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Abstract
In view of the intensity of focus on public health developments this paper is presented as a timely sharing of one nursing population's perceptions and experiences in response to the public health agenda. It is based on an on-going research project evaluating the public health nurse function in one primary care trust (PCT), in the North of England. It is guided by theories of change and action research methodologies and data has been collected in the form of individual and group interviews. A variety of interpretations of thE public health nurse role and the relationship with the health visiting role are explored. Some of the tensions and challenges involved in operationalising the public health response are then exposed. Attention is drawn to the potential impact of the lack of a distinctive role model of practice development in this area. Health visitor perceptions of their current and potential contribution to the public health agenda are reported and three models of public health provision are emerging.
Key words: public health nursing, health visiting, models of practice
Introduction
All community nurses are facing the challenge of responding to the public health agenda. Service organisation and delivery responses have been varied and are continuing. Scotland1 has chosen to follow a particular model country wide. This involves the introduction of public health practitioner posts which have a significant leadership and strategic role. Alongside this there is the new education provision for public health nurses. In contrast, the response in England has been more diverse with multiple models being adopted. Indeed Craig2 reports that:
`The term `public health nursing' is relatively new to the UK. It appears to have been introduced early in the 1990s without proper definition and has sparked off wide debate and some confusion about the potential roles of nurses in relation to public health.' (p5)
This paper is developed from an on-going study evaluating the introduction of a public health nurse post in what was a primary care group (PCG), in a city in the north east of England. This post was intended as a complement to existing community nursing roles. The post remit was to lead/assist with specific project activities such as service and population need mapping, contribute to training needs audit...