Public health nurses and community registered general nurses (ONMSD)
Public health nurses (PHNs) are registered nurses with a specialist nursing qualification. They provide the core nursing and midwifery care in the community.
Community registered general nurses (CRGNs) support and contribute to community services.
PHNs and CRGNs are based in health centres and primary care centres. Care is also delivered in the home and clinic setting.
Role of the national lead for public health nursing (ONMSD)
The national lead for public health nursing is responsible for:
- public health nursing strategy development and implementation
- encouraging collaboration by promoting multidisciplinary working at both primary care and network level
- provides support to the Directors of Public Health Nursing (DPHNs) national group to put in place organisation change
- ensures that evidence based community nursing standards are in place nationally
- ensures integration of public health nursing services with primary care structures including GP’s and practice nurses
- promotes the use of Quality Care Metrics within community nursing and continuous quality improvement
- manages change necessary to achieve organisational and primary care objectives
Ina Crowley - Project Officer, lead for the PHN Sponsorship Programme.
About public health nurses
Public health nurses (PHNs) in Ireland currently work as part of a multidisciplinary team.
PHNs offer guidance and information to clients about how best to meet their health needs, when they meet patients. PHNs assess whether other health professionals are required in the primary care team.
PHNs provide a generalist nursing service to a broad range of patient or client groups including:
- older people who live at home
- people who are chronically ill at home
- people who are acutely ill at home
- people who are dying at home
- expectant mothers and mothers who have recently given birth
- people with disabilities
- people suffering social deprivation
- members from the travelling community
- children (settings include infant welfare services, child health services and school health services)
- those who have contracted hepatitis C directly or indirectly from the use of human immunoglobulin-anti-D or from the receipt within Ireland of any blood product or a blood transfusion
About community registered general nurses
Community registered general nurses (CRGNs) work alongside the PHN. The primary focus of the CRGN is on individual patients and care of the older person.
The CRGN works closely with the PHN to assess plan and implement nursing care and works in the home and clinic environment. CRGNs undertake relevant education and training programmes relative to their role in community nursing.
Types of work and resources
Information about the work of PHNs and CRGNs and useful resources if you are working as a PHN or CRGN:
Both PHNs and CRGNs provide direct clinical nursing care to:
- children and adults referred to the service from acute hospitals and GPs
- referrals from all other sources.
All referrals received into the PHN service undergo a preliminary screening process. Referrals accepted to the caseload are then prioritised for a domiciliary or clinic assessment. Clinical services provided include but not limited to:
- continence management
- continence care
- wound care
- oncology support and end of life care
- general nursing care to patients that are chronically ill or disabled
We collaborate with local specialist palliative care teams. Referral onwards to relevant services is provided.
Mothers, babies and child health
The PHN provides the following services to mothers within 72 hours of discharge from the maternity hospital service:
- provides information and support about looking after a newborn baby.
- conducts developmental assessments on the first visit.
- provides information on breastfeeding support groups, well baby clinics and postnatal support groups.
The HSE provide the following services to school aged children:
- A school hearing and vision screening programme for children attending primary schools.
- A school immunisation programme for children attending public and post primary schools.
Mothers, babies and child health resources:
PHNs and CRGNs provide a wide range of services to older persons. Services include:
- holistic nursing assessment
- onward referrals as appropriate to therapy and other allied health professionals.
PHNs carry out assessments using for example the InterRai. The InterRai is a comprehensive IT based standardised assessment. It assesses the health and social care needs of people over the age of 65 years who may be looking for support.
Older people resources:
PHNs have an important role in caring for patients with cancer. PHNs provide care at home to patients undergoing cancer therapy. Care includes survivorship and palliative care.
Cancer care resources:
Palliative care aims to improve the quality of life for patients and their families when their cancer can no longer be cured.
As well as providing relief from pain, nausea and other symptoms, palliative care offers support and comfort to patients.
It involves caring for their physical, emotional and spiritual needs. PHNs assess the holistic needs, palliative care/end of life nursing needs of all patients in the community.
Palliative care resources:
PHNs and CRGNs play a role in illness prevention and health promotion. PHNs and CRGNs play an important role in caring for the well and for the sick.
To ease that process, we must provide people with appropriate information. PHNs and CRGNs have a key role in providing that information in the form of health teaching.
Every interaction with a client can be an educational intervention. For example, when in a clinic or doctor’s office, if a patient comes in with a cut, it’s the perfect time to check the chart for the last tetanus booster.
Health promotion resources:
Public Health Nurses (PHNs) and Community Registered General Nurses (CRGNs) may come into contact with vulnerable people who may be exposed to the risk of abuse, harm or neglect. They play an important role in safeguarding both adults and children.
Under The Children First Act 2015 legislation, all mandated persons are required to report any knowledge, belief or reasonable suspicion that a child has been harmed, is being harmed or is at risk of being harmed (pages 12 – 13, Children First Act 2015).
- Health Service Executive Safeguarding Vulnerable Adults
- Safeguarding Vulnerable Persons at Risk of Abuse National (PDF, 64 pages, 2.00 MB)
- Policy and Procedures (PDF, 64 pages, 2.00 MB)
- Children First Act 2015 (PDF, 28 pages, 490 KB)
- Tusla Children First legislation and guidance, publications and forms
- Tusla Children First E-Learning Programme
- National Quality Improvement Team open disclosure information
Healthcare associated infections (HCAI)
A healthcare associated infection (HCAI) is an infection that is acquired after contact with the healthcare services. HCAIs occur after treatment in hospitals, outpatient clinics, nursing homes and other healthcare settings including community settings such as the home.
It is important that PHNs and CRGNs take the necessary precautions to prevent and control HCAIs.
- HSE Health Care Associated Infection and Antimicrobial Resistance – Information for the public and healthcare workers
- HIQA Draft national infection prevention and control standards for community services (PDF, 100 pages, 2.07 MB)
The following material may be useful in your role as a healthcare professional:
- National Quality Improvement Team National Consent Policy
- HSE National Health and Safety Function Lone Working Policy and Guidelines 2017 (PDF, 34 pages, 432 KB)
- HSE Protecting HSE staff from second-hand smoke in domestic settings (PDF, 20 pages, 363 KB)
- Manual Handling and People Handling Policy (PDF, 35 pages 452 KB)