Role of Nurses in Health Promotion

Public health nurses are a link between the government and the population concerning public health. With children, young people, and families as their main target groups, PHNs can contribute to changing and improving the quality of life and reducing inequality in the population. The concept of public health, which can be understood as “collective action for sustained population-wide health improvement”, has traditionally had a narrow view of public health. This biomedical disease model is based on a pathogen-risk focus, with attention given to problem-solving strategies.

Local communities are considered as arenas for health promotion. The population can be divided into two groups: a population-at-risk group, with a focus on disease prevention; and a population-of-interest group, with an emphasis on health-promotion strategies. This form of thinking was recognized in the former regulations for public health nursing and in the successor, a recent national professional directive for health promotion and disease-prevention work in public health nursing. It highlights the goals of PHNs’ work in child health clinics and school health services: to promote mental & physical health, good social & environmental conditions, and to prevent disease & injury.

As early as possible, the service shall screen children and young people, conduct an assessment, and make a referral if needed. This universal service shall target both individuals and the population. PHNs’ social mandate with an increased emphasis on population-based work and particularly health-promotion strategies, such as empowerment stimulated by meeting with service users in an open and respectful way and engaging in dialogue, thereby revealing their own resources has become more complex. However, a review of the international literature shows that nurses often misunderstand the concept of health promotion.

Their focus has been on changing individual behaviors; meanwhile, the population focus has been somewhat ignored. The role of expert as the traditional nursing position is a view shared not only by patients and service users but also by PHNs. The more complex PHN role may still be unclear and, thus, hard to manage and define. Drawing clear jurisdictional boundaries with other professions is of importance in establishing an autonomous profession; however, these professional borders can be renegotiated which might be the current case in public health nursing.