Grant: Travel Awards - Institute Community Support

Public health across British Columbia, Canada has been subject to recent organizational and policy changes. These changes are due, in part, to a series of national public health crises, such as SARS, Walkerton E. coli outbreak, and the tainted blood scandal. In response to these events, there has been concerted effort to renew and strengthen the organization and delivery of public health programs and services across the the country. Indeed, the public health system in British Columbia has undergone multiple policy changes over the last decade. Currently we have minimal understanding of how these recent organizational and policy-level changes in the province have affected the services provided by public health practitioners, particularly public health nurses (PHNs). PHNs constitute the largest contingent of the public health workforce and work to improve the health of individuals, communities, and populations by preventing disease, disability, and injury, promoting health, and reducing health inequities. The purpose of this study was to improve our understanding of how recent organizational and policy changes have shaped the nature of public health nursing practice, how PHNs have managed this change, and the perceived impact on health outcomes and health inequities in the community. Findings from this qualitative study suggest that PHNs are concerned over the changing nature of the practice and are finding it increasingly difficult to be effective in broader health promotion and community development efforts due, in part, to the organizational structure in which they work. This research will provide British Columbia policy and decision-makers knowledge of how recent public health policy and organizational changes have shaped workforce services and, in turn, can inform organizational and policy decisions moving forward.