The intent of this position statement is to underscore the critical nature of the role of the public health nurse to the health of New Yorkers and to guide the development of public policy toward enhancing the public health nurse workforce in New York State.
It is the position of the New York State Nurses Association that:
The American Public Health Association/Public Health Nursing section (APHA/PHN, 2003) defined public health nursing in 1996 as “the practice of promoting and protecting the health of populations using knowledge from nursing, social, and public health sciences; a systematic process by which:
The current federal environment requiring disaster and bioterrorism preparation at the local governmental levels has further heightened the need for a robust public health nursing workforce. Public health nurses engage in activities to prevent, plan for, and respond to public health emergencies by administering prophylaxis and treatment, providing patient education and tracking, evaluating reactions, and counseling and referring clients.
Public health nurses weave their understanding of the community they serve with their unique knowledge base in public health nursing. As clinical experts, strategists, and collaborators, public health nurses have the distinctive ability to interpret the importance of health and illness concepts in order to advocate for clients, families and populations to health planners and policy makers at all private and public levels of health care.
Public health nurses work in a variety of different roles within a broad spectrum of public health systems in a number of work settings and locations. Regardless of the setting, however, the public health nurse’s role ranges from working toward the prevention of illness, injury or disability to the promotion and maintenance of the health of populations. In a recent study by a federal health care agency (HRSA, 2005), public health nurses work in local, district, and state offices providing direct care to individuals and populations of individuals as well as in positions of program management oversight. While different states have different educational requirements for public health nurses, New York State requires the baccalaureate degree in nursing for registered professional nurses to practice public health nursing.
According to HRSA (2005), recruiting public health nurses is especially difficult in rural areas. These difficulties stem primarily from budget constraints, a general shortage of registered professional nurses, low salaries and lengthy processing time for new hires. On the other hand, public health nurses are likely to be retained. Some of the local and district health agencies in this federal study reported that funding cutbacks for programs have led to reductions in direct patient services at the local level provided by public health nurses. In fact, HRSA cites New York State as an example where Medicaid managed care has resulted in a reduction in the level of direct patient services provided by local health agencies.
In addition to recruiting issues, HRSA (2005) identified gaps in public health nursing education in such areas as core public health concepts, clinical topics, manager/leadership education and an overall lack of advanced education programs at the baccalaureate and master program levels particularly in rural areas.
The ability of the public health nurse to be able to “promote and protect the health of populations using knowledge from nursing, social, and public health sciences” (APHA/PHN, 2003) is currently hindered to the detriment of the public’s health. Overall, HRSA (2005) identified budget constraints as the greatest barrier to adequate staffing of governmental public health agencies. Add to this a lack of formal public health education, clinical and managerial education, and lack of access to advanced public health nursing education especially in rural areas and the public’s health is at even greater risk.
The public’s health is at much greater risk without implementation of the following recommendations:
Approved by the Board of Directors on January, 1997 and June 8, 2006. Reviewed and revised by the Expanded Council on Nursing Practice on March 10, 2006.
Cary, A. (2003). Editorial: Public health nursing credentialing and the “pseudo-shortage.” Public Health Nursing, 20(2), 83-4.
Heath Resources and Services Administration. (2005). Public health workforce study. Bureau of Health Professions: Rockville, Maryland.
Public Health Nursing Section of the American Public Health Association. (2003). Definition of public health nursing. Accessed February, 2006 at: http://www.csuchico.edu/~horst/about/definition.html.
Public Health Nursing Section of the American Public Health Association. (2003). The role of public health nurses. Accessed February, 2006 at http://www.csuchico.edu/~horst/about/roles.html.
Rowney, R. & Barton, G. (2005). The role of public health nursing in emergency preparedness and response. Nursing Clinics of North America, 40(3), 499-509.
For more information on nursing practice, contact NYSNA's Education, Practice and Research Program at 518.782.9400, ext. 282 or by e-mail.