Public Health Nursing workforce trends: Looking toward and planning for the future

Public Health Nurses (PHNs) are essential in improving the health of their communities. It is critical to identify PHN workforce trends to understand their impact on the health of residents of the state. PHNs were surveyed in 2006 to obtain baseline data and a follow-up survey was conducted in 2010 with a special focus on documenting a PHN/population ratio for Massachusetts. As in 2006, the 2010 survey was distributed statewide. Information on PHNs education, experience, age, scope of practice, populations served, compensation and preparedness was collected. A total of 174 surveys were returned for 183 municipalities representing more than 80% of the state's population. Data from 2010 was analyzed and compared to 2006 survey data. PHNs remained well educated, with the majority having a BSN or higher. PHNs continued to have breadth and depth of nursing experience and significant public health experience. PHNs attendance at Local Emergency Planning meetings increased as did PHN participation in exercises and drills. Emergency preparedness training percentages improved in all areas surveyed. The 2010 survey documented that the PHN/population ratio is well below the ASTDN recommendation of 1 PHN/5000 population. Enumerating a decentralized PHN workforce in a state of 351 municipalities that individually maintain and administer local public health services is extremely challenging. Despite the difficult economic climate there are innovative public health nursing practices being developed in both urban and rural communities. Robust marketing and advocacy strategies are essential to address the inadequate PHN/population ratio and the impact on the health of Massachusetts residents.