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Public Health Nursing in Ireland

Community nursing in Ireland evolved in the 19th century from the work of individual religious orders in providing nursing care in the home setting. Efforts for more widespread organisation of community nursing services stemmed from the Queen’s Institute of District Nursing in the 1890s. This was a branch of the Queen Victoria Jubilee Institute for District Nursing in the UK. Nurses who were trained by this organisation became known as ‘Jubilee Nurses’ a term which persisted right up the 1970s and 1980s (see image 1). On completion of their training, ‘Jubilee Nurses’ were recruited to districts who could afford to house and pay them, and their work was governed by voluntary district nursing associations. Another voluntary initiative called the Lady Dudley scheme was established in the poorest parts of Ireland (mainly Connaught), in 1903 by the wife of the Irish Viceroy, Lady Rachel Dudley. Nurses funded under this scheme were called ‘Lady Dudley Nurses’ (Prendergast and Sheridan 201).

Both Jubilee and Lady Dudley nurses lived in the areas in which they worked and dealt with all the nursing needs of the area’s populations, albeit initially curative rather than preventative care. It was a precondition that the voluntary district nursing committees organised accommodation for a nurse before she could be recruited to a district. Often these accommodations were two-roomed cottages where the front room could double as a dispensary or surgery. In other cases, the nurse lived over the existing dispensary building which was also used by the local General Practitioner (GP). These old buildings are still visible in many parts of rural Ireland today (see image 2 below). However, they are now (mostly), replaced by modern primary care centre buildings which are in complete contrast (see image 3 below).

Although preventative nursing services were available since 1915, mandated by the Notification of Births (Extensions) Act 1915, the term Public Health Nurse in Ireland was first used in 1924 with the introduction of the school health service. Despite this long history it was not until 1960 that a separate register for public health nurses was established by the regulatory body, An Bórd Altranais (ABA), (now called the Nursing and Midwifery Board of Ireland (NMBI) (Irish Nurses and Midwives Organisation INMO 2013). This move heralded a national involvement by ABA in public health nursing education in 1968. Prior to this, a course of 8 weeks in length was available for nurses with less than 3 years of district or Jubilee nursing experience (Prendergast & Sheridan, 2012), but up to six months for less community experienced nurses (INMO 2013). Thus, Public Health Nursing has been a registrable qualification since the 1960s.

Educational preparation was carried out directly by An Bórd Altranais from the 1960s until 1986. In the 1980s, the PHN course moved to a Higher Education Intuition (HEI) setting, specifically University College Dublin (UCD), where the first Diploma in Public Health Nursing was awarded in 1987 (O’Shea 2008). It is now provided in three HEIs nationally, namely, UCD, University College Cork (UCC) and University of Galway.

A key report influencing the 1990s and 2000s was the Commission on Nursing (1998), which established funding for research and led to Health Research Board (HRB) research grants to nursing staff. Indeed, one of the Commission on Nursing (1998) reports examined specifically the international perspectives on nursing in the community (Leahy-Warren 1998).

Since 2006, a centralised process has been in place for the sponsorship and recruitment of public health nurses. In 2008 the recruitment and sponsorship of public health nursing students came fully under national governance which ultimately controls the yearly selection of students to meet workforce needs. The HEIs and the Health Service Executive (HSE) work closely to manage a national joint application process and successful applicants are contracted to the HSE for the duration of the programme and for a period of 18 months on completion. Thus, Public Health Nursing education in Ireland is more tightly controlled than when it originated. While the Postgraduate Diploma in Public Health Nursing programme dominated community nursing education in UCC, attempts were made over the years to extend the community nursing education offer but funding has prevented its strategic development.

Public Health Nursing in Ireland, like community nursing services around the world, is in the midst of health policy changes, which seek to strengthen primary health care and population health. Sláintecare was published in 2017 and unlike previous health service reform documents is a cross-party 10 year plan (Department of Health 2017). Care in the community at all levels is a cornerstone of this plan, as is greater interdisciplinary and inter-sectoral team working to improve outcomes for persons accessing the health services. Public Health Nursing in Ireland continues to be a generalist nursing profession due to the rural nature of communities, providing preventative and curative nursing to individuals, families, and communities across the lifespan. There have been efforts to change to a specialist model and there are many who believe this will happen sooner rather than later!

Image 1 - cover of text by

Image 2 - Old style health centre / dispensary building Kilcoole, Co. Wicklow

Image 3. Blackrock hall Primary Care Centre, Cork

The information provided in this blog is condensed from the following publication which has a full reference list:
Mulcahy H (2019) Community/Public Health Nursing -Origins to 2019. In. McCarthy G & Hegarty J. (2019) Catherine McAuley School of Nursing and Midwifery. 25 years Origins to 2019. Cork, School of Nursing and Midwifery, UCC (pp94-98)


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