American Public Health Association
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Public Health Nursing
Section Newsletter
Spring/Summer 2007

MESSAGE FROM THE CHAIR

Eliminating health disparities is one of our PHN Section Strategic Priorities. In our continuing dialogue about the PHN Priorities, eliminating health disparities is a thread throughout each of our other priorities: ensuring social justice; strengthening the public health work force; actively engaging students; and promoting environmental health.

 

You might remember that in the winter newsletter I shared my belief that public health nurses are the right people to make this vision a reality.  Our 2006 Annual Meeting in Boston provided us with the impetus to energize and move us forward to achieve these priorities.  Since the 2006 Annual Meeting, your Section leadership has been hard at work on several projects related to our priorities.  In March, 35 Public Health Nursing Section leaders were in attendance at our Mid-Year Meeting in Washington, D.C. Once again, the wheels were turning, and everyone participated in brainstorming ways to improve health care for the most vulnerable among us. Even before the formal meeting began, members went to “the Hill” to meet with their representatives and senators about public health issues and/or participated in committee meetings. Reports from some of those meetings are in this Newsletter. Several APHA staff participated with us, shared APHA visions and concerns, and listened as we presented our vision and priorities.

 

Advocacy is a key imperative towards eliminating health disparities.  At our mid-year meeting, APHA staff and Diane Downing, PHN representative to the Action Board, addressed advocacy.   In public health nursing, advocacy is not a choice, it a responsibility that each of us must take seriously. We are a team of professionals who can make a difference at local, state, and federal policy levels that can impact the health of populations. This year APHA has made health care for uninsured and underinsured children a top priority. Funding the State Children’s Health Insurance Program (SCHIP) is essential to providing health care coverage for all kids. In 1997, SCHIP was established and funded for 10 years.  Currently, should SCHIP be fully funded and improved upon, it has the potential along with Medicaid to cover roughly three-quarters of the nation’s children (APHA, 2007, Issue Brief). Public health nurses can help in this endeavor. We must assure that the continuance of SCHIP funding is not at the expense of Medicaid. Once secured, we must ensure that it includes a comprehensive, prevention-focused health care package that is of high quality and meets the health care needs of the children it covers.

 

I urge each of you to read APHA’S SCHIP Issue Brief.  This brief provides in-depth data related to the benefits of SCHIP, including a portrait of uninsured children in the United States.  SCHIP has the potential for improving their health care access for America’s most vulnerable children.  I urge you to contact your Congressional delegation, attend their town meetings during their August recess, and let them hear from you regarding the public’s health needs. Make copies of the APHA SCHIP Issue Brief and leave it with your senator or representative. Use the data from this brief as talking points with them – remember they are interested in meeting the needs of the public, their constituents. Public health nurses are experts in health care delivery, and our Congressional leaders need to hear the facts and issue from those of us who are directly involved in providing health care to the public.

 

While we are tackling the issue of children’s health care, we must not forget everyone else. Health care, universal health care, is high on the public’s agenda for the United States.  Data released in August 2006 by the Census Bureau showed that the number of uninsured Americans stood at a record 46.6 million in 2005, with 15.9 percent of Americans lacking health coverage.  “The number of uninsured Americans reached an all-time high in 2005,” said Robert Greenstein, executive director of the Center on Budget and Policy Priorities.  “It is sobering that 5.4 million more people lacked health insurance in 2005 than in the recession year of 2001, primarily because of the erosion of employer-based insurance.” (Center on Budget and Policy Priorities, 2006). It is past the time when we should hold our elected officials and current candidates accountable for leading the United States to a level of health care coverage taken for granted in many other countries.

 

At least two presidential candidates have come out with plans for universal or near-universal health care coverage. In our role as advocates for the public’s health, we must hold all candidates of both parties accountable for leading our country forward with a universal health plan for all of our citizens and residents.  As nurses and public health nurses we must exercise our collective power and advocate for social change and health care system improvements that eliminate health disparities and achieve health equity.

 

 - Debra Gay Anderson, PhD, APRN, BC

PARTNERSHIPS FOR PUBLIC HEALTH AND NURSING

The PHN Section is seeking partnerships with organizations that share its commitment to a strong public health infrastructure, best practices, and advocacy for system change on behalf of the health of all populations, with special emphasis on those who are most vulnerable. These partnerships will comprise: state or regional level public health nursing associations; national nursing and public health organizations and associations that support the mission, vision, and strategies of the association; and any organization with which we are actively engaged in public health action.

We are part of the Quad Council of Public Health Nursing Organizations, an alliance of the four national nursing organizations that addresses public health nursing issues, and includes the Association of Community Health Nurse Educators (ACHNE), the American Nurses Association’s Congress on Nursing Practice and Economics (ANA), the APHA Public Health Nursing Section (APHA), and the Association of State and Territorial Directors of Nursing (ASTDN). Over the years, the Quad Council has approved a definition of public health nursing and a set of national public health nursing competencies, served to regularly update the Scope and Standards for Public Health Nursing, given environmental health principles and recommendations for public health nursing, and conducted many other activities. This work has taken place over many years, and all are sustained by succeeding leaders in each of the four organizations.

In today’s complex society and in the face of several decades of erosion of the public health infrastructure and the public health nursing role, it is time to expand our partnerships to include those beyond our discipline and our sector. Therefore, it is proposed that the PHN Section engage a wide array of potential partners – organizations, associations and agencies – that share the Section’s vision, values and commitment to both excellence and to moving the public health and nursing agendas forward.

Envision the following:

  • A Committee on Affiliate State PHN Associations that is linked to the APHA PHN Section.
  • A PHN Section Partnership Council that fosters, implements, and supports public health nursing amidst a strong public health infrastructure at the local, state, regional, national and global levels.

    You are invited to join a conference call in October to discuss the development of a Partnership Council and propose potential partnership organizations, agencies, and associations. For further information about the conference call, please contact Marjorie Buchanan, RN, MS, at mbuch003@son.umaryland.edu.

    PHN PRACTICE MATTERS

    Practice issues are central to the work of the PHN Section, but, unfortunately, we do not have a clear place in our Section's infrastructure for the consideration of overall practice matters.  Our recent environmental health and maternal and child health endeavors both point to the need to have a clear place within the Section for addressing emerging practice issues such as these.  For example, members of the Section are presently at work on rebuilding the bridge between public and environmental health, while others are providing consultation to a primary care home visiting program on how to create a broader public health approach.  These efforts are both occurring through Section task forces.  However, “task force” indicates a time limited effort, and it has become clear that a more sustained approach over time is often needed.  

     

    Our PHN Section Workforce Committee is addressing the many issues surrounding the nursing shortage and public health, and agreed to serve as an “incubator” for building a Practice Committee.  At the PHN Section’s Midyear Meeting on March 24, 2007, the Workforce Committee hosted a discussion of the Section and practice issues.  The Workforce Committee will present a proposal for a Practice Committee for approval by the Section Council at the November meeting in Washington, D.C. 

     

    Before that meeting takes place, a full discussion will be conducted by conference call in September or October 2007. All interested PHN Section members will be invited to join in that discussion.  Key themes that emerge from that conference call will be incorporated into a draft document for review by the Workforce Committee and final decision-making by the Section Council. 

     

    A very preliminary draft is included here for members’ consideration in preparation for that conference call.

     

    Practice Committee Call

     

    Date:  Wednesday, Oct. 3, 2007

    Time:  1:00 p.m. – 2:30 p.m.

     

    Please contact Marjorie Buchanan at mbuch003@son.umaryland.edu if you would like to join the call.  She will then send information on joining the call.

     


     PROPOSED PRACTICE COMMITTEE

     (Preliminary Draft:  June 11, 2007)

     

    Goal:  Foster comprehensive, high quality public health nursing practice throughout the U.S. and globally.

     

    Objectives: 

     

    1.  Define PHN practice in collaboration with the Quad Council of PHN Organizations;

    2.  Promote ethical principles for public health nursing practice;

    3.  Support for ANA Scope and Standards for PHN Practice;

    4.  Describe array of PHN practice roles and responsibilities;

    5.  Identify practice priority areas with identified working groups for PHN Section;

    6.  Establish/maintain PHN Section partnerships focusing on PHN Practice in priority areas;

    7.  Develop guidelines, tools, resources, and linkages for PHN practice;

    8.  Collaborate with other PHN Section committees on matters related to PHN practice, especially Research, Education, and Policy Committees.

     

    Committee Structure

     

    • Chair: Marjorie Buchanan, MS, RN
    • Members:
      • Interested Section members
      • Section Liaisons to Other APHA Sections
    • Strategies:  Working Groups on Identified Practice Areas

     

    Areas of Current Concentration

     

    • PHN infrastructure for practice partnerships and initiatives.
    • Descriptions of PHN practice elements and guidelines for integration.
    • Linkages to information about effective public health and nursing programs, tools, and resources.
    • Emerging public health and nursing practice issues affecting Public Health Nurses.

    Current Special Initiatives

     

    • Environmental Health Working Group:  Environmental Health Greenprint for Action (Robyn Gilden and Rita Lourie)
    • MCH Working Group:  Health Steps Consultation – Moving from Primary Care to Public Health Approach (Joyce Edmonds)


     

    Environmental Health Working Group

     

    Co-Chairs: Rita Lourie & Robyn Gilden

     

    Purpose: Rebuild the Public Health Nursing bridge between public and environment health.

    Goals:

    1. Establish ongoing formal linkage with Environment Section of APHA through an appointed PHN-Environment Section Liaison;
    2. Establish/maintain PHN Section partnerships with environmental health leaders and organizations that further PHN efforts to improve health;
    3. Raise awareness of PHN practice and leadership in environmental health;
    4. Develop PHN practice guidelines, tools, resources, and linkages in environmental health.


     

    Maternal Child Health Working Group

     

    Chair:  Joyce Edmonds

     

    Purpose:  Foster comprehensive, high quality public health nursing practice in maternal and child health throughout the United States and globally.

     

    Goals: 

     

    1.  Establish ongoing formal linkage with MCH Section of APHA through an appointed PHN-MCH Section Liaison; 

    2.  Establish/maintain PHN Section partnerships with MCH leaders and organizations that further PHN efforts to improve maternal and child health; 

    3.  Raise awareness of PHN practice and leadership in MCH; 

    4.  Develop PHN practice guidelines, tools, resources and linkages in MCH.

    VISION - VOICE - VISIBILITY

    The PHN Section is beginning the Vision, Voice, and Visibility Campaign (V3) to educate the public and other health professionals about public health nursing and its essential evidence-based role in the health care delivery system. Events have transpired over the past two years that indicate a decline is occurring the recognition of the critical role that PHN knowledge and skills play in positive health outcomes. Public health nursing organizations are taking action to respond to this challenge, and to mount an assertive leadership role in both public health and nursing that is proactive in nature.

    V3 Vision

    • Strong and effective public health nursing leadership to enhance population health.

    V3 Mission

    • Strengthen the PHN Section’s capacity to be fully engaged, active, and leading the way in public health and nursing

    V3 Goals

    1. Generate awareness and recognition of essential role of PHNs among the public, the public health sector and the nursing profession.
    2. Increase PHN capacity for moving from strategy to action.
    3. Strengthen PHN economic position to generate greater numbers of PHNs, PHN positions and PHN impact.

    V3 Strategies

    1. Name, claim, and reframe traditional public health nursing roles and interventions.
    2. Form partnerships with national organizations and associations that ensure public health nursing is represented whenever public health and nursing stakeholders are convened.
    3. Foster state level public health nursing associations that advocate for essential public health and nursing strategies and services.
    4. Develop social marketing capacity to ensure the most effective communications about public health nursing are conveyed to the public, to policy makers, to the public health infrastructure, and to the health professions.

    V3 Outcomes For Public Health and Nursing

    • PHN Section is recognized as a leading/essential voice for public health and nursing
    • PHN knowledge, skill, perspective, and engagement are recognized as essential to primary, secondary and tertiary prevention efforts throughout the nation and globally
    • PHN role is consistently documented, described and widely communicated.
    • The PHN work force grows in both government agencies and in the private sector.
    • The PHN specialty certification is both recognized and rewarded by both the public/private sectors
    • Interest in public health nursing as a specialty area of practice grows, with concomitant growth in educational programs

    V3 Outcomes For the Section and APHA:

    • Section membership increases.
    • Section leadership roles and recognition increase.
    • Members actively seek PHN Section and APHA leadership positions.
    • APHA elected and staff leaders seek out the PHN Section and its members in addressing public health matters.

    QUAD COUNCIL ADDRESSES PHN SHORTAGE

    The Quad Council of Public Health Nursing Organizations has developed a position paper on the public health nursing shortage.  Endorsed by the Quad Council in February 2007, the position paper highlights the complexity and magnitude of the shortage and its potential impact on the health of the population.  The Quad Council outlines 18 recommendations to address the public health nursing shortage that includes increased wages, federal funding, a public health nursing research agenda, public health nursing education, and faculty development.  A full version of the report will be available on the PHN Section Web site at a later date.  Read the Quad Council paper here: QCPHNShortage207.pdf

    PHN RECRUITMENT and RETENTION

    I would be surprised if there were not any PHNs out there who have not experienced first-hand the issues associated with recruitment and retention. In general, our salaries are significantly lower than our nursing counterparts in acute care, and we struggle to maintain and increase services with a diminishing work force.  So what can individual PHNs do to help? One answer is to take on the personal responsibility of mentoring a few of our own.

     

    How do I do it?

     

    Just look around and find students who are interested in public health nursing or PHNs with a little less experience. Become a part of their support system, whether you decide to engage in a formal or informal mentoring relationship, or just provide a listening ear. Look out for opportunities for their professional advancement. Help them with their decisions. Be a supportive friend.

     

    Benefits?

     

    They are abundant.  You will develop a deeper relationship with colleagues, and you contribute to an organizational culture that nurtures and promotes public health nurses… a good place to work! It may not overcome all of our problems with recruitment and retention, but it will help!

     

    Betty Daniels, MN, RN
    Medical College of Georgia

     


     

    Calling All Students Interested in Public Health Nursing!

     

    The APHA Public Health Nursing Sections wants you to participate in our Section activities. The Annual Meeting will be held in Washington, D.C. Nov. 3-7, 2007.

     

    Our section’s mission is to enhance the health of population groups through the application of nursing knowledge to the community. We have active committees that focus on 1) environmental health, 2) social justice and health disparities, 3) student engagement, and 4) workf orce development.

     

    We are advocating for “Health for All” through the promotion of a broad view of health and involvement in the many sectors influencing the health of communities.

     

    If you are interested in helping us with this mission, please contact Mary Lou England at englandmarylou@co.kane.il.us or jomareng@peoplepc.com or Betty Daniels at bdaniels@mcg.edu. We want and welcome you!

    PHN SECTION REPRESENTED AT USPHS GLOBAL HEALTH SUMMIT

    PHN Section Chair Debra Gay Anderson, RN, PhD, was invited to speak at the U.S. Public Health Service Scientific and Training Symposium: Global Health Summit II - Improving Health and Safety Through Diplomacy. The goal of the panel in which she participated was to provide participants with insight into public health issues at the state and local levels and to explore collaborative efforts between federal, state, and local agencies and academia. Dr. Anderson described a collaborative project between the Kentucky State Department of Health and the University of Kentucky that enabled the formation of mentoring teams for BSN students and provided for collaborative monthly seminars co-facilitated by state PHN consultant Connie Richmond and Dr. Anderson. They were able to draw upon the expertise of several state level PHNs who provided the students with the opportunity to become involved in state level programs. She discussed with the attendees the importance of collaborating with academia and mentoring students into the role of the Public Health Nurse. Dr. Anderson also talked about the Institute of Medicine Report that addressed the importance of prevention and community-based collaborative research. The IoM recommendations include:

    1. Increase learning opportunities for students;

    2. Congress should increase HRSA funding;

    3. Recognize and reward public health practice research;

    4. NIH should increase funding for population-focused and community-based prevention research; and

    5. Academic institutions should support population-focused and community-based prevention research.

    Dr. Anderson ended her presentation with the challenge to attendees to become preceptors and mentors for students and new graduates; to continue their quest for lifelong learning; to take their specialty exam; and to be active in their professional organization, the PHN Section of APHA.

    PHN SECTION GRANTED ANCC APPROVER STATUS

    The American Nurses Credentialing Center (ANCC) granted to the APHA/Public Health Nursing Section accreditation status as an approver of continuing nursing education on March 29, 2007. This means that APHA may now approve activities developed by external organizations for health education, medicine and/or nursing Continuing Education (CE) contact hour credits. Recent changes by the ANCC Commission on Accreditation (COA) set the initial accreditation time-period at two years with a status report at the end of the first year.

    Another recent change by the ANCC COA is annual reporting by all accredited entities, and submission of some activities every other year. Our reports are available on the APHA Web site under Continuing Education Program.

    The APHA CE staff manager, Annette Ferebee, Beth Benedict and Pearl Holland will attend the ANCC workshop for accredited providers and approvers, and the 2nd Annual Symposium on CE in Atlanta at the end of July. Beth attended the ANCC workshop for accredited approvers that was held at the ANCC headquarters in Silver Spring on June 15. APHA continues with its commitment to assure that we attend the ANCC events for accredited organizations. Sonda Oppewal and Beth attended the 2006 workshop and Symposium. Just prior to our mid-year meeting, Beth and Annette held our PHN provider and approver meeting at APHA headquarters with CE core group members who had an option to call in if they could not attend.

    APHA has changed the interdisciplinary continuing professional education committee to include two members from each of the accredited disciplines; health education, medicine and nursing. The committee was renamed as the Continuing Education on Accreditation Committee. Colleen Hughes and Beth are the CE core group members on the CEAC. The charge from the executive director is that this group is responsible for APHA's compliance to the accreditation requirements for each of these disciplines, and for the development of a 'single multi-disciplinary CE system within APHA' for both provider and approver functions.

    Kaye Bender continues on the APHA Education Board, and she represents the nursing CE core group in the review process of the Learning Institutes which includes QUAD Council.

    Thanks to the CE core group members: Kaye Bender, Marjorie Buchanan, Colleen Hughes, Kathy Jaskowiak, Pearl Holland. Welcome to our new core group member Donna Westawski.

    Thanks to our peer reviews in the approver process: Derryl Block, Carolyn Blue, Jeanne Leffers, and Irene Sandvold.

     

     - Beth Benedict, PHN Education Committee Chair

    PHN CHAIR-ELECT IN THE NEWS

    PHN Section Chair-Elect Jeanne Matthews was interviewed for a feature article about public health nursing in the May 7, 2007 issue of Advance For Nurses. Written by public health nurse Kate Brewer of Arlington, Va., the article discussed the challenges of defining what public health is today and the diminishing public health nursing work force.  In addition, the importance of forming partnerships and collaborating with the broader community was highlighted as a foundation for addressing emerging public health issues and providing effective population-based care.  Read the complete article: AdvanceArticle.pdf

    TELL YOUR PUBLIC HEALTH NURSING STORY

    An idea surfaced at the PHN Section mid-year meeting to video document our stories as public health nurses.  It would begin with y ou developing a story as a public health nurse, your practice, your successes.  Either during or prior to the Annual Meeting, you would sign up for a 5-minute video interview.  I would film and edit the interviews and post them on youtube and eventually on our section Web page. Interested? Let me know what you think by contacting me at Rlourie1@aol.com.

     

    Rita Lourie, MSN, MPH

    Temple University

    Philadelphia

    (215) 707-4872

    KANE COUNTY PHNS MAKE A DIFFERENCE

    Public Health Nurses are making a difference in promoting health! Public Health Nurses in Kane County, Ill., wondered what was contributing to the increase in asthma in children. Two specific items emerged when they looked at contributing causes: leaf burning and more vehicles.

     

    In working towards a solution the issue, public hearings were initiated by the local county board to implement a leaf burning ban policy, particularly in densely populated areas.

     

    Public hearings were held around the county. Evidence was presented. As a result an ordinance was passed banning the burning of leaves in certain areas of the county and during certain times of the day. PHNs are making a difference!

     

     - Mary Lou England

    A CALL FOR PUBLIC HEALTH NURSES

    An investigation to determine the role and value of public health nurses in the United States is conducting by Erin D. Maughan, RN, MS, PhD.  Dr.  Maughan is looking for “frontline” public health nurses to participate in the study.  Participation in the study includes a one on one telephone interview.  The interview should take approximately 30-40 minutes. Questions will include details about your experience with and knowledge of public health nurses, demographics including educational background, age and employment; and your own personal views about and feelings toward health care.  Dr. Maughan is seeking representation from public health nurses throughout the United States. There are minimal risks for participation in this study and no direct benefits to participants. However, it is hoped that through your participation, researchers will learn more about the knowledge and understanding of public health nurses here in the United States and how they express their job functions. This study has IRB approval and all study protocols will be followed (i.e. information will remain confidential).  If you are interested in participating in this study, please contact Erin Maughan at (801) 422-4893 or erin_maughan@byu.edu .  Thank you!

    APHA LAUNCHES “HEALTHY YOU”

    As a member of The Nation's Health Advisory Committee within APHA, I am writing to let you know about Healthy You, a new free public health resource that you can use in your community health outreach.

    Created by the The Nation's Health, APHA's newspaper, Healthy You is a one-page fact sheet that focuses on a new public health topic each month. From bike helmet safety and allergies to portion sizes and disaster preparedness, Healthy You has your community in mind and is always written in a fun, easy-to-understand style.

    About 30,000 people receive Healthy You each month via their copies of The Nation's Health, but anyone can download the page for free at www.apha.org/publications/tnh/healthyyou .

    We'd love to hear how you use Healthy You, so if you pass them out or share them in your community, drop us a line and let us know. We welcome your ideas on Healthy You topics, so if there is something you'd like to see in a future edition, e-mail nations.health@apha.org.

    Donna Westawski, MSN, RN

    Chair, PHN Section Communications Committee

    Member, The Nation's Health Advisory Committee

    APHA

    www.thenationshealth.org

     

    POSITION RECRUITMENT

    Public Health –Seattle & King County  seeks a Personal Health Services Supervisor (PHSS) responsible for daily supervision of our Family Health Clinic at the North Public Health Center located in North Seattle. The Clinic PHSS provides direct supervision of the work of professional, paraprofessional, and support staff assigned to services and programs at North Public Health Center.  The incumbent is responsible for supervising and coordinating the delivery of public health services and ensures compliance with mandated clinic and agency-wide protocols and guidelines.  The PHSS/clinic supervisor provides clinical leadership to optimize care team functioning in order to facilitate quality health care services to public health clients.  The Clinic PHSS reports to the Area Manager and works closely with public health center management and lead staff to meet practice management and performance measures including quality care, service excellence, access, resource utilization and financial performance.

    Qualifications: Current Washington State RN License, BSN from a NLN accredited school or equivalent is required.  The ideal candidate will have progressively responsible nursing supervisory experience in ambulatory care or a public health setting.  King County offers a superior benefits program.  Click here to view the full position announcement or go to http://www.metrokc.gov/health/about/jobs.htm.

    BECOME A PHN SECTION MEMBER NOW

     

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    Join Us at the APHA 135th Annual Meeting in Washington, D.C.

    Nov. 3-7, 2007

     

    Register Now!