Situation: A team of public health nurses organizes a low-in… | 마이메르시 MyMerci
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Nursing Practice I — Community Health Nursing
문제

Situation: A team of public health nurses organizes a low-income farming barangay using Community Organizing Participatory Action Research (COPAR). The team has already completed its site selection and courtesy calls. After three years, the health organization plans, carries out, and evaluates its projects without the nurses' help. However, its meetings are canceled whenever the chairperson is out of town. What should the nurses do next?

해설
Two conditions must be met before the organizer phases out: the organization must run its projects on its own, and its leadership must not rest on one person. Planning and running projects shows the first, but canceled meetings show dependence on one leader. Developing secondary leaders, a sustenance and strengthening activity, comes before gradual withdrawal.
같은 주제 다음 문제Situation: A public health nurse is assigned to organize and assess a coastal barangay in …이 문제가 수록된 문제집PLNE Question Bank 150014,000원 · 무료 체험 가능

심화 해설

Understanding the COPAR Phase

In Community Organizing Participatory Action Research (COPAR), the final phase is sustenance and strengthening, where the community organization becomes self-reliant. The scenario describes an organization that has achieved functional independence in project implementation—planning, carrying out, and evaluating projects without nurse assistance. However, a critical vulnerability remains: meetings are canceled when the chairperson is absent, indicating overdependence on a single leader.

Before nurses can phase out, two conditions must coexist. First, the organization must demonstrate autonomous project management. Second, leadership must be distributed and shared, not concentrated in one person. The scenario shows the first condition is met but the second is not. This is not yet a fully mature, self-sustaining organization.

The presence of project autonomy without leadership depth means the organization remains fragile—a single absence can stall all collective activity. The nurses’ next step must address the leadership gap, not the project capability gap.

Why Developing More Leaders Is the Priority

Option 4—developing more leaders who can share the chairperson’s tasks—directly targets the identified weakness. This is a sustenance and strengthening activity that builds secondary leadership. When multiple members can facilitate meetings, make decisions, and represent the organization, the group no longer depends on one person’s presence.

This aligns with evidence on leadership development. A systematic review of leadership development for nursing practice models emphasizes that effective leadership is built through structured, intentional development of multiple individuals, not reliance on a single leader . Similarly, a structured nursing leadership development program for succession planning showed that preparing future leaders through mentorship and competency-based content increases perceived leadership competence across a cohort, not just one person .

In community settings, patient and public involvement research shows that sustained community engagement depends on processes that distribute responsibility and build collective capacity rather than concentrating authority in one representative . When involvement is broad-based, the community or organization becomes more resilient to individual absences.

Transformational leadership principles reinforce this: leaders who inspire and motivate teams toward shared goals also invest in developing others’ leadership potential, creating a pipeline of capable members . The nurses’ role here is to facilitate that development—through training, mentoring, and creating opportunities for other members to lead meetings and projects.

Why the Other Options Are Incorrect
OptionWhy It Is Not the Next Step
1. Withdraw gradually and turn over recordsPremature. Withdrawal requires both project autonomy and leadership depth. The organization still depends on one person for meetings, so phasing out now would leave it vulnerable to collapse when that leader is unavailable.
2. Hold a new election to replace the chairpersonDoes not solve the root problem. Replacing one leader with another still concentrates authority in a single person. The issue is not the current chairperson’s competence but the lack of shared leadership. A new election without developing other leaders would simply shift the dependency.
3. Chair the meetings themselves when the chairperson is awayReintroduces nurse dependence. This moves the organization backward, away from self-reliance. The goal of COPAR is for the community to run its own affairs, not for nurses to fill leadership gaps indefinitely.
Clinical and Community Nursing Application

In COPAR, the nurse’s role shifts across phases: from initiator and facilitator in the entry and organizing phases to consultant and capacity-builder in the sustenance phase. The scenario places the team in the sustenance phase, where the nurse should not take over tasks but instead build the community’s internal capacity to handle those tasks independently.

Key point! Leadership development is not a one-time event but a continuous process of identifying, training, and mentoring multiple potential leaders within the organization. This is what transforms a group from being run by one person to being run by a collective.

Watch out! Do not confuse project implementation skills with organizational sustainability. An organization can run projects well but still collapse if its leadership structure is fragile. Both dimensions must be assessed before phasing out.

The nurses should implement activities such as leadership training workshops, assigning co-facilitators for meetings, rotating meeting chair responsibilities, and mentoring emerging leaders. These actions directly build the secondary leadership needed for the organization to function even when the primary chairperson is unavailable.

임상 시나리오

COPAR Phase-Out ReadinessTwo conditions before nurses withdraw

Before phasing out, the organization must show autonomous project management and distributed leadership. This group runs projects independently but cancels meetings when the chairperson is absent, so only one of two conditions is met.

The priority is developing secondary leaders who can share the chairperson's tasks. This is a sustenance and strengthening activity that builds leadership depth before gradual withdrawal.

Caution

Do not withdraw yet or chair meetings yourself. Withdrawal would leave a fragile organization, and nurse-led meetings reinforce dependence on external organizers.

핵심 개념

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