3078.0: Monday, October 22, 2001 - 1:00 PM

Abstract #19151

Diamonds in the rough: Learning to be a public health nurse

Lee SmithBattle1, Margaret Diekemper, RN, MSN, CS2, and Sheila Leander, RN, MSN1. (1) Saint Louis University, 3525 Caroline St., St. Louis, MO 63104, 314-577-8980, smithli@slu.edu, (2) Nursing, Maryville University, 8039 Gannon, St. Louis, MO 63130

The development of clinical expertise among public health nurses (PHNs) remains unexamined. Two succcessive studies were designed to address this gap by recruiting 60 nurses from various practice settings and with varied levels of experience. During group and individual tape-recorded interviews, PHNs detailed examples of meaningful and difficult clinical situations; less experienced nurses (n=20) were also reinterviewed twice in six month intervals and observed one time in clinical situations for a four to six hour period. For this paper, narratives from the less experienced PHNs were analyzed with interpretive methods to describe changes in their understanding of PHN practice over time and to capture the development of clinical know-how. The themes to be described include: moving from a technical to a situated understanding of practice, grasping the big picture, and learning the community or population through the eyes of clients. This analysis extends the authors' previous work and is consistent with recent PHN documents. However, the findings may be at odds with undergraduate educational practice which increasingly promotes aggregate practice in the absence of population-focused clinical experiences with individuals and families.

Learning Objectives: 1. Describe the development of clinical know-how among public health nurses. 2. Discuss what promotes and undermines the develoment of clinical know-how among public health nurses. 3. Describe the implications of the findings for orienting and mentoring newly hired public health nurses.

Keywords: Practice-Based Research, Public Health Nursing

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

The 129th Annual Meeting of APHA