Following the Patient: Nursing in the Community
Public Health is the science and the art of preventing disease, prolonging life and promoting physical and mental health and efficiency...
C. E. A. Winslow, The Evolution and Significance of the Modern Public Health Campaign (1923)
The new field of public health nursing that emerged in the 1890s offered early School of Nursing graduates a challenging alternative to private duty and hospital nursing. With nurses at the forefront, the public health movement spread across the nation. Hundreds of privately run charitable organizations funded nursing services. Convinced that disease itself would soon be conquered, middle and working class Americans welcomed public health nurses into their homes, schools, and factories. Public health nurses, freed from the restrictions of hospital nursing, expanded their scope of duties and responsibilities and acted with considerable independence as both nurses and teachers.
The nursing profession's leadership role in public health proved to be short-lived. By the mid-1920s, public health was increasingly a governmental concern and public health nurses had become health teachers rather than direct caregivers.
Above: Nursing student on public health rotation in western Baltimore, 1960.
Redefining Public Health to Serve the Community
Beginning in the 1960s, the term "community health nursing" emerged to describe the work of private, community-based, non-profit organizations providing services not offered by government agencies. Over the next two decades, community health nursing broadened to include nursing practice in a variety of community-based settings from health departments, schools, worksites, and visiting nurses associations to physician's offices, non-profit clinics, and for-profit home health companies.
Today, community health nursing combines the traditional public health concern for health promotion and disease prevention among underserved populations with the provision of direct care in the home. Nursing's future challenge will be to reunite these aspects of practice and deliver health care for the benefit of entire communities.