"I think the National Nurse Office is a great idea. I would just hope that if there are state coordinators and teams (it was not clear if these are volunteer positions or paid) that they would coordinate closely with exisiting local and state public health efforts already undertaken by state and local health departments so that there is not duplication of effort and that efforts in promoting health are coordinated. Perhaps even contracting with exisiting health departments and provide funds so that their own local staff, who are already familiar with the community, would help them to expand their outreach and education efforts."
Answer: Yes, the state coordinators would be federally paid positions. These individuals most likely already work in the public health system in their own state and would take over this job, leaving the job they have now to be filled by another public health nurse. The state coordinator would absolutely work alongside the existing state and local health departments to avoid duplication and better coordinate the volunteer National Nurse community teams. A member of the community team may be a nursing student, a retired or currently working nurse. This individual may only wish to participate in one of the four community educational programs available to the public or may choose to do all four. This is strictly their decision.
Nurse from California replies:
"Some states have a director of nursing at the state level for public health (Calif. does not though we would like one). For
those states that do have such a nurse, it would be important to have this new "state nurse" have a clear role that coordinated with the existing director of nursing at the state level. There is already such a lack of understanding among the public and politicians about what public health nursing is and does that further confusion should be avoided. Also there is a great need to move these efforts at health improvement from the individual level (interacting with people one by one) to the
community and systems level of practice. We have been greatly influenced by our Minnesota colleagues articulation of public health nursing practice at 3 levels. Historically, improvements in health for the whole population have come from improvements in the physical and social environment rather than attempting to influence people one by one. Public health nursing is playing a stronger role in this especially related to "creating healthy communities". I would hope that the National Nurse effort would tie into the achieving of the goals of Healthy People 2010 and would allow for customization at the state level given that states have varying degrees of the severity of certain problems and varying degrees of health disparities."
Response:
The already existing state nurse would work with the National Nurse state coordinator and help to disseminate information from the Office of the National Nurse to the community level.
The National Nurse will complement the work of the Surgeon General as well as the Director of the CDC and the HHS Secretary. The weekly broadcasts coming from the Office of the National Nurse will heighten the public's awareness and knowledge about nursing and public health. Maybe some politicians will watch or listen to the broadcast too.
The National Nurse is one solution to a complex problem-the present crisis in our healthcare system. It is not meant to solve every problem, but to be one pragmatic and cost effective solution.
Healthy People 2010 would have more chance of succeeding with the Office of the National Nurse than without it.
We, the National Nurse team, welcome your emails, comments, and suggestions. Nursing is teamwork, and when we work together, our patients win.
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