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Public health RNs satisfied, but face challenges

Thursday June 27, 2013
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A new report details the significant challenges facing the public health nursing workforce.

More than 2 in 5 state health departments report having "a great deal of difficulty" hiring nurses, and nearly 40% of state and local health departments report having insufficient resources to fill vacant nurse positions, according to the report.

The report, released by the Robert Wood Johnson Foundation, is described as the first comprehensive assessment of the size, composition, educational background, experience, retirement intention, job function, and job satisfaction of nurses who work for state and local health departments.

Researchers with the University of Michigan Center of Excellence in Public Health Workforce Studies collected data from state and local public health departments and surveyed public health nurses. Those surveyed reported concerns about job stability, compensation and career growth in light of budget-tightening at many state and local health departments.

Yet these nurses also reported very high levels of job satisfaction and felt they are making a difference in their communities. Such factors could bolster recruitment efforts, according to an RWJF news release.

The report offers a snapshot of the public health nurse workforce — estimated at 34,521 full-time equivalent RNs — and highlights the need for ongoing systematic monitoring to inform competency, compliance and credentialing efforts; permit better alignment of academic resources with workforce needs; and allow for better understanding of the relationship between workforce infrastructure and population health outcomes.

Among the key findings:

• Nearly 2 in 5 respondents to the survey (39%) report their highest nursing degree is a diploma/associate’s degree. Only 10 states require public health nurses to have BSNs.

• Providing clinical services is part of the work done by RNs in state and local health departments, but these nurses assume a wide variety of roles, including health promotion, disease surveillance, community health assessment, policy development and more.

• The public health nursing workforce does not reflect the diversity of the communities it serves: Only 4% of public health nurses self-identify as Hispanic/Latino, and 95% of those in leadership positions self-identify as white.

• The public health nurse workforce is aging, but most RNs do not intend to retire within the next five years.

• Recruitment and hiring of RNs into public health nurses positions can be challenging, particularly for state health departments.

• Lack of promotion opportunities is a concern to both health departments and RNs.

• Public health nurses report extremely high levels of job satisfaction despite reporting high levels of dissatisfaction with salaries.

Recommendations in the report, created by the project’s advisory committee, include:

• Develop feasible opportunities for additional education and training for public health nurses.

• Improve the pipeline and intensify recruitment so public health nurses in health departments reflect the racial and ethnic composition of the communities they serve.

• Determine how changes in the functions of public health departments, due to healthcare reform and the transformation of public health agencies’ work, may affect the education public health nurses need.

• Identify options to address concerns about recruitment, compensation and promotion opportunities.

• Conduct follow-up studies to monitor size, composition, capacity and functions of the public health nurse workforce over time, to help ensure the workforce is well-prepared to meet emerging needs.

"It should be a high priority to address gaps and take steps to strengthen the public health nursing workforce," Pamela G. Russo, MD, MPH, senior program officer for RWJF, said in the news release. "As health reform is implemented, and as public health agencies are transforming to a more population health-oriented role in promoting health and protecting communities, public health nurses will need additional training to keep pace with the changes. The size, makeup and preparation of the public health nursing workforce greatly affect the ability of agencies to protect and improve the health of people in their jurisdictions."

Read the report: www.rwjf.org/content/dam/farm/reports/reports/2013/rwjf406659.


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