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"The Public Health Nurse carries with her/him a vision of sef-reliant, competent communities, families and individuals."
Public Health Nursing is a nursing practice area of the Indian Health Services. It is distinct from hospital-based nursing or ambulatory care nursing, in that it focuses on outreach and community health. The IHS/PHN program grew out of services provided by field matrons employed in the 1890's by the Bureau of Indian Affairs to: instruct people on sanitation and hygiene; perform emergency nursing services; and, prescribe medicine for minor illnesses, As communities grew and medicine advanced, so did the role of the public health nurse.
The Cherokee Nation first contracted with the IHS to manage the PHN program in 1980. Since that time, many changes have occurred in the tribal health service, including improvement of existing facilities and construction of new ones. The Cherokee Nation PHN program in now a part of Community Health services, with PHNs stationed in each of the rural health centers and at the two hospitals in the tribal jurisdictional service area. This structure provides for a more consistent approach to both prevention and chronic disease management through the development of collaborative and coordinated community resources.
The PHN functions independently, exercising skills based on judgment accumulated through experience and specialized training. Public Health Nursing is staffed by RNs, LPNs and PHN assistants. The RN supervises, and has graduated from a school accredited by the National League of Nursing; they are also required to joining the program. The American Public Health Association describes the PHN as "a person who synthesizes a body of knowledge from the public health sciences and public health nursing theory for the purpose of improving the health of a population." Basically, PHNs are trained to treat communities through their treatment of individuals. PHNs work cooperatively with other tribal health programs as well as many outside agencies to inform and educate patients on prevention issues and disease management. PHNs consult with physicians from a variety of specialties, and often work very closely with Community Health Representatives and other home health aids, supervising the work they do in monitoring home-bound patients.
The PHN addresses the environmental, psychosocial, economic and education needs of the patient, as well as the influences which effects his/her overall health status. This begins with the well being of mothers and their children. Through the holistic view of the patient's well-being , consideration of mental as well as physical health is involved, especially as it pertains to destructive behaviors and substance abuse. Improvement of community health is enhanced through encouragement of the individual patient's involvement in his/her own wellness. Prevention is a standard part of the PHN's work through the collaborative, interagency surveillance and tracking of communicable diseases in addition to education of the individual. Designed to have nurses participate in the interdisciplinary treatment of clients, the PHN program at its most effective will result in the development of intervention for patients throughout their lifespan. The goal is to provide services that are likely to contribute most to reducing, in the shortest time, the years of productive life lost.
For more information on PHN services in you community, contact the PHN department at the Indian clinic of hospital nearest your residence.
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