In a bid to provide better health in the community, the approach to the management of health has since evolved from curative and rehabilitative to preventive care. Over the time, the changes have been aggravated by various eventualities hence the modification in the approaches. The main purpose of this paper is to outline the milestones made looking at the specific developments over time. The paper also outlines the functions of the community health nurse at different levels. Of the essence, the paper states the impact of community health nursing in the quest to form a better and healthy nation.

The concept of public health nursing involves both health promotion and infection prevention measures. The concept has evolved over the years due to various circumstances. In the U.S, the concept of public health has gained profound support over the recent past. The belief of healing as the only health care has maintained the ascendancy over preventive and promotes health care over a stretched period. By the fact that so many resources are allocated to manage the sick, both the government, insurance companies and individuals have resulted in a preventive form of healthcare model. The concept of public health nurse came into play as long as the 1800 by the initiatives of Florence Nightingale. She provided training to her nurses on the public health concept and assigned them areas in London. The specific nurses were held responsible for the people's health in their areas of allocation. According to Florence, nightingale the work they were engaged in was to remove things that disturb health. The substances that agitated health include drink, diet, drains and damp.

Nightingales model of district nursing emerged in the United States New York city in 1877. At the time of district model emergence, graduate nurses provided care for the sick in their residence. Lillian Wald, emerged as the leader of the public field at this time. After establishing Henry street settlement house, Lillian Wald realized that the source of the sickness at the homes comprises larger societal problems.

As the concept of public health nursing gained popularity, there arose issues that propelled its implementation to a higher level. The cost of treatment in the hospitals became too expensive for individuals and the insurance companies. By the fact that there are a shortage of nurses and the limited hospital bed capacity, most individuals reverted to home-based care where they needed a physician, and the nurse treats them at the comfort of their homes. The government too in a bid to reduce expenditure on the curative measure has reverted to funding the preventive model of care. However, in the early years, the public health concept did not get a good reception by the governments.

The main work of the public health nurses lies with communities; this includes the families and individuals that make up the communities including all the systems that affect the communities. Public health nurses work in schools, homes, jails and clinics. The nurses have a myriad of roles that they play in the provision of their services. They key push of the of the public health nurse is the availability and accessibility of affordable housing by working with supportive housing advocates since the environment that one dwells in plays a key role in the health status. The nurses are responsible for the immunization rates in the community.

The public health nurse has to conduct a survey on the rates of immunization which later guides the decision making on the provision of vaccines. The nurses in public health play a great role in the epidemiology; they also help young mothers to take care of themselves and taking care of their young ones. The public health nursing, therefore, is of the essence in the promoting health status of a nation by the fact that it addresses the problems from the roots.

The practice of public health has led to a greater impact on improving the public's health through individuals, families and population-based interventions and health strategies. The public health nurses impact has been demonstrated clearly. The impact is evident by the fact that long-term improvement reported with a number of randomized prospective clinical trials has been reported in children and women's lives visited by the public health nurses. Swiadek (2009), agrees on the children various improvement areas included, behavior problem incidences reduced, the achievement the scores increased, the level of aggression decreased, and the intellectual functioning increased.

On the other hand, the mothers who received the care of public health nurse showed a better outcome of reduced substance abuse, long between pregnancy intervals, improved infant-maternal interaction and more. Studies by olds in the year 2004 showed an improved outcome between families that received public health nurse with those that received services from the paraprofessionals.

The nurses provide their services to the number of people per a single nurse in the different levels of care delivery. Because of the difference in the numbers the nurse will be guided on the approach to use if the provision of the services. The various approaches are convenient if all the people are served adequately. At the local level, the nurse serves 24.6% of the total clients' people while in the state level the nurse serves 35.8% of the clients' people, in the national level the nurse plays a major role of policy formulation to a greater extent they also serve 39.6% of the clients (Van Wave, Scutchfield & Honoré, 2010)

The shortage of the nurses who lead to an increased number of people a nurse serve has led to the increased need for more public health nurses. The overwhelming numbers pose a challenge of providing adequate care to the members of the public. However, the statistics have led to increased number of young people taking nursing as their undergraduate course (Stanhope et al., 2014).

The concept of public health nursing has evolved over time. It has seen the number of hospital admissions dwindles and increased health in the community. The increased number of clients who need the public health services has led to a more sophisticated mode of training. More young citizens have joined the nursing profession.


Stanhope, M., & Lancaster, J. (2014). Public health nursing: Population-centered health care in the community. (Rev. 8th ed.)Philadelphia: Mosby Elsevier.

Swiadek, J. W. (2009). The impact of healthcare issues on the future of the nursing profession: The resulting increased influence of community-based and public health nursing. Nursing Forum, 44(1), 19-24.

Van Wave, T. W., Scutchfield, F. D., & Honoré, P. A. (2010). Recent advances in public health systems research in the United States. Annual Review of Public Health, 31, 283-295. doi:10.1146/annurev.publhealth.012809.103550.

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