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INTRODUCTION

Jennifer, a public health nurse (PHN), has worked for the Weaver County Health Department for 10 years. Jennifer's first nursing position, after completing her bachelor of science in nursing (BSN) and passing nursing boards, was on a medical-surgical unit in a large metropolitan hospital. Since her public health experience in nursing school, she has been eager to find a public health nursing position. She now works at a small local health department in the town of Aurora, the county seat of Weaver County.

Aurora is surrounded by an agricultural community. Corn, soybeans, and sugar beets are the major crops. Cattle are also raised in this area. The town of Aurora has a population of 15,000. German immigrants settled Aurora in the 1850s. Today, Aurora is a multicultural community. The racial makeup is 91% Caucasian, 2% African American, 3% Hispanic or Latino, 1% Native American, 1% Asian, 1% Pacific Islander, and 1% Other. The median income is $33,000.

Weaver County has a significant population of migrant workers from Mexico, who comprise a large segment of the workforce for many farms in the area and also provide the labor for a poultry-processing company, located on the northern edge of the county, that opened 10 years ago. Residents of the town have learned that they need to adapt in order to assimilate a new cultural group into their community.

Sarah, a public health nursing student, has been assigned to work with Jennifer to complete her public health nursing field (clinical) experience. Sarah is excited to start this project. Sarah is completing her undergraduate BSN degree at a university about 45 miles from Weaver County and is familiar with the county only from media reports regarding the difficult racial issues there over recent years. She grew up in an urban area, where a variety of cultures and races were represented. Sarah, who is Korean and was adopted into a family in the United States as an infant, is eager to learn about not only the role of the PHN but also how the community environment affects the work of the Weaver County Public Health Department and its PHNs.

As Sarah reflects on her public health nursing class, she remembers the three core functions of public health: assessment, policy development, and assurance. Along with this underlying framework, she knows the importance of the Cornerstones of Public Health Nursing. Sarah is particularly interested in learning about how independent nursing practice is carried out and how PHNs use the Public Health Intervention Wheel in Weaver County. She will spend five weeks with Jennifer, learning as much as possible about public health nursing.

SARAH'S NOTEBOOK Competency #4 Practices Public Health Nursing Within the Auspices of the Nurse Practice Act

  1. Understands the scope of nursing practice (independent nursing functions and delegated medical functions)

  2. Establishes appropriate professional boundaries

  3. Maintains confidentiality

  4. Demonstrates ethical, legal, and professional accountability

  5. Delegates and supervises other personnel

  6. Understands the role of a PHN as described ...

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