Community Health Nursing Roles Paper

Instructions
RN 406 Community Health Nursing Roles Paper

Choose a role of the public /community health nurse as outlined in the Stanhope and Lancaster (2015) course text. The roles are described in detail in the following chapters 13, 16, 28, 29, 30. 31, 32 and include the Public Health Nurse in Local, State, National Level, Case Manager, Program Manager, Occupational Health, School Nurse, Faith (Parish) Nurse, Home Health Nurse, Hospice Nurse, and new emerging roles such as Telehealth, Transitional Health, Care Coordination, and Infection Control.

The paper should be 3-4 pages (excluding the title page and reference page), in APA format 7th edition. Include headings (level one, in bold, and centered) and correctly formatted reference citations in-text and on the reference page. Please use a minimum of 4 references, one being from the Stanhope and Lancaster text, and the others being from scholarly sources (nursing journals, etc.) Use only web sources from .org, .edu, or .gov. Resources from .com sources are not acceptable and should not be included.

Introduction to Paper (10%) Begin the paper with an introduction to the topic, briefly stating what will be covered in the purpose statement such as The purpose of this paper is………..

Educational Background, licensing, certification required and experience needed for the role (20%) Discuss the required educational background (BSN, MSN, etc ) additional licenses/certification needed, (PHN, etc) exams for licensing/certifications, and specific nursing experience expected (years of experience as an RN).

The patient population served including the setting/environment (20%) Discuss the main patient population the nursing role will serve (school-aged children, etc). Approximately how many specific patients/clients will the nurse reach? What are the setting (school, clinic, etc) and main environment for serving the population?

Professional duties of the role, including additional professionals who may be part of the interdisciplinary team (20%) Discuss the main duties of the nurse role and other healthcare professionals (social worker, etc) who may collaborate/partner with the nurse providing care/services to the patient/client population.

Importance of the role and projected need for the future (20%) Project ahead approximately 5-10 years and discuss the importance of the role as an advocate and the projected needs of the population in the future. Include actual data from the US Bureau of Labor Statistics, including the state of California.

Conclusion/Summary (5%) Finish the paper with a summary of what was covered and a conclusion with any additional thoughts and insight gained on the nursing role.

Final Paper (5%) APA Format, minimum of 4 references from scholarly sources, additional resources, headings, grammar, punctuation, complete in required content

ANSWER

Public Health Nurse (PHN)

Public health nursing is not a new concept in the country. Contrary to popular opinion, public health nurses have existed since 1910. However, these roles lost their prominence when new care models emerged, i.e., hospitals. The U.S healthcare system has been experiencing new unprecedented challenges such as health disparities, an increasingly aging population, and chronic disease burden. These health issues, coupled with the Affordable Care Act of 2010 (ACA), inspired the system to shift its focus from acute and specialty care to disease prevention and health promotion. This new approach emphasizes primary care, transitional care, disease prevention, care coordination, and health promotion roles. Consequently, positions such as public health nurses re-emerged to fulfill these new obligations. However, nurses need to understand what skills, qualifications, and competencies are required to perform these roles successfully. This paper aims to analyze public health nurses’ educational, licensing, and accreditation requirements. It will also examine their roles and the projected need for the future.

Educational Background and Licensing Requirement

The legal requirement for practicing as a PHN is a valid registered nurse (RN) license. Nurses can obtain an RN license with an associate degree from a recognized or accredited institution, but a Bachelor’s Degree is preferred. After completing the nursing program, the nurse sits for the National Council Licensure Exam Registered Nurse (NCLEX-RN). The nurses receive the RN license after passing the NCLEX examination.

Nurses are often advised to get some working experience before advancing into the public health field. After gaining work experience, the nurses can apply for PHN Certification. The following are the eligibility criteria for sitting for the National Board of Public Health Examination (American Public Health Association, 2021):

• Student or Alumni of a program accredited by the Council on Education for Public Health
• A Bachelor’s Degree in any relevant field and at least five years’ experience in public health
• A Master’s Degree and at least three years of working experience.

Applicants who meet one of these educational/experience criteria are eligible for the Certified Public Health examination. The PHN certification is provided once the individual has passed this examination.

Patient Population

Public health nurses do not provide services to individual patients. Instead, they serve whole populations. For example, they can focus their health interventions on a given racial or ethnic group. Typically, the nurse identifies health issues affecting their communities. Then, they determine which patient population is affected by the health issue. If the health issue is obesity, the PHN identifies which group has the worst outcomes. The patient population could be children, an ethnic or racial group, or people of a particular age group or gender who have been disproportionately affected by the health condition. Other patient populations include smokers, individuals with sedentary lifestyles, frail elderly, the homeless, and those with specific disease risks (Kulbok et al., 2012).

There are no specific nurse-patient ratios because these nurses serve whole populations. Most PHN work in community health centers, non-profit organizations, government agencies, home health agencies, state or local health departments, school health programs, worksites & housing developments, community nursing centers, etc (Kulbok et al., 2012).

Professional Duties of the Role

Public health nurses are expected to be competent in the following areas: social justice and health equity, evidence-based approaches to public health, collaboration and partnership, communication, program planning & management, policy & advocacy, law & ethics, leadership, and public health sciences. They address the population-specific health needs, e.g., health disparities (Kulbok et al., 2012). They conduct comprehensive assessments to identify various determinants of health, including socio-cultural factors, environmental, physical, historical, and environmental factors. They apply systems thinking and clinical experience to implement evidence-based solutions to address the identified issues. They are also skilled in recognizing community resources and opportunities that could help address the inequities affecting their patient populations.

Another role relates to community collaboration. Kuo et al. (2021) point out that public health nurses no longer work in traditional medical care settings. Their positions now require these nurses to comprehensively collaborate with the community to conduct health assessments. This collaboration is also required when planning population health improvement initiatives and health promotion programs. Here, they play the role of a coordinator or integrator, ensuring that all relevant stakeholders are involved in the health improvement initiatives.

Health education involves teaching community members about behavioral changes. This education empowers the target population to take control of their well-being and health. It does this by improving their self-efficacy and individual competencies in managing their health. The PHN needs communication competencies such as information sharing and effective oral and written skills to perform this role effectively (Kulbok et al., 2012). Public health nurses provide leadership in advancing population health. Their management roles include program management and program planning and evaluation, while their leadership roles involve policy development and advocacy.

The Multidisciplinary Team that works with Public Health Nurses 

The PNH may collaborate with an RN from a clinical setting, social worker, primary care provider, community leaders, community members, and policymakers to perform their roles.

Importance of the Role and its Projected Future 

Public health nurses constitute an integral component of the government’s response plan during crises. Additionally, they often contribute to creating innovative health systems such as surveillance and patient monitoring tools that help identify and address emerging public health threats. They also serve as advocates because one of their primary jobs addresses health disparities. These disparities are often caused by structural factors, e.g., discriminative policies. Therefore, to eliminate the disparity, the public health nurse must remove the structural barriers.

What is the Projected Need?

The past few years have provided devastating data on the public health system. The American Nursing Association conducted a national survey and revealed that public health nurses account for only 1.6% of the nursing workforce in the country (Pittman & Park, 2021). Over 41% are aged 50 and above, implying that this population will be retiring in a decade or so. In 2000, there were approximately 76,127 public health nurses in the country, but this number reduced to 53 084 in 2018 (Pittman & Park, 2021). Public health nurses registered for the highest decline compared to the other nursing professions. The Trust for America’s Health (TFAH) organization revealed that more than 55,000 positions in public health were lost between 2008 and 2017 (Sullivan-Marx, 2020). These declines were attributed to budget cuts and underfunding.

The government has been cutting funds allocated to public health infrastructure, resulting in job losses. Research evidence also reveals that the local public health system is underfunded by approximately $4.5 billion (Sullivan-Marx, 2020). In 2018, public health only accounted for 2.5% of the $3.5 trillion healthcare budget. Sullivan-Marx (2020) reports that the government re-allocated about $6 billion intended for public health initiatives to pay Medicare physician payments. The same incident happened in 2017 and 2018 and remained the same until COVID-19. In response to the Pandemic, Congress invested billion into public health. Although the government has increased funding to the sector, these funds are still inadequate. Public health nurses will need more infrastructural support to effectively perform their roles in the future.

Future Outlook

The U.S. Bureau of Labor Statistics (2019) predicted 11,700 new job openings in the public health field between 2020 and 2030. According to the agency projected that the growth rate in the industry will be 10% to 15% (U.S Census Bureau, 2019). Currently, there are about 17,000 community and social services specialists in California. The Bureau of Labor Statistics predicts that this number will grow to 18 400, an 8% annual job increase. Between 2018 and 2028, the agency expects a yearly increase in job openings to be 2,140. This data provides a positive future outlook for the public health industry.

Conclusion/Summary

To become a public health nurse, one must pass the NCLEX exam and obtain their license and clinical experience. Getting a public health nursing certification requires either a Bachelor’s Degree in nursing with five years of working experience or a Master’s Degree with three years of experience in public health. The applicant must also be a student or alumni of a program accredited by the Council on Education for Public Health. The patient population includes smokers, individuals with sedentary lifestyles, frail elderly, the homeless, and those with specific disease risks. They work in community health centers, non-profit organizations, government agencies, home health agencies, state or local health departments, school health programs, worksites & housing developments, and community nursing centers. They often serve as collaborators, leaders/managers, educators, partners, and policy advocates. Although its future outlook is positive, the industry is still threatened by underfunding and constant budget cuts. The government should increase investments in public health to promote outcomes.

References

American Public Health Association. (2021). Candidate handbook. American Public Health Association. https://nbphe-wp-production.s3.us-east-1.amazonaws.com/wp-content/uploads/2017/05/CPH-Candidate-Handbook.pdf

Kulbok, P., Thatcher, E., Park, E., & Meszaros, P. (2012). Evolving public health nursing roles: focus on community participatory health promotion and prevention. The Online Journal of Issues in Nursing, 17(2). https://doi.org/10.3912/OJIN.Vol17No02Man01

Kuo, C.-P., Hsieh, P.-L., Chen, H.-M., Yang, S.-Y., Hsiao, Y.-L., & Wang, S.-L. (2021). Community health nursing competency and psychological and organizational empowerment of public health nurses: A cross-sectional survey. Healthcare, 9(8), 993. https://doi.org/10.3390/healthcare9080993

Pittman, P., & Park, J. (2021). Rebuilding community-based and public health nursing in the wake of COVID-19. OJIN: The Online Journal of Issues in Nursing, 26(2). https://doi.org/10.3912/ojin.vol26no02man07

Sullivan-Marx, E. (2020). Public health nursing: Leading in communities to uphold dignity and further progress. Nursing Outlook, 68(4), 377–379. https://doi.org/10.1016/j.outlook.2020.07.001

U.S Census Bureau. (2019). Community and social service specialists, all other. Https://Www.bls.gov/Ooh/About/Data-For-Occupations-Not-Covered-In-Detail.htm#Community%20and%20social%20service%20occupations. https://www.onetonline.org/link/result/21-1099.00?c=we

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