THE ROLE OF NURSING
IN PUBLIC HEALTH
Sarah Coulter Danner MSN CPNP CNM
Chairperson, Department of Nursing
Oglala Lakota College
Definition of Public Health Nursing
• Public health nursing is the practice of
promoting and protecting the health of
populations using knowledge of nursing,social
and public health sciences
Systematic Approach
• 1. Assess the health and health care needs of a
population in order to identify sub-populations,
families and individuals who would benefit from
health promotion or who are at risk of illness,
injury, disability or premature death
• 2.Develop a plan with the community to meet
the identified needs taking into account available
resources
Systematic Approach
• 3. Implement the plan at the community, family
or individual level
• 4.Evaluate the impact of the intervention
• 5.Use the results of the evaluation to influence
and direct current delivery of care, deployment
of health resources and the development of
local, state and national health policy and
resources to promote health and prevent disease.
Role of the Public Health Nurse
• To: Provide input to interdisciplinary programs
that monitor, anticipate and respond to health
problems in population groups for all diseases
or public health threats including bioterrorism
• To: Evaluate health trends and risk factors of
population groups to help determine priorities
forming targeted interventions
Role of the Public Health Nurse
• To:
• Work with the community or specific population
groups to develop targeted health promotion
and disease prevention activities
• To: Evaluate health care services
• To: Provide health education, care, management
and primary care to individuals and families who
are members of vulnerable populations and high
risk groups
Public health nurses integrate
community involvement and
knowledge of the entire population
with the personal clinical
understandings of health and illness
gleaned from the experiences of
individuals and families within the
population.
The nurse working in public health
should be a voice for members of the
community to voice problems and
desires
The public health nurse can apply
her knowledge of strategies to
choose the intervention(s) that meets
the needs of a particular community,
family or individual
The nurse is the agent who translates
and applies the knowledge of health
and social sciences to individuals
and population groups through
specific interventions, programs and
advocacy
He or she also articulates and
translates health and illness
experiences of diverse, often
vulnerable, individuals and families
to the health planners and policy
makers
Standards of practice have been
established by the American Nurses
Association
The Quad Council, made up of four
public health nursing organizations,
has established core competencies
These competencies reflect an
agreement by the Quad Council that
the public health nurse requires
preparation at the baccalaureate
level.
However, in many states nurses
doing public health work are not
baccalaureate graduates.
Even early on, the shortage of
nurses affected the hiring of BSN or
MSN prepared nurses. Public health
departments could not compete with
hospital systems.
The specialist level competencies
require preparation at the Master’s
level in community and /or public
health nursing.
Associate degree RNs need extensive
orientation and education to achieve
the competencies.
Having said that, with the shortage
of nurses continuing and getting
worse over the next decade what can
we do as nurse educators to ensure
that some public health framework
is included in curriculum at the
Associate Degree level?
We bring some statistics to the
attention of our students.
In a recent government funded study
at the Harvard School of Publlic
Health, Dr. Christopher Murray
stated that the five counties with the
lowest life expectancy were all in
South Dakota and three of the
counties make up the Pine Ridge
Indian Reservation.
Shannon, Bennett and Jackson
Counties have a 66.6 year life
expectancy. These are the counties
that comprise Pine Ridge Indian
reservation. Todd County part of
Rosebud Indian reservation has the
same life expectancy.
In Clear Creek County in
neighboring Colorado a person can
expect to live to 81.3 years.
Even with the five counties with the
lowest life expectancy in the US,
South Dakota placed 18th in state
ranking with a life expectancy of
77.7.
What conclusions can be drawn?
These are statistics that mean
something to our students. This is
home to most of them.
A brief introduction to statistics
helps these students to interpret data
that describes the incidence of Type
2 Diabetes, heart disease, obesity,
immune system disorders, cancer,
suicide, depression and MVAs
They all have relatives with at least
one of these diseases.
Community Service Projects that
impact pieces of this morbidity and
mortality.
Creating an awareness
An important piece of service
learning is the student’s reflections
and how it changed their lives and
their view of their community
N. 218 Foundations of Holistic
Nursing Care –Fall Semester
• Each student will complete:
10 hours- Case Study of elderly individual within
the community- home or assisted living facility
–
–
–
–
Comprehensive health assessment
Nursing diagnoses
Assessment of medications and environment
Process recordings
N. 224 Maternity Nursing
• “Shadow “visit with Community Health Nurse
for Postpartum/Newborn visit
• Nursing student then makes one home visit on a
new postpartum mother and her newborn and
makes an assessment.
SIDS, postpartum
depression,imunizations
Nursing 234:
Students spend time serving in a
nearby soup kitchen and at the Pine
Ridge jail
for this course on mental health
imbalances
Reflections
In Nursing 324 the topic for the term
paper must be taken from the
Healthy People 2010 Objectives.
In this course focusing on the
wholistic health of children and their
families, the students must, in pairs
or small groups, prepare and present
an educational session to parents or
the targeted children concerning an
area of risk to their health such as
the prevention of tooth decay,
promotion of self esteem, nutrition
and activity, preventing STI’s,
accidents in the home or car safety.