Public health nurses have long impacted the health of the communities they serve through population-level health assessment and intervention, and by evaluating the outcomes of public health programs. In fact, public health nurses have played a major role in some of the most dramatic public health achievements of the 20th century, including immunizations, workplace safety, healthier mothers and babies, family planning, and recognizing tobacco as a health hazard.
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How the DNP Prepares Nurses to Become Leaders in the Public Health Field
The Doctor of Nursing Practice (DNP)-prepared public health nurse is a valuable asset, providing an advanced level of expertise and knowledge at the community level amid significant changes in the healthcare system. As more Americans enjoy access to healthcare under the Affordable Care Act, DNPs in public health have proven to be instrumental in facilitating the transition. As we embrace the most significant system-level change in healthcare to come along in decades, the value of DNP-educated nurses serving in key public health leadership roles will only increase.
According to The Doctor of Nursing Practice Essentials (3rd Edition, Zaccagnini and White), the DNP-prepared public health nurse plays a pivotal role in the multifaceted public health nursing profession, protecting and promoting health and preventing disease and disability in communities throughout the U.S.
Their leadership capabilities allow them to contribute to public health initiatives through:
- Assessment: Collecting data on and monitoring a population’s health status and making that information available
- Policy Development: Providing leadership in the development of policies designed to support the health of a population; includes the use of scientific knowledge to make decisions about policy
- Assurance: Ensuring that community-oriented health services are available to those who wouldn’t otherwise receive them; also ensuring that a competent public health workforce is in place
Doctoral-prepared public health nurses serve as program directors who oversee the planning, piloting, and implementation of evidence-based population health programs initiated at the state or federal level. Just a few of the government agencies where DNP-prepared public health nurses work include the U.S. Public Health Service, the Centers for Disease Control and Prevention, and the American Public Health Association.
How DNP-Prepared Nurses in Public Health Improve Lives in the Communities They Serve
DNP nurses lead population-based health programs, promoting them at federal and state legislative committees and jurisdictional board meetings. These healthcare leaders advocate for population health initiatives through correspondence and public testimony and within planning groups.
DNP-prepared public health nurses routinely lead programs associated with:
- Maternal and child health
- Immunizations
- Healthcare services
- School health
- Family health
- Home care
- Children with disabilities
- Women, infants, and children (WIC)
- Refugee health
- Chronic diseases
- Adults with disabilities
- Environmental health
According to Zaccagnini and White, DNP public health nurses are a beneficial addition to multiagency planning groups that oversee these programs, as they have a skillset rich in:
- Policy development
- Financial astuteness
- Informatics
- Patient-centered care
- Quality improvement
- Safety
- Interprofessional teamwork and collaboration
DNP public health nurses also lend their expertise in other settings:
- Academia: DNP public health nurses in academic settings teach, direct programs, and conduct research to ensure the quality of the public health nursing workforce.
- Public Policy: DNP nurses in public policy and advocacy serve as executive nurse leaders in state departments of health, where they ensure the effectiveness, quality, and efficiency of programs and services and the size/education level of the workforce needed to satisfy the nursing needs of the state.
- Acute/Long-Term Care: In acute and long-term care settings, DNP public health nurses manage population-based infection prevention, quality improvement, safety, and emergency preparedness programs.
- Health Systems: In health systems, DNP public health nurses provide a continuum of care to chronically ill and rehabilitating patients in home care, palliative care, hospice, and complex care.
- Insurance Companies: Insurance companies employ DNP public health nurses to impart their knowledge regarding practice-based evidence related to client outcomes within specialty programs.
The Value of the DNP in Public Health Nursing
The Quad Council of Public Health Nursing, an entity that includes four national nursing organizations that address public health nursing issues, designed a competency model for public health nurses, which they grouped into eight domains:
- Analytic assessment skills
- Policy development and program planning skills
- Communication skills
- Cultural competency skills
- Community dimensions of practice
- Basic public health sciences
- Financial planning and management skills
- Leadership and systems thinking skills
At the advanced level, public health nurses are expected to be proficient in the above named domains—proficiency often attained through the completion of a practice-focused doctorate degree with an aggregate/systems/organizational focus in public health.
Both the Quad Council and the American Association of Colleges of Nursing (AACN) also support the DNP for community/public health nursing at the clinical level. The Quad Council’s position is that a doctoral education is a must for meeting the practice standards of public health nursing where the ability to work autonomously and make decisions independently is vital. The DNP is recognized for better preparing public health nurses to practice to the fullest extent of their training and licensing authority as it pertains to diagnosing illnesses and prescribing medicine.
The Office of the Chief of Public Health Practice, Centers for Disease Control (CDC) has partnered with national public health organizations to develop performance standards that will be part of an accreditation process for governmental public health actions. Public health nurses educated at the doctoral level are best prepared to meet the vision, mission, and goals of the CDC’s initiative and provide leadership and guidance at a time when municipal, state and federal public health programs will be expected to meet accreditation standards.
The Association of Community Health Educators has long promoted graduate-level education as being the base standard for preparing the public health nursing leaders of the future. This is because today’s public health nurses are expected to assume high-level roles in the planning and implementation of health promotion and maintenance programs.
A DNP program prepares public health nurses to become leaders in policy development, advocacy, education, management, and practice. DNP-educated nurses in public health are therefore capable of:
- Leading efforts to attain optimal health for populations, whether on a local, national, or global scale
- Establishing public health priorities in a confident and articulate manner
- Collaborating with local, national, and global government entities to develop health initiatives
- Leading health policy development at all levels to address health disparities
- Developing programs designed to improve the health of populations
- Leading healthcare reform efforts within and across healthcare systems
DNP-prepared public health nurses are positioned to achieve leadership roles in:
- National and international health agencies
- State and local public health departments
- Colleges and universities
- Legislative bodies
- Private businesses
- Managed care organizations
- Not-for-profit health promotion organizations