What's in a Name? Evolution of Public Health Nursing

Background: After following a young girl to visit her mother lying on a bed of blood stained sheets following the birth of a child, Wald (1915) wrote “that morning's experience was a baptism of fire…On my way from the sick-room to my comfortable student quarters my mind was intent on my own responsibility. To my inexperience it seemed certain that conditions such as these were allowed because people did not know, and for me there was a challenge to know and to tell (Wald, 1915, p. 8). Wald recognized the need to educate both the public and the profession about health care in the community. This care included both the care of the ill and the well person in the community. Over time, terms describing the nurse that provided this care included district nurse, visiting nurse, public health nurse, community health nurse, and home health nurse. As the public health nursing role evolved, so did the nomenclature, leading some to question, “what is a public health nurse? Methods: A historical review of the published public health nursing literature beginning in the late 19th throughout the 20th century was completed. ?” This study examines the history of public health nursing and the educational requirements of this role by exploring the shift in roles as the names changed throughout the late 19th century until today. Results: The changing name reflects a variety of social, political, and economic factors that affected the implementation and focus of the role of the public health nurse. Conclusions: The ability to continue to work in public health, regardless of the term applied to their work, shows the resiliency of public health nurses. Social justice, although challenged by competing factors, remains a common thread of this specialization. Gaining clarity in the evolving role of the public health nurse offers greater opportunity to educate leaders in public health nursing.