Public health nursing--the opportunity of a century.

Abstract

This year marks both the completion of a century ofpublic health nursing in the United States and the beginning of national health care reform. Public health nurses across the nation are wondering what these major turning points mean for them in their practices. An even more central question is, How can public health nursing best be used to advance the public health mission, particularly in the face of health care reform? This is not a question for nurses alone. Rather, it is a question for health departments, public policy experts, and communities as they seek to ensure the health of the people in a rapidly changing, unpredictable system of health services.Perhaps this question is best answered by considering some ofthe lessons learned from a century of public health nursing services. First, we have learned that public health nurses are "functional."That is, the form oftheir practice has from the beginning followed the functions required by society.' Lillian Wald's found-

Community-Oriented Primary Care: A Model for Public Health Nursing

“…The centennial celebration for public health nursing occasioned several special articles (Salmon 1993;Zerwekh 1993;Reverby 1993;Buhler-Wilkerson 1993) that praised the work of public health nursing and then challenged the profession to advance its public health mission. Authors expressed concern that public health nurses had been diverted from their central roles in assessment, surveillance, policy, health promotion, and disease and injury prevention activities.…”

“…Nurse leaders who honored the legacy of the founder Wald supported a vigorous role for public health nursing in a reformed health care system (Salmon 1993;Zerwekh 1993;Reverby 1993;Buhler-Wilkerson 1993). One advocated public health nurses becoming a "centerpiece for a workforce that will move health departments forward in .…”

“…Five years after the initiation of the urban demonstration project in 1988, public health nursing celebrated its centennial (1993), thereby prompting its leaders to examine their profession's roots, mission, and role in the future (Salmon 1993;Zerwekh 1993;Reverby 1993;BuhlerWilkerson 1993). By the end of the decade, the national Public Health Functions Project published its preliminary recommendations for public health nursing (Gebbie and Hwang 2000).…”

Preparing currently employed public health nurses for changes in the health system

“…Public health nurses require additional skills in assessment, policy development, and assurance to provide both public health practice at the community level and populationbased individual health care services. 11,12 These needs have been described well in such recent documents as the Public Health Nursing Section of the American Public Health Association (APHA) statement on public health nursing practice 13 and an Association of State and Territorial Directors of Nursing (ASTDN) report that links nursing, public health core functions, and essential public health services.…”

Der Beitrag der Pflegeberufe zur Bevölkerungsgesundheit

“…Im Gegensatz zu heute ergab sich das Tätigkeitsfeld nicht primär aus der Frage, was eine Krankenschwester zu tun oder zu lassen hatte oder welche Rolle sie im Gesundheitswesen einzunehmen hatte, sondern aus den wechselnden Notwendigkeiten und Bedürfnis-sen der armen Bevölkerungsschichten. "The profession of public health nursing was created in response to the social, political, economic and environmental forces that threatened the health of Americans a century ago" [16].…”