Question

While they are often used interchangeably, what is the main difference between public health nursing and community health nursing? in essay format 100 words

Answer 1

Ans) As you note, many use the terms interchangably and confusion exits about differences in meaning between the two terms.

- Until the 1970s-1980s the field was called public health nursing (PHN). It was actually the first specialty area of nursing requiring nurses to be "trained" for public health beyond their diploma education.

- Public health nurses were generally employed by governmental agencies (federal, state, local, county, city) health departments, while nurses who provided care through visiting nurse agencies were called visiting nurses. That said, in my work as a PHN for a city/county health department in the 1970s I did make home visits as well to address specific public health projects such as maternal child health, communicable disease and so forth as well as home care for those with no insurance or health access to care in their homes. Therefore for many the term public health nursing became identified as care for "poor people'.

- That and the development of non-governmental programs to provide care in the community led to new terminology of "community health nurse".

- Nursing textbooks written for American students during the late 1970s forward were usually called "Community Health Nursing".

- A shift occurred so that all nurses who delivered care in the community were called community health nurses and as homecare began more medical-surgical than focused on traditional public health the terminology became less clear, Then in the late 1990s a push came to "reclaim" the public health roots.

- While care is still delivered in communities, distinctions such as population focused care (for public health) as well as community-based (which included all services performed in the community whether they served only individuals or communities were used. Today we still see the joint use as community/public health nursing used to encompass nursing that adddresses the needs of individuals, families, groups, and populations in the community.

- Boundaries between these two concepts exist in relation to the level of assessment. Public health nurses are trained and educated to assess the population overall. Whereas the community health nurse's knowledge lies within assessing the needs of individuals and families within the population that they work.