PDF of document phn_mini
Title and Credits
What is a Public Health Nurse?
Critical Functions
Funding Sources
Survey Background
and Methodology
Retirement Concerns
      Table 1: Average Age by Region (Universe)
  Table 2: Regional Age Distribution (Universe)
Description of Sample
Response Rate
      Table 3: Response Rates by Region
  Table 4: Response Rates by Age Group
Age and Demographics Distribution
      Table 5: Respondent Age Distribution by Region
      Table 6: Respondent Job Title by Age Group
  Retirement Plans
      Table 7: Respondents’ Retirement Plans by Age Group
      Table 8: Highest Degree Obtained in Nursing by Respondent Age Group
Education Distribution
      Table 9: Highest Degree Obtained in Nursing for Respondents by Region
      Table 10: Respondent Job Classification by Highest Education Completed in Nursing
  Retirement Plans
      Table 11: Respondents Plans to Retire by Highest Education Completed in Nursing
Tenure Distribution
      Table 12: Respondents’ Reported Tenure as a PHN by Region
      Table 13: Satisfaction
Intention to Leave
Why Would You Leave Nursing?
      Table 14: Why Would You Leave Nursing Altogether?
      Table 15: Longevity
Funding Source
Starting Work in PHN
      Table 16: Primary Reason You Chose to Work in Public Health
  Staying in PHN
      Table 17: Primary Reason You Choose to Stay in Public Health
Appendix A



The Government Performance and Results Act of 1993 (GPRA) goals and performance measures for the U.S. Department of Health and Human Services focus on the outcomes and results of the many health and human service programs administered by the department. These goals are usually expressed in terms of a program’s impact on its target population or improvements in population characteristics. However, work force planning provides the means for achieving the program goals by ensuring “the right numbers of the right people in the right place at the right time (U.S. Department of Health and Human Services, 1999).”

State health agencies have begun implementing work force planning strategies to gauge the present and future personnel needs of their organizations in relation to their strategic direction, and to assist in the development and implementation of work force strategies that ensure efficient alignment between organizational and human capital needs. According to the 2007 Association of State and Territorial Health Officials (ASTHO) work force survey, 61% of state health agencies instituted work force planning programs within the last five years (ASTHO, 2008). Work force planning enables managers to make informed human resources decisions to address worker shortages due to competition related to retirement, private sector competition, hiring freezes, etc. It is a fundamental tool, critical to quality performance that will contribute to the achievement of program objectives by providing a basis for justifying budget allocation and workload staffing levels (U.S. Department of Health and Human Services, 1999).
The U.S. public health work force is vital to protecting and improving the health of the American public. In state governments alone, over 100,000 workers are charged with achieving the public health mission of, “fulfilling society’s interest in assuring conditions in which people can be healthy (ASTHO, 2008).” However, public health nursing is in the midst of a critical shortage. In this time of increasing demands on public health to respond to issues such as emergency preparedness, new emerging infections, and significant increases in chronic illnesses, competition for nurses in general, and public health nurses in particular, is fierce. According to the Quad Council (2006), the current shortage is complex and results from multiple and varied factors such as an overall shortage of registered nurses, an aging population of nurses, a poorly funded public health system that results in inadequate salaries, inadequate numbers of baccalaureate nursing graduates, a growing shortage of nursing faculty, and invisibility of public health nursing in media and marketing campaigns.

Wyoming is affected by the same shortage issues as the nation. Recent research (Leonard, 2008) projected that the number of registered nurses (RNs) needed in the state’s health care industries will double by 2016. One method often employed to address occupational shortages is a wage increase. Gross average quarterly wages for continuously employed RNs in Wyoming have steadily risen over the past years (Leonard & Szuch, 2008) from $12,999 in second quarter 2006 to $14,176 in second quarter 2008. While increasing wages may serve to increase the number of nurses working in the private sector, they may also decrease the availability of nurses for the public sector (nurse educators, public health nurses, etc). Differing sources of financing and customer bases may have influences on staff salaries. For example, educational entities and public health are likely to be funded by a government grant or legislative allocation and are essentially responsive to the community as their customer base. As such, the budget and associated staff salaries are more likely to be fixed than other entities, such as hospitals or clinics.

The combination of an aging nurse work force and limited ability to recruit qualified nurses into public health could have far reaching implications for communities, especially in Wyoming. Without an adequate supply of baccalaureate prepared nurses to replace retiring nurses, the state will have to fill the positions with associate’s degree prepared nurses. Doing so could lead to a less formally educated, less competent work force which directly impacts the ability to provide evidence-based, population-focused care (Ouzts, 2008). As such, the Wyoming Department of Health, Community and Public Health Division requested a study of the Wyoming Healthcare Commission by Research & Planning (R&P) to study the retirement plans as well as satisfiers/dissatisfiers of the current public health nursing work force. By doing so, the Public Health section hopes to develop a succession plan which will promote and protect the health of Wyoming citizens by ensuring a competent public health nursing work force.

What is a Public Health Nurse?

A public health nurse is a specialized type of registered nurse that combines nursing knowledge with public health principles. According to the American Public Health Association (n.d.), the primary focus of public health nursing is improving the health of the community as a whole rather than just that of an individual or family.

A bachelor’s degree in nursing is considered a minimum requirement for public health nursing practice by many nursing professions and professional nursing organizations (Quad Council, 2003). A bachelor’s degree in nursing is thought to provide the background in social science and public health science such as epidemiology and environmental health needed by a public health nurse. Increasingly, public health nurses are enrolling in advanced degree programs in public health, community health nursing, and other public health specialties (Public Health Functions Steering Committee, 1995).

Ideally, the work of public health nurses is defined as primary prevention, meaning they work to prevent disease, injury, disability, and premature death. They work closely with other public health professionals such as environmental health specialists, health educators, epidemiologists, public health physicians, and nutritionists. In addition, they work with local communities to assess and prioritize the major health problems and work to alleviate or eliminate these problems and the conditions that contribute to their development.

Critical Functions

Public health nurses:

Funding Sources

Wyoming Public Health Nursing is a section of the Community and Public Health Division of the Wyoming Department of Health. It is a partnership between the state and county governments for the provision of public health nurse offices in each of the 23 Wyoming counties. A memorandum of understanding allows each county to provide funding for support services, office space, county employees, and a percentage of the state employee salaries. The state provides a percentage of state employee salaries and provides nursing supervision, program consultation, and oversight. Each county public health nursing office is staffed by a nurse manager who is responsible for program administration with local oversight by the Board of County Commissioners, and in some counties, a local board of health. The State public health nursing section provides nursing oversight, supervision, and consultation from the chief nurse executive, three state public health nursing supervisors, and three program consultants. Additional program funding is provided through state and federal grants including Public Health Emergency Preparedness, Maternal Child Health, Community Block Grants, and Wyoming Health Council (Ouzts, 2008).

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