An exploratory study of the role of the town nurse

Despite being a highly industrialized country, the United States of America (USA), ranks37th in the world in a number of health outcomes including life expectancy, universal health coverage for core services, maternal outcomes and obesity rates among adults. Public health nursing is being called to respond to this need. What is missing from the literature is a description of the role of the Town Nurse. A descriptive, exploratory study of the role of the Town Nurse was conducted to explore the roles usefulness in meeting the goals of the Patient Protection and Affordable Care Act through the Community Transformation Grants; that of health promotion and disease prevention. There is little known about the role of the Town Nurse and its relationship to these goals. This study used in-depth interviews to obtain a description of the role, the barriers and facilitators for further development of the role and its impact on the community. Ten female, Caucasian nurses in New England were interviewed. The nurses had been employed in the role between 6 months and 50 years. Interviews were conducted at their places of work or in their community. The findings were based on a series of interview questions. The data was analyzed using Schatzman and Strauss\u27 recommendations for field notes. Audio tapes were transcribed and analyzed addressing the three research questions and then by a cross-nurse comparison. The Town Nurse was described as having expectations which include a population focus, responsibility for identifying and meeting the health needs of the community, addressing needs across the lifespan, collaborating with others and working within the context of a multi-level system. The nurses enact these expectations by being autonomous, being members of the community, being flexible and doing home visits. The skill set required by the Town Nurse is clinical competency. In addition, three sub-types of Town Nurses were identified: one with a focus on individuals, one with a blended focus and the last with a focus at the population level. Implications for theory include that the model will be useful for increasing understanding of the role. Research implications include the need for empirical testing of the outcomes for the Town Nurse in addressing the goals of the Patient Protection and Affordable Care Act (PPACA). There are also implications for education, including the need to incorporate the Town Nurse model into the current textbooks and literature