The Nurse’s Role in Global Health
With a total of approximately 3 million registered nurses (RNs) in the United States, these professionals play a prominent role in healthcare throughout the country. They factor even more significantly into healthcare delivery throughout the world, with an extremely significant number of about 32 million nurses across the planet. Nurses provide about 90 percent of healthcare services in the world, and for that, they deserve intense appreciation. With those statistics in mind, here is a look at global nursing as it currently stands.NURS 4115 – Role of the Nurse —Public and Global Health Essay Paper
The Nurse’s Worldwide Role
A world without nurses is almost impossible to imagine. Everywhere you turn, nurses are there to provide leading-edge treatments to patients from all walks of life. Nurses work in various settings, including wellness clinics, hospitals, schools, churches and businesses, and they work with people throughout the lifespan.
Why Nurses Matter in Global Health
In the United States, nurses have a rather clearly defined role. However, in many locations throughout the world, there are not enough doctors available to provide the care that people need. Luckily, there are nurses, and if it were not for them, these individuals would not receive any healthcare services at all. Nurses make a major contribution by addressing various health issues. Here is a short list of service situations or issues nurses might face:
Birth and Delivery: In various remote areas such as in rural Africa, there is not enough money to pay a doctor who can set up a practice. Or there may be other obstacles to having a local doctor. Fortunately, nurse-midwives are excellent in the role of caring for mothers before, during and after childbirth.NURS 4115 – Role of the Nurse—Public and Global Health Essay Paper
Primary Care: Also in rural, remote or poverty-stricken areas, physicians may not be available to provide primary care services, and nurses are there to deliver many of those services. One challenge these areas face is that the health conditions people have are often more complex and difficult to treat.
Cholera: Illnesses and diseases we rarely encounter in the U.S. can be problems in certain other areas of the world. For example, cholera is an issue in Haiti, so nurses there get the chance to help numerous people with that disease.
Tuberculosis: Nurses in Peru have been able to develop a program with the world’s highest cure rates for drug-resistant tuberculosis.
Partnerships and Collaboration
It is wonderful to see medical centers in various areas of the world collaborate. Here are two examples of innovative and resourceful partnerships:
The Dana-Farber Cancer Institute in the U.S. is working to create a nursing oncology partnership with an organization in Rwanda. Oncology nurses from the U.S. will work directly with Rwandan doctors and nurses to share knowledge.NURS 4115 – Role of the Nurse—Public and Global Health Essay Paper
Regis College in the U.S. is working with the Haitian Ministry of Health and PIH to address the shortage of nursing education in that country. The end result will be a three-year master’s program for Haitian nurses.
Nurses are leaders who make a positive difference by advocating for health and providing healthcare throughout the world. In many instances, despite their incredibly huge and generous contribution across the globe, nurses are treated almost as though they are invisible. They deserve to have a prominent voice when world leaders get together to address health issues and develop national and international policies. They also need more resources, such as for mentorships, leadership and nurse education. One way of receiving additional education and preparation is through online programs, and an online RN to BSN program is ideal for receiving high-quality education in an efficient way.
People who believe in the value of nursing should remind as many people as possible, as often as possible, about the value that nurses bring to the world. We need to advocate for nurses having a greater voice on the world stage. Their contributions to healthcare are already spectacular, but when they have a bigger platform, who knows how far they can go?NURS 4115 – Role of the Nurse—Public and Global Health Essay Paper
Global Health: The Role of Nursing Research
A decade ago, the Institute of Medicine defined global health as “health problems, issues, and concerns that transcend national boundaries, may be influenced by circumstances or experiences in other countries, and are best addressed by cooperative actions and solutions” (Board on International Health, Institute of Medicine, 1997). This definition continues to guide and shape the understanding of the role of nursing in advancing global health. More recently, Bunyavanich and Walk up (2001) identified a paradigm shift in which the concept of global health has replaced international health. The concept of global health acknowledges the interconnections of nations and the impact of geopolitical, social, and fiscal considerations on healthcare policy. In contrast, international health creates a distinction based on the border between a specific nation and other nations. Currently, the more inclusive concept of global health acknowledges the necessity of addressing socioeconomic disparities; global patterns of migration; redistribution of the healthcare workforce often to more affluent nations; environmental change; urbanization; and violence, whether related to war, terrorism, or security threats (McGill International Health Initiative, 2007). NURS 4115 – Role of the Nurse—Public and Global Health Essay Paper
Although nurses have been on the front line in addressing global healthcare problems and issues, relatively little has been documented about the contributions of nurse researchers and nursing research to global healthcare priorities. In delineating an agenda and framework for nursing research regarding global health, researchers may draw upon the overarching goals of the United Nations Millennium Project (2005). Global healthcare priorities are identified, with eight quantifiable goals and benchmarks to be achieved by 2015. The Millennium Project goals must be tempered against regional priorities. For example, goals related to promoting gender equality and empowerment of women may not be supported at the regional level. Thus, nurse researchers interested in advancing global health must be prepared to address the inherent tensions that exist between the regional and global priorities.
As nurse researchers collectively delineate priorities for nursing research, it is important to reflect upon the factors that may adversely affect the advancement of nursing research pertinent to global health. Two broad themes are presented: (a) lack of visibility and (b) limited support for nursing research regarding global health within the larger world of nursing science. NURS 4115 – Role of the Nurse—Public and Global Health Essay Paper
Visibility
Research conducted to address global health requires use of multidisciplinary and multinational teams. Although nurse economists, health analysts, and epidemiologists may contribute to this research, authorship of reports may be dictated by political and ideological considerations. For example, Dr. Mary Paterson of The Catholic University of America has conducted seminal work on strengthening of health systems in developing nations and in countries where the health system infrastructure has been damaged by war and political unrest (Paterson, Telyukov, Faraq, & Al-Shiakhli, 2003; Telyukov & Paterson, 2004; Telyukov, Paterson, Gotsadze, & Jugeli, 2003). Her research has not been recognized readily as nursing research because it is presented within the context of health policy and analysis as opposed to pure research and because it is published in venues such as technical reports commissioned by the World Bank and other global organizations instead of the nursing journals.
The visibility of nursing research regarding global health is influenced also by the way in which nurse researchers interested in global health are educated and socialized. The traditional academic preparation for a nurse researcher involves master’s-level preparation in nursing followed by either doctoral-level studies in nursing or a related discipline and, hopefully, postdoctoral work. However, nurse researchers interested in global health may opt for graduate education in public health, health economics, and health policy because the curricula are more responsive to their career goals. By branching into related areas at the master’s level instead of at the doctoral level, these researchers join a different community of scholars. Furthermore, lacking a master’s-level degree in nursing, their appropriateness for membership as nursing faculty requires specific justification to certain accrediting bodies and groups. Thus, they may face additional marginalization and devaluation of their contribution to nursing science. NURS 4115 – Role of the Nurse—Public and Global Health Essay Paper
Finally, some ambivalence may exist regarding the boundaries of nursing research. Although the richness of the diverse backgrounds of nurse researchers in the area of global health benefits the understanding of global aspects of nursing, some may also view their research as blurring or diluting the uniqueness of nursing research. Paralleling the discussion regarding the nature of global versus international health is a discussion regarding the nature of nursing research in an increasingly global environment versus global healthcare research of relevance to nursing.
Support for Global Health Research
The role of nursing research in advancing global health is limited also by the existing nursing research infrastructure. As a result, although nursing research has been used to address many health problems with a global component, additional follow-up studies are required to make the transition to a global health perspective. For example, U.S. nurse researchers have made a significant contribution to the understanding of factors influencing the risk of HIV/AIDS transmission and the subsequent development of behavioral interventions for risk reduction. Given the global nature of HIV/AIDS, this body of behavioral research is potentially relevant in regions of the world where HIV/AIDS is endemic. However, to tailor these interventions to specific regions of the world, additional research addressing the efficacy of these interventions within the context of horticultural and political factors and fiscal constraints is necessary.
In addition, research including subjects from other countries has often been patterned after the multi centered clinical trial model. As a result, homogeneity of study groups regardless of country of origin is a desired attribute, thus blunting the ability of the research to address complexities across nations. Thus, although this research is international, it is not global. Finally, nurse researchers interested in global health must aggressively pursue other funding avenues. Traditional funding sources such as the National Institutes of Health understandably give funding priority to research that addresses national healthcare issues. Similarly, only a small subset of private foundations and agencies funding nursing research, such as the Bill and Melinda Gates Foundation (http://www.gatesfoundation.org), promote research related to global health. NURS 4115 – Role of the Nurse—Public and Global Health Essay Paper
In conclusion, it is hoped that, through this initiative between Nursing Research and other journals, the hidden face of nursing research in global health will be appreciated more widely. Whether at the level of individual interventions, community action, or healthcare analysis and policy development, nursing research has an enormous yet unrealized potential to advance the global healthcare agenda. I hope that these statements about the limitations in the nursing research agenda will challenge nurse researchers to expand support of an increasingly global agenda.
The role of nurses in advancing global health
On International Nurses Day, SHOPS Plus recognized and celebrated the vital role private sector nurses and midwives play in ensuring that health services are delivered to those who need it most. Nurses are the backbone of many health systems, particularly in countries that face severe human resource shortages.
SHOPS Plus works closely with private nursing and midwifery networks worldwide to ensure this invaluable cadre of health professionals is strengthened to advance health priorities in family planning, HIV and AIDS, child health, and integrated primary health care. NURS 4115 – Role of the Nurse —Public and Global Health Essay Paper
The Nursing Leadership in Global Health Symposium brought together more than 230 attendees and international health providers representing 14 countries. The goal was to address improving care of patient populations by elevating the voice and influence of nursing on health policy and programming.
“The guiding force of our conference came from a shared observation with Partners in Health’s Sheila Davis: ‘Although nurses deliver 90 percent of health care to the world, they remain largely invisible. Their absence constitutes a global health crisis,’” said Vanderbilt’s Carol Etherington, MSN, associate professor of Nursing and the symposium’s coordinator.
“The focus of this event was to empower and engage nurses to be stronger patient advocates and activists at global, national and local levels, reducing the lost dollars and lost lives that result from their exclusion at decision-making tables.”
Nashville Mayor Karl Dean and Her Royal Highness Princess Muna Al-Hussein of Jordan addressed speakers and guests last week at the Renaissance Hotel in Nashville. Al-Hussein is the mother of His Majesty King Abdullah the Second of Jordan, and has a longtime interest in developing nursing as a significant force in the quality and distribution of health care in her home country and around the world.
“Global health is facing unprecedented challenges, and nurses are at the heart of meeting them,” said Al-Hussein. “Nurses worldwide represent a force of abilities that can shape and advance health care. Studies consistently show that investing in nurses is one of the most effective tools of promoting health care. With time and energy, along with access to adequate resources, nurses can make a world of difference in the lives of people and populations.”NURS 4115 – Role of the Nurse —Public and Global Health Essay Paper
The conference featured more than 30 speakers presenting a variety of plenary sessions and breakouts following one of four tracks focused on how to increase the influence of nursing within global health: leadership and management; policy; advocacy; and field engagement.
Key takeaways include:
• Nursing is a key component in scaling up global programs through development and nurturing inter-professional health care teams.
• Nursing roles are expanding in developed countries, but in far too many areas of the globe, nurses are in extreme need of mentoring and networking with their colleagues within and across borders.
• Nursing education programs must strengthen the teaching of health policy development to increase future nursing presence in policy making issues.
• All nurses must have competency in the concept of community health to support global health work that transcends borders.
• Partnership with patients is at the core of nursing and a key component of patient-centered health, which can be harnessed to promote patient power in policy making.NURS 4115 – Role of the Nurse —Public and Global Health Essay Paper
• Nurses must take advantage of opportunities to fill gaps and needs of fragmented health care systems around the world.
empowering nurses to improve global health
27 February 2018 – As part of efforts to improve global health, the World Health Organization (WHO) and International Council of Nurses are supporting the Nursing Now campaign – a 3-year global health initiative of the Burnett Trust for Nursing that will be launched in February 2018. The campaign, which continues until the end of 2020, aims to raise the status and profile of nursing to improve health and enable nurses to maximize their contribution to achieving universal health coverage.
The campaign will be launched on 27 February in Geneva, Switzerland, hosted by Hospital Universalizes de Genève (Geneva University Hospitals), in the presence of WHO Director-General Dr Tedros Adhanom Ghebreyesus and Her Royal Highness Princess Muna Al-Hussein of Jordan, Patron for Nursing and Midwifery in the Eastern Mediterranean Region. On the same day, the campaign will be launched at an event in London.
The vital role of nurses in supporting the health sector and the importance of acknowledging their role is highlighted by HRH Mona Al-Hussein, “It’s time to give nurses greater recognition, investment and influence. “We must capitalize on one of our best assets, the largest group of health care professionals, by equipping nurses to provide high quality patient-centered care and play an integral role in leading change in the health sector.”
While globalization and technological advances are creating new opportunities, disease and demographics changes, in addition to natural and man made disasters, are placing increased pressure on already strained health care systems. Chief among these is the additional burden placed on health care personnel as a result of dealing with the consequences of war, emergencies and an increasing number of refugees and displaced populations in the Eastern Mediterranean Region. NURS 4115 – Role of the Nurse—Public and Global Health Essay Paper
“Nurses and midwives are unsung heroes in responding to the health needs of communities affected by emergencies in our Region. Empowering nurses and enhancing their capacities will save lives and improve health and well-being at all times,” said Dr Jacquard Mahjong, acting WHO Regional Director for the Eastern Mediterranean.
The Nursing Now campaign recognizes that nurses are at the heart of country efforts to improve health for all. As one of the most trusted professions, nurses provide effective and quality care for people of all ages, and are central in addressing the increasing burden of noncommunicable diseases, such as cancer and heart disease. Nurses are indispensable members of health teams and as health professionals closest to the public play a crucial role in health promotion, disease prevention, treatment and care. WHO estimates that nurses and midwives represent nearly one half of the global health workforce. However, for all countries to reach health-related Sustainable Development Goal 3 “Ensure healthy lives and promote well-being for all at all ages” WHO estimates that the world will need an additional 9 million nurses and midwives by 2030.
The campaign aims to ensure that by the end of 2020 the health workforce generally, and nursing and midwifery in particular, have a far more prominent role in global health policy development and planning. It also aims to promote greater investment in developing nursing and midwifery education, practice and regulation, as well as improving standards and quality of care, and employment conditions. More nurses are needed in leadership and policy development, particularly in delivering universal health coverage and addressing current and emerging health problems. Another important aim of the campaign is ensuring evidence is made more readily available to policy- and decision-makers on the impact of nursing, and ensuring greater dissemination and sharing of good practices in nursing and the ways in which these good practices can be emulated.NURS 4115 – Role of the Nurse —Public and Global Health Essay Paper
What’s the role of nursing research in global health?
In September 2000, the UN highlighted eight objectives known as the Millennium Development Goals for the world community. Nurses and nursing science play an important role in virtually all of these. However, our impact is most obvious in reducing child mortality, improving maternal health, and combating HIV/AIDS, malaria and TB, along with the prevention and management of chronic conditions. Particularly in low- and middle-income countries (LMICs), nurses and nurse scientists can help fill a critical need for the education and training of health workers, as well as designing and testing solutions to common health problems.
Approximately 1 billion people across the world have zero access to trained health workers. Many projects we support have shown that low-tech, local health care solutions – such as sari cloth filtering of water in Bangladesh – can be more beneficial than high-tech treatments.
What are examples of NINR’s global health successes?
NINE-supported researchers are integrating depression screening into HIV care in Southern India. UNA IDS estimates that 2.5 million of the 34 million people living with HIV are in India. Connecting this population to mental health resources and interventions to treat depression could lead to improved quality of life for those dealing with the multiple burdens of HIV. In Bangladesh, NINR co-funded a study that aims to reduce postpartum hemorrhage, the leading worldwide cause of maternal death and disability.NURS 4115 – Role of the Nurse —Public and Global Health Essay Paper
We also support studies in community-based outreach that show promise to lower the incidence of childhood diarrhea. As I mentioned, an NINR-funded study involved the use of a sari cloth filter to decrease the incidence of waterborne cholera. This is a sustainable intervention that elegantly utilizes readily available, low-cost material while empowering women. NINR is the lead NIH institute for research in advancing end-of-life care, which presents some of the most critical challenges in clinical care today. An NINR-funded end-of-life bereavement study conducted in South Africa showed the remarkable resiliency of adolescents who have lost a loved one to AIDS.
How is NINR engaged in research training?
NINR partners with Fog arty on a number of research training projects. One example is the University of Illinois at Chicago’s School of Public Health and College of Nursing’s AIDS International Training and Research Program. This multidisciplinary effort fosters long-term scientific capacity to address the AIDS epidemic in Chile, Indonesia and Malawi through hands-on training. Another example is a new interdisciplinary project working with local health care workers in Argentina to study the efficacy of a text messaging intervention to improve medication adherence in TB patients.NURS 4115 – Role of the Nurse —Public and Global Health Essay Paper
What are NINR’s global health plans looking forward?
Nursing science has always been based on interdisciplinary collaborations. The WHO has acknowledged the importance of international research collaborations through the designation of Nursing Collaborating Centers, which focus on team-based research of regional or global significance. NINR will continue to facilitate global training partnerships, promote earlier entry of nurses into research training programs, and strengthen the scientific basis for clinical practice. We will also work to integrate technology and advanced interdisciplinary research methods. Data science will remain vital, including use of “big data” from electronic health records, wearable devices, m Health, point-of-care diagnostics, data visualization and various non-health specific data such as GPS, Google Maps and social media.
Community health nurses, sometimes called public health nurses, are registered nurses (RNs) who are trained to work in public health settings such as county or state health departments, schools, jails, and businesses. Because of their roles in the community as caregivers, they often form close bonds within the communities they serve and form lasting relationships. They become area experts on health and wellness.
On any given day, community nurses can be found running wellness clinics, coordinating emergency preparedness for disaster relief, or treating injuries and illnesses.NURS 4115 – Role of the Nurse—Public and Global Health Essay Paper
Community nursing integrates evidence-based research with community health needs to provide care based on science and evidence. They must determine the cultural and socioeconomic needs of the community and adjust care as needed. In this role, RNs may be required to have a baccalaureate nursing education with studies in population-based health and community health nursing. RN to BSN programs allow nurses to study the theory and research behind public health practices and apply them to everyday practice.
“They are educated to see each person for whom they care in the context of his or her life—all the factors that impact that person’s life and well-being,” the Robert Wood Johnson Foundation, the nation’s largest healthcare philanthropic organization, said in a call to action for improved public health. “Indeed, nurses have a responsibility and an obligation—by virtue of their education—to promote population health no matter where and how they practice.”
Community Health Nurses’ Roles
Working as a community nurse is unlike any other nursing position. By helping whole communities, community nurses act as educators, disease and injury prevention specialists, research scientists, community advocates, emergency preparedness experts, public health liaison, and healthcare professionals. In more detail, the roles of public health nurses are:NURS 4115 – Role of the Nurse —Public and Global Health Essay Paper
1. Disease prevention specialist
Community health nurses focus on long- and short-term care for disease prevention. Their work includes averting or controlling the spread of the flu and other communicable diseases. They work with patients to support diabetes self-management and improve diabetes control. They also work with mothers of newborns to reduce the rate of infant mortality and in schools to identify gaps in services.
2. Community educator
As educators, community health nurses focus on presenting materials in a clear and understandable format. They provide information to individuals, families, and communities that create a framework for healthy living and healthy choices. In schools they may teach sex education and HIV education classes. In the public, they hold classes and seminars on diabetes management. Overall, they focus on community health education as a step to preventive healthcare.NURS 4115 – Role of the Nurse —Public and Global Health Essay Paper
3. Leader
Community health nurses use evidence to implement policy changes and quality-based practices. They lead collaborative efforts to produce successful health outcomes and provide critical medical and social services in communities.
4. Researcher
As researchers, community health nurses collect and use evidence to execute positive changes for better health. Research is used to validate funding for public health programs, reduce inequalities in healthcare, and increase access to services.
5. Advocate
Public health nurses advocate on the local, state, and federal level to provide better access to healthcare, protect funding for public health programs, and reduce or eliminate health disparities. They help families arrange assistance through social services programs such as the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), which provides healthcare and nutritional services for low-income pregnant women, breastfeeding mothers, and children under age 5.
6. Caregiver
Community nurses cross cultural, language, and literacy boundaries to shape the health and well-being of children and adults. They provide prenatal care and education for expectant mothers, including information about maternal nutrition, referrals for childbirth classes, and postpartum assistance. They also provide resources for parents to understand proper childhood development and discipline techniques.NURS 4115 – Role of the Nurse —Public and Global Health Essay Paper
In addition, community nurses play other varied roles, said Virginia Crandall, Senior Community Health Nursing Director for the Florida Department of Health in Hernando County. She said working as a public health nurse provides an opportunity to use skills not used in a hospital setting.
“Whether it is Ebola, Zika, budget challenges, hurricanes, clinic operations, dog bites, tuberculosis, sexually transmitted diseases or HIV, there is always a new challenge and a new opportunity to make a positive difference,” she said.
Future Of Community Health Nursing
Healthcare experts say public health has made great strides in the past decades, allowing people to live longer and healthier lives. The smoking rate is down and more people have health insurance. Health reform efforts have improved the quality of healthcare and slowed the growth rate of medical costs, the U.S. Centers for Disease Control and Prevention (CDC) said.
Even with that, however, the United States falls short of providing equitable access to healthcare, the CDC said. Racial, socioeconomic, and ethnic disparities continue in healthcare, the federal agency said. A vital component to change is local communities taking leading roles in public health and continued support by community health nurses.NURS 4115 – Role of the Nurse —Public and Global Health Essay Paper
The Association of Public Health Nurses (APHN) said partnerships between public health nurses, communities, populations, and organizations are essential to the future of public health. The association said public health nurses could bridge the gaps between siloed clinical health and public health, ensuring optimal well-being for communities and populations.
“Public health nursing remain the largest discipline in the public health field, consistently providing leadership in an unsettled health system environment,” the association said in a position paper titled “The Public Health Nurse: Necessary Partner for the Future of Healthy Communities.”
“As public health nurses continue to move beyond traditional public health settings and integrate their practice with community systems, their value and strength will continue to evolve as well.”
Many nurses are now participating in global health at the international level. They are involved in organizations that promote and provide access to healthcare in developing countries. They are participating in relief efforts in countries impacted by natural disasters. Nurses are advocating for policies that eliminate health disparities related to poverty, illiteracy, and gender discrimination. They are providing consultation in other countries to help nurses improve their status and to expand their roles through further education. To be effective in these global efforts, nurses must learn about the specific healthcare needs and healthcare systems of the involved countries as well as learning about the culture of the people. Health is the expression of physical, psychological, spiritual, and social well-being manifested and determined by the adaptive abilities of persons. Perceptions and levels of health vary among people throughout the lifespan. Health is affected by personal initiative, interaction between healthcare providers and persons as they access the healthcare delivery system.NURS 4115 – Role of the Nurse—Public and Global Health Essay Paper Nursing has a major role in being culturally sensitive to the needs of increasingly diverse populations and in helping people access healthcare services. Professional nursing is an art and science, which facilitates health promotion, risk reduction, disease prevention, management of disease and illness in individuals, families and communities. Critical thinking, application of theory and incorporation of research are inherent in the professional nursing role and provide the basis for judicious decision-making, problem solving and health planning. Professional nurses embrace values, behaviors, and recognized standards that are the foundation for ethical and legal practice. They advocate for clients in providing compassionate, culturally sensitive care. Nurses use critical thinking and problem solving to assess, design, manage and evaluate care in collaboration with clients and health professionals. Professional nurses assume many roles in the provision of direct and indirect care to individuals, families, and communities in a variety of settings. The professional nurse is accountable for the delivery of competent, cost-effective care that will result in expected outcomes.
Public health nurses comprise the largest professional segment of the workplace in public health and are involved in the prevention, education, advocacy, activism, assessment, and evaluation of Public Health. They hold a vital role in the prevention of disease and help to promote community health and safety. For students already in a nursing program or who are already a practicing nurse, public health nursing offers a variety of opportunities to make significant changes in public health. While most nurses care for one patient at a time, public health nurses care for entire populations. The ability to work with whole communities allows public health nurses to help in educating the community about health issues to improve their health and safety and facilitate access to care.
What are Some of the Responsibilities of a Public Health Nurse?
- Assessing health trends to identify health risk factors specific to communities
- Assigning priorities for health-related interventions in order to provide the greatest benefit
- Advocacy with local, state and federal authorities in improving the access to health services in under served communities
- Design and implement health education campaigns and activities for disease prevention
- Provide information on local health programs and services that are available to improve access to care
- Providing direct health care services to at-risk populations
What are Some of the Areas of Employment for Nurses in Public health
Public health nurses are employed in government agencies, nonprofit organizations, community health centers and other organizations improving health at a community level. They may work alone or on multidisciplinary teams, and they often supervise other health care and lay personnel. In addition to working with communities, they work behind the scenes planning activities, managing budgets and evaluating the effectiveness of public health programs.NURS 4115 – Role of the Nurse —Public and Global Health Essay Paper
What is the Job Outlook and Salary Range for a Public Health Nurse?
There is a growing demand for public health nurses, particularly in those low-income communities that are medically under served. Many government agencies have recognized the benefits of preventive and health education services provided by public health nurses in attempting to reduce overall health care costs. Because they often serve a diverse population, Bilingual nurses that are fluent in both Spanish and English are in desperate needed. The average annual salary for a public health nurse is $51,000 however; salaries can vary greatly due to company, location, industry, experience and benefits. Salaries also vary greatly depending on job location, educational level and requirements.
Public health nurses integrate community involvement and knowledge about the entire population with personal, clinical understandings of the health and illness experiences of individuals and families within the population. They translate and articulate the health and illness experiences of diverse, often vulnerable individuals and families in the population to health planners and policy makers, and assist members of the community to voice their problems and aspirations. Public health nurses are knowledgeable about multiple strategies for intervention, from those applicable to the entire population, to those for the family, and the individual. Public health nurses translate knowledge from the health and social sciences to individuals and population groups through targeted interventions, programs, and advocacy.
Public health nursing may be practiced by one public health nurse or by a group of public health nurses working collaboratively. In both instances, public health nurses are directly engaged in the inter-disciplinary activities of the core public health functions of assessment, assurance and policy development. Interventions or strategies may be targeted to multiple levels depending on where the most effective outcomes are possible. They include strategies aimed at entire population groups, families, or individuals. In any setting, the role of public health nurses focuses on the prevention of illness, injury or disability, the promotion of health, and maintenance of the health of populations.NURS 4115 – Role of the Nurse —Public and Global Health Essay Paper
Examples of Public Health Nursing Activities
Examples of public health nursing activities include the following:
- Evaluating health trends and risk factors of population groups and helping to determine priorities for targeted interventions.
- Working with communities or specific population groups within the community to develop public policy and targeted health promotion and disease prevention activities.
- Participating in assessing and evaluating health care services to ensure that people are informed of available programs and services and assisted in the utilization of those services.
- Providing essential input to interdisciplinary programs that monitor, anticipate, and respond to public health problems in population groups.
- Providing health education, care management, and primary care to individuals and families who are members of vulnerable population and high-risk groups.
Public health nurses provide a critical linkage between epidemiological data and clinical understanding of health and illness as it is experienced in peoples’ lives. This understanding is translated into action for the public good. An illustration of this role is the surveillance and monitoring of disease trends within the community. Emerging patterns that potentially threaten the public’s health are identified and appropriate interventions planned, coordinated and implemented. This is a role that public health nurses can do in any setting; however, it occurs mainly in the public sector. Public health nurses contribute to systems for monitoring crucial health status indicators such as environmentally caused illnesses, immunization levels, infant mortality rates, and communicable disease occurrence, in order to identify problems that threaten the public’s health and develop effective interventions.NURS 4115 – Role of the Nurse —Public and Global Health Essay Paper
Public health
Acheson defines public health as “the science and art of preventing disease, prolonging life and promoting health through the organised efforts of society.”(9) This definition identifies the collaborative nature of public health work, which is seen as a collective view in meeting the health needs of local populations. The Royal College of Nursing (RCN) and the Community Practitioners’ and Health Visitors’ Association (CPHVA) have identified the principles of public health.(10,11) The RCN identifies six key aspects to public health work that can be utilized in practice (see Box 1).
The work of the district nurse, however, is mainly concerned with working at an individual level, where district nurses are involved in giving health education advice to those who already have a chronic illness. Although this approach has been criticized for its focus on individuals and families, with less concern for health in the wider community, it is an important aspect of public health work. Providing a service at home can help reduce service inequity and inequalities in health for those who are housebound and those whose health needs may be overlooked by other members of the primary healthcare team. However, a combination of approaches should be utilized (see Box 1) in order to maintain a positive conception of health. This approach is concerned with the health and social well being of communities in its widest sense.(12)NURS 4115 – Role of the Nurse —Public and Global Health Essay Paper
Barriers to a public health role
District nurses may argue that their work is concerned with clinical priorities and that public health work is given a low priority when managing a busy caseload. Being attached to general practice could also act as a barrier to public health as general practice in the UK follows a medical model approach to healthcare.(13) However, the role of the practice nurse is evolving in response to the GMS contract and the National Service Frameworks in achieving targets that include a health promotion focus. There are also professional implications, as the third part of the nursing register recognizes only specialist community public health nurses, of which district nurses are not included.(14) This division could suggest that district nurses need not be concerned with this aspect of their role. Indeed, the more complex roles that are required of a public health approach, such as lobbying and campaigning for healthier communities, have been seen as the traditional roles of health visitors. However, health visitors may also argue that this part of their role has been eroded because of managing busy caseloads and the need to achieve government targets.
Integrated working
Primary healthcare teams, however, provide an ideal skill mix in order to fulfill the aims of a public health approach. Practitioners are also familiar with the community in which they work and they are known by the local community. Added to this is their local knowledge of services and sectors that are involved in health and community care. NURS 4115 – Role of the Nurse —Public and Global Health Essay Paper
Practitioners working together in an integrated way can complement each other’s roles and prevent gaps in service and duplication. Health visitors and school nurses are experienced in working with well populations and vulnerable groups, and they have knowledge and experience of community development work. In contrast, district nurses, practice nurses, community sick children’s nurses and community mental health nurses are mainly concerned with chronic disease management and mental health problems. These roles can include working with groups as well as individuals and offering clinics to prevent and monitor health problems.
Bull recognizes the need for and benefits of nurses working in an integrated way.(15) Zahner and Gredigs’ views on public health nursing identify the importance of collaborative working, and integrated team working would seem to complement this approach.(16) Despite the benefits of working in this way, the Audit Commission’s survey of district nurses found that not all primary healthcare teams had adopted this approach.(17) Indeed, there are problems in team working in primary healthcare, such as a lack of understanding of each other’s roles and a lack of a shared philosophy. Therefore it will be important to invest time and commitment in building a successful team if the above approach to public health is to be a success.
The team will need to decide on a shared philosophy with shared objectives so that the aim of the team is clear with everyone working towards that aim. This may take many weeks or months to achieve, but it is important that practitioners agree as failure to do so can result in the team losing direction and in the long term becoming disenchanted. NURS 4115 – Role of the Nurse —Public and Global Health Essay Paper
District nurses can act as change agents as they are already accustomed to managing teams as part of this role. New ways of working, however, may result in resistance by some team members; therefore district nurses need to understand the principles of change management if they are to succeed.(18) Although a district nurse may instigate this way of working, a more suitable change agent may emerge from the team from another discipline, and this needs to be recognized, as self-interest must be forsaken in the interests of other team members and ultimately the public. It must be recognized that collaboration with statutory and non statutory sectors will be essential when specific program mes are being planned. Understanding how people live and manage their lives in different circumstances is also essential where consultation with the public is fundamental in providing needs-led program mes.
The way forward
Practitioners will face a number of challenges when developing roles that integrate public health and primary healthcare.(19) These will include:
- Time and resources – protected time will be needed for possible training and skills for the role.
- Developing and maintaining a local health profile.
- Defining the health priorities for the local community.
Perhaps the most challenging issue, however, will be to develop a shared philosophy of primary healthcare and public health, as without a shared vision the venture is unlikely to succeed. Practitioners may therefore need to revisit the concepts and principles of a public health approach in informing their understanding of what can be a complex activity.NURS 4115 – Role of the Nurse —Public and Global Health Essay Paper
Conclusion
The government’s response to reducing health inequalities has seen a resurgence in a public health approach to healthcare. District nurses have a pivotal role in primary healthcare and are in an ideal position to make a difference to the health of local populations. However, district nurses cannot undertake a public health role on their own. They will need to work collaboratively with other primary healthcare team members as well as statutory and non statutory sectors and the public themselves. Working as part of an integrated team can provide the experience, knowledge and skills to provide a public health approach to primary healthcare, and district nurses can act as change agents in managing this process by involving themselves in local policy groups rather than being driven by others.
Impetus for development of academic structures to promote nursing’s role in global health NURS 4115 – Role of the Nurse —Public and Global Health Essay Paper
In 2010, the Lancet Commission on Education of Health Professionals for the 21st Century recognized the fundamental need for ‘robust, competent and professionally capable workforce’, and the incongruity between current health worker competencies and actual skills required in an increasingly global and interconnected world. The commission noted that although workforce shortages are recognized as a primary deterrent to improving health outcomes, the quality of the health workforce, specifically professionalism and leadership skills need to be addressed in order to make lasting, sustainable improvements in global health (Bhutta et al. 2010). Addressing these human resources for health challenges will be required to meet the 2030 Sustainable Development Goals (United Nations, 2015b).NURS 4115 – Role of the Nurse —Public and Global Health Essay Paper
Producing nursing cadres and other health professionals with the capacity to address existing and future global health challenges requires both instructional and institutional innovation. Within the field of nursing, this includes improving education and promoting policies which allow for expanded clinical scope of practice, especially in low‐resourced, high‐need settings (Institute of Medicine, 2010; Maier & Aiken 2016). Structures must also strengthen existing and new global health nursing science, support robust global health education for future nursing scientists and facilitate nurse involvement in the shaping of global health policy.
Nurses are the largest cadre of the global health workforce, providing 90% of health care worldwide (Bryar et al. 2012). Nursing scientists further contribute unique, front line perspectives to produce innovative solutions to global health’s most challenging problems. Task shifting/sharing, systems analysis, quality improvement, clinical training interventions and models of care delivery are a sample of innovations led by the nursing field. At the policy level, nursing certifications and regulatory bodies ensure quality care across heterogeneous sites (Blaauw et al. 2014; Dawson et al. 2015; Doherty & Coetzee 2005; Martinez‐Gonzalez et al. 2015; McCarthy et al. 2013; Moraros et al. 2016; Willcox et al. 2015).NURS 4115 – Role of the Nurse —Public and Global Health Essay Paper
The role of nurses within policy forums and influential decision‐making bodies within the global health space has been limited (World Health Organization, 2011). To increase participation of nurses in policy creation, the International Council of Nurses (ICN) recommended three key strategies: ‘coordinating nursing actions, maintaining solidarity with the profession and developing strong leadership’ (Benton 2012). Investing in academic structures is one important way to expand the effective participation of nursing in global health policy development.
Sustainable academic structures to promote global health nursing: research, education, policy and partnership
A review of existing global health program mes within top‐tier United States SoN (Table 1), and a directed search of institutional websites, related grey and peer‐reviewed literature, distilled four domains central to the promotion of global health within nursing academic institutions and formed the basis of the REPP framework (Fig. 1). Using the Research, Education, Policy and Partnership (REPP) framework, academic entities can ensure core areas are addressed when developing and implementing strategies to promote effective nurse participation in global health research, education and policy development through effective partnership. Investments in each of these four areas create a sustainable foundation which promotes engagement of a critical mass of global health nursing scientists and practitioners within academic institutions who are linked and mutually supporting.NURS 4115 – Role of the Nurse—Public and Global Health Essay Paper These university‐level collaborative networks foster broader connections to similar national, regional and international nursing and non‐nursing organizations engaged in promoting nursing’s role in global health research and policy (IHI, 2003). Simultaneously fostering cross‐disciplinary collaboration is key so nursing perspective is not soiled but rather intentionally included in both broader global health research and policy decision‐making.
Global health issues (GHIs) require global cooperation in response, planning, prevention, preparedness, and care that reflects health equity issues among nations. These issues require complex inter professional and inter agency cooperation and solutions that involve governments, non-profits, and many times include private companies and foundations. More than ever, the response to GHIs requires a broader understanding of how connected we are in today’s world. This article considers response to issues of emerging infectious diseases, human trafficking, maternal-newborn health; preparedness for health inequities within a framework of social justice, equity; and distributional of health workers globally. We define and describe emerging global health issues from a nursing perspective and offer a call to action for nurses to increase awareness as global leaders. NURS 4115 – Role of the Nurse —Public and Global Health Essay Pap
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