THE ROLE OF NURSING IN PUBLIC HEALTH Sarah Coulter Danner MSN CPNP CNM Chairperson, Department of Nursing Oglala Lakota College

Definition of Public Health Nursing Public health nursing is the practice of promoting and protecting the health of populations using knowledge of nursing,social and public health sciences

Systematic Approach 1. Assess the health and health care needs of a population in order to identify sub-populations, families and individuals who would benefit from health promotion or who are at risk of illness, injury, disability or premature death 2.Develop a plan with the community to meet the identified needs taking into account available resources

Systematic Approach 3. Implement the plan at the community, family or individual level 4.Evaluate the impact of the intervention 5.Use the results of the evaluation to influence and direct current delivery of care, deployment of health resources and the development of local, state and national health policy and resources to promote health and prevent disease.

Role of the Public Health Nurse To: Provide input to interdisciplinary programs that monitor, anticipate and respond to health problems in population groups for all diseases or public health threats including bioterrorism To: Evaluate health trends and risk factors of population groups to help determine priorities forming targeted interventions

Role of the Public Health Nurse To: Work with the community or specific population groups to develop targeted health promotion and disease prevention activities To: Evaluate health care services To: Provide health education, care, management and primary care to individuals and families who are members of vulnerable populations and high risk groups

Public health nurses integrate community involvement and knowledge of the entire population with the personal clinical understandings of health and illness gleaned from the experiences of individuals and families within the population.

The nurse working in public health should be a voice for members of the community to voice problems and desires

The public health nurse can apply her knowledge of strategies to choose the intervention(s) that meets the needs of a particular community, family or individual

The nurse is the agent who translates and applies the knowledge of health and social sciences to individuals and population groups through specific interventions, programs and advocacy

He or she also articulates and translates health and illness experiences of diverse, often vulnerable, individuals and families to the health planners and policy makers

Standards of practice have been established by the American Nurses Association

The Quad Council, made up of four public health nursing organizations, has established core competencies

These competencies reflect an agreement by the Quad Council that the public health nurse requires preparation at the baccalaureate level.

However, in many states nurses doing public health work are not baccalaureate graduates.

Even early on, the shortage of nurses affected the hiring of BSN or MSN prepared nurses. Public health departments could not compete with hospital systems.

The specialist level competencies require preparation at the Master’s level in community and /or public health nursing.

Associate degree RNs need extensive orientation and education to achieve the competencies.

Having said that, with the shortage of nurses continuing and getting worse over the next decade what can we do as nurse educators to ensure that some public health framework is included in curriculum at the Associate Degree level?

We bring some statistics to the attention of our students.

In a recent government funded study at the Harvard School of Publlic Health, Dr. Christopher Murray stated that the five counties with the lowest life expectancy were all in South Dakota and three of the counties make up the Pine Ridge Indian Reservation.

Shannon, Bennett and Jackson Counties have a 66.6 year life expectancy. These are the counties that comprise Pine Ridge Indian reservation. Todd County part of Rosebud Indian reservation has the same life expectancy.

In Clear Creek County in neighboring Colorado a person can expect to live to 81.3 years.

Even with the five counties with the lowest life expectancy in the US, South Dakota placed 18th in state ranking with a life expectancy of 77.7.

What conclusions can be drawn?

These are statistics that mean something to our students These are statistics that mean something to our students. This is home to most of them.

A brief introduction to statistics helps these students to interpret data that describes the incidence of Type 2 Diabetes, heart disease, obesity, immune system disorders, cancer, suicide, depression and MVAs

They all have relatives with at least one of these diseases.

Community Service Projects that impact pieces of this morbidity and mortality.

Creating an awareness

An important piece of service learning is the student’s reflections and how it changed their lives and their view of their community

N. 218 Foundations of Holistic Nursing Care –Fall Semester Each student will complete: 10 hours- Case Study of elderly individual within the community- home or assisted living facility Comprehensive health assessment Nursing diagnoses Assessment of medications and environment Process recordings

N. 224 Maternity Nursing “Shadow “visit with Community Health Nurse for Postpartum/Newborn visit Nursing student then makes one home visit on a new postpartum mother and her newborn and makes an assessment.

SIDS, postpartum depression,imunizations

Nursing 234: Students spend time serving in a nearby soup kitchen and at the Pine Ridge jail for this course on mental health imbalances

Reflections

In Nursing 324 the topic for the term paper must be taken from the Healthy People 2010 Objectives.

In this course focusing on the wholistic health of children and their families, the students must, in pairs or small groups, prepare and present an educational session to parents or the targeted children concerning an area of risk to their health such as the prevention of tooth decay, promotion of self esteem, nutrition and activity, preventing STI’s, accidents in the home or car safety.