Public health and the role of the nurse: the need for greater clarity

Implementing the Rock Challenge

This paper presents the qualitative process findings from an evaluation of a school-based performing arts programme, ‘Rock Challenge’. Rock Challenge aims to promote healthy life styles ‘by building resilience amongst young people involved’. The research aimed to capture the experiences and perceptions of young people’s involvement in the programme, particularly in relation to the concept of the ‘drug-free high’, support offered throughout the programme and participants’ response to Rock Challenge as a drug-prevention initiative. Findings from the study suggest young people felt very positive about their involvement and, in particular, valued the skills and experiences associated with organising a performance, team-working, developing confidence, friendship, fun and excitement. The excitement felt during dance rehearsals and the live performance was associated with the concept of a ‘drug-free high’, feeling good in the absence of drugs and alcohol, and was seen as a key benefit of the programme. While support from teachers and families was perceived as high, difficulties were identified in the recruitment of males and students vulnerable to substance misuse and recommendations are made for improvement. The health promotion opportunities for school nurses and other public health practitioners and personal, social and health education co-ordinators are highlighted.

Exploring the contribution of district nurses to public health

To date the public health role of district nursing has been less well defined than in other branches of community nursing. A qualitative study examining the public health role of district nurses was undertaken in a West Yorkshire primary care trust. The study explored the range of public health activities currently undertaken by district nurses, the agendas perceived as most conducive to input and the organizational barriers that prevented greater involvement in public health from district nurses. Focus group and individual semi-structured interviews were undertaken with 21 members of the district nursing team and analysed using thematic content analysis. The findings suggest that district nurses were already undertaking a range of public health and health education activities but much of the work was opportunistic. District nurses perceived themselves as well placed to undertake locally based health action because of their profile in the local communities together with local intelligence. However, ineffective referral criteria were considered to be the most prohibitive barrier against making a greater contribution to health improvement.

The role of district nurses in public health: a discussion

The government has challenged community nurses, through recent policy changes, to become more involved in improving the health of local populations. However, very little has been written about the role of district nurses within this agenda. This article explores these opportunities and discusses some of the challenges facing district nurses if they are to embrace this new agenda. A model is examined which details four approaches to public health in which district nurses could contribute: individual advice-giving, personal support, environmental control and community development. District nurses have many valuable skills and attributes that could be utilized within all four approaches; it is important that they use these skills in collaboration with others. There will be implications for the future education and leadership of district nurses.

A stage planning programme model for health education/health promotion practice

AIM

To investigate the validity of a stage planning programme model for health education/health promotion practice in nursing settings and to develop a specific model for this purpose. Background/rationale. The last decade or so has seen a marked increase in the amount of health educational/health promotional activities that nurses are expected to undertake. This has followed concerted calls to make health promotion a familiar and recognized part of nursing practice. Despite this, however, current health-related practices are still unstructured, haphazard and under-evaluated. This state of affairs is further compounded by the lack of any generic and systematic nursing planning process model by which health education/health promotion programmes are applied in practice. This paper puts forward the case for such a model, develops it, and demonstrates its possible application in clinical settings.

METHOD

A systematic literature review was conducted in order to develop a new theoretical perspective for health promotion/health education nursing practice. The proposed model has evolved from this new perspective. The process of developing this model has drawn on existing contemporary planning models--using them as a means to develop a conceptual framework. Consequently, the proposed model seeks to critique, adapt and adopt some of their components within a nursing context.

CONCLUSION

If the current situation continues, in which planning process models are not adopted as a routine part of practice, then nursing may well remain a "bystander" in health promotion/health education.