Health: Nursing Week – Honoring pioneers of the field

By Tammie Bertram/Franklin County Health Department, Published:

The founder of modern nursing, Florence Nightingale, was born May 12, 1820. In dedication to her, the week of May 12 is designated as National Nursing Week.

Nightingale was the first nurse leader to require an education base for those wanting to practice nursing. In addition, she was the first nursing theorist. Her environmental theory saved many lives during the Crimean War. Sanitation, light and fresh air along with other simple measures were implemented and the mortality rate at the hospital where Nightingale worked decreased 66 percent.

It was also the basis for another well-known nurse, Lillian Wald, to coin the phrase “public health nursing.” Wald is best known for her work in the slums of New York’s lower east side. Although born to an affluent family Wald was troubled to learn about the conditions of the poor immigrant families that lived in distressed conditions during the late 1800s and early 1900s. Mary Brewster, a classmate of Wald, joined her to create the first “Visiting Nurse Service.”

The nurses worked to educate the residents about infection control, disease transmission and personal hygiene. They emphasized the value of preventative care and healthier personal habits. They were considered the first public health nurses because of the preventative element of their work and the delivery setting, which was outside of the hospital.

Wald once said, “Nursing is love in action, and there is no finer manifestation of it than the care of the poor and disabled in their own homes.” 

Public health nursing came to Kentucky in 1925 when a public health nurse named Mary Breckinridge moved to Leslie County near Hyden and set up practice. Breckinridge founded the “Frontier Nursing Service” which featured nurse midwives.

The nurses traveled on horseback to homes in eastern Kentucky. They delivered babies but also taught public health prevention, good nutrition and preventive health habits and also treated those who were ill.

According to the American Public Health Association, in the 2013 article The Definition and practice of Public Health Nursing, the primary focus of public health nursing is improving the health of the community as a whole rather than just that of an individual or family.

The highlight of nursing practice by public health nurses is primary prevention. Preventing disease, injuries, disability and premature death by implementing interventions to stay healthy.

Public health nursing aims to improve the health of all populations and considers the barriers and complexity of all cultures. The patient in public health nursing is the community and the public health nurse advocates for health in all community policies. 

The Affordable Care Act has the possibility of having a huge impact on public health nursing. It was noted in a 2013 report by the Centers for Disease Control and Prevention that for every $1 spent on prevention $8-$13 can be saved in health care.

The public health nurse stands to play a significant role in implementing the prevention component by educating the public on preventative and environmental initiatives to improve health. 

A baccalaureate degree is highly recommended as entry level for public health nurses. The concepts of clinical prevention, population assessment, health policy, finance, regulatory and professional collaboration are needed for the public health nurse to take the leadership role in the new and changing healthcare environment. 

Tammie Bertram, RN, MSN, is the director of nursing with the Franklin County Health Department, 100 Glenn’s Creek Road.

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