A descriptive study of self-reported functions and competencies of entry level public health nurses in Texas

Abstract

The purposes of this study were to determine functions and competencies for entry level public health nurses, to determine if initial preparation affects functions and competencies, to determine sources of knowledge and skills for practice, to determine congruence between baccalaureate content and practice, and to determine effects of initial preparation, work experience, continuing education and work setting on functions and competencies. Subjects included the total population of entry level nurses in Texas. A questionnaire organized according to the nursing process was developed. Reliability estimates for each instrument subscale ranged from .93 to .97. A usable return rate of 77.46 percent was achieved for mailing procedures. Descriptive, chi-square and regression statistics were used in data analysis. The functions most frequently performed were directed toward individuals. At the community level, nurses are involved primarily in implementing functions rather than assessing, diagnosing, planning and evaluating. Nurses perceived themselves as more competent to perform nursing functions than they have the opportunity to perform them. Nursing functions were compared with public health content for baccalaureate curricula. Functions were congruent with content for services to the individual and family with incongruencies in delivery of skilled care to families in the home, applying epidemiological principles, and community functions involving diagnosing, planning, and evaluating. An alternative hypothesis of significant differences among baccalaureate and non-baccalaureate prepared nurses for functions and perceived competency was rejected for 63 of 73 items. Null hypotheses of no relation among basic education, work experience, work setting, continuing education and functions and competencies revealed that attending workshops and work experiences in the health department were consistent predictors of functions and competencies relating to assessing, diagnosing, planning, implementing, evaluating and epidemiology. Initial preparation was significant only in the overall equations for evaluating and applying epidemiological principles. It appears that the requirements of the work place have greater influence on the functions and competencies than does initial preparation. Public health nursing was the most important source of knowledge and skills for practice with initial preparation being second. Baccalaureate prepared nurses perceived their initial preparation as significantly more valuable than non-baccalaureate nurses.