In recognition of Public Health Week and in celebration of World Health Day (April 7), today we're launching our new Public Health Nursing Series, written by William (Billy) Rosa, author of the forthcoming title, Nurses as Leaders: Evolutionary Visions of Leadership (June 2016).

The Public Health Nursing Series is a 20-blog collection that sparks a dialogue about each and every nurse's role in advancing and creating the future of global health. With a focus on cultural considerations and the current status of healthcare in nations worldwide, nurses will learn how they are called to contribute to each of the United Nations' 17 Sustainable Development Goals, an international initiative that seeks to end poverty, protect the planet, and ensure prosperity for all over the next 15 years.This series makes the case that every nurse, regardless of title, position, or credential, is a public health leader.

Understanding the Nurse as  Public Health Leader (Part 1)

I’ve always thought of myself as a public health nurse, even before I knew what it really meant or how others in healthcare defined it. To me, being a public health nurse means I am a leader in my profession who integrates the art of caring for vulnerable populations along with the science of evidence-based disease prevention and treatment. It requires a willingness to advocate for patients, families, communities, and nations in a way that improves and promotes wellness and wellbeing. Most of all, public health is a forum for nurses and nursing to impact sustainable change on a broad spectrum, from local health facilities to global infrastructures, all while working to overcome fiscal and economic barriers to change and drive necessary policy development. Our dual loyalties to both nursing and public health resonate with each other deeply. They are, in fact, more connected than many of us might think at first glance.

According to the American Public Health Association (APHA, 2016), “Public health promotes and protects the health of people and the communities where they live, learn, work and play… to prevent people from getting sick or injured…  [it] promote[s] wellness by encouraging healthy behaviors… improves our quality of life… and reduces human suffering.” Reading this definition of public health gave me pause. Are these not my moral-ethical foundations of nursing? Have I not been educated and guided by my professional organizations to lead and advocate for these very priorities of humanistic, dignified care? In fact, I struggled to see the difference between the APHA’s definition of public health and my own definition of nursing.

To clarify, I looked to the American Nurses Association (ANA, 2016) for their definition of nursing and found that it includes the same “… protection, promotion and optimization of health,” parallel emphases on preventative wellness and the mitigation of suffering, and a focus on advocacy for individuals and populations alike. Well, that settles it! I am absolutely a public health nurse. In fact, as professionals committed to the health and well-being of the populations we serve, we, as nurses, are all essential components to realizing the goals of public health initiatives worldwide.

Nurses in the service of public health possess the potential to transform healthcare, not only at the point of delivery, but in the creation, direction, and implementation of system-wide advances that increase access to and delivery of quality care. Transformation is not possible until nurses understand their potential as leaders. We must each foster the development of powerful leaders at all levels of nursing and public health in order to realize the vision of health equity, improved outcomes, and the positive, collaborative transdisciplinary relationships called for by the Institute of Medicine (2011).

Personally, I have come to believe in something I call evolutionary leadership. In my upcoming book to be published by Springer, Nurses as Leaders: Evolutionary Visions of Leadership (Rosa, 2016a), I have collaborated with thirty of the profession’s most accomplished clinicians, nurse educators, deans, CNOs, executives, acclaimed authors, global advocates, policy experts, holistic guides, nurse coaches, editor-in-chiefs, organizational presidents, NGO founders, spiritual practitioners, and administrators, to provide broad perspectives on what constitutes leadership and how we can learn to embody it. Evolutionary leadership “…merges all corners of the discipline into a cohesive force for health and wellbeing; … fully embraces the art and strategically engages the science of nursing; … [provides] historical context and… foresight; and [seeks] to unveil and awaken the inherent leader dwelling within each nurse, regardless of position, title, credentials, or specialty” (Rosa, 2016b).  It isn’t enough to have a vision for leadership; it must be put into action, both locally and globally, through an ongoing commitment to advocacy.

In order to become evolutionary nurse leaders in the service of public health, we can begin by expanding how we think of our current role…

If you are a bedside nurse caring for patients at the individual level, start to consider how you impact an entire community through the intimacy of your one-on-one nurse-patient relationship. Through the care you give, education you provide, and advocacy you demonstrate, your efforts impact an entire family, block, neighborhood, and population. Bedside nurses are public health nurses.

If you are an educator, consider how your beliefs about health and wellbeing inspire entire classrooms of students, who take your expertise back to their colleagues, patients, and families. What you teach and how you teach it maintains far-reaching effects. Educators are public health nurses.

And if you are an administrator, just take a moment to acknowledge how the policies and protocols you promote, the safety you procure, and the quality outcomes you strive for elevate the very health of a city, state, or country. Without a doubt, administrators are public health nurses.

As we move forward with this Public Health Nursing series, we will begin to explore the links that connect us, regardless of our current position or title, to global public health systems and international health goals worldwide. As I see it, public health nursing is a service to the wellbeing of humanity, a process of striving to honor cultural differences while redefining what it means to be a global citizen.

You are a public health nurse.

Carry on.


American Nurses Association. (2016). What is nursing? Retrieved from   

American Public Health Associaton. (2016). What is public health? Retrieved from   

Institute of Medicine. (2011). The Future of Nursing: Leading Change, Advancing Health.    Washington, DC: The National Academies Press.

Rosa, W. (ed.). (2016a). Nurses as Leaders: Evolutionary Visions of Leadership. New York, NY: Springer, in press.

Rosa, W. (ed.). (2016b). Preface. In W. Rosa (Ed.), Nurses as Leaders: Evolutionary Visions of Leadership. New York, NY: Springer.

More about the Author

William (Billy) Rosa, MS, RN, LMT, AHN-BC, AGPCNP-BC, CCRN-CMC, is currently Visiting Faculty, University of Rwanda and ICU Clinical Educator, Rwanda Military Hospital, Human Resources for Health Program in partnership with the New York University Rory Meyers College of Nursing. He currently has over 65 publications for refereed and non-refereed journals, newspapers, magazines, and national platform blogs and his book, Nurses as Leaders: Evolutionary Visions of Leadership, will be released by Springer in June 2016. Billy currently sits on the US Advisory Board for the Nightingale Initiative for Global Health, and most recently received the American Association of Critical-Care Nurses' 2015 National Circle of Excellence Award and the Association for Nursing Professional Development's 2015 National Change Agent/Team Member Award.

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Part 2 - A Word on Cultural Humility