Details
Public health nursing, also known as community health nursing is a nursing specialty focused on public health. The term was coined by Lillian Wald of the Henry Street Settlement, or, Public health nurses (PHNs) or community health nurses "integrate community involvement and knowledge about the entire population with personal, clinical understandings of the health and illness experiences of individuals and families within the population."[1] Public health nursing in the United States traces back to a nurse named Lillian Wald who, in 1893, established the Henry Street Settlement in New York City and coined the expression "public health nurse". A Public or Community Health Nurse is expected to comply with the duties and limitations of the American Nurse Association (ANA) publication Public Health Nursing: Scope and Standards of Practice.[2]
Public health nurses work within communities and focus on different areas to improve the overall health of the people within that community. Some areas of employment for public health nurses are school districts, county or state health departments, and departments of correction. The public health nurse looks for areas of concern within the community and assesses and plans ways through which the concerns can be resolved or minimized. Some health concerns a public health nurse may work on are infection control, health maintenance, health coaching, as well as home care visits for welfare and to provide care to certain members of the community who may need it. The Centers for Disease Control and Prevention[3] is a leading health indicator in preventing morbidity and mortality. Clinical preventative services such as immunizations and routine screenings for colorectal cancer, blood pressure control and diabetes management are key to improving the Nation's health.[4]
Public health nursing focuses on betterment of the community as a whole. Public health nursing is used to promote and protect the population through knowledge of caring for patients at the bedside, in the community, and through social aspects. The public health nurse must assess the needs of the population and limitations to care. Interventions then must be planned and put into place to produce the best possible outcome for the patient. The community health nurse then evaluates effectiveness of the plan while making changes. In combination, this allows the community health nurse to incorporate the community with the health of the patient.[5]
Credentials
[edit]To become a Public Health Nurse (PHN), one must be a Registered Nurse, licensed by the state and must possess a Baccalaureate Degree.[6] The ANA offers an ANCC credential for specialized Public Health Nursing known as the Advanced Public Health Nursing-Board Certified (APHN-BC) credential.[2] In some states, no additional education is required to begin working as a Public Health Nurse. Some jobs require a Public Health Nurse Certificate and most jobs require on the job training.[7] This certificate is offered at many institutions across the United States and many can be completed online such as the National Board of Public Health Examiners' Certification in Public Health (NBPHE). This certification requires a bachelor's degree, five years of public health work experience as well as the passing of the exam. This exam covers many fields of study including leadership, ethics, program administration, policies and health equity.[8]
Due to COVID-19, there is a great need for more healthcare professionals in all scopes of practice. As responders to public health emergencies, Public Health Nurses play a major role in providing care to the communities in which they serve. Their role during a pandemic involves providing education, especially to those that have tested positive or been exposed and need to isolate.[9] They also participate in hotlines where the community members can call with questions and give up to date information from the Center for Disease Control.[9] The role of the PHN encompasses promoting healthy lifestyles, identifying people at risk for diseases, and aid in disease prevention which are all ever so important currently.
There are four major actions that PHN organizations can take to promote and expand PHN certification: (1) increase awareness, (2) provide education and coaching on the advanced PHN certification by portfolio process, (3) expand the definition of practice hours for certification to be more inclusive of population‐level practice particularly for faculty whose ability to accrue practice hours is limited by teaching, scholarship, and service demands, and (4) reinstitute BSN certification. Increasing awareness of the PHN certification and support for applicants is critical to the continued viability of this certification. PHN organizations can accomplish this through a comprehensive credentialing marketing campaign including dissemination of promotional materials, collaborative conferences, webinars, and strategies. PHN organizations can target local and state health departments, school districts, colleges and universities, and other nursing associations. The initial focus will be master's‐prepared nurses as there is currently not a credentialing mechanism for baccalaureate‐prepared nurses.[10]