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Changing View of the Client and the Role of Nursing Assessment


As a student progressing through the nursing program, my view of who constitutes a “client” has expanded greatly from initial classroom teachings. Where I once saw clients as solely individuals receiving direct care in isolated clinical settings, I now understand clients also to encompass familial units, social groups, cultural communities and entire populations embedded within various social and environmental contexts. This paradigm shift reflects my deepening comprehension of nursing’s significant role in addressing both the clinical and non-clinical root determinants of health through broader public health initiatives focused on health promotion, disease prevention and community empowerment at large spatial and demographic scales.

Changing View of a Client

When I first entered nursing school, a client was someone occupying a hospital bed or seated in an exam room. The focus was on specific medical conditions, treatments and caring for individuals in isolated clinical settings. However, through courses like community health nursing, I have learned that our work involves advocating for and supporting the health and well-being of any person, family, social group or population we come into contact with, both inside and outside of clinical environments (Lambden et al., 2019). A client can now be defined as any individual, family or group we work with to address health needs through various means, including not only direct patient care but also health promotion programs, public health education and empowerment initiatives targeting vulnerable populations like the elderly, schoolchildren, homeless individuals, cultural minorities, and more. We must consider people within their full socioeconomic and environmental contexts and recognize the myriad interrelated community-level and systemic determinants of health operating at multiple interactive scales.

Differences between Assessments

One difference between public health and clinical nurses is the scope of assessments. Clinical assessments focus narrowly on an individual’s medical history and physical exam, while public health assessments cast a wider net, collecting data on entire populations to understand community-level issues. In terms of data collection, clinical nurses prioritize subjective reports and objective findings to diagnose conditions. In contrast, public health nurses emphasize quantitative population-level data like demographics, socioeconomic factors, and morbidity and mortality statistics – they study trends over time (Raghupathi & Raghupathi, 2020). The analysis also differs, as clinical nurses analyze assessment findings to determine a patient’s prognosis and plan of care. In contrast, public health nurses employ statistical analysis to identify priority health problems faced by the community, which involves comparing subgroups to discover inequities.

Furthermore, interventions diverge – clinical assessments prompt individualized treatment plans for patients. However, public health assessments are used to design broad interventions aiming to promote health and modify behaviors across an entire population, such as immunization programs, food accessibility initiatives, and public education campaigns (Stockmann, 2018). Lastly, partnerships are approached differently, as clinical nurses can treat and refer patients within separate specialties, but public health requires a coordinated, comprehensive approach integrating inputs from sectors like education, social services, transportation, and urban planning – cross-sector collaboration is essential to address social determinants of health.


In conclusion, throughout my nursing education, I have gained a broader perspective of who constitutes our client and the various roles of nursing assessment. Where I originally viewed clients narrowly as individual patients, I now recognize their existence within familial, social and environmental networks that profoundly influence health outcomes. Additionally, the lens of public health has illustrated how the assessment approach and purpose diverge when shifting context from clinical to community settings. No longer focused solely on medical diagnosis and treatment, nursing assessments in public health cast a wider gaze across populations to comprehend intersect oral determinants. This knowledge better equips me to provide holistic, preventative and equitable care wherever my career may lead. By continuing to expand both my definition of the client and understanding of the assessment approach, I aim to serve individuals and communities with empathy, competence and an appreciation of their lived realities.


Lambden, S., Laterre, P. F., Levy, M. M., & François, B. (2019). The SOFA score—development, utility and challenges of accurate assessment in clinical trials. Critical Care23(1).

Raghupathi, V., & Raghupathi, W. (2020). The influence of education on health: an empirical assessment of OECD countries for the period 1995–2015. Archives of Public Health78(1).

Stockmann, C. (2018). Presence in the Nurse–Client Relationship: An Integrative review. International Journal for Human Caring22(2), 49–64.


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