Background Josephine Lawrence (name changed to protect anonymity) has been a community health nurse employed by the city for almost five years. Working in the public sector is radically different from working in a private healthcare institution, notes Lawrence, who had practiced as an RN for ten years prior to her career change. When asked what precipitated the change. Lawrence said that a lot of it had to do with the way her mind works. She always preferred “big picture” issues, as she put it, recognizing the need for greater community activism, empowerment, and advocacy.

Changes to the Profession

According to Lawrence, the profession has not changed appreciably over the past four to five years. The most important changes to healthcare in general have been due to legislation and policy, with the Affordable Care Act having less of a bearing on community health operations than on the budgets and management of private institutions. Lawrence noted, for example, that “expands public health and prevention programs to support communities and individuals,” (“Public Health Nurse,” n.d., p. 1). Moreover, Lawrence has seen shifts in attitudes towards the role that public health nurses play. The career is increasingly data-driven, and community health nurses...

When Lawrence first started working as a community health nurse, she focused more on program planning and budgeting. Now, she is much more involved in epidemiology and public relations. She still focuses a lot on financial management but has to take into account issues related to marketing public health campaigns, coordinating resources among multiple stakeholders, and assessing the effectiveness of community interventions.
Addressing the Needs of High Risk Populations

One of the most important goals of public health nursing is to reduce health disparities, according to Lawrence. The city set aside additional funds in the budget to help the homeless community this year, which has inspired Lawrence to put together a new team of advocates, social workers, and nurses who are planning new programs to offer vaccines, medical tests, and substance abuse counseling. The city also approved a new safe injection site for drug users, which in the past two years has already been instrumental in reducing the number of preventable infections as well as dramatically reducing the number of overdoses. High risk populations like the homeless, children in foster care, the poor, and the elderly who live alone are continually assessed for…