The Role of PHN

Public health nurses (PHN) act as a bridge between individuals and families in a community and the planners and policy makers of the local government. To the citizens of the community, they bring health care and education, and they take back reports on health trends and threats to the population groups served by the city or county. The nurses' primary focus is threefold: prevention of illness and injuries, promotion of healthy practices and maintenance of health for all in the community.

History

• The concept of public health nursing began in 1859 when the legendary nurse, Florence Nightingale, assisted London officials in organizing a program that assigned nurses to each neighborhood of the city to deal with the health concerns of that geographical area. The term "public health nurse" was actually coined by Lillian Wald of the United States, who established the Henry Street Settlement in New York City during the late 1800s. Although public health nursing first meant caring for the sick poor in their homes, Wald could see that the illnesses being treated had their origins in larger problems of society. By 1950, the emphasis of care had shifted from the home to the clinic. Well baby and immunization clinics for the uninsured flourished, and public health nurses worked to control communicable diseases like polio and tuberculosis.

Improving Lifestyle Choices

• Today's nurses concentrate on prevention and education. They may now work in settings that include schools and workplaces. Public health nurses serving at the job site are known as occupational health nurses. In general, public health nursing is focused on educating the public about behaviors that may lead to health problems, such as smoking, unhealthy food choices, lack of exercise and driving while intoxicated.

Community Issues

• Public health nurses often are engaged in working to solve issues that affect more than just the individual. These may include tougher controls on tobacco and alcohol sales to minors, fluoridation of drinking water and identification and reduction of hazards in the workplace. Some public health experts think that this should be the primary focus, rather than care of the individual.

Input to Government Officials

• An important part of a public health nurse's job is evaluating health trends and risk factors in the sector where they are employed and helping the community's health planners to develop public policy to target interventions. The funding for local government's public health work, by and large, comes from state and federal sources and is often for a specific problem only. If the community has significant other needs, the local government may be required to fight for funding, using the information brought forth by public health nurses.

The Future

• With the expansion of managed care plans and the Medicaid program in the 1990s, caring for the low-income sick has shifted more to private companies, freeing public health nurses to work toward the prevention of health problems in the community. While once a hospital diploma or associate's degree was accepted as training for a public health nurse, the minimum now is a bachelor's degree in nursing, and many in the field are studying for advanced degrees so they can specialize in one of the emerging areas of public health.