children with persistent asthma to a program that combined supervised daily controller medication at school with telemedicine visits from the school to a primary care provider, or to enhanced usual care, and found that children in the school program had more symptom-free days and fewer emergency visits or hospitalizations than the comparison group. For the nine-year-old in this family, a school-based arrangement could solve the problem the parent described most often: mornings when the controller inhaler is forgotten because the parent who usually gives it is still at work.
The school nurse I shadowed for one morning described the arithmetic of the job: more than five hundred students across two buildings, about forty with an asthma diagnosis on file, and inhalers for only some of them actually in the office. Much of the morning went to phone calls with parents who could not be reached until evening. That arithmetic explains why a school program that also connects the child to a primary care provider is valuable: the school nurse cannot manage forty children's asthma alone, but can be the link that keeps each child's care moving.
The Home Setting
Home visiting shows what no other setting can: the environment where the child sleeps. On a home visit with the pantry's community health worker, I saw what the family had not thought to mention. The bedroom wall shared with the bathroom had a dark patch of mold behind the bed, there were signs of cockroaches in the kitchen, the child slept with several stuffed animals, and the family used a scented plug-in air freshener. Each of these is a known asthma trigger, and none would have been visible in a clinic.
Home-based care can do more than observe. Krieger et al. (2005) tested a community health worker intervention in Seattle and King County in which workers made multiple home visits to families of children with asthma, assessed triggers, provided education and supplies such as allergen-impermeable bedding covers and cleaning kits, and helped families talk with landlords. The higher-intensity version improved caregiver quality of life and reduced urgent care use compared with a lower-intensity version. For this family, home visits could provide bedding covers and pest-control supplies, replace the air freshener with a fragrance-free option and support a request to the landlord about the mold, which is the family's right under housing codes but a step many renters fear to take alone.
The Workplace Setting
The third setting is easy to overlook: the parent's workplace. The parent cleans office buildings at night and uses spray cleaners, bleach-based products and floor strippers. Occupational health nursing addresses the health of workers in relation to their work, and here the work matters for the whole family in two ways. First, the parent reported a cough and wheeze that improve on days off. Folletti et al. (2014) reviewed epidemiological studies of cleaning workers and found an increased risk of asthma or rhinitis in most of them, linked to cleaning sprays, bleach, ammonia and the mixing of products, and suggested prevention through product substitution, avoiding mixtures, respiratory protection, education and medical surveillance. The parent may be developing work-related asthma and should see a provider.
Second, the night schedule shapes the child's care. A parent who sleeps in the morning cannot easily give the controller medication or attend a daytime appointment. An occupational health nurse at a large employer could address both, but most small cleaning contractors have none, so the community nurse's role is to recognize the work connection, refer the parent and explain the family's options.
The parent also described what the workplace offered: no health service, a supervisor who changed every few months, and safety data sheets in English only. When I asked whether gloves or masks were provided, the parent said gloves sometimes, masks never. A community nurse cannot inspect that workplace, but can teach the parent which products are most likely to irritate the airways, how to ask for safer alternatives, and where to report unsafe conditions without giving a name.
Comparing the Three Settings
Each setting reaches a different part of the problem. The school reaches the child daily and can make medication routine. The home reaches the triggers and the housing conditions that no medication can fix. The workplace reaches the parent, whose health and schedule both affect the child. Each also has limits. School nurses carry large caseloads and see only the school day. Home visits depend on a family's trust and on enough staff to make repeated visits. Workplace health services are thin for low-wage contract workers, who are often the people with the greatest occupational exposure.
The settings work best when they are connected. In this case the community health worker shared the home findings, with the parent's permission, with the school nurse, who updated the asthma action plan and contacted the child's provider about school-supervised dosing. The parent agreed to a clinic visit for the night cough. No single setting would have produced that combination. Community nursing in Trenton is less about any one place than about the links between them.
References
Folletti, I., Zock, J.-P., Moscato, G., & Siracusa, A. (2014). Asthma and rhinitis in cleaning workers: A systematic review of epidemiological studies. Journal of Asthma, 51(1), 18-28. https://doi.org/10.3109/02770903.2013.833217
Halterman, J. S., Fagnano, M., Tajon, R. S., Tremblay, P., Wang, H., Butz, A., Perry, T. T., & McConnochie, K. M. (2018). Effect of the School-Based Telemedicine Enhanced Asthma Management (SB-TEAM) program on asthma morbidity: A randomized clinical trial. JAMA Pediatrics, 172(3), e174938. https://doi.org/10.1001/jamapediatrics.2017.4938
Krieger, J. W., Takaro, T. K., Song, L., & Weaver, M. (2005). The Seattle-King County Healthy Homes Project: A randomized, controlled trial of a community health worker intervention to decrease exposure to indoor asthma triggers. American Journal of Public Health, 95(4), 652-659. https://doi.org/10.2105/AJPH.2004.042994
Reading the NUR 4420 Module 4 assignment instructions
The fourth module of NUR-4420 usually explores the settings where community health nurses practice, such as homes, schools, workplaces, clinics and shelters. The written assignment commonly asks you to describe two or three settings, explain the nurse's role and scope in each, discuss the strengths and limits of each setting for a health problem in your community, and support your discussion with evidence. In a few sections, a short interview with a nurse from one setting is part of the assignment. The TESU course site holds the exact prompt; check how many settings to cover, whether a single health problem or case should link them, and how much of the paper should describe your own clinical experience.
How this NUR 4420 Module 4 example is built
The example introduces one family with a child who has persistent asthma and a parent who cleans offices at night, then follows the family through three settings. The school section describes the school nurse's role and supports school-supervised controller medication with a randomized trial. The home section reports triggers seen only on a visit and supports community health worker home visits with a randomized trial. The workplace section explains occupational health nursing and connects the parent's cough to evidence on cleaning workers and asthma. A comparison section names what each setting reaches and its limits, and the final paragraph shows how linking the settings produced a combined plan for the family.
Reading the NUR 4420 Module 4 grading rubric
A mentor reading a settings paper is checking whether each setting and the nurse's part in it are described correctly, analysis of strengths and limits, application to a community health problem, use of evidence, and writing. The analysis row often carries the most weight; mentors look for a comparison that shows what each setting can and cannot do rather than three separate descriptions. Using one case or problem across settings is an efficient way to show this. Evidence should support the interventions proposed in each setting. Scope matters too: the paper should show what nurses in each setting actually do and when they refer. Respect for families and privacy is expected in the case description.
Common NUR 4420 Module 4 mistakes, and how to avoid them
Students often write three encyclopedia entries, one per setting, with no connection between them. Link the settings with a single health problem or family. Another common gap is ignoring the workplace or limiting occupational health to large employers with on-site nurses; many workers have no occupational health service at all, which is itself an important finding. Support interventions with evidence rather than describing them as good ideas. Keep the family composite and avoid identifying details from your placement. Describe the nurse's scope accurately in each setting. If you want a settings paper written around a health problem from your own placement, the desk can prepare a version from your notes. Finally, name what the nurse in each setting cannot do and where that nurse would refer.
Write yours, or have the desk draft it
This paper is an original model document written by our desk, not a submitted student paper and not an official Thomas Edison State University document. Read it for the moves, then write your own to the instructions in your classroom. If you want one built to your exact prompt and rubric, the first custom sample is free and arrives in 24 to 48 hours.
More NUR 4420 and Accelerated B.S.N. Program sample papers
- NUR 4420 Module 1: Community as Client Paper
- NUR 4420 Module 2: Community Assessment Paper
- NUR 4420 Module 3: Vulnerable Population Analysis
- NUR 4420 Module 5: Community Diagnosis and Plan
- NUR 4420 Module 6: Community Project Evaluation
- NUR 3280 Module 2: Health History and Interview
- NUR 4500 Module 6: Plan Defense Presentation
NUR 4420 Module 4 questions, answered
Where can I find a free NUR 4420 Module 4 sample paper?
One Trenton family's asthma runs through the whole paper above, across school, home and job, with a margin note on each sheet; use one health problem from your own placement to link the settings you are assigned.
Which community settings should I write about in NUR-4420?
Choose the settings your directions name, or the ones most relevant to a health problem in your community. Schools, homes and workplaces are common choices; shelters, clinics, faith communities and correctional facilities are also community settings.
What does a school nurse do for a child with asthma?
Keeps and follows the asthma action plan, manages symptoms during the school day, keeps rescue medication available, communicates with families and providers, and in some programs supervises daily controller medication.
What is occupational health nursing?
Nursing focused on the health of workers in relation to their work, including exposure assessment, injury and illness prevention, surveillance and return-to-work care. In community practice, recognizing work-related illness and referring workers is part of the role even without an on-site program.
How do I show the strengths and limits of each setting?
For each setting, describe what the nurse can see and do there that is hard to achieve elsewhere, and what the setting cannot reach. A comparison paragraph that sets them side by side makes the analysis clear.