Public health nursing - vaccination clinic
Career Resources

The Crucial Nature of Public Health Nursing

Public health nursing is a vital part of the health system that helps keep our country’s citizens healthy. While much of their work may go unnoticed, public health nurses (PHNs) and their colleagues continue their sometimes underappreciated interventions behind the scenes.

Public health nursing may not be as high-tech and trendy as the ED or ICU, but we can’t deny its importance to every citizen. According to the Association of Public Health Nurses (APHN), PHNs are the largest segment of the professional public health workforce.

The APHN states, “Public health nurses have always been, and must continue to be, catalysts and change agents.” But what does this mean in the complicated context of real-life issues facing the most underserved communities? PHNs take education into communities and meet people where they are, discussing in real time how public health initiatives can improve their health and lives.

What Are Public Health Nurses?

Public health nurses are registered nurses or licensed practical/vocational nurses who promote and protect the health of communities. They’re often referred to as community health nurses, with the two names used interchangeably. PHNs advocate for better health outcomes and changes in healthcare, usually for specific patient populations. They work directly within communities, providing education and tools for people to improve their health outcomes.

The public health nurse role began as early as 1893. The Henry Street Settlement, established in 1893 by nurse pioneer Lillian Wald, was an early example of public health nursing at its finest. Wald focused on the well-being of women, children and families on the Lower East Side of Manhattan. Henry Street’s impact was profound on safe playgrounds, establishing the first public school nurse position, summer camps, visiting nurse services, establishing a mental health clinic and much more. Still functioning today, Henry Street is a model for nurses who work closely with their community.

What Does a Public Health Nurse Do?

Public health nursing patients

PHNs serve in many areas, are integral in preventing diseases and reducing health risks, and play a critical role in public safety. For example, educating people on clean water and air, performing vaccination and disease surveillance and talking about laws enforcing bicycle helmets, motorcycle helmets and seat belts all fall under the banner of public health.

However, the primary role of a public health nurse is to promote public wellness. This promotion may include assisting underserved or at-risk patients and helping them access care. By interacting directly with vulnerable, high-risk populations, PHNs can be agents of change to improve health outcomes for those that would benefit the most. They take broad public health measures and distill them into actionable items for individuals in various settings.

Public health nurses help improve access to care and adherence to public health directives, like vaccination campaigns. They go directly into neighborhoods and educate citizens on the benefits of specific vaccines. They may even have those vaccines available at a mobile set up and ready to administer. In other situations, the focus may be on health promotion, such as discussing the importance of helmets at a public safety event or the risk of tuberculosis after an exposure event.

Prevention of disease is another fundamental part of what PHNs do. Routine vaccinations are integral to disease prevention, as are educational programs and literature about smoking, pollution, bicycle safety and gun violence. Public health nurses are educators in the community, separate from the hospital system and able to intervene before a person interacts with a large health system.

The wide range of services provided by PHNs may also include:

  • Disease tracking and reporting
  • Case management of individuals with diseases like tuberculosis
  • Coordination with local agencies involved in food distribution, soup kitchens and support for the homeless or those experiencing food insecurity
  • Disaster response and emergency planning
  • Helping authorities identify victims of abuse and human trafficking
  • Managing public health budgets
  • Collaborating with private organizations and local, state and federal government entities
  • Working with politicians on health policies and regulations

Public health nurses have also been at the forefront of the COVID-19 pandemic, educating the public about vaccines, transmission, limiting exposure and when to seek treatment. The COVID-19 pandemic severely tested the capacity of the United States public health system, and PHNs were among those on the front lines of pandemic response. Public health nurses took charge of coronavirus testing and the distribution, administration and documentation of COVID-19 vaccines around the country. Additionally, PHNs served as infection control and prevention consultants and epidemiology experts.

Who Should Become a Public Health Nurse?

If you’re interested in educating the public and focusing on preventing disease, illness and injury, public health nursing may be for you. Also, if understanding the role of disease in your community and partnering with state, local and federal agencies to track and treat diseases like tuberculosis and STIs seems intriguing, you may find public health fascinating.

You must graduate from an accredited nursing program, pass the NCLEX and be licensed to work as an RN or LPN in the state where you wish to practice. While you may want to work in a hospital or care facility first, it’s unnecessary. Simply having the desire to work in an outpatient or community setting and working directly with at-risk or traditionally underserved populations helps you be successful as a public health nurse. A passion for health equity and health promotion is undoubtedly an advantage since these are fundamental to public health nursing in general.

If your goal is a job you enjoy with an excellent salary, public health nurses in permanent positions earned an average hourly rate of $37.24 nationwide in early September 2022. However, in some areas like California, the hourly rate rose as high as $79 in some positions. Salaries often hinge on experience and facility setting, with wage data varying from state to state. However, the overall average is on par with other nursing specialties. Public health nursing may offer more flexibility and independence due to the nature of the job compared to roles in direct care settings like an ICU or nursing home.

How Can PHNs Improve Health Equity?

Health equity strives for fairness, optimal health and well-being for all populations by eliminating disparities based on race, ethnicity, gender, gender identity, religion, sexual preference, geography, mental status and disability. Public health nurses are uniquely poised to advocate for health equity and work to eliminate health disparities because of their direct relationship with the communities they serve.

PHNs can connect people with resources they may need, including education, assisting with access to social services and providing direct care like administering vaccinations or assessing chronic and acute illnesses. It may be more on the organizational level, like setting up a wellness screening for diabetes or hypertension or addressing mental health needs in the community. With such a broad scope of practice, public health nurses can target their interventions specifically to the communities they serve and adjust their interventions accordingly.

Assisting underserved populations to tap into resources like food pantries, soup kitchens, safe housing and other services are activities that many PHNs find satisfying. Hunger, homelessness, human trafficking and violence can happen anywhere, and PHNs can make a difference by educating vulnerable populations and being change leaders in their communities.

Public health nurses are the backbone of public health in the United States. Without them, the health system lacks a preventative focus and instead would rely only on treating disease once after it occurred. Public health nursing is a rewarding and community-empowering role that allows for independence and productivity beyond what might be available in traditional hospital or facility-based nursing. It’s a truly rewarding and unique career choice within the larger world of nursing.

keith
Keith Carlson

Keith Carlson, BSN, RN, NC-BC, is a nurse, holistic career coach, writer, podcaster, and keynote speaker. He's conducted over 2,000 coaching sessions with nurses from all walks of life. His podcast, "The Nurse Keith Show", reaches nurses worldwide with fascinating interviews and messages of inspiration and career strategy. Keith lives and works in beautiful Santa Fe, New Mexico.

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