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1

Status of the Community/ Public

Health Nursing Workforce:

The ASTHO Report





Presented June 1, 2006

Rose Conner, RN, M.Ed., Deputy Director

Arizona Department of Health Services









2

Nursing Shortage

What Does the Picture

Look Like Nationally?









3

Nursing Shortage

What Does the Picture

Look Like Nationally?









4

National

Nursing Shortage Average

Local Situations Vary, but Urban and Rural

Areas Are Both Experiencing a Shortage of

Registered Nurses, and Students Entering

Nursing Programs







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5

National

Nursing Shortage Average

Local Situations Vary, but Urban and Rural

Areas Are Both Experiencing a Shortage of

Registered Nurses, and Students Entering

Nursing Programs









6

ASTHO Issue Brief

April 2005



37 States Replied to Survey



30 of 37 Report that Public Health Nursing Is

Public Health Field Most Affected by Worker

Shortage, along with Laboratorians,

Epidemiologists and Environmental Health

Professionals





7

Public Health Nurses

Comprise Largest Group of

Public Health Professionals

in Health Departments

Across the Country



11% of Total Public Health Workforce / 25% of

All Public Health Professionals





8

State Health

Departments Vary in

Organizational Structure



Decentralized Health Departments Tend to

Provide Programmatic Administrative Support

Centralized Health Departments Provide

Clinical Services and Community Health Direct

Service





9

1988 IOM Report



The “Future of Public Health” Report

Recommended that Public Health Should Focus

on the Core Functions of Assessment, Assurance

and Policy Development









10

Positions Identified

as Clinically Focused

Have Been Eliminated,

Leaving Gaps in Critical

Community Nursing Services





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11

The Public Health Nurse

in 2006

Average Age……………………………………………46.6

Eligible to Retire……………………. Within 5 Years

**In some states, 40% Are Eligible to Retire Now





Functioning in Departments with Vacancy Rates

Up to 20% and Turnover Rates of 14%



Has a Bachelor’s or Master’s Degree in Nursing

and Public Health

12

Roles/Responsibilities

of the Public Health Nurse

in 2006









13

Prevention Services

TB Control

Immunizations

STD Control

Family Planning

Women/Children’s Health

Tobacco Control

Diabetes prevention

Obesity/Nutrition Program Development



14

Emergency Preparedness

Community Education

Mass Immunization Plans

Hospital and Community Preparedness









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15

Emergency Preparedness

Community Education

Mass Immunization Plans

Hospital and Community Preparedness









16

Data/

Quality Assurance

/Research

Epidemiology

Birth Defect/Cancer Registries

Cancer Registry









17

Licensure Services



Hospital

Home Health

Hospice

Long-Term Care

Assisted Living

Child Care

Behavioral Health







18

The Public Health Nurses



Educational and Clinical Background Makes for

a Desirable Candidate for a Multitude of

Environments -- Further Exacerbating the

Shortage of Nurses for Critical Public Health

Roles









19

Average Health Departments

Do Not Pay Commensurate

with Local Employers









20

What Is Being Done

to Address the Shortage?









21

What Is Being Done

to Address the Shortage?









22

Enhancing Recruitment



Increasing Eligible Candidates

to Enter Nursing and

Public Health Programs

Outreach Programs Are Being Conducted, Both --

Locally and Nationally -- to Highlight Nursing As a

Valued Professional



In Many States, There Is Up to a 3-Year Waiting List

to Enter a Nursing Program





23

Increasing Nursing Faculty

and Educational Resources

Need to Increase the Number of Faculty, and

the Number of Student Slots for Associates

Degree, Bachelor of Science in Nursing, and

Master’s Programs

States Are Investing in Programs that Will

Increase Student Slots and Faculty

Positions/Salaries

AZ 2004 SB1260

AZ2005 SB1294



24

Increasing Nursing Faculty

and Educational Resources



The Public Health Preparedness

Workforce Development Act of 2005

Introduced by Senator Chuck Hagel (R-

Nebraska) and Richard Durbin (D-IL)

Would Address Nursing Student and

Faculty Loan Repayment Programs to

Assist in Infrastructure Development

25

Enhancing Retention

Salaries Must Be Equitable

Health Departments Need to Continue to Advocate for

Salary Adjustments for Public Health Nurses









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26

Career Advancement

Health Departments Need to Provide

Continuing Education for Their Nursing

Personnel and Allow for Movement Through

the System, Based On the Nurse’s Interest and

Abilities







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27

Career Advancement

Health Departments Need to Provide

Continuing Education for Their Nursing

Personnel and Allow for Movement Through

the System, Based On the Nurse’s Interest and

Abilities









28

Health Departments Need to

Provide Leadership

Programs that Provide

Opportunities for Public

Health Nurses to Advance

into Senior Management

Roles

Leadership Academies and Leadership Institutes



29

Research Needs to be

Conducted to Identify

Best Practices that Can

Be Replicated to Retain

Staff

Evidence-Based Practice Models









30

Long-Term Strategies to

Provide Older Worker with

Opportunities, Such as Job

Sharing and Post-Retirement

Programs Are Essential to

Maintaining Knowledge and

Experience within Health

Departments

31

Public Health/Community

Health Educators, Leaders,

Nurses Need to Highlight the

Contributions to

Communities’ Health and to

Provide Information to Local

& National Policy Makers

Regarding the Value of Public

Health/ Community Nurses

32

APHA

ASTDN

ASTHO

ACHNE

…Are Great Advocates and Partners that Are

Instrumental in Informing the Policy Makers of

the Critical need to Support Our Nursing

Colleagues into the Future







33

Thank You!!





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34



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