Role Of The Family Nurse Practitioner In Global And Domestic Disease Surveillance Essay Paper

Role Of The Family Nurse Practitioner In Global And Domestic Disease Surveillance Essay Paper

The economic crash in the late 2000s and epidemics that cross countries in a matter of hours and days are all fueled by greater connections, information technology, international travel, and migration patterns. One can see how quickly a crisis or issue in one country can affect and spread to other countries through porous borders and technology venues. No longer are borders defined by traditional lines or maps as they once were. In fact, this idea of boundaries may provide a false sense of security and detachment from issues occurring in other parts of the world.Role Of The Family Nurse Practitioner In Global And Domestic Disease Surveillance Essay Paper

What Is Community Health Nursing?
Community health nursing is a discipline that incorporates evidenced-based research along with advances in science and new approaches for improving the health The practice takes into consideration the cultural and socioeconomic backgrounds of the people in the community to ensure appropriate interaction and sensitivity when working with them.

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A community is a group of people in a specific location, which includes places where people live, work and go to school. Most people belong to multiple types of communities. Community health nursing is commonly practiced in geographic locations like cities and rural areas.

What Is the Goal of Community Health Nursing?
The goal of community health nursing is to promote, protect and preserve the health of the public. Community health nursing involves these basic concepts:Role Of The Family Nurse Practitioner In Global And Domestic Disease Surveillance Essay Paper

Promote healthy lifestyle
Prevent disease and health problems
Provide direct care
Educate community about managing chronic conditions and making healthy choices
Evaluate a community’s delivery of patient care and wellness projects
Institute health and wellness programs
Conduct research to improve healthcare
What Is the Role of a Community Health Nurse?
The primary role of community health nurses is to provide treatment to patients. Additionally, community health nurses offer education to community members about maintaining their health so that they can decrease the occurrence of diseases and deaths. They plan educational assemblies, hand -out fliers, conduct health screenings, dispense medications and administer immunizations.

Nurses also may distribute health-related items like condoms and pregnancy tests. Examples of some health issues that community health nurses try to control or eliminate are:Role Of The Family Nurse Practitioner In Global And Domestic Disease Surveillance Essay Paper

Infectious and sexually transmitted diseases
Obesity
Poor nutrition
Substance abuse
Smoking
Teen pregnancy
Where Do Community Health Nurses Work?
Community health nurses work in hospitals, community centers, clinics, schools and government health agencies. Community health nurses are important to regions where healthcare is not easily accessible, so they can travel to remote places and isolated areas of a city.

How Do You Become a Community Health Nurse?
To become a community health nurse you must first work as a registered nurse. If you only have an associate degree you might want to consider completing a Bachelor of Science in Nursing (BSN) degree program. Many schools like Northeastern State University (NSU) offer RN to BSN programs.

NSU has an online RN to BSN program that includes the course Community Health Nursing. This course examines the theory and research used in nursing and the public health practice, which promotes and preserves the health of communities. Students are given the opportunity to apply their current knowledge and what they learn in the course. They are paired with a community and other healthcare professionals to experience community health nursing.Role Of The Family Nurse Practitioner In Global And Domestic Disease Surveillance Essay Paper

Nursing care should be available to every American. Throughout the country, there are entire communities of people prone to chronic illnesses, infectious diseases and economic hardships. Community health nurses have the ability to improve the welfare of individuals and their communities. They are at the forefront of bringing quality patient care to the most vulnerable and underserved members of society.

Nurses play a significant role in public health and frequently serve in positions of responsibility at public health agencies, nonprofit groups and educational organizations. Public health nurses help the public stay healthy by assisting with the development, promotion and management of public health initiatives. Public health nursing (PHN) is dedicated to researching and implementing best practices for nurses who work in this field. PHN emphasizes preventive care and basic health education to help communities reduce disease, improve quality of life and enable more people to live healthier lives. With these goals in mind, nurses collaborate with local health departments and other organizations to provide health education, study population health changes, work on disease prevention initiatives, and coordinate similar efforts.

While most nurses care for one patient at a time, public health nurses care for entire populations. By working with whole communities, public health nurses are able to educate people about health issues, improve community health and safety and increase access to care.Role Of The Family Nurse Practitioner In Global And Domestic Disease Surveillance Essay Paper

Public health nurses believe a person’s health is affected by many factors, including genetic makeup, lifestyle and environment. Instead of waiting for patients to come to the hospital with an illness, they go into communities to try and help people improve their health and prevent disease.

For people who don’t have access to care, public health nurses may also provide direct health care services, including preventive care, screening services and health education.

Public health nurses also:

Monitor health trends and identify health risk factors unique to specific communities
Set local priorities for health-related interventions to provide the greatest benefit to the most people
Advocate with local, state and federal authorities to improve access to health services for underserved communities
Design and implement health education campaigns and disease prevention activities, such as immunizations and screenings
Tell people about locally available health care programs and services to improve access to care
Educate and provide direct health care services to vulnerable and at-risk populations
Health education is a primary focus of public health nurses. Drawing on their training as registered nurses, public health nurses give people reliable, useful information about how to protect their health.

In presentations at schools, community groups, senior centers and other local groups, public health nurses explain proper nutrition, demonstrate effective safety practices, promote early detection of common diseases, tell people how to care for disabled or ill family members and inform people about other important health issues. Their goal is to make health information easy to understand, so people can take greater control over their well being.Role Of The Family Nurse Practitioner In Global And Domestic Disease Surveillance Essay Paper

In low-income and rural communities, public health nurses also provide critical health care services. They immunize schoolchildren, provide pre-natal and well-baby care and teach the elderly how to stay safe and healthy at home. They also must be able to recognize and respond to potential health crises.

Community Health Nurses’ Roles
Working as a community nurse is unlike any other nursing position. By helping whole communities, community nurses act as educators, disease and injury prevention specialists, research scientists, community advocates, emergency preparedness experts, public health liaison, and healthcare professionals. In more detail, the roles of public health nurses are:

1. Disease prevention specialist
Community health nurses focus on long- and short-term care for disease prevention. Their work includes averting or controlling the spread of the flu and other communicable diseases. They work with patients to support diabetes self-management and improve diabetes control. They also work with mothers of newborns to reduce the rate of infant mortality and in schools to identify gaps in services.

2. Community educator
As educators, community health nurses focus on presenting materials in a clear and understandable format. They provide information to individuals, families, and communities that create a framework for healthy living and healthy choices. In schools they may teach sex education and HIV education classes. In the public, they hold classes and seminars on diabetes management. Overall, they focus on community health education as a step to preventive healthcare.Role Of The Family Nurse Practitioner In Global And Domestic Disease Surveillance Essay Paper

3. Leader
Community health nurses use evidence to implement policy changes and quality-based practices. They lead collaborative efforts to produce successful health outcomes and provide critical medical and social services in communities.

4. Researcher
As researchers, community health nurses collect and use evidence to execute positive changes for better health. Research is used to validate funding for public health programs, reduce inequalities in healthcare, and increase access to services.

5. Advocate
Public health nurses advocate on the local, state, and federal level to provide better access to healthcare, protect funding for public health programs, and reduce or eliminate health disparities. They help families arrange assistance through social services programs such as the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), which provides healthcare and nutritional services for low-income pregnant women, breastfeeding mothers, and children under age 5.

6. Caregiver
Community nurses cross cultural, language, and literacy boundaries to shape the health and well-being of children and adults. They provide prenatal care and education for expectant mothers, including information about maternal nutrition, referrals for childbirth classes, and postpartum assistance. They also provide resources for parents to understand proper childhood development and discipline techniques.

In addition, community nurses play other varied roles, said Virginia Crandall, Senior Community Health Nursing Director for the Florida Department of Health in Hernando County. She said working as a public health nurse provides an opportunity to use skills not used in a hospital setting.Role Of The Family Nurse Practitioner In Global And Domestic Disease Surveillance Essay Paper

“Whether it is Ebola, Zika, budget challenges, hurricanes, clinic operations, dog bites, tuberculosis, sexually transmitted diseases or HIV, there is always a new challenge and a new opportunity to make a positive difference,” she said.

Future Of Community Health Nursing
Healthcare experts say public health has made great strides in the past decades, allowing people to live longer and healthier lives. The smoking rate is down and more people have health insurance. Health reform efforts have improved the quality of healthcare and slowed the growth rate of medical costs, the U.S. Centers for Disease Control and Prevention (CDC) said.

Even with that, however, the United States falls short of providing equitable access to healthcare, the CDC said. Racial, socioeconomic, and ethnic disparities continue in healthcare, the federal agency said. A vital component to change is local communities taking leading roles in public health and continued support by community health nurses.

Te Association of Public Health Nurses (APHN) said partnerships between public health nurses, communities, populations, and organizations are essential to the future of public health. The association said public health nurses could bridge the gaps between siloed clinical health and public health, ensuring optimal well-being for communities and populations.

“Public health nursing remain the largest discipline in the public health field, consistently providing leadership in an unsettled health system environment,” the association said in a position paper titled “The Public Health Nurse: Necessary Partner for the Future of Healthy Communities.”

“As public health nurses continue to move beyond traditional public health settings and integrate their practice with community systems, their value and strength will continue to evolve as well.”

Public health nurses comprise the largest professional segment of the workplace in public health and are involved in the prevention, education, advocacy, activism, assessment, and evaluation of Public Health. They hold a vital role in the prevention of disease and help to promote community health and safety. For students already in a nursing program or who are already a practicing nurse, public health nursing offers a variety of opportunities to make significant changes in public health. While most nurses care for one patient at a time, public health nurses care for entire populations. The ability to work with whole communities allows public health nurses to help in educating the community about health issues to improve their health and safety and facilitate access to care.Role Of The Family Nurse Practitioner In Global And Domestic Disease Surveillance Essay Paper

What are Some of the Responsibilities of a Public Health Nurse?
Assessing health trends to identify health risk factors specific to communities
Assigning priorities for health-related interventions in order to provide the greatest benefit
Advocacy with local, state and federal authorities in improving the access to health services in underserved communities
Design and implement health education campaigns and activities for disease prevention
Provide information on local health programs and services that are available to improve access to care
Providing direct health care services to at-risk populations
What are Some of the Areas of Employment for Nurses in Public health
Public health nurses are employed in government agencies, nonprofit organizations, community health centers and other organizations improving health at a community level. They may work alone or on multidisciplinary teams, and they often supervise other health care and lay personnel. In addition to working with communities, they work behind the scenes planning activities, managing budgets and evaluating the effectiveness of public health programs.

What is the Job Outlook and Salary Range for a Public Health Nurse?
There is a growing demand for public health nurses, particularly in those low-income communities that are medically underserved. Many government agencies have recognized the benefits of preventive and health education services provided by public health nurses in attempting to reduce overall health care costs. Because they often serve a diverse population, Bilingual nurses that are fluent in both Spanish and English are in desperate needed. The average annual salary for a public health nurse is $51,000 however; salaries can vary greatly due to company, location, industry, experience and benefits. Salaries also vary greatly depending on job location, educational level and requirements.

To work as a Public Health Nurse what Graduate Degree should I pursue
To work as a nurse in Public health a Master’s Degree in Nursing (MSN) or a Master’s Degree in Public Health (MPH) is strongly advised. Public health nurses pursuing an MPH also may choose to pursue a specialization in public health, such as epidemiology and biostatistics, as well as environmental health.

Public health nurses are individuals who are highly dedicated in working to improve their community’s health and access to care. They must be able to work well with large groups and to be sensitive to cultural differences.Role Of The Family Nurse Practitioner In Global And Domestic Disease Surveillance Essay Paper

An international health nurse may work on a wide range of global health issues in a number of settings. They may be employed by government agencies (e.g., the United Nations, the World Health Organization, or nongovernmental organizations). They also could be independent consultants. The topics of importance to global nursing include the increasing disparity in access to health care; the growing population of the poor (more than one billion people do not have access to basic health and social care, regardless of availability); the rapid environmental changes and degradation of the environment; economic recession and crises in parts of the world that affect the financing of health care; the inability of technology to face epidemics and deadly threats from diseases such as HIV/AIDS, malaria, and tuberculosis; the growing crises and emergencies such as internal conflicts, civil wars, and natural disasters that affect the health delivery systems and access to care.
International health nurses are committed to care for all persons across the life cycle—pregnant women, infants, children, adolescents, adults, and the elderly—and especially vulnerable groups—the poor, refugees and displaced persons, street children, and the homeless.
In setting the future directions for global health policy, nursing and midwifery are key elements. As nurses and midwives already constitute up to 80% of the qualified health workforce in most national health systems, they represent a potentially powerful force for bringing about the necessary changes to meet the needs of health for all in the 21st century. Their contribution to health services covers the whole spectrum of health care, promotion and prevention, as well as health research, planning, implementation, and innovation.Role Of The Family Nurse Practitioner In Global And Domestic Disease Surveillance Essay Paper

EDUCATIONAL REQUIREMENTS

Registered nurse licensure is required; graduate preparation in nursing or public health is desirable.

CORE COMPETENCIES/SKILLS NEEDED

■ Knowledge of major global health risks such as HIV/AIDS, tuberculosis, smoking, and environmental hazards
■ Knowledge of epidemiology
■ Skills in community mobilization for integrated health development
■ Immunization knowledge and skills
■ Leadership skills
■ Skills in preparing nurses to be ready for emergencies and crisis situations
■ Disaster planning and intervention skills
■ Ability to enhance team building and leadership abilities of nurses as health care providers and planners
■ Public health knowledge
■ Skill in demonstrating cost-effective care through primary health care and the critical role of nurses in the health care team

Why Nurses Matter in Global Health
In the United States, nurses have a rather clearly defined role. However, in many locations throughout the world, there are not enough doctors available to provide the care that people need. Luckily, there are nurses, and if it were not for them, these individuals would not receive any healthcare services at all. Nurses make a major contribution by addressing various health issues. Here is a short list of service situations or issues nurses might face:

Birth and Delivery: In various remote areas such as in rural Africa, there is not enough money to pay a doctor who can set up a practice. Or there may be other obstacles to having a local doctor. Fortunately, nurse-midwives are excellent in the role of caring for mothers before, during and after childbirth.Role Of The Family Nurse Practitioner In Global And Domestic Disease Surveillance Essay Paper

Primary Care: Also in rural, remote or poverty-stricken areas, physicians may not be available to provide primary care services, and nurses are there to deliver many of those services. One challenge these areas face is that the health conditions people have are often more complex and difficult to treat.

Cholera: Illnesses and diseases we rarely encounter in the U.S. can be problems in certain other areas of the world. For example, cholera is an issue in Haiti, so nurses there get the chance to help numerous people with that disease.

Tuberculosis: Nurses in Peru have been able to develop a program with the world’s highest cure rates for drug-resistant tuberculosis.

Partnerships and Collaboration
It is wonderful to see medical centers in various areas of the world collaborate. Here are two examples of innovative and resourceful partnerships:

The Dana-Farber Cancer Institute in the U.S. is working to create a nursing oncology partnership with an organization in Rwanda. Oncology nurses from the U.S. will work directly with Rwandan doctors and nurses to share knowledge.

Regis College in the U.S. is working with the Haitian Ministry of Health and PIH to address the shortage of nursing education in that country. The end result will be a three-year master’s program for Haitian nurses.Role Of The Family Nurse Practitioner In Global And Domestic Disease Surveillance Essay Paper

Nurses are leaders who make a positive difference by advocating for health and providing healthcare throughout the world. In many instances, despite their incredibly huge and generous contribution across the globe, nurses are treated almost as though they are invisible. They deserve to have a prominent voice when world leaders get together to address health issues and develop national and international policies. They also need more resources, such as for mentorships, leadership and nurse education. One way of receiving additional education and preparation is through online programs, and an online RN to BSN program is ideal for receiving high-quality education in an efficient way.

People who believe in the value of nursing should remind as many people as possible, as often as possible, about the value that nurses bring to the world. We need to advocate for nurses having a greater voice on the world stage. Their contributions to healthcare are already spectacular, but when they have a bigger platform, who knows how far they can go?

Nurse practitioners (NPs) are registered nurses who have completed additional education to prepare them to deliver a broad range of services including the diagnosis and treatment of acute and chronic illnesses. They are one of four categories of advanced practice registered nurses, with the others being certified nurse-midwives, nurse anesthetists, and clinical nurse specialists.

California is 1 of 22 states — and the only western state — that restricts NPs by requiring them to work with physician oversight. A large body of research has linked such restrictions to a lower supply of NPs, poorer access to care for state residents, lower use of primary care services, and greater rates of hospitalization and emergency department visits. Although dozens of studies demonstrate that the quality of NP care is comparable to the quality of physician care, and that there is no difference in care when there is no physician oversight, proponents of scope of practice restrictions continue to argue that oversight is necessary for quality care.Role Of The Family Nurse Practitioner In Global And Domestic Disease Surveillance Essay Paper

California’s Nurse Practitioners: How Scope of Practice Laws Impact Care describes the regulations that govern scope of practice for NPs in California and in other states, and summarizes recent research on how these laws impact care.

Key findings include:

Physician supply in California will meet less than half of demand for primary care in 2030, but this gap can be filled by projected growth in NP and physician assistant supply. Policy leaders point to the elimination of unnecessary barriers to NP care as a means to address this primary care shortfall, especially in rural and underserved areas.
Multiple systematic reviews of the literature conclude that NPs provide care of comparable quality to physician care, even when practicing without physician oversight. Findings were similar beyond primary care, including in prescribing, chronic disease management, and ordering diagnostic tests. The findings were also reflected in rural and community health center settings.
Physicians currently bill time for overseeing NPs, resulting in practices offering them stipends of anything from $5,000 to $15,000 annually to cover this cost. This cost is passed along to patients, and would be removed if NP oversight hours were reduced or ended. Additionally, limiting the supply of NPs may lead patients to seek more expensive care, again increasing costs.

Seven out of 10 deaths in the United States are due to chronic disease such as cancer and Type 2 diabetes, according to the Centers for Disease Control and Prevention External link (CDC). Many of these conditions are preventable. Studies have shown that evidence-based preventive care services can improve health by identifying risk factors for poor health outcomes sooner and addressing them before they become complicated and potentially debilitating. This active approach to care also helps lower costs for health care systems and patients alike.Role Of The Family Nurse Practitioner In Global And Domestic Disease Surveillance Essay Paper

Preventive care services include regular check-ups, vaccinations against diseases, counseling on important health topics (e.g., smoking cessation), cancer screenings (e.g., mammograms), and routine screenings such as those for blood pressure and cholesterol levels.2

Prevention improves entire communities by helping people live longer, healthier lives. Healthy children have more days in attendance at school and an easier time participating and learning. Adults spend more time working and are productive in the workplace. Seniors who stay healthy are able to maintain their autonomy for longer and enjoy a greater sense of well-being. Racial and ethnic minorities in particular stand to benefit from preventive care, as they exhibit higher rates of chronic disease.3

Policymakers recognized that finances prevent some people from seeking preventive care. That is why the Affordable Care Act (ACA) of 2010 mandates that private health plans provide coverage for an array of preventive services. The ACA has helped to improve access to care by expanding health insurance coverage to those who did not previously have it.4

How NPs Can Make an Impact on Disease Prevention
Nurse Practitioners (NPs) have the potential to play a significant role in preventive care, which has traditionally been provided by primary care physicians. Most NPs — up to 90 percent — are prepared in primary care and can manage 80 percent to 90 percent of the care provided by physicians.6 Moreover, while physician education focuses on diagnosis and treatment, NP training concentrates more on holistic care for individual patients, families and communities. NPs also play an important role in prevention and health promotion across the lifespan. This makes NPs uniquely positioned to influence patient behavior by developing strong, trusting, long-term relationships. Through one-on-one dialogue, NPs can empower individuals to make better health choices and make lifestyle changes that help prevent chronic disease.Role Of The Family Nurse Practitioner In Global And Domestic Disease Surveillance Essay Paper

The settings in which NPs practice can help expand preventive care to those who need it most. Research shows that Nurse Practitioners specializing in primary care are more likely than primary care physicians to practice in urban and rural areas. NPs are also more inclined to care for uninsured patients and other at-risk groups.6 NPs work in a variety of settings, such as community health clinics and in-store or standalone urgent-care clinics, where patients can quickly be treated for an array of episodic illnesses. Other practice locations include college campuses, worksite health centers and independent clinical practice environments.

The role of NPs in preventing illness and disease can also extend beyond the exam room into the community, where they play a valuable part in health promotion, education, and advocacy. As an example, American Association of Nurse Practitioners member Lt. Meg Whelpley recently discussed her trajectory External link with Daily Nurse. Whelpley went from bedside nurse to officer in the Commissioned Corps of the U.S. Public Health Service. In her current role, she serves as an NP with the National Heart, Lung, and Blood Institute at the National Institutes of Health (NIH). Her responsibilities range from evaluating patients enrolled in research protocols to administering cardiac evaluations for underserved populations in surrounding areas.

A Case for Greater Use of NPs

Americans are growing older, living longer, and gaining health insurance coverage in increasing numbers, but the supply of physicians is not meeting the demand for services. According to a report by the Association of American Medical Colleges (AAMC), the United States will face a major physician shortage by the year 2025. In terms of primary care specifically, this shortage could reach up to 31,000 physicians.7 These projections, however, are based on traditional health care delivery models. They don’t account for the potential of NPs to play a role in providing preventive services.Role Of The Family Nurse Practitioner In Global And Domestic Disease Surveillance Essay Paper

Research proves that Nurse Practitioners are just as qualified as physicians to provide comprehensive care — and patients agree. One study from the University of Michigan found that satisfaction scores among low-income patients for Nurse Practitioners were notably higher than for physicians. The study looked at questionnaires completed by low-income patients enrolled in a community public health care plan. Eighty percent of respondents felt that NPs always listened carefully to their needs. Other questions pertained to how much respect providers showed to patients. Physicians scored an average of 7.2/10 on the survey, while NPs had an average score of 9.8/10.8

NPs who specialize in primary care have the capacity to reduce the strain on our already burdened health care system. Yet legislative and regulatory barriers in many states, such as licensure laws and “scope of practice” policies, limit the services provided by NPs and prevent them from practicing to their full potential.6 These are barriers that must be addressed sooner rather than later, or we will continue to undervalue an invaluable NP workforce.

As the United States moves forward under the new Trump administration, the future of the ACA remains unclear. However, regardless of how change unfolds, NPs will remain crucial players in the U.S. health care system. It will be important to ensure that these professionals have the opportunities and resources necessary to improve preventive health measures on a variety of levels — and in so doing, highlight the importance of preserving health rather than simply treating illness. Allowing advanced-practice nurses to leverage the full breadth of their training can lead to a comprehensive, equitable health care system that meets the needs of every citizen.Role Of The Family Nurse Practitioner In Global And Domestic Disease Surveillance Essay Paper

AN OVERVIEW AND HISTORY OF PUBLIC HEALTH AND PHN
While improvements in healthcare and scientific knowledge also made an impact, great strides in public health caused significant improvements in life expectancy for many people living in the developed world over the past few centuries. Basic changes such as the introduction of indoor plumbing and better hygiene practices reduced disease transmission and enabled people to live longer and better than ever before.

By the mid-19th century, improved knowledge about disease led local communities to begin implementing significant changes in sanitation. These efforts dramatically reduced contagious disease transmission. Public health began developing as a separate field, and public health workers learned more about disease transmission through populations. Health education for the public became part of public health workers’ arsenal in the fight against contagious illness. Vaccinations, improved sanitation and better hygiene brought many of public health’s most important victories as new longevity and wellness milestones were reached. As well-educated healthcare professionals, nurses are at the forefront of these community efforts and provide essential knowledge and expertise to public health initiatives.

In the 20th century, PHN grew beyond treatment and began tackling the increasingly complex factors that contribute to illness and influence health. Nurses observed the need for greater advocacy within local communities. The impact and potential of healthcare leadership to transform community health led many nurses to see the value in political advocacy, community organization and grassroots educational initiatives. PHN then began to encompass a range of different nurse-led efforts to improve health at the community level. Nurses were encouraged to listen to and empower local community members.Role Of The Family Nurse Practitioner In Global And Domestic Disease Surveillance Essay Paper

DISEASE PREVENTION TODAY
Public health departments customize their work to fit the communities they serve and the health needs of local populations. Since there are many different possible causes of disease and types of illnesses, public health workers must be able to understand the underlying causes of disease to effectively stop transmission and prevent future cases. Many public health efforts address issues of sanitation, personal interactions, and business or public practices that impact health. Educational campaigns, regulation of industry, and the planning and implementation of sanitation and hygiene initiatives may all fall under local health departments’ responsibilities. Nurses are needed at every level of public health work.

Preventing disease requires that these efforts are well-coordinated and responsive to community needs. When disease outbreaks occur, PHN nurses quickly respond with scientifically sound, sensible means of controlling the spread of illness. Prevention of future outbreaks requires that infection sources are identified and properly managed. For example, foodborne illness may be prevented by training cooks and food-service personnel to properly store, prepare and serve food. Caregivers, childcare workers and others who regularly interact with vulnerable populations may be taught best-practices for disease prevention. Presentations to local groups can teach individuals how to care for themselves, keep their families safe and prevent diseases from spreading. These and other campaigns need the specialized knowledge and skills of public health nurses.

THE ROLE OF NURSES
Today, public health nurses serve their communities in a variety of positions. Nurses in this field often serve as leaders, educators, advocates and researchers, all in addition to their nursing roles. Many public health nurses practice, study, develop and lead public health campaigns. Some also teach other nurses, other public health workers and the public at large. Some nurses serve as policy makers and craft legislation that advances the cause of health and wellness. Within local communities, nurses are also needed to teach preventive health practices so more people can live healthy, productive lives.Role Of The Family Nurse Practitioner In Global And Domestic Disease Surveillance Essay Paper

PHN is a rapidly changing field, reflecting improvements in nursing care, public health knowledge and scientific development. Nurses can work in PHN as generalists or they can pursue advanced education in the field and work as specialists with more significant responsibilities. Typically, PHN jobs require candidates who are flexible and capable of serving as leaders. To advance in the field, nurses should pursue additional PHN education.

Public health nursing is a field with strong opportunities. Nurses in this field work closely with local residents, businesses, governments, nonprofit organizations, researchers and other healthcare professionals to help communities become healthier. These nurses can help prevent the spread of disease by providing education, developing programs, supervising health campaigns and contributing their knowledge to public health work. PHN is continuing to change as advancements in the field allow nurses to do even more for community health.

A review of the literature of global health issues uncovered numerous concerns, from global warming and terrorism to emerging infectious diseases. This article focuses on one infrastructure issue that continued to surface and impacted each of the additional GHIs we selected: emerging infectious diseases, human trafficking, and maternal-newborn health. Nurses can potentially impact each of these three prominent concerns. However, the mal-distribution of health workers around the globe, an infrastructure issue, impacts the effort to prevent these emerging GHIs and/or care for patients, families, and communities affected by, or at risk from them. It is also clear that two key concepts must be addressed in relation to GHIs, social justice and equity and the existence of health disparities as a result of multiple influencing factors.

Of great concern in GHIs is the maldistribution of the healthcare work force in terms of geography, disease, infrastructure and resources. GHIs occur in numerous ways and are influenced by a multitude of factors that can best be impacted by the nursing community with awareness building, focused education, nurse activation, and infrastructure support, with the nurse acting as a sentinel. Of great concern in GHIs is the maldistribution of the healthcare work force in terms of geography, disease, infrastructure and resources. The ability to impact GHIs depends, in part, on the presence of appropriate resources of all types, including human. In the next section, we will define and briefly describe the three emerging global health issues to provide context for the reader  Role Of The Family Nurse Practitioner In Global And Domestic Disease Surveillance Essay Paper

Definitions of Key Global Health Issues
Infectious Diseases
Infectious diseases… have been defined as “emerging.” These diseases respect no national boundaries, with increased incidence in humans in the past 2 decades or threat of increase in the near future, have been defined as “emerging.” boundaries. They include new infections resulting from changes to or evolution of existing organisms; known infections spreading to new geographic areas or populations; previously unrecognized infections appearing in areas undergoing ecologic transformation; and old infections reemerging as a result of antimicrobial resistance in known agents or breakdowns in public health measures (Morse, 1995).

Human Trafficking
Human trafficking is defined as all acts involved in recruiting, harboring, transporting, providing, or obtaining a person for compelled service or commercial sex acts through the use of force, fraud, or coercion (DeBaca & Sigmon, 2014). This global health issue, although not new, has recently garnered increased concern.

Maternal-Newborn Health
Maternal mortality is defined as the death of a woman while pregnant, or within 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management (i.e., from direct or indirect obstetric death), but not from accidental or incidental causes (Morse, 2014). The major causes of death in newborns include complications of premature birth and intra-partum related complications (previously labeled as birth asphyxia and sepsis) (Bhutta & Black, 2013).Role Of The Family Nurse Practitioner In Global And Domestic Disease Surveillance Essay Paper

Nurses and Health Inequities
Many defined roles and responsibilities for public health nurses also apply to nurses in other specialties and settings. The public health nurse roles and responsibilities to eliminate health inequalities and achieve equity are delineated in a Position Paper (Association of Public Health Nurses, 2015) that focuses on the importance of awareness of self and others; trust as a foundation of every human relationship; and humility in acknowledging what is not known about diverse cultures and populations. Many defined roles and responsibilities for public health nurses also apply to nurses in other specialties and settings. Additionally, nurses must recognize and understand the impact of social determinants of health on population outcomes, including genetics; social and physical environments; socioeconomic status; biologic and behavioral responses; access to care; availability of food and transportation; and others. Poverty, inequality, and social determinants of health not only contribute to global health issues but can also adversely impact morbidity, mortality, and health outcomes (Quinn & Kumar, 2014).

Nurses in roles across health system and community settings are well positioned to assess individuals, communities, and populations; advocate for justice and equality; and partner with legislators and inter-professional leaders to identify, implement, and evaluate a “strengths-based approach” that engages communities addressing local, national and global health issues. However, many countries lack sufficient healthcare workers, including nurses, to address THIs.Role Of The Family Nurse Practitioner In Global And Domestic Disease Surveillance Essay Paper

Maldistribution of the Healthcare Workforce
While a growing shortage of healthcare workers is predicted over time, there is also a parallel estimated increase in the global population. In 2013, the World Health Organization (WHO) estimated that the world will be short 12.9 million health-care workers by 2035; today, that figure stands at 7.2 million (World Health Organization, 2013). As recently as 2009, two reports estimated the global shortage to be more than four million health workers (Joint Learning Initiative, 2004; Salafsy, Glasser & Ha, 2005; WHO, 2006). While a growing shortage of healthcare workers is predicted over time, there is also a parallel estimated increase in the global population.

As of July 2015, the world population of 7.3 billion was projected to reach 8.5 billion by 2030 and 9.7 billion by 2050 (United Nations, 2015). Most of the projected increase in the world population is expected to occur in Africa or other countries with already large populations. During 2015-2050, half of the world population growth is expected to be concentrated in nine countries: India, Nigeria, Pakistan, Democratic Republic of the Congo, Ethiopia, United Republic of Tanzania, United States of America (U.S.), Indonesia, and Uganda, listed according to the size of their contribution to the total growth (Greysen, Chen, & Mullan, 2011).

The United States and Canada, which comprise 14 percent of the world population, bear approximately 10 percent of the world disease burden, have 37 percent of the global health workforce and spend about 50 percent of the world financial resources for health. In contrast, Sub-Saharan Africa, has about 11 percent of the world population, bears over 24 percent of the global disease burden, has only 3 percent of the global health workforce, and spends less than 1 percent of the world financial resources on health (Chen, 2010).

The number of healthcare workers is only one of many factors impacting access to care on a global scale. The widening gap between supply and demand of healthcare workers indicates the need for an urgent response. Closing the gap to improve access to care is not as simple as producing more healthcare workers. Many factors impact the balance of demand and the supply of timely, appropriate care. The number of healthcare workers is only one of many factors impacting access to care on a global scale.

Allocation of adequate financial resources and infrastructure are longstanding global health issues. Human resources for health have been significantly underfunded, which contributes to maldistribution of healthcare workers (Chen et al., 2004). Often described as an unequal ratio of health workers for the population, maldistribution simply means there are a misalignment of the number and/or skillsets of healthcare workers in comparison to the demand for services within the specific population or geographic area.Role Of The Family Nurse Practitioner In Global And Domestic Disease Surveillance Essay Paper

In many countries, health worker shortages are exacerbated by severe maldistribution… most professionals seek urban-based, middle-class professional work and personal lives. Maldistribution is a major challenge to improving access to care for underserved populations, as well as in addressing workforce shortages and clinical competencies. In many countries, health worker shortages are exacerbated by severe maldistribution (Chen et. al., 2004). This is not a new phenomenon; most professionals seek urban-based, middle-class professional work and personal lives.

Geography is a major driver of access to healthcare, especially in the global setting. In most areas across the world, urban-rural disparities exist. Rural areas tend to have fewer health resources and lower staffing across clinical professions. For individuals living in rural areas, it is often difficult to access healthcare services due to transportation, terrain, distance to providers, and inadequate infrastructure (Salafsy et al., 2005). It is common for individuals who live in rural areas to delay care until their conditions are severe and require more intensive treatment. This situation often results in more expensive care and poorer clinical outcomes.Role Of The Family Nurse Practitioner In Global And Domestic Disease Surveillance Essay Paper

Healthcare workers are not easily attracted to many rural areas where there are limited options to work. They may perceive negative lifestyle differences when compared to urban and suburban options. Salaries for health workers tend to be lower in rural areas, but these individuals may work longer hours due to the limited number of providers. In the United States, the cost of health professionals has significantly increased. For the past fifty years, the cost of medical education has increased at a rate unsurpassed in history (Chen, 2010). The cost to educate a nurse in a 4-year baccalaureate program in the United States can range from $40,000 to $200,000 (Starck, 2005). Healthcare providers in many areas around the world seek positions in areas that enable them to practice their chosen profession, meet living expenses, and obtain a certain standard of living.

Lack of an adequate supply and global maldistribution of healthcare resources has created significant gaps in access for many populations. This poses a major social justice issue. In general, social justice is the view that everyone deserves equal economic, political, and social rights and opportunities. This concept is an essential belief of the nursing profession (ANA, 2015). Ideally, nurses should strive to assure that everyone who needs care can access the services they need. Access to equal care and treatment, however, remains an elusive goal. Social justice is more than treating people fairly; it involves rejection of the status quo for the greater good. Role Of The Family Nurse Practitioner In Global And Domestic Disease Surveillance Essay Paper