public health nurse

public health nurse

The Importance of Public Health Nursing

1. Introduction

This book is about the health of the public and the professional role of the nurse who is prepared educationally for the public health nurse (Appendix A). The purpose of this book is to aid the nurse in understanding and practicing the art of public health nursing. For the past 10 years, members of the nursing faculty of the University of North Carolina School of Public Health have been actively assisting registered nurses who are students in the University Division of the School of Public Health to understand and practice this art. This has been an exciting experience which has brought many insights and rewards. The practice of public health nursing has been approached with a sense of adventure and has led into many new areas. These experiences have been shared in teaching conferences and individual consultation with public health nurses throughout the state. In recent years, courses have been developed which are specifically oriented to public health nursing education at the University. This book is an outgrowth of all these activities and is based on the belief that the concepts of public health nursing as developed in a school of public health can be effectively communicated to any nurse who has had a general nursing background. Communication at such a level is made possible by the belief in the essential unity in all nursing. In writing for a general nursing audience, an attempt has been made to avoid discussing the all too obvious need of adequate preparation of the nurse and nurse program planning. These subjects are considered to be pressing issues which are now being settled to a large extent by authoritative public and professional group action. Sufficient literature is available on these subjects. This does not mean that these activities are not relevant to public health nursing; in fact, all public health nurse practices is integrated into the total program of other professional groups and the degree of its effectiveness is largely determined by the extent to which it is able to direct and influence the activities of these groups. This point is well documented in a recent joint publication by the ANA and NAPHA on the preparation of nurses for public health. Miles and Fines also write specifically on nurse program planning in public health. During this writing, the authors have been sensitive to the personnel and fiscal difficulties of health agencies and the fact that the resulting limitations may influence the possibility of practical application of our discussions in the immediate future. Planned change, however, can be implemented gradually only as the goal is clear and as the opportunity arises. The authors have also recognized that some content may be controversial. This is particularly so with respect to the discussion of the problems of efficiency and economy in nursing practice. It is hoped that the specific suggestions made are viewed as open to dialogue and that any criticism is offered constructively.

2. Role of a Public Health Nurse

Understanding the importance of public health nursing is key to its practice. A public health perspective is derived from a healthy understanding of what makes a community healthy. Joseph and the Healthy Policy in Canada claim that, “Health is a reflection of the capacity of individuals and groups to express themselves and realize their own goals and to adapt and cope with the physical, social, and emotional environments of life. Health is not the object but the capacity. It is not a state but a resource that helps people to achieve other things” (Joseph, 1998, p. 3). The healthy public policy is essential to health as it moves beyond the healthcare sector and focuses on the health of the whole society. It is also the most powerful and far-reaching form of policy that can be used to promote health. This is done through improving living conditions, controlling resources, protecting the environment, social justice, and allocating resources.

The role of a public health nurse is to work in a community to address local health needs by identifying at-risk populations and using the tools of public health to promote, protect, and preserve the health of the population. Public health nursing involves working at the different levels of prevention, including primary, which is done through health promotion and education; secondary, which is done through early diagnosis and treatment; and tertiary, which is done through long-term care. Public health nurses work across all ages in a variety of settings such as home health, public health departments, school, occupational health, and acute care, to reduce geographical and social health disparities on individuals, families, and communities. Public health nursing is a systematic process by which nurses work to promote health, prevent disease, and improve the health of a community. This is done through assessment, policy development, and assurance. The goals of public health nursing are taken from Healthy People 2010, which includes the following top 10 objectives:

3. Impact of Public Health Nursing

A great example of this is found in the Disaster Management Cycle. Through mitigation, a PHN might work to identify those who would be most vulnerable in a disaster and create an emergency plan to ensure their safety. The nurse might also work to educate others in the community on how to prevent a disaster. This could be through a fire safety program at the local school. If there was a disaster, a PHN would be able to work to organize a quick and efficient disaster response to ensure that the health of the community is restored. By doing this, the nurse would be working to create a healthier and safer community.

Public health nursing has a great impact on the community it serves. Through the nursing process, PHN’s use their skills to identify the healthcare needs of the population. They are able to prioritize and strategize to ensure that the high priority needs are met in a cost-effective manner. This is done by prevention through the promotion of healthy behaviors and ensuring that there is adequate healthcare policy. The intervention can be anywhere from creating public policy to ensuring that a professional individual or group is taking the proper action. Through this process, the population is empowered to help themselves and create a better overall health status.

4. Challenges in Public Health Nursing

The challenges of working with families of diverse backgrounds and cultures are many. Making a home visit to a family whose race, ethnic background, language, or customs are different from the public health nurse’s own can be a complex situation. The public health nurse may need to be sensitive to issues related to historical experiences of particular racial or ethnic groups with health and health care. An effective home visit involves teaching and learning on the part of the family and the nurse. This teaching and learning may be most effective when the public health nurse can enlist the aid of a community member who shares ethnicity or language with the family. In addition, it is important to identify and work with informal and formal community supports that can assist children and families.

Public health nursing practice involves working with communities and population groups. This orientation allows the public health nurse to learn about resources and supports that are available in the community to meet health needs. In every community, numerous factors affect the health and well-being of children. The manner in which public health systems are organized affects the services that can be provided to the community. Consequently, nurses in public health encounter many scenarios in which they can do little to directly impact the health of children. Working with children and families with complex health care needs requires creativity in using whatever resources are available to meet needs.

5. Conclusion

1. To promote, protect, and preserve the health… 2. To prevent injuries and diseases… 3. To take action in creating a conducive environment, 4. To help the needy, etc… (p. 4)

This is the mission of public health nursing, and the foundation and execution of their roles using nursing processes are in a set of principles outlined by the World Health Organization (2008):

The demographic and epidemiological information discussed in this paper holds a crucial element in the application of the nursing process and the goals of health promotion and disease prevention. By understanding the trends of health and illness in various communities, public health nurses are able to plan appropriate interventions and preventions. The health status of at-risk populations and the availability of health resources are significant issues which need to be understood by public health nurses. This information provides the basis for a community assessment and ultimately leads to improved health outcomes.

It is finally time to put more emphasis on a shift of the definition of nursing health care and the role of public health nurses. Throughout the history of nursing, nurses have taken on many different roles. Today, the goal of nursing is directed towards health promotion and the prevention of disease. The efforts of these more recent goals have been demonstrated in the development of community health nursing.