Independent nursing practice: A role for the public health nurse

Most nurses will tell you that “making a difference” in another persons life is the most important variable for job satisfaction. For the past five years, Community Parish Nursing has “made a difference” in the lives of over 200 of our frail neighbors, who lived within the town of Reading MA. This mission was accomplished because of a key role: Nurse Advocate. Independent nursing practice gave the nurse an opportunity to be self-directed and creative in building a lasting relationship with each frail elder. Qualitative data supports the supposition that when the frail elder has an “acute” medical episode that requires emergency care, that individual can easily becomes at risk for losing his/her ability to return to their community. Because the nurse advocate had a relationship with the frail, when that ultimate acute medical situation occurred, the nurse was in a position to effectively collaborate and coordinate with the health care team and community support services to assure the desired wishes of the frail to return to their home. Effective nurse advocacy made this outcome a reality thereby “making a difference” for the client. Nurse advocacy, the art and science of nursing, has always been a legitimate role of the professional nurse. However, the nursing profession must lay public claim to this area of independent practice by designing and marketing nurse advocacy certification programs within the academic setting. As nurse advocate, the public health nurse will have one more role option to “make a difference” within the community.