By Janet E. Resop Reilly, DNP, APRN-BC, RN, Julie Fargen, MSN, RN, and Kimberly K.

Walker-Daniels, BSN, ADN, RN-BC, CMSRN

A Public Health Nursing Shortage

Encouraging nurses to go back to school can augment this workforce.

n 1980 there were 219 pub lic health nurses per 100,000 people; by 2000 this number had dropped to 158 per 100,000, acc ording to a 2008 report by the Robert Wood Johnson Founda tion. Fewer nurses are entering this fieldeven as their services are in greater de mand. Last years Patient Pro tec tion and Affordable Care Act and Health Care and Education Rec onciliation Act extend the provision of prevention and well ness services that are often provided by public health nurses. In light of a predicted gen eral shortage of 1 million nurses by 2020, the In stitute of Medicine, in its recent Future of Nursing report, stressed the im portance of attracting and retaining wellprepared nurses in multiple care settings, including those in public health. Although a bachelor of science in nursing (BSN) degree isnt universally required for entry into public health nursing, its practically essential. The U.S. military, U.S. Department of Veterans Af fairs, U.S. Public Health Service, many hospitals, and some states require a bachelors degree as the minimum educational preparation for nurses. Yet most RNs with di plomas or associates degrees dont continue their education and are thus ineligible to work in public health. The 2008 National Sample Survey of Registered Nurses found that only 12.4% of nur ses who obtained a diploma or associates degree between 2001 and 2004 went on to earn an addi tional degree. Unfortunately, recruiting nurses to BSN programs for the study of public health isnt as simple as
ajn@wolterskluwer.com

hanging a help wanted sign. Among the formidable barriers is a lack of information about public health nursing in associates degree program curricula, which typically expose students to hospitalbased and long-term care nursing

options are more plentiful for nurses who attain a BSN. In addition, these students are offered guidance on the procedures to follow when transferring credits. Two BSN-level nursing courses, Commu nity

Options are more plentiful for nurses whoattain a BSN.

J.E. Resop Reilly J. Fargen
K.K. Walker-Daniels

almost exclusively. Associates de gree students may be more likely to consider completing a BSN and working in this field iftheyre taught about the role of pub lic health nurses as educators and case managers and learn about the potential advan tages autonomous practice and flexible hours, for instanceof a career in public health. Other barriers facing students who seek to further their education include a significant outlay of time and money, personal and family issues related to these chal lenges, and the complexity of the application process. Structured advisingand professional mentoring that focuses on each students particular needs can help address these concerns. The nursing student support staff at the University of Wisconsin Green Bay Professional Program in Nursing, which specializes in RN-to-BSN education, speak to students earning their associates degrees in the classroom and atedu cational fairs, for instance, emphasizing that professional

Health Nursing and Nursing Research, are also offered to select students before they formally matriculate into the BSNcompletion program, speeding up the time it takes to achieve this degree. We must nurture in all students the belief that an associates degree is just the first step on the way to a BSN or more adv anced degree. Doing so will enable us to develop a public health nurs ing workforce that meets the intensifying demands placed on this field. t
Janet E. Resop Reilly is an assistant professor and family NP at the University of WisconsinGreen Bay Professional Program in Nursing. Julie Fargen is an in structor of nursing at Western Technical College, La Crosse, WI. Kimberly K. Walker-Daniels is a medicalsurgical nurse in Madison, WI. Contact author: Janet E. Resop Reilly, reillyj@uwgb. edu.This manuscript was supported byfunds from the Division of Nursing, Bureau of Health Profes sions, Health Resources and Services Admin istration (HRSA), and the Depart ment of Health and Human Services (DHHS) under DHHS/HRSA D11HP07731, Linking Education and Practice for Excel lence in Public Health Nursing.

AJN t July 2011

Vol. 111, No. 7

11