2018 Volume 67 Issue 4 Pages 402-412
The integrated community care system is aimed at establishing a regional system that can provide services such as housing, health care, medical care, nursing care, and welfare for the community. Public health nurses have been actively engaged in the work related to local health, welfare, medical care, etc. Therefore, there is high expectation with regard to the contribution of public health nurses to the new community-based care system.
Firstly, I assess the current situation of public health nurses by examining prior research, survey reports, and administrative materials. Secondly, from the viewpoint of public policy studies, I clarify the role of public health nurses in the integrated community care system. For this purpose, I focus particularly on public health nurses of municipalities (cities, towns and villages).
In municipalities, public health nurses belong to various organizations and are engaged in the duties of various fields. Today, a major responsibility of a public health nurse is the management of cross-sectoral public activities. As street-level bureaucrats, they are responsible for implementing policies related to daily life of citizens. It is also clear that the contribution of public health nurses to policy making is increasing.
In conclusion, the role of public health nurses in the integrated community care system is 3-fold: (1) to coordinate experts in the fields of health, welfare, medical care, and nursing care who are working in a community; (2) to link various departments and organizations of municipalities involved in care; and (3) to get involved in the policy making of all fields in their municipality in addition to making policies and projects related to care. In other words, it is the role of making policies based on the actual condition of the community and citizens' needs. In order for public health nurses to play all 3 roles, they must function not only as specialists but also as generalists. It is also required to develop the capacity of policy making as well as policy implementation.
