EDUCATIONAL QUALIFICATIONS OF PUBLIC HEALTH NURSES

Transcription

1 EDUCATIONAL QUALIFICATIONS OF PUBLIC HEALTH NURSES 1. General Scope of Public Health Nursing PUBLIc health nursing is one of the basic organized community health services. It utilizes the philosophy, content, and methods of public health, the knowledges and skills of professional nursing, and is typified by the provision of a family-centered type of service. It includes comprehensive nursing care of individuals and families, community services such as epidemiological investigations, participation in health education, and community organization for health action. It is a vital part of the pattern of service interwoven with the contributions of other professional health and allied workers with similar goals. The public health nurse is employed, in some cases, by tax-supported organizations, such as a local or county health department or board of education; in other instances, she is employed by a voluntary agency, such as a visiting nurse association or by an agency supported by both tax and voluntary contributions and fees. The public health nurse works with individuals, families, and groups in the community-people at home, at school, at work, or in the public health center. She serves in many ways. She provides nursing care and treatment, and health counseling. She cooperates with other professional personnel and citizens' groups with planning, interpreting, and putting into action the community's health program. The increased emphasis on case finding in chronic diseases as a public health responsibility, on mental health, rehabilitation, geriatrics, and on care of the sick at home has resulted in a need for increased numbers of public health nurses. Public health nursing offers challenging opportunities for service in programs of broad scope, opportunities for nurses to participate with a variety of other public health workers in the efforts to help meet the health needs of people, and opportunities for employment security and advancement on merit. The need to expand and improve public health nursing services remains a persistent challenge. There has been some evidence of increased financial support to official and voluntary health agencies and funds have been made available for education in public health. Scholarships for nurses are available through local and state health departments, federal agencies, voluntary health agencies, and through universities with approved programs of education in public health and public health nursing. Opportunities for advanced education carry with them opportunities for professional advancement in a public health career. As of January 1, 1960, there were 34,093 nurses employed for public health work in the United States, Puerto Rico, and the Virgin Islands. The categories and numbers were as follows: Agency National agencies Universities State health agencies: State health department Other official Nonofficial Nurses MARCH,

2 Local health agencies: Local official Visiting Nurse Association Other nonofficial Combination agency Board of education All agencies-other personnel: Full-time supplemental (R.N., L.P.N.) Part-time (P.H.N., R.N., L.P.N.) 13,567 3, ,144 11, , Functions of Public Health Nurses A. Staff Nurse A qualified public health nurse under guidance and nursing supervision should be able to carry out the following functions: nursing care, health counseling and guidance, health education, and collaboration with other professions. Examples of her activities are: 1. Helps families secure appropriate medical, hospital, and other needed care. Gives nursing care to patients requiring parttime professional nursing service in the home, school, and industrial plant under medical direction. 2. Observes the environment and identifies factors in the home, school, and community that have a bearing on the health of the family, and helps family effect changes in the environment or in the organization of activities that will eliminate or modify the hazard. 3. Helps in promotion of positive health through counseling with well individuals. 4. Teaches through demonstration and discussion, conducts group classes and conferences, such as expectant parents, child health, and home care of the sick. 5. Assists with community health education activities. 6. Consults and plans with other professional personnel as she works with individual and family concerning their health problems. 7. Plans with the patient and other agencies for continuity of care in hospital, clinic, school, industry, home. 8. Helps plan, manage, and provide nursing services in clinics and well child conferences. 9. Prepares and uses records, reports, and statistical information for appraisal, planning of program, and direct patient care. 10. Interprets agency program and policies in her daily activities and participates in planning and carrying out the public health nursing aspects of the agency program. 11. When so designated, represents the agency in professional organizations and in community groups. B. Supervisor A qualified public health nursing supervisor will have acquired a knowledge of the principles of supervision and skill in applying them in her work with staff nurses. Under the guidance of a nurse director or the director of health, she provides leadership and supervision to the nursing staff. Examples of her activities are: 1. Carries responsibility for evaluation of nursing performance and improving the quality of nursing service provided. 2. Works with the director and other members of the staff in program planning and evaluation. 3. Carries responsibility for determining and maintaining standards of nursing services and practices. C. Consultant The specialized public health nursing consultant has responsibility for promoting, developing, and integrating nursing aspects of a specialized program in public health and the generalized public health nursing consultant carries similar responsibility for nursing in the over-all public health program. Examples of her activities are: 1. With program director and others in specialty program determines objectives and plans for program operation and methods of program evaluation of specialty program. 2. With supervisors, plans for and participates in inservice education programs for staff. 3. Plans for and participates in the preparation of program guides, manuals, and other educational materials. 4. Initiates, plans for, and participates in special studies relating to specialty programs and nursing services. D. Administrafor The public health nursing administrator plans, implements, and evaluates 502 VOL. 52, NO. 3, A.J.P.H.

3 EDUCATIONAL 4QUALIFICATIONS OF PUBLIC HEALTH NURSES the public health nursing service for which she is responsible. She sets and maintains standards of practice in accordance with agency policies and objectives. Examples of her activities are: 1. Works with the director of health and other bureau or division chiefs, or director of health and board of directors in a combined agency in establishing over-all policies in relation to nursing. 2. Participates with health director and individual program directors in developing programs and nursing's contribution to these. 3. Interprets and implements the accepted policies. 4. Provides professional direction for the nursing staff and participates with them in planning and evaluating the nursing services. 5. Prepares and submits budget estimates in relation to nursing services and education. 6. Interprets public health nursing to other disciplines in the agency, other agencies, and to the public. Ill. Educational Qualifications of Public Health Nurses above; or (2) a similarly approved program for the nurse who is already a graduate of a three-year diploma school of nursing. In making this recommendation, the American Public Health Association recognized there are nurses now actively engaged in public health nursing who lack this type of formal education and that for a period of time nurses with public health experience and partial preparation will be employed in staff positions. B. Graduate Education. for Public Health Nursing A. Baccalaureate Level Three components are essential in the education of nurses for the public health field: (1) general education at the college level; (2) basic education in nursing; (3) specific content in public health nursing and public health. These three components have been combined at the baccalaureate level in a growing number of educational institutions.1 The staff nurse employed in public health should hold a baccalaureate degree from a college or university which has met certain accreditation requirements having specific reference for the public health nursing field as stated in reference 1. She should hold a current license to practice as a registered professional nurse. Preparation for public health nursing may be obtained either through: (1) a basic collegiate program in nursing approved for public health nursing as Preparation for supervisory, administrative, or consultative positions in public health nursing should be secured at the graduate level in an approved school of public health* and/or graduate nursing programst approved for the preparation of public health nursing supervisors, administrators, and consultants. A graduate program in public health nursing should include study in three main areas: (1) public health nursing; (2) public health sciences, particularly epidemiology, biostatistics, and public health administration; (3) the functional area in which the public health nurse expects to be employed-supervision, administration, or consultation. In case of consultation, advanced work in the specialty area (maternal and child health, chronic diseases, etc.) also is essential.2 In a graduate program, the public health nurse would be expected to achieve an understanding of the research process as well as first-hand knowledge of the contributions of the multidisciplinary group in the public health field. Selected experiences under faculty guidance in appropriate field settings are important if the advanced *Approved by American Public Health Association. t Approved by National League for Nursing. MARCH,

4 student is to develop public health nursing skills and test theories relating to both content and functional areas of practice. REFERENCES 1. In August, 1961, there were 85 basic collegiate programs and 59 baccalaureate programs for the graduate of the diploma school of nursing which were accredited by the National League for Nursing. Educational Programs in Nursing Accredited by the National League for Nursing Nursing Outlook 9: (Feb.), Additional Educational Programs Accredited by the National League for Nursing, Ibid. 9:505 (Aug.), Such accreditation means that these programs in nursing have met specific requirements for public health nursing. 2. For information concerning qualifications for teacher. in public health nursing, see appropriate materials from the American Nurses' Association and the National League for Nursing, Department of Bacca. laureate and Higher Degree Programs. 'ENDIX Proposed Classification of Public Health Nurses Minimum Public Health Type of Title Education Experience Educational Program* Public health Bachelor's degreet None Basic collegiate pronurse including approved gram approved for (staff nurse) preparation for public health nursing public health or similarly approved nursing baccalaureate program for diploma school graduates Public health Master's degree: Two years Master's degree pronure with preparation gram in school of (supervisor) in public health public health, school, and public health nursing of nursing, or other school offering graduate program in public health nursing Public health Master's degree Four years Master's degree as nurse as above (including above including (consultant) one year as advanced preparation supervisor) in specific area (functional or clinical) Public health Master's degree Five years Master's degree nurse as above (including program as above (administrator) three years in supervisory or consultant capacity) * Accredited by National League for Nursing and/or American Public Health Association (Schools of Public Health). t Because of the present limited supply of qualified public health nurses, especially in certain geographic areas of the country, employing agencies may wish to designate additional classifications for nurse graduates of diploma programs with specific amounts of education in or accepted by a program approved for the preparation of public health nurses (less than a baccalaureate degree) and for collegiate graduates whose programs lack accreditation for public health nursing. Additional classifications may also be needed for advanced staff level responsibilities which may also require preparation beyond that defined for a qualified public health nurse. I Since the supply of nurses qualified at the master's level to fill supervisory positions is limited, employing agencies may wish to make some substitutions of experience in lieu of a master's degree. S04 VOL. 52, NO. 3, A.J.P.H.

5 EDUCATIONAL QUALIFICATIONS OF PUBLIC HEALTH NURSES COMMITTEE ON PROFESSIONAL EDUCATION (1961) THOMAS PARRAN, M.D., Chairman GEORGE JAMES, M.D. BERWYN F. MATTISON, M.D., Secretary KARL M. MASON, M.P.H. JAMES L. TROUPIN, M.D., Associate Secretary MARION I. MURPHY, Ph.D. JESSIE M. BIERMAN, M.D. GEORGE G. READER, M.D. RA-LPH H. BOATMAN, Ph.D. RAY E. TRUSSELL, M.D. ROBERT E. COKER, M.D. ROBERT H. FELIX, M.D. W. HARDING LE RICHE, M.D., Consultant DONALD J. GALAGAN, D.D.S. WILSON G. SMILLIE, M.D., Consultant The Committee on Professional Education expresses grateful appreciation to the Subcommittee on Educational Qualifications of Public Health Nurses which assisted with the preparation of this report. This subcommittee consists of: MARGARET B. DOLAN, R.N., Chairman MABLE E. GROVER, R.N. HEDWIG COHEN, R.N. RoSCOE P. KANDLE, M.D. JAMES A. CRABTREE, M.D. S. S. LIFSON, M.P.H. HELEN L. FISK, R.N. MARGARET MCLAUGHLIN, R.N. Stroke Rehabilitation with Existing Resources The Heart Association of Southeastern Pennsylvania, in cooperation with the Pennsylvania Department of Health and the Public Health Service, has completed and reported on a two-year rehabilitation project. This has shown that stroke patients "can be substantially aided toward recovery in the home through coordinated use of local facilities"-words from the project's 32-page booklet "Stroke Rehabilitation Program in Delaware County, Pa." Expanding on the HASP's findings: with careful diagnosis and therapeutic supervision immediately or shortly after the stroke "reduction in dependency... can be accomplished in the average community by means of existing nursing and therapy resources." In a one-year period 53 patients were referred to the program, 40 of whom were accepted for rehabilitation. Of the 32 who completed treatment, 24 were bedfast at time of referral. At the end of the period under report, 21 patients had gained complete independence in activities of daily living, and six were close to this goal. Some were back on full-time employment or housekeeping, and others were back at work on a limited basis. Most of the patients were in their 60's and 70's. The plans and methods of the seven local agencies that joined forces to produce this success story are described in the booklet. Information on its availability from HASP, 318 South 19th St., Philadelphia 3, Pa. MARCH,