Public Health Nursing Job Descriptions: Do they Align with Professional Standards?

Background: The American Nurses' Association (ANA) 2007 Public Health Nursing: Scope and Standards of Practice along with the Quad Council's PHN Competencies frame the practice of public health nurses (PHNs). The preface for ANA's PHN Scope and Standards encourages using the standards as the basis of PHN job descriptions. This study sought to assess the extent to which PHN job descriptions are aligned with the ANA's PHN Scope and Standards and the Quad Council competencies.

Methods: We obtained PHN job descriptions from three local health departments in Illinois and three in Washington. All PHN job descriptions (n=12) were used, irrespective of degree requirements. First, we created a cross-walk of ANA PHN Scope and Standards with the Quad Council Competencies to assure consistency in our coding of statements. Statements from the job descriptions were content analyzed, categorizing statements into the 16 ANA PHN Scope and Standards and using Quad Council Competencies as additional definitions of each category. To code all job statements related to PHN practice, two categories were added which were MPH competencies from the Associations of Schools of Public Health. Interrater reliability was established with a second researcher.

Results: Only 2 PHN job descriptions required a Master's degree. All 12 PHN job descriptions had statements related to Standards #4 Planning, #8 Education, and #12 Ethics. Overall, less than half of the PHN job descriptions had statements coded as Standards #13 Research (42%), #14 Resource Utilization (42%), or #5c Consultation (33%). Only two job descriptions (17%) included statements related to Standard #3: Outcome Identification.

Conclusions: Our small sample indicates key population-focused PHN standards were not included in job descriptions. Attention to the human resource management aspect is necessary to align job descriptions with current professional scope and standards for basic and advanced PHN practice. The lack of statements regarding Standard #3 Outcome Identification has serious implications for PHN involvement in quality improvement and health care planning. Future research needs to examine the consequences of not aligning PHN job descriptions with and not practicing each of the professional PHN standards.