Community-Oriented Primary Care: A Model for Public Health Nursing

• Published in: Journal of health politics, policy and law policy and law, 2001-06, Vol.26 (3), p.617-634
• Main Authors: Cashman, Suzanne B., Bushnell, Frances Kathleen Lopez, Fulmer, Hugh S.
• Format: Article
• Language: English
• Subjects: Boston; Clinical Competence; Collaboration; Community; Community care; Community Health Centers - organization & administration; Community-Institutional Relations; Curricula; Fellowships and Scholarships; Health care; Health care policy; Health Care Services; Health Promotion; Health sciences; Health services; Hospitals; Humans; Initiatives; Leadership; Medicine and Health; Models, Educational; Nurses; Nursing; Organizational Objectives; Physicians; Pilot Projects; Political Science; Politics; Population; Preventive medicine; Primary care; Primary health care; Primary Health Care - organization & administration; Primary Prevention; Professional Training; Public Health; Public Health and Health Policy; Public Health Nursing - education; Public Health Nursing - organization & administration; Public Policy; Specialization; Studies; Training; United States
• ISSN: 0361-6878; 1527-1927
• DOI: 10.1215/03616878-26-3-617

The American Public Health Association defines public health nursing as the"practice of promoting and protecting the health of populations using knowledge from nursing, social, and public health sciences." In 1993,celebrating the centennial anniversary of its founding, nurse leaders recognized systemic changes have required nurses to function in clinical,illness-oriented roles rather than in their more traditional community and public health roles. With nurses' public health skills atrophying, these leaders urged members of the profession to eschew specialization and return to their generalist roots founded on the principles of community-based prevention and health promotion. Soon the Public Health Functions Project, designed in part to identify skills and curriculum needs of an array of practicing public health workers, examined the public health nursing profession. Its recommendations seek to ensure that public health nurses are trained to respond to current challenges that face public health. In this essay, we describe how a fellowship program that predated this national project by almost a decade anticipated the recommendations for shaping public health nursing by enrolling midcareer nurses in a program that taught the principles and practice of community-oriented primary care. Such principles represent a merger of clinical care with population health sciences; its more recent expressions teach clinicians to work as partners with communities to identify and address health problems. In reporting on this program, we show how nurses in practice can embrace their generalist roots, meet current challenges, and play a lead role in realizing the nation's goals for the year 2010. These aims incorporate recent recommendations for preparing public health nurses for change in the health care system.