Competence in public health nurse practice: What it takes to be proficient in a small, full-service health department

The Public Health Practice Standards of Performance for Local Boards of Health in New Jersey is the legislative law for public health nursing practice in the state. The standards mandate that public health nursing practice incorporate the core public health functions of assessment, assurance, and policy development within the art and science of professional nursing practice through a systematic process which promotes and protects the public health. The implementation of the mandates of this law at the county level is the responsibility of the Public health nursing division of the county health department. These mandates are fulfilled through a variety of programs that will be described. There is a concern that nurses are not prepared to assume the role as described in the law. The difficulty providing competent public health nursing services will be analyzed through a review of the public health curriculum of a local community college and a local baccalaureate program. The job description and skills needed for day to day practice in a local public health department are compared with the educational preparedness of the nurse. In addition to concerns about educational preparedness, there are political and legislative changes that affect the ability of the public health nurse to function. The local, state and national political and legislative climate and its impact on public health nursing practice will be discussed. Suggestions to prepare and support the public health nurse for a career in local public health agencies will be presented.