Community Health Nursing

Great challenges and great opportunities.

By Phyllis Meadows, PhD, RN

M
any challenges influence the overall treat people living with HIV and AIDS and in efforts
health of communities. Infectious dis- to help the elderly effectively manage their chronic
eases, such as tuberculosis, can spiral out health problems and remain at home.
of control in many urban settings. Children’s health The Public Health Security and Bioterrorism
and well-being are still threatened by preventable Response Act of 2002 added a new dimension to the
diseases, environmental toxins, violence, accidents, public health professional’s role. It catapulted commu-
and injuries. Unequal access to health care and nity health nursing to the center of emergency
insurance coverage has notably increased morbidi- response plans that would provide mass prophylaxis
ty and mortality among infants, pregnant women, and contain and manage biochemical threats. Com-
and other vulnerable populations. munity health nurses, especially those in
Amid these challenges, all nurses can improve public health settings, are now considered first respon-
health outcomes and expand the infrastructure for ders—a role that traditionally belonged to law
monitoring and managing diseases. In traditional enforcement and emergency response professionals. In
public health settings, community health nurses the event of a public health threat, community health
work to ensure that expectant and new mothers nurses will organize and administer immediate care.
have the resources to appropriately care for them- Community or public health nurses may specialize
selves and their children. They can be found in the in areas such as home care; case management; clinical,
WIC Program (the Special Supplemental Nutrition school, or corporate nursing; or pharmaceu-
Program for Women, Infants, and Children) admin- tical sales. Community health nurses with advanced
istering well-baby assessments, vaccinations, and degrees can also find opportunities in higher education
newborn screenings, as well as in lead abatement and clinical research. The skills needed for these
programs managing the care of children with lead diverse areas can vary, but at a minimum, nurses
poisoning. should have a bachelor’s degree and sound clinical
Community health nurses are valued for their experience. Some public health settings have relaxed
adaptability and willingness to provide care in their minimum requirements in response to the nurs-
many settings, including community health clinics, ing shortage. Nurses who choose traditional public
churches, homeless shelters, and schools. These health or home care should have a broad understand-
nurses provide comprehensive care to patients with- ing of health issues and be comfortable with autono-
in their homes, at organized events such as health my, change, and uncertainty.
fairs, and at agencies and institutions serving people Nurses entering this specialty must highlight not
who have particular health needs. Advanced prac- only their clinical skills, but also their critical think-
tice nurses in communities improve access to care ing, advocacy, and analytical abilities. Communities
and lower costs at nurse-managed clinics on college are dynamic, and nurses must adapt to be able to pro-
campuses and at primary and secondary schools. vide patients with whatever care they need. The pay
They develop and implement corporate wellness for community health positions can be lower than
programs, thereby supporting the health and pro- that for similar positions at major health facilities;
ductivity of employees and their organizations. however, many community positions require few, if
Nurses in community health work with diverse any, weekend or holiday hours.▼
partners and providers to address complex chal-
Phyllis Meadows is the director and health officer of the
lenges in the community. Nowhere is this more evi- Department of Health and Wellness Promotion of the City of
dent than in current efforts to identify, reach, and Detroit. Contact author: [email protected].

AJN • CAREER GUIDE 2009 19