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Review: Ready, willing and able? Specialist community public health nurses’ views of their public health role

For at least 30 years nurses who work in community settings have struggled to clarify the specifics of their roles and practices, and the research reported in ‘Ready, willing and able? Specialist community public health nurses’ views of their public health role’ adds substance to the dialogue. In some discussions in the United States, the terms ‘community health nurse’ and ‘public health nurse’ have been used as synonymous, and at least one edition of the standards for professional nursing practice grouped all forms of nursing practice outside of hospitals and similar institutions together. More recent dialogue has made the distinctions clearer: there are many nurses who practice in community settings, providing individuals and families with clinical nursing care; other nurses who practice in communities are applying public health skills to the health of the whole population. The challenges to clarity come from at least two sources: the preparation of the individual nurse and the nature of position expectations. At least in the US, the focus of training and clinical experiences outside of hospitals or other inpatient settings may have been primarily provision of home health services or other individual services associated with treatment of a specific incidence of illness. While the students learn a great deal about providing care in a setting with less technical support, and in one controlled by the patient or family rather than a health organisation, they may not have learned much about public health, that is, how to work with groups and institutions to develop conditions in which people can become or stay healthy. The research reported here makes clear that this latter population focus is the goal of the specialist community public health nurses, although they experience frustrations, wish to have more resources and more interdisciplinary understanding and support. The second challenge to clarity is in part inherent in the nature of public health nursing practice and the expectations associated with such jobs. Among the professions practicing public health (medicine, nursing, environmental science, health educators among others),