From the time of Florence Nightingale, nurses have applied a holistic approach toward treating patients within the context of their communities. Today, this approach entails promoting and practicing population health. To do so effectively, nurses need supportive educational, policy, research, and workplace environments.
My passion for public health was ignited early on in my career in nursing, serving children and families in St. Louis’ Head Start program. I quickly realized that the health of the individuals for whom I cared depended on a complex mix of factors—including personal choices, the opportunities they had available to them (or not), and the resources within their communities. And my time in St. Louis set me on a career path in nursing that has shown me just how integral a role nurses can play in the health of not just their individual patients, but the broader population.
Nurses have always played a key role in improving our nation’s health and well-being. We see people—not just at different stages of their lives, but also in all of the different places our patients live—using nursing skills and expertise to care for them in many different ways.
We need that valuable perspective, training, and expertise to help build a Culture of Health and well-being, now more than ever. In the 20th century, our focus was on reducing deaths from communicable diseases such as tuberculosis and pneumonia—and we succeeded, adding nearly 30 years of life expectancy to American lives. Now, in the 21st century, we face a different kind of “epidemic”—premature death caused by noncommunicable diseases driven, in turn, by the multiple determinants of health.
Across all ages and demographics, our nation suffers from increased rates of chronic conditions. We are living shorter, sicker lives than people in many other countries.
We can’t solve these problems by using the same kind of thinking that created them. We must improve health by creating fair and just opportunities for everyone, through systemic change that addresses urgent needs such as acute care, criminal justice reforms, and income assistance and improves vital conditions that enhance well-being—from education to employment to a healthy living environment. Every day, nurses work in the places where these urgent needs and vital conditions intersect.
Arturo Rodriguez, RN, MPH, CPM, a 2015 Culture of Health Prize winner, works at that intersection every day in Brownsville, Texas. Arturo, the local director of public health and wellness, led city efforts to turn an abandoned rail line into a multi-use, paved trail that not only encourages physical activity, but spurs residential pride. On any given day, you’ll find bikers, joggers, dog-walkers, and families out for a stroll on the new trail. The trail project has sparked other changes, too—such as an indoor smoking ban that is helping the community achieve better health. And Arturo has begun leadership training to sustain the work that’s been done in Brownsville, and train the next generation of public health nurses.
How do we replicate examples such as Arturo’s and harness this nation’s more than 3 million nurses to build healthier communities? By equipping nurses with the tools they need to practice truly population-focused nursing.
Earlier this year, the Robert Wood Johnson Foundation set out to explore the roles nurses can play in helping our nation reverse course on the declining health of its citizens and promoting the health of the population. We commissioned a white paper, Catalysts for Change: Harnessing the Power of Nurses to Build Population Health in the 21st Century, to identify specific calls to action not just for nurses, but for nurse educators, policymakers, researchers, business leaders, and more.
These recommendations focus on five broad areas:
- Nursing education—including integrating population-focused nursing concepts into the curriculum for nursing students at all levels.
- Nursing practice—including fostering cross-disciplinary collaboration and providing nurses with tools to connect families with local resources.
- Nursing leadership, with a focus on nurturing nurses and nurse leaders who consider individuals and families in the context of their environment—and supporting a pipeline of population-focused nursing leaders.
- Population health research, which means both supporting the development of nurse researchers—and ensuring we study the impact of nurses on population health initiatives.
- Nurse advocacy and policy, supporting efforts already underway in support of the Institute of Medicine’s 2010 report, The Future of Nursing—and advocating for funding for population-focused nursing education and research.
If you’re a nurse, you can play a pivotal role in helping this work move ahead. Are you an acute care nurse? Know your community and how to link your patients to needed resources. Read your hospital’s community health needs assessment. If you are a public health nurse, help people understand your role. Talk to businesses, city officials, and other people who don’t work in health care to help them see beyond the visiting nurse role and understand how you can contribute to better outcomes through making connections and improving community services and systems. No matter where you work, you can make a difference by building relationships across sectors and roles, advocating for the most vulnerable—and by helping craft solutions.
Not a nurse? You’re not off the hook. If you’re a business leader, a health care professional, a policymaker—or anyone who cares about the health of our communities—make an effort to bring in a nursing perspective to your discussions. Help redesign our systems so that nurses have the right resources and environment to continue this crucial work of building the best possible health and well-being for all.
Read more about population-focused nursing, and let’s work together to create change.
About the Author
Paul Kuehnert, former assistant vice president, provided leadership and management direction for the Foundation’s work related to leadership and transforming health and healthcare systems.