4.3 Article

Overcoming barriers and improving public health nursing practice

Journal

PUBLIC HEALTH NURSING
Volume 40, Issue 1, Pages 114-123

Publisher

WILEY
DOI: 10.1111/phn.13139

Keywords

community health nursing; nursing workforce; public health nursing practice; public health systems; school health

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

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