• NU - Public Health Nursing

    Shorter length of stays in acute care settings over recent years as well as increasing numbers of community-based treatment facilities have resulted in a transition of care to the community. However, gaps in health care and emerging community services result in the need for nurses to engage in community-based initiatives designed to improve health outcomes. 

    As a consequence of the shift in focus, the number of public health nurses has increased. Public health nurses focus on the care of population and primary prevention as they utilize evidence-based strategies to provide cost-effective care that addresses ongoing health needs of the community.

    The American Association of Colleges of Nursing notes "health promotion and advocacy for systems geared toward health versus illness are central to our community and nursing agendas for future health care reform. AACN advocates health prevention strategies for keeping health care costs contained and promotes awareness of the value of nursing in terms of cost, productivity and patient outcomes." (AACN)  As the focus of care shifts from acute care to community-based care nationally, it is imperative for nurses to develop the competency to not only intervene effectively in community settings but to advocate for improved and innovative care options.

    Public health nursing roles involve collaboration and partnerships with communities and populations to address health and social conditions. (Kulbok, P.A., Thatcher, E., Park, E., Meszaros, 2012) Nurses who practice in public health settings collaborate with community leaders, organizations, and other key stakeholders to develop programs that promote the health of the community. Public health nurses reach out to the community and consider the health of diverse populations as they focus on interventions to improve conditions that adversely impact the health.

    Presently many nurses think about public health when they read about catastrophic natural disasters that devastate communities and result in mass casualties. Experience reminds us that communities lack sufficient capacity and in many cases resources to respond effectively. Public health nurses, while presently limited in number, have the necessary expertise essential to managing the fallout from the disaster and save lives. In fact, many nurses may be involved in a disaster of one kind or another, whether they see an accident on the side of the road, a flood hits their area, or a train derails outside of their town. It is apparent that public health nurses possess the knowledge and competence to address the emergent needs of populations affected by diverse life-threating events. As leaders in practice and partners in care, nurses make a difference working proactively in the community to educate and plan for swift action should the need emerge.

    In addition to natural disasters, populations can also fall victim to man-made disasters, such as those events that occurred on September 11, 2001. We also need to be concerned about terrorist attacks where biologic and chemical weapons are used. In fact, the Centers for Disease Control (CDC) have developed guidelines and identified competencies that indicate the preparedness of public health regarding emergency management of catastrophic events

    While it is critical that public health nurses plan for and respond to these disasters it is equally important that they address the ongoing community health risks due to economic, social, and environmental problems. Public health nurses competently address the myriad of actual and potential problems that local, national, and global communities face.

    Public health nursing requires a new body of knowledge and specific competence to effectively address the multifaceted problems that affect community health. The American Nurse Credentialing Center (ANCC) also defines a process for certification as a public health nurse. In addition each state defines the competencies necessary to practice as a public health nurse.

    As you think about your future practice, consider the cutting-edge opportunities that practice in a dynamic community and what the public health environment might offer. As a public health nurse, you can make a difference in the health of underserved and at risk populations. The focus on upstream care by the public health nurse may provide you with the best opportunity to make a difference.



    Kulbok, P.A., Thatcher, E., Park, E., Meszaros, P.S. (May 31, 2012) "Evolving Public Health Nursing Roles: Focus on Community Participatory Health Promotion and Prevention" OJIN: The Online Journal of Issues in Nursing Vol. 17, No. 2, Manuscript 1

    Sheila Rucki is a faculty member at Kaplan University. The views expressed in this article are solely those of the author and do not represent the view of Kaplan University.


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