Integrating environmental health into an undergraduate community health nursing course

Nurses are often the first members of the healthcare system to whom the public turns when environmental health hazards cause concern. Yet most nursing programs include scant formal environmental health content. This article describes a project that integrated significant environmental health content into an undergraduate community health nursing course. The revised course included additional environmental health classroom content and field experiences. Details are provided regarding changes to classroom content, revision of written assignments to include environmental health issues, planning and implementation of nursing student field experiences with environmental health professionals, and evaluations of the revised course. The article concludes with three recommendations to guide other schools of nursing, wishing to integrate environmental health into their curricula.     

Development and testing of a practicum matching program for baccalaureate nursing education,a local public health unit

This article describes a novel approach to nursing education, designed to improve the experience of both students in public health nursing, and the local public health unit where they affiliate. Students, faculty, and public health department staff developed a method for matching programs and needs of the local public health unit to the skills and learning needs of nursing students. We describe our experience articulating student competencies, program-specific functions, and an approach to matching student interests and learning opportunities to agency needs. Students, faculty, and staff rated the program moderately to very high in feasibility, satisfaction, and acceptability. Data suggest the novel program served to improve the quality of the practicum affiliation, to the satisfaction of both the school and agency, while contributing to a robust public health learning experience for emerging professional nurses.     

Factors associated with the professional competencies of public health nurses employed by local government agencies in Japan

OBJECTIVE: This paper aims to clarify some of the factors associated with the professional competencies of public health nurses (PHNs) employed by local government agencies in Japan. DESIGN: A cross-sectional study. SAMPLE: PHNs (N=1,614) working in local government agencies in Japan. MEASUREMENTS: Based on self-reported questionnaires, the nurses were grouped according to experience. Statistical differences between the groups were analyzed using analysis of variance. Multiple regression analyses were used to determine associated factors. RESULTS: Variables contributing to high self-evaluation of interpersonal health support competencies were length of experience as a PHN, an awareness of the role expectations of community health support and administration, marital status, and participation in off-the-job training programs. The same variables contributed to high self-evaluation of community health support and administration competencies. In addition, experience of job transfer or rotation was found to be a variable. CONCLUSIONS: These results show the importance of off-the-job training programs designed to foster exposure to a wide variety of personal and professional experiences. They also illustrate the importance of planned on-the-job training programs that promote an understanding of the nature of the field, as well as developing planning and administrative competency in career development.     

Using a digital storytelling assignment to teach public health advocacy

The need and expectation for advocacy is central to public health nursing practice. Advocacy efforts that effectively call attention to population health threats and promote the well‐being of communities rely on strategies that deliver influential messaging. The digital story is a lay method to capture meaningful, impactful stories that can be used to advocate for public health concerns. Readily available, user‐friendly digital technologies allow engagement in digital media production to create digital stories. This paper describes how digital story making can be utilized as an academic assignment to teach public health advocacy within an undergraduate nursing curriculum. Providing nursing students this artistic outlet can facilitate meeting academic learning goals, while also equipping them with creative skills that can be applied in future professional practice. Nursing educators can take advantage of institutional resources and campus culture to support the use of novel digital media assignments that facilitate application of advocacy concepts.     

Hints for the Aspiring Public Health Nurse

ABSTRACT The original article from which these excerpts were taken, “Some Hints to the Nurse Who Seeks to Become a Successful Partner in the Community Health Program,” by Mary Margaret Muckley, was published the 1923 volume of the original Public Health Nursing journal. The paper listed practical pointers to nurses wanting to work in the area of public or community health nursing. The author's advice involved personal attributes, professional engagement, skills, effective organization, and community relations. Much of the original article contained sound advice for aspirants to nursing work in community settings, but some advice may be considered too idealistic even for this optimistic time period. While the particular references to organizations and agencies existing in Helena, Montana have been omitted, the nurse reading the paper in 1923 had a general guide to her key stakeholders. The excerpts from this paper may give contemporary readers an appreciation of the endurance of what Muckley terms the public health nurse's “Valuable Assets.”     

Partnerships for learning population-based public health nursing: Web-delivered continuing education for public health nurse preceptors

Public health and other community health nurses frequently serve as preceptors to undergraduate student nurses learning population-based nursing in community/public health practicum courses. The extent of preparation and support for the preceptor role provided by schools of nursing is often limited. One strategy to address this problem is to provide targeted, Web-delivered continuing education (CE) to preceptors. A Web-delivered CE course entitled, "Partnerships for Learning Community Health Nursing," was created and pilot tested. Course content includes preceptor roles; assisting students in learning population-based public health nursing, critical thinking, and cultural competence; learning styles and teaching strategies; what to do in challenging situations; evaluation and feedback; and specific information about school policies, procedures, and course assignments. Precourse knowledge was assessed using a mailed survey. Postcourse knowledge and satisfaction were assessed using questions embedded in the course. Postsemester knowledge and satisfaction were evaluated through a postsemester survey. Knowledge gain was tested using repeated measures ANOVA and paired t tests. Thirteen preceptors participated in the pilot test. Repeated measures ANOVA indicated that knowledge gain occurred (multivariate F=55.603, df=2, error df=11, p<.0001). Participants increased knowledge from pretest to posttest (t=-10.25, p<.00001) and from pretest to end of the semester (t=-4.95, p<.0003). Knowledge decline from end of course to end of semester was not significant (t=1.94, p=.08). Participants reported satisfaction with the course. Web-delivered CE for community/public health nurse preceptors can support preceptor learning and is an acceptable method for receiving this type of education. Further research is needed on the impact of preceptor education on student learning.     

Moving upstream: Becoming a public health nurse, part 2

This article extends the argument in Part 1 that stand- ards, protocols, textbook knowledge, and other external guidelines, while important for beginners, must yield to the "real world" of practice. Additional narratives document how the development of practical reasoning, perceptual skills, and responsiveness to clients supplants the beginner's reliance on external guidelines and promotes a situated understanding of practice. This growth in understanding and clinical know-how, cultivated by frontline experience with individuals and families, fosters a perceptual grasp of the "big picture" and makes it possible for the nurse to learn the community through the eyes of clients. Experiences from home visiting and community-based activities provide critical lessons that inform and inspire nurses to act and think upstream. This interpretation provides additional evidence for legitimizing clinical practice as a rich source of situated knowledge and clinical reasoning.     

A crosswalk of foundational BSN population health documents and the AACN essentials

To guide the development of entry-level nursing education, the American Association of Colleges of Nursing (AACN) published the Essentials document in 2021 with a broadened scope of competencies. Community, population, and public health (CPPH) nurse educators use a number of foundational documents to crosswalk for gaps in the AACN principles, highlighting the need of including these contemporary documents within the baccalaureate CPPH nursing curriculum. In this crosswalk, the authors highlight important capabilities and knowledge exclusive to these fundamental documents and tools, as well as the relevance of these competencies and knowledge to CPPH baccalaureate nursing education.     

Public health nursing competencies 1953-1966: effective and efficient

The Quad Council of Public Health Nursing Organizations developed public health nursing competencies in 2003. They are guides for determining skills at two levels, and they identify public health nurses as providing care to individuals and families or to populations and systems with the nurse having proficiency, awareness, or knowledge. The primary purpose of this paper is to discuss historical nursing roles and qualifications as judged by the 2003 competencies, including educational preparation and experience for the administrative and staff nurse. The historical exemplar for the nursing roles is a combination public/private nursing association, referred to as the partnership, that took place in 1953-1966. Primary sources include archived material from the Instructive Visiting Nurse Association, Richmond, VA. Administrative responsibilities were divided between the chief nurse and the nursing supervisors. Staff nurse responsibilities included clinic activities, home visitation, and referral coordination between health care organizations. The delineation of nursing roles demonstrates nurses' meeting the 2003 competencies. Based on the Quad Council's 2003 public health nursing competencies, the partnership nurses were competent.     

A case study of a distance-based public health nursing/community health nursing practicum

Facilitating a distance-based public health/community health nursing practicum for RN to BSN students posed challenges and opportunities. Challenges included time involved in arranging the practicum, relationship building with agencies and staff, communicating with students, and the need for flexible practicum scheduling. Exposure to practice models from across the nation allowed students to compare and contrast these public health nursing models. Programs planning to offer this type of course should consider faculty workload particularly during the semester prior to teaching the practicum.     

Use of PHN competencies and ACHNE essentials to develop teaching-learning strategies for generalist C/PHN curricula

This paper provides a useful tool for the undergraduate community/public health nursing (C/PHN) faculty member to design courses and learning activities, and to interpret C/PHN education needs to undergraduate curriculum committees and administrators. Specifically, this paper provides a tangible bridge between the Public Health Nursing Competencies (Quad Council of Public Health Nursing Organizations, 2004) and the Association of Community Health Nursing Educators (ACHNE) Essentials of Baccalaureate Education (2000) for both didactic and clinical learning experiences. The tables may be used in multiple ways, including curriculum monitoring and improvement, course development and instructional design, clinical practice planning, and as a foundation for evaluation of conceptual learning and practice competence for the C/PHN generalist. Because C/PHN experiences in undergraduate education are unique and context based, the tables exemplify how two key guiding documents mutually frame the C/PHN educational experience supported by specific learning activities. Further, at a minimum, MSN preparation as a C/PHN specialist is clearly necessary for the teaching and learning of baccalaureate curricular components of C/PHN.     

Graduate education for advanced practice public health nursing: at the crossroads

The complexity of public health problems and advancement of science framing public health demand an expansion of traditional educational approaches and curriculum to prepare a futuristic advanced practice public health nursing (APPHN) workforce. This position paper sponsored by the Association of Community Health Nursing Educators challenges nurse educators to apply innovative strategies in preparing public health nursing (PHN) professionals and to expand curriculum paradigms to promote PHN's ecological approach to solving problems. To meet the challenges of ensuring public health in the 21st century, advanced practice public health nurses must have greater foundational knowledge in critical content areas discussed in this document. Competence in these areas will enable advanced practice public health nurses to address future health care challenges such as rapidly changing social structures, escalating knowledge explosion, globalization, and growth of new technologies. This education will prepare nurses to forge new knowledge and establish health care teams to create effective solutions.     

Use of health fairs to develop public health nursing competencies

This paper describes a community-campus partnership for health education established through the effort of faculty, students, and the community. Health fairs designed to address issues of concern to a community agency were originally conducted with nursing students. This partnership between nursing and a community was expanded to include social work, physical therapy, and medical students. A shared learning experience was structured through the presentation of health fairs in collaboration with agencies in Burlington, Vermont. One goal of nursing education is to produce professionals who have the beginning competencies of public health nursing. Reflection on the process, relationships, and outcomes of the health fairs revealed that students attained these beginning competencies in all eight public health nursing competency domains. Combining community-campus partnerships and an interdisciplinary focus enabled nursing students to become more responsive to community needs and to learn to work collaboratively toward creating healthier communities, thus building skills required for public health nursing.     

Overcoming barriers and improving public health nursing practice

Public health nurses (PHN) are critical to ensuring the health of communities. Absent the most basic information on the PHN workforce in our state, we conducted interviews with 21 PHN and school health nurse (SHN) leaders and an online survey of PHNs and SHNs practicing in Maryland (N = 491). Our study identified an older, very experienced, and well-educated workforce. Both the interviews and survey identified similar barriers: low salaries, recruitment and hiring challenges, limited funding for public health programs, and no opportunities for education or career advancement. Survey participants also identified barriers of inadequate leadership, recognition, and communication including PHNs not being represented at decision-making tables or at the state leadership level. Strategies to promote public health nursing from leaders and survey participants were similar: increasing awareness about what public health and PHNs do and their value; improving advocacy and stakeholder engagement; improving access and availability of services; improving PHN leadership representation at the state level; a improving PHN salaries and benefits including tuition reimbursement. Although results were similar to national studies, comprehensive, granular workforce data is critical to ensure the public health workforce can meet current and emerging public health needs and that public health infrastructure and services are appropriately funded.