[Development of professional competence in public health nurses]

Significant changes that are occurring in the community health care system, require that public health nurses who work for local governments to not only provide direct care but also to coordinate health care teams and participate in policy making. The purpose of this study is to investigate the current system of developing professional competence in public health nurses, and to consider ways to improve it.

The subjects, randomly chosen, were 100 chief public health nurses and 298 staff nurses in Hokkaido. Sixty-four chief nurses, 44 beginner nurses, 87 proficient nurses and 88 expert nurses responded. The data were collected with a self-administered questionnaire which necessitated the subjects to make a self evaluation of their practical competence and circumstances of its development.

Self evaluated competence, in making accurate assessments of individual needs and initiating direct care, developed with their experiences in the job, and was generally high. However, the questionnaire showed that self evaluation of their work and ability to do theoretical analysis and research was low and did not progress in conjunction with the length of work experience. Policy making experience was limited and policy making competence was evaluated as low, but there was an expectation that this competence would develop in time. Almost all of the respondents expected their professional competence to progress to higher levels. In particular, beginner nurses wanted to gain practical care competence; proficient and expert nurses wanted to develop their powers of theoretical analysis and do more research, while chief nurses were keen to gain competence in the area of policy making. The respondents reported that they sometimes attended academic conferences, but hardly did any research.

Low self-evaluation of public health nurses reflect a basic immaturity as a profession. They need to establish their profession and to increase their self-evaluated competencies as their careers develop. These findings showed the importance of establishing a system of continuing education that will cultivate competence in various aspects of their job and also motivate self study. These findings also reveal the importance of collaboration between the university as a vehicle for theoretical work and research and the work place as the embodiment of practical application.