The last time you went to get your flu shot, or had the school nurse check your child’s eyes, or had questions about your elderly mother’s care, did you ever stop to thank a public health nurse?
That is ok if you didn’t, because public health nurses tend to work a great deal behind the scenes, as they enact policy, direct change and promote good health in quiet discussions with families and stakeholders. They are usually happy to remain working on the ground, such as at health clinics in rural areas, discussing health with high school students, as well as the dangers of tobacco. They often screen children for hearing problems, and study which health programs are most effective.
The job of a public health nurse is very important and is very respected, as well as well paid (see chart), but it is mostly an unheralded role in health care that does not get much attention. And actually, this is how most public health nurses really want it.
But now that the Affordable Care Act is coming online and is going to bring a lot of health care changes, the profession is going to start to play an even bigger role in ensuring that the well stay well and the sick get better.
We are starting to shift from illness care and are focusing more on health promotion and prevention. So, there is a growing need for generalists in the public health nursing field. To attract more professionals to this field, it is important for people in the field to talk louder about the important work that these nurses do. They should talk about why the work is important, how it is highly fulfilling as a profession and is very important to the future of America.
One of the problems with the public health nursing field is that these professionals tend to work quietly and in the background. So, they often are the first ones to get funding cut when budgets get tight.
Even though the Affordable Care Act is pushing for more funds for disease prevention and providing more preventive care, doing financing for health promotion and prevention of disease is difficult and tricky because it is not that ‘sexy.’ It is very important work but it does not have the drama of medical shows on TVs.
But as we all know, the drama that you see on TV really does sell. In 2012, it was found that only 3% of health care dollars are used to prevent disease. But dealing with the consequences of chronic diseases that can be prevented costs the nation $7900 per patient. that is more than a trillion dollars to cover the 134 million Americans who have a chronic disease. Those costs are per year, by the way.
An investment of only $10 per person each year could save us over $2 billion in health care costs in about two years. That would be more than $18 billion a year in 20 years.
But many public health programs often have their budgets cut because wellness programs do not have the drama of being sick. One study found that the numbers of registered nurses that are employed in community and public health was cut by 50% by 2008.
But we always need to remember how important the work is that public health nurses do every day. The good news is that the American Nurse Association is publishing a new report called Public Health Nursing: Scope and Standards of Practice. This is a report that has 70 pages of standards of practice and professional performance for public health nurses, and it will tell us how public health nursing is moving forward and is helping to keep people healthy.
The nursing shortage affects all areas of the health care system, and public health nursing is no exception. Fortunately, with efforts such as those noted above, and new nursing programs, such as the new nursing program at UT Arlington with federal funding, we can start to fill the demand in this essential profession.