Are You Considering a Career in Public Health Nursing?
Marni Storey, BSN, MS, is interim director of Clark County Public Health in Vancouver, Washington, chair-elect of the Washington State Association of Local Public Health Officials, and a Robert Wood Johnson Foundation Executive Nurse Fellow (2013-2016).
I am often asked if I recommend public health nursing as a career option. My enthusiastic answer is ABSOLUTELY! I have been a public health nurse for more than 25 years and am one of a very few Americans who wakes up every day believing I have the best job in the world. There are many reasons I enjoy this profession, but three important pillars of public health nursing have kept me engaged for more than 25 years, and will keep me enthusiastic for many years to come.
The first pillar is that public health nursing services—including nursing assessment, intervention, and evaluation—are focused on a population, not on individuals. Whether you are interested in women, children, ethnic or cultural groups, or if you are interested in conditions such as HIV/AIDS, communicable diseases or obesity, the strategies used by public health nurses affect entire communities. While challenging, this population focus is also rewarding because, as a public health nurse, you are developing an understanding of an entire group of people or community in order to effectively carry out your nursing duties. This is very different from the individual relationships you develop in other nursing fields. Also rewarding is the chance to witness community transformation as a result of the collective impact of communities working together.
The second reason I believe this is a special field is because public health nursing is grounded in prevention and social justice. In public health, we address health issues using upstream primary prevention. Prevention at this level means addressing problems by asking ourselves what is the root cause of the problem and how can we prevent it. Using epidemiology and research, we are developing and testing interventions that address social determinants of health including poverty, housing, education, racism, adverse childhood experiences, and access to quality health care. By addressing these social determinants of health, public health nurses are also promoting social justice. Like our nursing pioneers of the past, including Lillian Wald, public health nurses recognize that until we eliminate inequality, health for all is unattainable.
A third reason I encourage people to consider public health nursing is that community-based interventions used by public health nurses have amazing reach and impact. Almost every strategy has potential to improve multiple health outcomes. For example if a public health nurse is working in a community to reduce obesity by improving access to healthy food—e.g., as part of a public health team developing community gardens or influencing city development planning to ensure opportunities for physical activity—than the team may also be reducing the risk of youth violence and child abuse while improving health for seniors and addressing climate change. As another example, if you are working to improve pregnancies and births or reduce child abuse and neglect, you are also increasing the likelihood of the parents’ economic success, the child’s success in school and future employment, and reducing future risks for depression, substance abuse, and chronic conditions like obesity and heart disease.
So how does all this come together in the life of a public health nurse? Examples of a typical day providing community-based care include working with a group of neighborhood residents to secure space for a community garden, and resources to plant and maintain the garden. A public health nurse may also help connect parents to school administrators to negotiate use of their playground as a safe place to play, or organize a park cleaning event in a low-income neighborhood. A public health nurse may testify at the local planning commission about the importance of safe sidewalks and open spaces for healthy living. Another public health nurse may be making home visits to provide anticipatory guidance to a pregnant teenager or helping a new parent find resources for her child with special needs.
Yes, I sound a little sappy about public health nursing, but I cannot think of another field where there is so much personal opportunity for growth and leadership that can have such profound impacts on the lives of so many!
Read more about the Robert Wood Johnson Foundation’s work on public health nursing.