In Some Ways, All Nurses Are Public Health Nurses, RWJF Scholar Says
By Alison Colbert, PhD, APRN, BC, Assistant Professor, Duquesne University School of Nursing, Robert Wood Johnson Foundation Nurse Faculty Scholar (2010-2012)
I knew I never wanted to work in a hospital. I have deep respect for nurses and all health care providers who do (a respect that deepens every day, as the health care system changes and evolves), but it just wasn’t going to be the place for me.
I’d been working with people living with HIV/AIDS for five years and my motivation for becoming a nurse was to do that work better. My plans to eschew hospital nursing unnerved my peers and some of my nursing faculty. Why didn’t I want to be a “real” nurse, they asked? (This question is tangentially related to the ones I got when I decided to pursue a PhD in nursing: If I wanted to be a doctor, why didn’t I go to medical school? But that’s a different story.)
To be honest, while I was sure I didn’t belong in a hospital, I wasn’t exactly certain where I did belong. So I started to look around. Turns out, if you start looking outside hospitals, nurses appear in the most interesting roles—some of them in “official” nursing positions, and others in positions where talented and smart individuals have brought nursing perspectives to non-nursing roles.
Public health and community-based nursing quickly became my passion as I watched nurses respond to infectious disease outbreaks, treat communities and populations, and provide care for individuals and families. What I saw was real nursing happening in a variety of places outside the hospital. Nurses in communities were responding to health challenges right there—in homes, neighborhoods, and in the shared community spaces of the people they sought to serve.
Once I had a name for the specialty, I started to look into public health and public health nursing. I learned about the complexities of surveillance, the nuances of public health policy, the enforcement of laws meant to keep our communities safe, and the overarching commitment to protect public health.
I learned about Lillian Wald (who coined the term “public health nurse,”) the Henry Street Settlement, and how even in the late 1800s and early 1900s, some true visionaries understood the connection between poverty, racism and health. A lot of what I learned about the later years of the specialty centered on the role of public-health workers at the local, state and national levels.
My respect for those professionals increases daily—especially now, as we are losing our public health workforce at a terrifying rate. I took on the identity of community/public health nurse, and I haven’t looked back since.
My current work focuses on the health care needs of women as they are released from jail. As a Robert Wood Johnson Foundation (RWJF) Nurse Faculty Scholar (2010-2012), I’ve met inspiring leaders in health and health care: physicians, researchers, public policy specialists, and nurses.
In an address to RWJF Nurse Faculty Scholars at a meeting earlier this month, John Lumpkin, MD, MPH, senior vice president and the director of the Health Care Group at RWJF, talked about an important conceptualization of public health provided by the Institute of Medicine (IOM) in its 2002 report on the Future of Public’s Health in the 21st Century. He called government the backbone of public health, but cautioned that this requires meaningful collaboration from all sectors of the community—practitioners, health care organizations, businesses, nonprofits, academics, media, etc.—in order to meet our shared goals.
If we want to secure healthy futures for Americans, the many different roles that nurses play must complement each another and create a vision for health and health care that is just and equitable, that eradicates disparities, and that gives voice to the vulnerable among us.
All nurses, regardless of where they practice, are part of this team. All nurses, it turns out, are public health nurses.