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Public health nurses (PHNs) working in Well Baby Clinic in Israel's Haifa district were voicing great distress to inspectors-the impossibility of meeting their workload, feeling overwhelmed, poor physical, and technological conditions. They were feeling tired and frustrated and burn-out was rising. The district's nursing management took the decision, together with Tel Aviv University's nursing research unit, to conduct a quality improvement project based on issues that arose from meetings with focus groups on the nurses' difficulties. This paper is a case study of a quality improvement project targeting nurses daily working life. One of its chief contributions is as a study of meeting PHNs' frustration by integrating focus groups and round-table brainstorming (involving nurses, clinic managers and nursing inspectors) in order to identify targets for practical intervention. This strategy has been very successful. It has provided the district's nursing management a battery of forcefully argued and realistically grounded proposals for making the work of Well Baby clinics more relevant to their communities and giving nurses (a) the conditions to meet their assignments and (b) greater professional self-respect.

Objective: To test the relationship between job satisfaction, professional self-image, work environment, organizational commitment (OC), and quality of life at work (QoLW) among public health nurses in Israel. To determine which variables can predict OC and QoLW among public health nurses. Design and Sample:One hundred and thirty-two public health nurses participated in this cross-sectional study with a structured self-administered questionnaire that examined OC, professional self-image, job satisfaction, nursing work environment, and QoLW. Pearson correlation tested correlations between variables and multiple regression was conducted to predict OC and QoLW. Measurements:The five measurements (job satisfaction, professional self-image, work environment, OC, and QoLW) based on validity questionnaires with high internal confident.Results: All five variables showed a significant positive correlation. Job satisfaction (t = 5.77, p < 0.001) and nursing work environment (t = 4.55, p < 0.001), contributed significantly to the explanation of OC and QoLW variance. Nursing work environment (t = 6.42, p < 0.01) and job satisfaction (t = 2.99, p < 0.01) were the variables that predicted QoLW. Conclusions:Nursing managers should be proactive and create a professional environment for nurses to encourage their OC and QoLW as factors that may influence public health nurses. K E Y W O R D Sjob satisfaction, organizational commitment, professional image, public health nurses, quality of life at work

Aim Using the case of Israel, we examine the confluence of current philosophies of health care along with the historical trends of health promotion/disease prevention services to consider strategies for increasing inclusiveness and for updating and improving their service delivery. Background Health services in Israel are at a crossroads. Plans to integrate the historic, nurse‐operated, nationwide programme, providing health promotion/disease prevention services to pregnant women and young children for all residents (Tipat Halav) into the National Health Service System's existing Sickness Funds are under discussion. Sources of evidence Using a discourse approach, this paper examines the current and historical context of health promotion/disease prevention services. Our history shows an increasingly treatment‐based perspective and dwindling support for inclusive services. In the current health system, Tipat Halav nurses solely provide inclusive health promotion/disease prevention services to pregnant women and young children. Informed by the World Health Organization, a reorientation to health promotion/disease prevention is essential in an ageing society where chronic rather than infectious diseases are the reigning health problems. Conclusion Israel needs to reorganize the health system using a public health approach that both incorporates existing structures and establishes new ones, such as creating a network to elicit community input, and instituting nurse‐operated clinics designed to provide health promotion/disease prevention services for all ages and all residents. Implications for health and nursing policy The newly created health system framework demands activism among all health professionals to legislate for an inclusive, holistic orientation. Master's level clinical programmes in community health nursing are vital to ensure the provision of optimal health promotion/disease prevention services.