Public health nurses' views on their position within a changing health system

To date nursing research exploring the relevance of the practice environment has focused substantially on the experiences of hospital-based nurses. More recently greater attention has been paid to the community nursing environment and nurses involved in primary health care. This study considers the context of public health nursing in New Zealand, firstly by exploring the creation and development of the public health nursing role and secondly by presenting the results of a survey of nurses' views of their practice environments and of their professional positioning at the time of the introduction of Primary Health Organisations (PHOs). One hundred and sixty seven public health nurses across New Zealand firstly provided quantitative ratings of aspects of their practice environment (utlising the Nursing Work Index Revised (NWR-I)), and secondly gave written responses to: (a) the aspects of a work environment that make it a good place to practice as a public health nurse; (b) preferences for employment within Public Health Units, in PHOs or with Maori health providers; and (c) advantages and disadvantages of all three settings. This paper focuses on the qualitative questions only as the NWI-R findings will be reported elsewhere. Findings suggested the importance of good leadership, education/orientation, support, recognition and resources within a public health nursing environment. The main preference of the participants was for working within a District Health Board Public Health Unit, although disadvantages were acknowledged.