Innovative Pediatric Nursing Role: Public Health Nurses in Child Welfare
Innovative Pediatric Nursing Role: Public Health Nurses in Child Welfare
The role of a pediatric public health nurse (PHN) practicing health case management in a child welfare agency was developed to meet the increasing health care demands and severe health problems of children in foster care. Federal and state government appropriated monies to fund this role to alleviate the difficulties in coordinating health care between the child welfare system and health care providers. Informal observations of the PHN in a large metropolitan child welfare agency in California were categorized using the Minnesota Public Health Intervention Model. Nurses functioning in this role are part of a team, with social workers, to promote the safety of children in foster care and to assure that health is part of a safe environment.
The role of pediatric Public Health Nurses (PHNs) in child welfare agencies was developed to improve the health care and health outcomes of children in foster care. This new nursing role in health case management offers nurses the opportunity to interface with the legal, political, and organizational world of foster care to advocate for children in protective custody. PHNs have joined the social workers in child welfare agencies to help meet the challenges of caring for children with serious physical and psychological problems. Social workers are not trained in the language or practice of health delivery and have difficulty dealing with the extensive health problems of foster children (Carlson, 1996; Simms, Freundlich, Battistelli, & Kaufman, 1999; Smart, Russell, & Custodio, 1998). Thus, the social worker is the legal case manager within the foster care system and the PHN provides health counseling, referrals, and consultation to the foster caregivers, health care providers, and the social workers.
This article describes the impetus for the new nursing role as a result of recognition of the health problems of an expanding population of children in foster care, delineates the historical beginnings of the role in California, and summarizes informal observations of nurses in the role. The pediatric PHNs, also called foster care nurses, were observed performing their job functions within a large county child welfare organization in California. The Minnesota Public Health Nursing Intervention Model provided a framework for the observations. The foster care nurses have the potential to change the face of health care delivery to the foster care pediatric population, but must function within the confines of a case management role within non-healthcare setting, the child welfare agency. Working within the organizational context of the child welfare agencies has proven difficult for nurses because the organizational goal of safety does not always include health (Schneiderman, 2005).
The role of a pediatric public health nurse (PHN) practicing health case management in a child welfare agency was developed to meet the increasing health care demands and severe health problems of children in foster care. Federal and state government appropriated monies to fund this role to alleviate the difficulties in coordinating health care between the child welfare system and health care providers. Informal observations of the PHN in a large metropolitan child welfare agency in California were categorized using the Minnesota Public Health Intervention Model. Nurses functioning in this role are part of a team, with social workers, to promote the safety of children in foster care and to assure that health is part of a safe environment.
The role of pediatric Public Health Nurses (PHNs) in child welfare agencies was developed to improve the health care and health outcomes of children in foster care. This new nursing role in health case management offers nurses the opportunity to interface with the legal, political, and organizational world of foster care to advocate for children in protective custody. PHNs have joined the social workers in child welfare agencies to help meet the challenges of caring for children with serious physical and psychological problems. Social workers are not trained in the language or practice of health delivery and have difficulty dealing with the extensive health problems of foster children (Carlson, 1996; Simms, Freundlich, Battistelli, & Kaufman, 1999; Smart, Russell, & Custodio, 1998). Thus, the social worker is the legal case manager within the foster care system and the PHN provides health counseling, referrals, and consultation to the foster caregivers, health care providers, and the social workers.
This article describes the impetus for the new nursing role as a result of recognition of the health problems of an expanding population of children in foster care, delineates the historical beginnings of the role in California, and summarizes informal observations of nurses in the role. The pediatric PHNs, also called foster care nurses, were observed performing their job functions within a large county child welfare organization in California. The Minnesota Public Health Nursing Intervention Model provided a framework for the observations. The foster care nurses have the potential to change the face of health care delivery to the foster care pediatric population, but must function within the confines of a case management role within non-healthcare setting, the child welfare agency. Working within the organizational context of the child welfare agencies has proven difficult for nurses because the organizational goal of safety does not always include health (Schneiderman, 2005).
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