Public Health Nursing in Ireland: A Critical Overview*

Abstract

The World Health Organization have stressed the importance of nurses and midwives as a "force for health" in society's efforts to tackle the public health challenges of our time. The public health challenges are both diverse and complex. Principally, they emanate from a social model of health that takes cognizance of our behavior, our environment, and the historical, political, and cultural structures that facilitate health or militate against it. This paper provides a critical overview of public health nursing in Ireland, toward situating both our contribution to public health and some of the challenges that lie ahead of us. Specifically, it looks at nonquantifiable practice, where, through the presentation of stories, the wealth of public health nursing work is demonstrated in the ordinary voices of public health nurses. The potential risk of ignoring and minimizing the contribution of public health nursing in future developments in primary care in Ireland is discussed. Finally, it is proposed that public health nurses need to get political.

Public Health Nurse Perceptions of Empowerment and Advocacy in Child Health Surveillance in West Ireland

“…Thus, the capacity to advocate in public health nursing is deeply influenced by the hierarchical nature of the nursing profession and the cynicism that can at times permeate organizational culture. Participants in the study believed that they needed to become more political (by this, they meant access to shared governance and decision making) and this reflected Clarke's (2004) argument that PHNs need to develop their political role. In order to do this, as argued by VanderPlaat (2002), PHNs need to see themselves as potential social activists, committed to an emancipatory ethic, who challenge barriers that stand in the way of meaningful social change not only for their clients but also for themselves.…”

How Can the Empowerment Role of Public Health Nurses (PHNs) Be Fostered? A Review of an Exploratory Research Study Conducted in Ireland and Current Evidence

“…The mandate for PHNs does not make clear how PHNs are to work in a health promoting way. To enable the empowerment of PHNs, the Health Service needs to actively involve PHNs in the decision making process, related to their role development (Clarke, 2004). Redefining the role will involve letting parts of the role go and sharing the role with other healthcare professionals.…”

“…Also, Clarke (2004) suggests that raising the power of PHNs can be supported by PHNs getting a seat at the table of power, by making their invisible work visible, by advocacy for the role of the PHN by all, by the political education of PHNs and by PHNs receiving training with other members of the multidisciplinary team.…”

“…Raising their profile will raise the power of PHNs. To raise the profile of PHNs, Clarke (2004) and Hanafin et al (2002) suggest that PHNs need to make visible their non-quantifiable work because otherwise policy makers and practice developers will conceptualise their roles into simplistic tasks and ignore the special, creative, and artistic aptitude, capacity and strength which is public health nursing. This will improve the recognition and status of the PHN by other professionals and clients (Clarke 2004).…”

The Community Client Need Classification System ? a dependency system for community nurses

“…PHNs are required to have a higher diploma in public health nursing and also hold a general nursing and midwifery qualification. Registered General Nurses (RGN) are in the minority in the community and are not required to have a formal education in community nursing (Clarke 2004). The increasing elderly population coupled with an increased population from 3.6 million in 1998 to 3.9 million in 2002 (Department of Health and Children 2003) and a shorter length of hospital stay, has resulted in an increased demand for community nursing in Ireland.…”