What is Public health nursing?
Public health nursing is the practice of promoting and protecting the health of populations using knowledge from nursing, social, and public health sciences.
The title “public health nurse” designates a nursing professional with educational preparation in public health and nursing science with a primary focus on population-level outcomes. The primary focus of public health nursing is to promote health and prevent disease for entire population groups. This may include assisting and providing care to individual members of the population. It also includes the identification of individuals who may not request care but who have health problems that put themselves and others in the community at risk, such as those with infectious diseases. The focus of public health nursing is not on providing direct care to individuals in community settings. Public health nurses support the provision of direct care through a process of evaluation and assessment of the needs of individuals in the context of their population group. Public health nurses work with other providers of care to plan, develop, and support systems and programs in the community to prevent problems and provide access to care.
What are ethical issues?
Ethical issues occur when a given decision, scenario, or activity creates a conflict with a society’s moral principles. Both individuals and public health practitioners can be involved in these conflicts since any of their activities might be put into question from an ethical standpoint. Public health practitioners including nurses are subject to these issues in their relationships with other individuals or in their relationships with organizations and the same goes for organizations.
These conflicts are sometimes legally dangerous since some of the alternatives to solve the issue might breach a particular law. On other occasions, the issue might not have legal consequences but it might generate a negative reaction from third parties. Ethical issues are challenging because they are difficult to deal with if no guidelines or precedents are known. For this reason, public health regulatory bodies and associations have ethical codes that provide a useful framework for practitioners and institutions to make adequate decisions whenever they face one of these conflicts.
Ethics are essential to the integrity of the public health nursing profession as it helps ensure better population care. Public health nursing is a highly fast-paced job with new challenges arising daily and public health nurses across the globe all dealing with similar ethical dilemmas. Many of these situations are rooted in protecting the population or patients ‘ rights, adequate staffing, advanced decision-making, and quality of care. Unfortunately, with the large number of inexperienced public health nurses entering the profession, many of them are unfamiliar with dealing with ethical issues in nursing.
Examples Of Ethical Issues In Public Health
There are several examples of ethical issues in public health nursing. Consider how you might respond to each. In addition, consider your own feelings and biases when addressing these scenarios.
- You arrive at a client’s home for a visit late on a Friday afternoon. This single mother of three tells you that she does not know what she will do for the weekend because she is out of food and does not have anyone to help her. You know that she is new to town and does not have an established support network. Her WIC and SNAP are used for the month. The food shelf is closed until Monday. She asks you if you know anyone she can borrow money from.
Should you loan/give her the money? Should you go purchase some food?
Knowing this would not be a financial hardship for you, what is your role as a nurse?
- One of your prenatal clients informed you that she does not plan to immunize her baby. Her husband objects to “putting poison in the baby.” Although she has been interested in the education you have provided on the topic, she is afraid of disagreeing with her husband. You know there is a history of domestic violence.
Should you encourage immunizations? If the baby doesn’t get immunized, is this medical neglect?
Do you need to report this to anyone?
- An elderly client pays his grandson $100 a week to drive him to the grocery store and pharmacy. The client does not have enough money to pay for his newly prescribed insulin and is afraid that if he tells his grandson that he can’t pay him he will quit coming to help.
Is the client a vulnerable adult? Is this financial exploitation? Do you need to report it?
- One of your clients with tuberculosis has personal care assistant (PCA) services provided by her daughter. You arrive one day to find the client lying on a mattress on the living room floor and “can no longer walk,” although there are no other symptoms that would indicate a health concern, and the client was walking at the last visit. You learn later that day someone is coming to evaluate for additional PCA hours. If she is allowed additional hours, her daughter can make additional income and not have to get a second job.
Is this fraud? Do you need to report it to anyone? Is this client a vulnerable adult?
- You worked with a client throughout her pregnancy and now, postpartum, while she is establishing breastfeeding. She told you that she smokes “weed” every once in a while, to deal with the anxiety of being a new mother. Generally, she smokes in the evening when her boyfriend is home from work and can help with the baby.
What concerns do you have? Would your concerns be the same if she was still pregnant?
Is this a child protection issue?