Adding Diversity to the Ranks of Public Health Nursing Leadership: Q&A with Shirley Orr, MHS, APRN

Nov 19, 2014, 11:39 AM

Today at the American Public Health Association annual meeting in New Orleans, Shirley Orr, MHS, APRN, a Robert Wood Johnson Foundation Executive Nurse Fellow and public health consultant, and Doris Brown of the Louisiana Department of Health, will be talking about opportunities for nursing leaders to implement the recommendations of a 2010 Institute of Medicine Report entitled “The Future of Nursing.” This report looks at ways that the nursing profession can transform itself in order to better align with population health and more effectively collaborate to create a healthier overall population.

NewPublicHealth recently spoke with Orr about how nurses can help improve community and population health. This interview has been lightly edited for clarity and length.

NewPublicHealth: What does the nursing profession need to do in order to align itself with a focus on population health?

Shirley Orr: A couple of things in particular that stand out are education and diversity. We recently did a public health nursing enumeration that was funded by the Robert Wood Johnson Foundation, and we found two things in particular relating to the recommendations. First, that overall, public health nurses need new skills and they need higher levels of education to be able to function more collaboratively and within collaborations—both within health care and with other community partners.

Second, we found that nationwide, the demographic profile of public health nurses does not look like the population that we serve. Ethnic minorities are very much underrepresented among public health nursing—particularly in leadership roles.

We have a very urgent need to recruit more nurses of color into the ranks of public health nursing leadership.

NPH: Why is that necessary?

Orr: A core component of nursing curriculum today is culture competency. That being said, we also know that having nurses who understand populations very, very deeply by having a frame of reference for that population and being a member of that population really are able to help to get the highest level of engagement from the population. They’re also best prepared to understand the culture, the needs, the motivations about populations, so they’re really best positioned to be able to carry out in partnership strategies that are going to make a difference long-term in the health of populations. 

We’re actually doing the poorest in terms of Latino representation among public health nurses, which is especially important given that Latinos are such a growing group within our overall population. We really do need to do some targeted recruitment, scholarship opportunities to identify nurses and then hopefully to develop them into leaders for public health.

We’re excited because the Campaign for Action, which is a Robert Wood Johnson-funded initiative, has had a particular focus on increasing the overall diversity of the nursing workforce.

One of the things we’re highlighting in our presentation at APHA is how important it is for public health nurses nationwide to become engaged with their state action coalition so that they are able to work to help transform public health nursing so that it is more effective and more relevant for the future.

We really need to extend public health nursing into the rest of the health care system so we can help move toward a Culture of Health and we need to diversify public health nursing at all levels of practice.

We really do feel that public health nurses, can be champions for bringing more inter-professional collaboration to health care because they have one foot in health care and one foot in public health. They can help to bridge those practice areas and create more momentum around those collaborations to bring health care and public health closer together.

NPH: Any final thoughts?

Orr: I really see great potential when public health nurses engage more deeply in their state action coalition. Those coalitions are part of the future of nursing and we have a huge need and opportunity to get public health nursing to the table and to be leaders in their states’ action coalition.

Health care is changing very, very dramatically—specifically away from solely providing care for individuals who are ill or have suffered some sort of an unintentional injury. In the future, that’s still important, obviously, but health care is really adopting a stronger focus on population health and not only keeping populations healthier, but how we move the needle on the overall health of our entire population. That’s what public health is and always has been about.

Go here to learn more about the Robert Wood Johnson Foundation’s focus on public health nursing.

This commentary originally appeared on the RWJF New Public Health blog.