The History of Public Health and the Role of the Community Health Nurse

TheHistory of Public Health and the Role of the Community Health Nurse

In1893, Lilian Wald public health nursing service. She was an Americannurse of German-Jewish ancestry. In 1893, she left medical school andbegan training nursing skills to a home class for underprivilegedimmigrant families immigrants located on the Lower East Side of theNew York City. The classes were based at Hebrew Technical School forGirls. Soon after beginning the home class, she moved in with anotherwoman nurse in a room located close to the patients that she offerednursing care at their homes. In addition, she made the term “publichealth nurse” to refer to nurses who specialized in providinghealthcare services to the entire community. Wald established theHenry Street Settlement, a non-profit social service agency thatoffers healthcare, social and arts programs services to all New Yorkresidents. Wald’s vision received eminent support fromphilanthropists such as Elizabeth Milbank Anderson and Jacob Schiff(Stanhope &amp Lancaster, 2008).

Communityand public health nursing services targets persons that cannot affordthe high cost of treatment charged in healthcare centers. Experiencednurses treat patients at their homes. For instance, individualssuffering from chronic diseases that would otherwise warrantinpatient treatment care receive treatment at their homes. This makestreatment substantially affordable thus, even the poor can affordprofessional healthcare costs. Public and community healthcareservices maintain professional standards through providingcomprehensive training to potential recruits (Jarvis, 1980).

Communityand public health nurses provide healthcare services to the elderly,poor, children, homeless, orphans and individuals suffering fromchronic illnesses. Majority of the patients public health nursesserve are underprivileged so they deserve subsidized medical care.Other beneficiaries of community and public health care nursinginclude persons suffering from chronic and stigma associated diseasessuch as HIV/AIDS, public volunteers interested in learning nursingskills, inexperienced nurses interested in joining public healthservices and persons suffering from mental issues (Robotham &ampFrost, 2006).

Publicand community healthcare nurses provide diverse interventions such asdelivering meals to the hungry and poor, establishing caregivingcenters for the elderly and starting companion centers where retiredindividuals can live as a family. The nurses also providejob-training services. They educate the public on strategies forgiving first aid to patients suffering from given conditions before aprofessional health expert can arrive. Finally, they offer counselingand shelter for the mentally unstable and domestic violence victims(Institute for Career Research, 2008).

Communityand public health nurses working in public health care settingsoperate at primary practice level. Primary care services encompassdaily healthcare services. The professionals are often the firstpersons that meet patients. If they diagnose that a given personcould be suffering from a particular condition, they may offer amedical solution or refer them to secondary healthcare providers(Stanhope &amp Lancaster, 2008). Secondary healthcare professionalsinvolve specialist that conduct further investigation to patientsthat are suspected to be suffering from a given condition. Forexample, if a primary healthcare provider suspects that someone issuffering from cardiology or cancer problem, they refer patients tosecondary healthcare professions that focus on treating the diseases(Douglass, 1996).

Ethicaldilemmas apply to situations where healthcare professionals have tochoose between doing right and wrong. However, choosing either optionmay often prove challenging as doing the right thing may causeinconveniences. For example, a nurse is responsible for taking careof patients in a vegetative state. All the life-support machines havepatients. One of the patients has been in the machine for more than ayear. A victim of car accident gets to a hospital in need of urgentlife support service. After considering the available alternatives,the nurse only remain with the option of disconnecting the elderlypatient who seems to have little chance of surviving the illness, orwatch helplessly as a patient dies due to lack of a free life supportmachine (Karlsson et al., 2010).


Karlsson,M., Roxberg, A., Silva, A.B, &amp Berggren, I. (2010). Communitynurses` experiences of ethical dilemmas in palliative care: a Swedishstudy. InternationalJournal of Palliative Nursing,16(5):224-31.

Jarvis,L. L. (1980). Communityhealth nursing: Keeping the public healthy.Philadelphia, Pa: F. A. Davis Co.

Robotham,A., &amp Frost, M. (2006). Healthvisiting: Specialist community public health nursing.Edinburgh Toronto: Elsevier Churchill Livingstone.

Institutefor Career Research. (2008). Careeras a public health nurse, community health nurse.Chicago: Institute for Career Research.

Douglass,L. M. (1996). Theeffective nurse: Leader and manager.St. Louis: Mosby.

Stanhope,M., &amp Lancaster, J. (2008). Publichealth nursing: Population-centered health care in the community.St. Louis, Mo: Mosby Elsevier.