New93 role standards, now public
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Role standards

Nursing

Public health nurse

What a public health nurse must be able to do without supervision when the patient is a household, a school or a population: work a reportable-disease case from the first call to the last contact, act on a duty to report, and get a family to a service that will still exist next week. Drawn from the Quad Council Coalition competencies that the public health nursing profession wrote for exactly this level of practice.

Practice this assessmentHire for this role
Expectations
10
Safety red lines
4
Sources
3
Version
1

Built from Quad Council Coalition of Public Health Nursing Organizations, Centers for Disease Control and Prevention, American Nurses Association. Reviewed by clinicians, last on .

01What the role is measured on#

Every verdict is made of the same five dimensions. Each is scored on its own, so a candidate sees where they are strong and where to work.

  • Clinical skillsThe hands-on and judgement work of the role: recognising what matters, acting in the right order, and knowing when something cannot wait.
  • Workflow and toolsGetting the work done in a real setting: the systems, records, equipment and handoffs the role runs on, used correctly and on time.
  • Patient communicationHow the role talks with patients, families and colleagues: listening, explaining plainly, and confirming what was understood.
  • Compliance and safetyThe rules that protect people: privacy, consent, infection control, reporting duties and the safety checks the role is accountable for.
  • Role knowledgeKnowing the job itself: what the role is responsible for, where its scope ends, and who to bring in when it does.

02What a ready hire does#

What a competent public health nurse does on day one, dimension by dimension.

Clinical skills

  • Works a suspected reportable-disease case from notification to closure: confirms the case against the surveillance definition, defines the infectious period, elicits and notifies contacts, and does it in the order that stops onward transmission first.
  • Administers vaccines and other medications under a standing order or protocol, screening the client and the order before giving and staying prepared for what could go wrong away from a hospital.

Workflow and tools

  • Reads population data against the community it describes, and turns a rate into a decision about where nursing effort should go.
  • Makes a referral that actually lands: matched to eligibility, warm where it matters, and followed up until someone confirms the client was seen.

Patient communication

  • Finds out what a person already understands, explains in plain language pitched to that, and checks by having it said back rather than asking whether it was clear.
  • Teaches a self-management skill in the home so that the person can do it without the nurse there, and knows what would make them call for help.

Compliance and safety

  • Recognises what the law requires them to report, reports it themselves on suspicion rather than on proof, and keeps working with the family afterwards.
  • Handles identifiable health information so that a disclosure made for public health purposes stays within what the law permits and no further.

Role knowledge

  • Knows what the system actually offers a household, gets them to it, and stays inside the public health nursing role while doing it.
  • Judges whether a piece of evidence or a guideline applies to the population in front of them before acting on it.

03Safety red lines#

Any one of these keeps a candidate from Ready Day One, whatever the rest of the score. They are published so nobody meets them for the first time in the assessment.

  • Tells a contact, an employer, a school or a neighbour who the index case is, or gives a description that identifies them, while notifying them of an exposure.

    Naming the source case exposes that person to retaliation, job loss and violence, and it is the fastest way to make the next case refuse to name contacts at all.

  • Agrees not to report a reasonable suspicion of abuse or neglect, or defers reporting until there is proof or until a supervisor decides.

    The mandated reporter's duty is personal and triggers on suspicion; a delay leaves a child or a vulnerable adult in the situation that raised the concern.

  • Books a routine appointment, or leaves a client to call a waiting list, when the client has disclosed suicidal intent or shows signs of an emergency that needs care the same day.

    A referral is not an intervention; a person in crisis left with a phone number and a date weeks away has been assessed and then abandoned.

  • Advises a client to stop, ration, split or substitute a prescribed medication, or to use a home remedy in its place, because the prescribed one is unaffordable or unavailable.

    Changing a prescribed regimen is outside the public health nurse's authority, and rationing insulin, inhalers or anticoagulants kills people who would otherwise have been bridged to a programme.

04Outside the role#

Knowing where the role stops is part of the standard. Going past it is not extra credit.

  • Does not diagnose or prescribe, and does not vary a prescribed regimen.Works under a current standing order or protocol for what they may give, and takes any change back to the prescriber.
  • Does not investigate suspected abuse or decide whether it occurred.Reports the suspicion to the agency with that authority, records the observations, and continues the nursing plan.
  • Does not identify the index case to contacts, employers or institutions.Notifies contacts of the exposure and what to do about it, and leaves the source unnamed.
  • Does not determine eligibility for benefits, housing or immigration relief.Prepares the household for the agency that decides, and says plainly what is not theirs to promise.
  • Does not provide psychotherapy or manage a psychiatric crisis alone in the field.Screens, stays with the person while arranging the same-day route to crisis services, and hands over to a licensed clinician.

05How it is assessed#

  • A spoken assessment

    An examiner talks the candidate through realistic cases from this role, and follows up the way a senior colleague would.

  • Five dimensions

    Each answer is read against the expectations above and rated on the same four-level scale.

  • The 70 bar

    Every scorecard shows the score against 70, overall and for each dimension, with the reason for the verdict.

  • Safety first

    Crossing one of the safety red lines holds a pass back, however strong the rest was.

The four levels

  1. Not yet
  2. Developing
  3. Proficient
  4. Exemplary
How a verdict is made

06Sources and review#

Drawn from the certification frameworks and practice standards below, and reviewed by clinicians. Version 1, last reviewed .

Cited as sources. Not an endorsement by the organizations named.

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