LAUSR

AIM To explore public health nurse (PHN) perspectives of their evolving work and how PHN work is managed in a Canadian health region. BACKGROUND Professional and public health organizations describe PHN practice roles as population focused work. Healthcare management directs PHN work to achieve specific goals. METHODS In this qualitative study, data were collected during focus groups with 42 PHN participants in one health region. Focus group data were analyzed for meanings and themes. RESULTS PHNs perceived increasing immunizations and limited resources for PHN work meant that population focused care for the public was rationed or missing. Participants perceived the healthcare organization directed, managed, and assigned PHN specialist work, however PHNs managed their client focused practice with knowledge, reasoning, and support from colleagues. CONCLUSIONS Evolving visible PHN work was managed by health organizational management directives to increase immunizations and disease control. PHNs managed their evolving visible and invisible work supported by their knowledge, practice values, and PHN colleagues. IMPLICATIONS FOR NURSING MANAGEMENT Nursing management must lead and communicate the vision supporting better health, better population focused care and health outcomes to PHNs and stakeholders, while reviewing resources needed to optimize public health nursing and improve population health.