A History of Public Health Nursing Michael L. Adams, RN NU 362: Intro to Health Promotion Mississippi University for Women Outline • Definition • Origins of Public Health Nursing Florence Nightingale Beginnings in the United States • Public Health Nursing in the 20th Century Early 1900s World War I African-American nurses in Public Health Between World Wars Increasing Chronic Illness 1960s Outline (cont’d) • Public Health Nursing in the 20th Century (cont’d) 1970s into the 21st Century. • Public Health Nursing Today • The Future of Public Health Nursing • Conclusion Definition According to Stanhope & Lancaster (2016), public health nursing practice is the synthesis of nursing theory and public health theory applied to promoting and preserving health of populations. Origins of Public Health Nursing Florence Nightingale • Born in Florence, Italy in 1820 • Known as the founder of modern nursing (History, 2016) • Established the first school of nursing • The school credited as the first institution to train professional nurses. Origins of Public Health Nursing Florence Nightingale (cont’d) • During the Crimean war, the field hospital for injured soldiers was very unsanitary. • She improved the conditions at the field hospital with simple interventions. • Became known as the “Lady with the Lamp,” due to her affection toward patients. Origins of Public Health Nursing United States Public health nursing in the United States began with organizing to meet urban health care needs, especially for the disadvantaged (Stanhope & Lancaster, 2016). The American Red Cross started home nursing care outside of large cities. Origins of Public Health Nursing United States (cont’d) As the importance of public health nursing was slowly being realized, Lillian Wald became a key leader of the field in its early days. (Stanhope & Lancaster, 2016). She believed healthier people were more productive members of society. Origins of Public Health Nursing United States (cont’d) Wald’s efforts with the American Red Cross were able to encourage the creation of public health departments. Public Health Nursing in the 20th Century Early 1900s • When the 19th century ended, there were almost 40 states with established health departments. • The federal government expanded their role in public health. • Dealing with infectious and parasitic diseases were an early goal of federal public health. Public Health Nursing in the 20th Century World War I During World War I, a nurse was loaned to the U.S. Public Health Service to establish public health outposts for military outposts. This was the first federal sponsorship of nurses (Stanhope & Lancaster, 2016). Public Health Nursing in the 20th Century World War I (cont’d) During the peak of the war, the U.S. was sending 100 nurses a day to the war (Stanhope & Lancaster, 2016). Public Health Nursing in the 20th Century African-American nurses in public health • Faced many challenges due to segregation • Dealt with racial and wage discrimination • Had a significant positive impact on their communities. Public Health Nursing in the 20th Century Between the World Wars The poor economy the 1930s had a drastic effect of the development of nursing. The impoverished had an increased need for nursing services that weren’t available due to low funding. The federal government put in place several funding programs to increase public health nursing. Public Health Nursing in the 20th Century Between the World Wars (cont’d) The expansion of federal government in the 1930s effected the structure of community health resources (Stanhope & Lancaster, 2016). In 1935, creation of the Social Security Act provided much needed funding to expand public health services. Public Health Nursing in the 20th Century World War II The war increased the need for nurses. They were needed at home and overseas. This need lead to federal funding to train new nurses. After the war, public health facilities saw an increase in emotional problems, accidents, and alcoholism (Stanhope & Lancaster, 2016). There were multiple medical advancements during this time, such as antibiotics and photofluorography. Public Health Nursing in the 20th Century Increasing Chronic Illness Due to the decrease in mortality in the first half of the 20th century, there was a significant increase in chronic illness. The public health field was forced to emphasize chronic disease prevention and treatment. The nursing field’s practice expanded to include the psychosocial aspects of clients and their families. Public Health Nursing in the 20th Century 1960s The Social Security Act, which included Medicare and Medicaid was introduced in 1965. The new funds provided by the act led to an increase in home health care. Public Health Nursing in the 20th Century 1970s into the 21st century During the 70s and 80s, the cost of health care increased greatly. This led to shifting of funds to acute care from public health. This led to a general decline in public health that was noted as early as the late 1980s. To reverse this decline, the federal government enacted programs like Healthy People. Public Health Nursing in the 20th Century 1970s into the 21st century (cont’d) In the 1990s, several nursing groups lobbied for health care reform. They felt issues like access, quality, and cost of healthcare needed improvements. In 2010 the Affordable Care Act was passed. Public Health Nursing in the 20th Century 1970s into the 21st century (cont’d) Nursing education improved during this period. Many professional nursing associations and groups issued position papers to this sentiment. The ANA developed Scope and Standards of Public Health Nursing Practice, and periodically revises it to maintain it’s currency. Public Health Nursing Today Advanced education in public health nursing is becoming more available. School nurses are slowly increasing nationwide. Increased research and evidence shows the value of public health nursing. Caring for increasing elderly population remains a challenge Remember mistakes of the past, so they aren’t repeated The Future of Public Health Nursing As the importance of preventing, instead of treating, disease is further realized, public health nursing will remain a growing field. Since the field is likely to grow, more nurses will be needed to practice in the public health setting. The Future of Public Health Nursing (cont’d) As a nation, we mustn’t forget the mistakes of the past. We still only spend 3% of healthcare dollars in preventing disease (Writers, 2019) We must keep public health programs adequately funded. Conclusion Public health nursing has undergone a multitude of changes since it’s beginning. The positive impact of the field cannot be denied. As a nation, we have witnessed what happens when public health is not properly funded. To keep our citizens healthy, we must maintain proper funding and research in the field of public health nursing. References [History]. (2016, February 29). Florence Nightingale: Changing the Field of Nursing - Fast Facts | History [Video File]. Retrieved from https://www.youtube.com/watch?v=B94Zf4Vye3Y Stanhope, Marcia, and Jeanette Lancaster. (2016) Public Health Nursing: Population-Centered Health Care in the Community. 9th ed., Elsevier. Writers, Staff. “The Need for Public Health Nurses on the Rise 2019 NurseJournal.org.” NurseJournal.org, NurseJournal.org, 10 Sept. 2019, nursejournal.org/community/need-for-publichealth-nurses-on-the-rise/.