A survey of public health nurses (PHNs) who work in official public health units in Ontario was undertaken to determine whether their perceptions of their roles and activities concurred with a 1990 Canadian Public Health Association report which describes the roles and qualifications of public health nursing in Canada. The survey questionnaire was completed by 1,849 PHNs in all 42 public health units (response rate = 85%). About one tenth of the PHNs reported no activity as a caregiver/service provider. Most PHNs reported being active in the roles of educator/consultant, social marketer, and facilitator/communicator/collaborator. The community developer, policy formulator, research/evaluator, and resource manager/planner/coordinator roles were less frequently performed, however, increased activities in such roles were expected in the future. Nurses said that they needed further preparation to perform the latter roles. These results have implications for deployment of PHNs as Ontario's health system shifts to community health and health promotion.
Public health nurses (PHNs) have been attached to family doctors' offices as one mode of organizing the delivery of nursing services in the community. However, different nurses function in different roles on a continuum from generalist to liaison. A descriptive study was undertaken to determine the most effective role for PHNs attached to family physicians' offices. Outcomes for both physicians and nurses were satisfaction with the role of the PHN, appropriateness of referrals, and accessibility for consultation. These outcomes were compared relative to the rating of PHNs of their role. A cohort of physicians without attachment PHNs were also surveyed to compare responses on the same criteria. The majority of nurses described their role generalist. This role was related to greater satisfaction for nurses and the physicians with whom they worked. Satisfaction with PHN service, ease of arranging consultation with PHN, and appropriateness of referrals from PHNs was greater for physicians who had the attachment than those who used the usual service.
To explore perceived roles and activities of Saskatchewan public health nurses (PHNs).
This replication study surveyed Saskatchewan PHNs using the instrument developed by the Hamilton-Wentworth Social and Public Health Services Division in a 1992 survey of Ontario PHNs. This instrument is based on the roles and activities for community/public health nurses described by the Canadian Public Health Association (1990). Descriptive statistics were used to analyze the 124 responses received.
Most of the nurses perceived that they were at least somewhat prepared for all of the roles. The activities of: caring for individuals and families; immunizing; educating individuals, families, and groups; acting as a resource person for clients and lay helpers; linking those needing services to appropriate community resources; and using marketing strategies were carried out most often by PHNs. Activities within the roles of community developer, policy formulator, researcher and evaluator, and resource manager/planner/coordinator were carried out to a much lesser degree. The roles and activities being done less often were also the ones PHNs felt less prepared to do.
It is important, as health authorities begin to support a more preventive approach to health care, that PHNs are competent in the roles outlined by the Canadian Public Health Association. As well as preparing new graduates for these roles, it is essential to provide continuing education for practicing PHNs. Public health administrators must also support public health nurses in carrying out these roles.
This study reports the findings of how district nurses (n = 23) and hospital nurses (n = 9) in cancer care experienced social support in immediate connection with demanding care situations, as well as the effect of systematic clinical supervision. The study is based on their own accounts. The data were collected by means of semi-structured interviews. The findings indicate that there is a great need to unburden oneself of job-related thoughts and feelings, and to receive support after having been in emotionally demanding care situations. The nurses were of the opinion that the supervision had provided relief, confirmation, and professional development. These findings can be understood in the light of Antonovsky's theory, "sense of coherence," which comprises the components: comprehensibility, manageability, and meaningfulness. More research is needed to discover further ways to support the personnel.