Bass Report

    Reflections on Community Health Nursing in Shomron (2002-2023) Introduction The following are insights into the role of culturally competent care, trust-building, personal contact, and evidence-based practice in public health , a crucial message in light of recent outbreaks of vaccine-preventable diseases in Israel. Throughout my tenure as a community health nurse in Shomron from 2002 to 2023 , I observed the importance of trust-building on a local level,  and the damage that a paternalistic management style does to healthcare delivery.  The Role of Trust and Culturally Competent Care in Public Health Imanuel is a largely haredi  (ultra-orthodox) community, founded in the late 1980's. It is unique in that it has never experienced an outbreak of a vaccine-preventable contagious illness. This success, I believe, was largely due to proactive community engagement, a crucial element in effective public health practice (Schim et al., 2007). The school nurse who pr...

" הנהלת פמי התקשרה וביקשה אם יש אחות שגרה בעמנואל שיכולה להיות האחות המקומית כאן. האם תשקלי לחזור?" - מזכירת מרפאה בעמנואל, אוגוסט 2025.  לא ידעתי אם לצחוק או לבכות.    אז לקח כמעט שנתיים עד שהבינו שבקהילה קטנה של אנשים שנמצאים חברתית בשולי התרבות הישראלית, אחות מקומית עדיפה על פני שיחות טלפון קרות ואחיות נודדות מרובות שבני האוכלוסייה המקומית לא מכירים ואולי אפילו חוששים מהן.    זו לא הייתה צריכה להיות הבנה כל כך קשה להגיע אליה .     "Femi management of school nursing called to see if there is a nurse who lives in Imanuel who can be the local nurse here. Would you consider returning?" - Secretary of health clinic in Imanuel, August 2025. I did not know whether to laugh or to cry. So it took nearly two years before realization descended that in a small community of people who are socially in the margins of Israeli culture that a local nurse is preferable over cold phone calls and itinerant multiple nurses who the members of the local population do no...

  אם פגשת אחות ששמה את הצרכים שלך במקום הראשון, שמקשיבה באופן פעיל, עם בסיס ידע רחב, זה לא מובן מאליו. שאל את השאלות הבאות: האם מקצוע סיעוד תומך במטופל, שם את המטופל במקום הראשון, שמקשיב באופן פעיל, אות בניגוד, כטכנאי המוחלף בקלות? הנה מאמר שדן בדיון המתמשך הזה. If you have had a good experience with a nurse, start asking the following questions: is the system in which she is working supporting her in patient advocacy, in spending time in active listening to patients' concerns, in looking at the whole picture and providing patient education with the patient as focus? The work that nurses do is shaped by are what they are taught in nursing programs, how the public views them, the management style that they are working under, and their own personal convictions. Or, in contrast, is the management style above her pressuring her to conform with parroted monologues, and even pressure patients into interventions that they do not want and may not even need? If you have met a nurse who care...

  Vaccines in Israel's schools: with most parents not attending vaccine administration when delivered in schools, how have parents granted permission for vaccines?   1 - From about 2002 until about 2007, the school nurse would send a notice to the parents of the upcoming vaccine day. Parents had to send the vaccine record ("pinkas chisunim") and the health declaration ("hatsharat briut") to the school to show their agreement to the vaccine.   2 - then, parents could either send the vaccine record, or the health declaration and a verbal agreement, or give a verbal agreement that included a health history that the nurse noted in the child's record.   3 - as of about year 2015, the health declaration was considered enough to grant permission, this was a hard copy that the parents would fill in and send to the school, but by year 2023, in non-Haredi school, this is is filled in by the parents on their computer or smart phone and automatically enters the child...

  Is nursing an autonomous profession? An autonomous profession is one run by the members of that profession. If nurses manage other nurses at the topmost levels of management, that would be an example of autonomy. But if nurses are being managed, ultimately, by lawyers and business models, then it is not autonomous. Imagine nurses working in the field. They see an issue with a policy or procedure that was imposed upon them by management. These nurses give feedback that this policy or procedure is incongruent with patient needs and safe care. An autonomous organization would welcome and value feedback. But if nurses are ultimately beholden to "the bottom line", that is, the profits of the company for which they work, then their feedback is not likely to be welcomed, their job satisfaction is likely to suffer, and patient care is likely to decline. Feminist theory can be used to empower any disenfranchised group. Traditionalists and conservatives need not write off feminist th...