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Public health nurses discuss why their work is important to them.

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Public Health Nursing: A Career with Meaning

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Prevention of Disease, Promotion of Health

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What is a Community/ Public Health Nurse?

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An interesting video on a job description.

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A Day in the Life - Mary (Public Health Nurse)

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"Public health nurses are directly engaged in the core public health functions of assessment, assurance and policy development. In any setting, the role of public health nurses focuses on promoting health, maintaining of the health of populations and preventing illness, injury or disability."

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Public health nursing is the practice of promoting and protecting the health of populations using knowledge from nursing and social and public health sciences.

Public health nurses are directly engaged in the core public health functions of assessment, assurance and policy development. In any setting, the role of public health nurses focuses on promoting health, maintaining of the health of populations and preventing illness, injury or disability.

Public health nurses interpret and articulate the health and illness experiences of diverse and often vulnerable residents to health planners and policymakers as well as assist members of the community in talking about their problems and aspirations. Evidence and data drive the practice of public health nurses, who translate knowledge from the health and social sciences to individuals and population groups through direct care, programs and advocacy.

Vision

Advancing social justice and equity to achieve population health for all.

Mission Statement

Innovating nursing to advance population health through: community and professional partnerships, evidence-based practice, workforce development, research, policy development, and advocacy.

Strategic Priorities

Public Health Nursing Section strategic priorities:

Advocate for social justice and health equity.

Support and engage members.

Increase resources and capacity.

History

The Public Health Nursing Section of the American Public Health Association had a protracted start that was initiated in 1918 and delayed by World War I. Finally in 1920 APHA's Governing Council adopted a resolution that a PHN Section be established. This was followed by an initial probationary period. The PHN Section held its first meeting in 1922 attended by 175 public health nurses. The APHA Governing Council appointed the PHN Section as a regular section of the association in 1923.

The Section has always focused on the status of public health and the ever-changing requirements for a competent public health nursing work force. Each decade the definition and role of public health nurses has been revised with the most recent revision, "The Definition and Practice of Public Health Nursing," published in 2013.

Section leadership works both independently and collaboratively. This is central to the section. In response to the Institute of Medicine's 1988 report, "The Future of Public Health," the chair of the PHN Section initiated a caucus among leaders of the 4 organizations (PHN Section/APHA, American Nurses Association, Association of State & Territorial Nursing Directors (now known as the Association of Public Health Nurses), and Association of Community Health Nurse Educators); this lead to the formation of the Quad Council of Public Health Nursing Organizations in 1989. The Quad Council Coalition of Public Health Nursing Organizations now includes the National Association of School Nurses.

In addition the PHN Section is proactive and responds to the needs of vulnerable populations and the wide health and social issues of the day. These are addressed during section meetings and in resolutions.

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Public health nursing is the practice of promoting and protecting the health of populations using knowledge from nursing and social and public health sciences. Public health nurses are directly engaged in the core public health functions of assessment, assurance and policy development.

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From the University of Pennsylvania.

"Nurses as Guardians of the Public’s Health"

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Lillian Wald, founder of the Henry Street Settlement (1893) in New York City, invented the term public health nursing to put emphasis on the community value of the nurse whose work was built upon an understanding of all the problems that invariably accompanied the ills of the poor. Wald's practice among the sick poor quickly convinced her that their diseases most often resulted from causes beyond an individual's control and that treatments needed to be prescribed in an all-round way with consideration for the social, economic, and medical aspects of each case. By looking at nursing practice from the patient's point of view, encouraging personal and public responsibility, and providing a unifying structure for the delivery of comprehensive, equally available health care, Wald conceptualized a new paradigm for nursing practice.

Whether a patient's problems were isolated and unusual or common to many was, according to Wald, important to know because the process of finding out the answer to this question often led logically to identification of an appropriate remedy. Wald's vision resulted in nursing practice that went beyond simply caring for patients and their families during illness to encompass an agenda of reform in health care, industry, education, recreation, and housing.

What Wald called "our enterprise of public health nursing" was not an isolated undertaking, nor was she a lone American heroine. Her paradigm for nursing practice was based on knowledge gained during two decades of experience in visiting nursing and owed much to Progressive reform and the public health movement of the turn of the century. Although Wald embodied the professionalization of visiting nursing, due credit must also be accorded the thousands of nurses across the country who legitimated the practice of nursing in the community.

To Teach Healthful Living and Disease Prevention

While Wald was developing her new agenda for the reform of society and delivery of health care, the changing emphasis of the "public health campaign" simultaneously created yet another aspect of the bond between nursing and public health. As the focus of the public health movement shifted from what eminent public health leader C-E.A. Winslow described as environmental sanitation and bacteriology to the personal conduct and health practices of the individual, it required a new worker, a teacher of healthful living and disease prevention. By 1910, most of the large visiting nurse associations and numerous boards of health and education had initiated disease-prevention programs for school children, infants, mothers, and patients with tuberculosis.

Health visiting offered nurses a new opportunity for professional independence, status, and economic security. As one medical authority suggested, they were the relay station to carry the power from the control stations of science, the hospital, and the university to the individual homes of the community. This was a time of unprecedented possibilities for nursing. Not, surprisingly, the number of agencies seeking their services had increased from only 58 in 1901 to nearly 2,000 by 1914. Nurses entering this new field had also begun to specialize, limiting their work to one age group or disease. Specialization, these nurses argued, allowed them to become experts, to lead others, and to contribute to the much needed literature in public health. They saw themselves as participating in the growing specialization of the medical profession. Because it was difficult to combine a focus on prevention with meeting the bodily needs of patients, the roles associated with care of the sick and health teaching increasingly diverged.

Wald argued that the public health nurse was the link between families' social, economic, and health needs and the services they required to become and stay healthy. She was therefore opposed to specialization and to the distinctions between health teaching and direct patient care. If the message of health was to be carried to troubled families, something also needed to be done for these families. Thus, the increasingly isolated and narrowly focused mission of health education challenged Wald's vision of a broadly focused agenda for nursing in the struggle for social betterment. Specialization was antithetical to her concept of public health nurses' organic relationship to their neighborhoods.

Prevention vs. Cure?

By the late, 1920s, public health nurses had indeed demonstrated their ability to advance the public health mission, but the field had reached a turning point. Despite the intent of reformers for a conceptually coherent and centrally structured set of public health services, there were nevertheless 4,262 separate, small and independent local government and voluntary agencies sponsoring public health nurses. This growth was characterized by an idiosyncratic mix of initiatives providing an unpredictable assortment of both preventive and curative nursing services. Gaps and duplication of services were an inevitable outcome. Isolated and uncoordinated, these agencies were increasingly vulnerable to shifts in community support and perceptions of need. As the confusion grew, the rationale for public health nursing became increasingly obscure to both its practitioners and the public.

In response, many nursing leaders began to campaign for the creation of comprehensive, coordinated community-based nursing services. Leaders now considered separating the curative and preventive functions of the public health nurse to be a mistake, and they argued for a combined model that would unite both voluntary and publicly funded agencies. Nurses within this more rational system would be general practitioners who would care for all people in the neighborhood, in sickness and in health, regardless of income or type of illness. Numerous studies and demonstration projects from the 1920s through the 1940s confirmed that such a system would eliminate duplication in administration, transportation, and health services. Despite their ability to demonstrate that this unification model met the needs of most of the patients it served, however, organized nursing was never able to create the institutional framework necessary to implement their vision.

The reality was that public health nursing was no longer able to engage the support of the larger infrastructures of medical and wider social institutions in their quest to create and finance comprehensive community-based care. The social, medical, and demographic circumstances that had created support for their work in the community were now much less urgent. With fewer immigrants, declining death rates from often dramatic and frightening infectious diseases, the growing dominance of chronic illness, and the centrality of the hospital, the work of the public health nurse seemed increasing inconsequential to the public.

Nurses as Guardians of the Public's Health

Over the years, public health nurses have assumed a variety of roles and titles, but in the absence of an influential or cohesive constituency, Wald's vision of nurses as guardians of the public's health could only be partially realized. Today, once again, frightening diseases, alienation among the disenfranchised, a vexing economic climate, and unmet health needs of populations at greatest risk constitute a crisis in caring. As we anticipate the implementation of health care reform, one cannot help but wonder if public health nursing might have the opportunity to be reinvigorated and returned to the role Wald prescribed. As historian Susan Reverby suggested during a previous campaign for health reform, such a paradigm shift could go a long way toward making an inadequate medical care system into a health care system that provides for all the public.

References

C.-E.A. Winslow. "The Untilled Fields of Public Health." Science, 51 (9 January, 1920): 23-33. Karen Buhler-Wilkerson, "Bringing Care to the People: Lillian Wald's Legacy to Public Health Nursing," American Journal of Public Health, 83 (December 1993): 1778-86.

Karen Buhler-Wilkerson, "Public Health Nursing: In Sickness or in Health?" American Journal of Public Health, 75 (October 1985): 1155-61.

Karen Buhler-Wilkerson. False Dawn: The Rise and Decline of Public Health Nursing, 1900-1930. New York: Garland Publishing Co., 1990.

Susan Reverby, "From Lillian Wald to Hillary Rodham Clinton: What Will Happen to Public Health Nursing?" American Journal of Public Health, 83 (December 1993):1662-63.

Marla Salmon, "Editorial: Public Health Nursing-The Opportunity of a Century," American Journal of Public Health, 83 (December 1993): 1674-75.

Karen Buhler-Wilkerson (1944-2010) was Professor Emerita, University of Pennsylvania School of Nursing and Director Emerita of the Barbara Bates Center for the Study of the History of Nursing.

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Lillian Wald, founder of the Henry Street Settlement (1893) in New York City, invented the term public health nursing to put emphasis on the community value of the nurse whose work was built upon an understanding of all the problems that invariably accompanied the ills of the poor.

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Possible careers for public health nurses

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Commissioned Corps of the U.S. Public Health Service

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Skip to main content

Where nurses lead.

Valued for their resourcefulness and initiative, nurses in the USPHS Commissioned Corps serve on the front lines of public health, providing care to underserved populations and developing innovations in health care.

Where nurses lead.

Valued for their resourcefulness and initiative, nurses in the USPHS Commissioned Corps serve on the front lines of public health, providing care to underserved populations and developing innovations in health care.

Officers In Action

A Message from Chief Nurse Officer RADM Mix

Becoming a nurse officer in the USPHS Commissioned Corps

Read full story

Types of Profession Opportunities

Nurse Practitioner

Qualification

Master's of science in nursing from a program accredited by the National League for Nursing Accrediting Commission or the Commission on Collegiate Nursing Education

Qualification

Passing score on the National Council Licensure Examination (NCLEX)

Qualification

Current, unrestricted, and valid Registered Nurse (RN) license from any U.S. state, Washington D.C., Puerto Rico, U.S. Virgin Islands, or Guam

Registered Nurse

Qualification

Bachelor's of science or master's of science in nursing from a program accredited by the National League for Nursing Accrediting Commission or the Commission on Collegiate Nursing Education

Qualification

Passing score on the National Council Licensure Examination (NCLEX)

Qualification

Current, unrestricted, and valid Registered Nurse (RN) license from any U.S. state, Washington D.C., Puerto Rico, U.S. Virgin Islands, or Guam

Benefits

Officers and their families receive medical and dental care at little or no cost through TRICARE. Coverage begins on the first day of service. Learn more

The USPHS Commissioned Corps offers a Basic Allowance for Housing, a tax-free amount to cover your rent or mortgage that is calculated by your rank/grade, duty station location, and dependent status.

The USPHS Commissioned Corps also provides a Basic Allowance for Subsistence, which offsets costs for officers' meals and is adjusted based on the cost of food as measured by the USDA food cost index. (The Basic Allowance for Subsistence does not cover meals for officers' family members.)

Public Health Service officers have access to the benefits provided in the Post-9/11 GI Bill after 90 days of active duty service, provided they have not used the benefits previously. Benefits include funding for tuition, housing, supplies, and more. Learn more

The Indian Health Service awards up to $50,000 in loan repayment to health professionals in exchange for at least two years of service in health facilities serving American Indian and Alaska Native communities. Learn more

The National Health Service Corps (NHSC) offers select medical professionals $60,000 in loan repayment in exchange for two years of service at a community-based site in a high-need health professional shortage area. Recipients must apply to and accept a position at an NHSC site. Learn more

The CDC Epidemic Intelligence Service (EIS) Program provides federal loan repayment in exchange for two years of service practicing epidemiology in CDC or state/local health departments. The repayment amount is based on availability of funds. Learn more

Where we serve

See where our officers are serving

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Ready to serve? See how to apply, from start to finish.

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Nurse | Commissioned Corps of the U.S. Public Health Service

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Become a nurse in the Commissioned Corps of the U.S. Public Health Service.

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This information comes from the University of St. Augustine for Health Services.

"What Does a Public Health Nurse Do?

The role of a public health nurse is to promote public wellness. In this capacity, nurses focus on helping underserved and at-risk individuals gain access to the care they need. The main goal of public health nurses is to help prevent disease and reduce health risks at the population level through evidenced-based care and education.

"In general, the responsibilities of public health nurses include:

Recording and analyzing aggregate medical data

Evaluating the health of patients and creating treatment plans

Monitoring patients for any changes in condition

Delivering top-quality care alongside physicians

Educating patients about available support services and helping them access care

Emphasizing primary prevention in order to avoid disease or injury before it occurs

Working with public health officials to help underserved communities gain access to care

Developing a relationship with patients and following up to track progress

Referring patients to other providers as needed

Assessing health trends in communities

Managing budgets of public health programs"

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University of St. Augustine for Health Sciences

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Public Health Nursing: Role and Responsibilities | USAHS

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Passionate about the fight to improve population health? Being a community nurse might be perfect for you. Read on to learn about public health nursing.

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A sample of a job opening for a public health government job in Ohio in 2023

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(Any one position may not include all of the duties listed, nor do the examples cover all of the duties that may be performed.)
Provides health guidance and instruction and demonstrates nursing techniques to patients, families, and caregivers;

Provides nursing consultation and patient health evaluation to social workers, foster parents, and child placement facilities;

Aids in the prevention and control of communicable diseases through education and epidemiological investigations and performs case follow-up;

Participates in immunization programs; participates in quality improvement assessment and feedback activities to raise immunization coverage levels; facilitates provider education programs to maximize office-based immunizations;

Participates in clinics, provides nursing services in community programs, and visits homes to provide nursing care and treatment under medical direction and/or nursing supervision;

Takes patient history, collects specimens, performs physical examinations, and provides treatment, counseling, and education;

Participates in or provides staff in-service education and community education;

Maintains records, prepares reports, and participates in audits, process improvement, and quality assurance programs;

Supervises the care given by other staff such as Licensed Practical Nurses, Medical Assistants, and Outreach Workers;

Participates in agency committees;

Coordinates agency services and community resources for patient care; coordinates home health care, hospice, and maternal/child health referrals with hospitals and other medical institutions; coordinates inter-disciplinary case conferences;

Assists in the assessment of the health of the community; promotes the wellness of the individual, family, and community; participates in community activities and public relations, as needed;

May provide nursing services for patients requiring specialized treatment such as pediatric, pre-natal, and communicable disease control;

May inventory and order vaccines and dispense medication and/or vaccines under standing orders of a physician;

May assist with writing clinical nursing public health policies and procedures;

May precept new staff, nursing students, and other students from allied professional health areas;

May be required to play an active role in providing basic health care needs in the event of a public health emergency;

May be assigned to serve as a member of a Disaster Recover/Business Resumption Team, Incident Response Team, or similar public health response team which may include the conduct of operations on a 24/7 basis at remote locations, as per the applicable bargaining unit contract.

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(Any one position may not include all of the duties listed, nor do the examples cover all of the duties that may be performed.)