June, 1953

In the homes she visits, the public health nurse inescapably

becomes an interpreter of public health practices-even in
such engineering matters as water fluoridation. Since she
cannot avoid influencing people, either for or against program
acceptance, it is well for her to go about her round of duties
prepared for her interpreter's role.

The Role of the Public Health Nurse in the

Community Water Fluoridation Program
ESTHER A. SCHISA, R.N.
Director, Public Health Nursing, Ulster County Health Department,
Kingston, N. Y.
pROGRESS in the field of public coveries are made in some laboratory-in
health increases the responsibilities New York, Paris or London. These discoveries
of the public health nurse as a member are translated into effective practical tech-
niques by testing an experiment and develop-
of the health agency team. Working ment of administrative routines in Washing-
under direct supervision of the health ton and the State Capitol. The city or county
officer, and as an adjunct to the special- board of health makes them available on a lo-
ists on the staff, the public health nurse cal scale. But it is the public health nurse-in
assists in the furthering of public health the city tenement or in the remote farm house
--who makes contact with Mother and Father
measures designed to prevent and reduce and Jennie and John. She is the ultimate
illness and to produce positive health.' channel through which the brilliant and bene-
She carries the message to the compo- ficent discoveries of science are actually made
nents who make up the community, the available to the people in the home.2
individual and the family. Her con- The community water fluoridation
tribution to the development of any program is now recognized as an im-
public health program is unique because portant part of the generalized field of
she is the one who gives direct service. public health. Through her teaching
It is she who works with the people, and education of the individual, family,
enters most into their daily lives, gains and community the public health nurse
their confidence and interprets the pro- plays her most important role in this
gram of a health department. Her program. The nurse must be equipped
contact is a continuing one. Professor *not only with her nursing skill, but with
C.-E. A. Winslow expresses this concept knowledge of scientific information re-
in the following quotation: lating to disease control and health pro-
The nurse is the spearhead of the public motion. If the agency by which she is
health campaign, its vital contact with the employed has accepted the water fluori-
individual family in the home. Basic dis- dation program as a part of their
responsibility, then the nurse must un-
*
Presented before a Joint Session of the American derstand the technics of water fluorida-
School Health Association, the Conference for Health
Council Work, and the Dental Health, Public Health tion, the need for the program in the
Education, and Public Health Nursing Sections of the community, the cost of the program, its
American Public Health Association at the Eightieth
Annual Meeting in Cleveland, Ohio, October 23, 1952. practical aspects, effectiveness and
10]
Vol. 43 COMMUNITY FLUORIDATION PROGRAM
methods of control. In order that such
a program may prove effective, it seems
imperative that a coordinated educa-
tional program administered by a health
department be implemented in an en-
deavor to thoroughly acquaint the com-
munity with its objectives. The public
health nurse emerges as a valuable tool
in this process. It should be pointed
out that the public health nurse needs
to maintain an objective viewpoint in
regard to any program such as water
fluoridation regardless of her own per-
sonal sentiments and beliefs.
The public health nurse has worked
closely with the health officer in the
communicable disease program, with the
public health engineer in providing safe
food, milk, and water supplies, with the
nutritionist in the teaching of well bal-
anced meals, with the health educator
in the organization of community health
programs, and with the dentist or dental
hygienist in the health programs in
schools and industry. Dental health
has always been a part of generalized
public health nursing. The addition of
the water fluoridation program to pub-
lic health dentistry merely necessitates
equipping each nurse with knowledge of
the relationship of fluorides to dental
caries. How does she actually imple-
ment this program in her service day by
day? As an example to illustrate how
the nurse is confronted with this prob-
lem I shall relate the experience of one
of the public health nurses in our
agency.
A mother with her infant and three
and one-half-year old preschooler, at-
tended a child health consultation in the
city. In her discussion with the public
health nurse regarding the doctor's
711
recommendation that the child be re-
ferred to the private dentist for care, she
questioned the fact that the city has
not had sodium fluoride added to the
water supply. She had read that other
communities were pursuing this policy.
She was very indignant that her child
was being deprived of the protection
against tooth decay that publicity had
led her to believe was available.
This clearly points up how important
it is for the nurse to be equipped with
skilled teaching ability and knowledge
of the water fluoridation program to
satisfy this mother's present concern
without endangering any. future com-
munity participation in this program.
The nurse's work in the child health
consultations, in her contacts with
school personnel, and in her daily visits
to individuals and families provides ex-
cellent opportunities for teaching dental
health. She emphasizes the importance
of good nutrition, cleanliness, and
supervision by a dentist and interprets
recent developments in the field of den-
tal research. The nurse cooperates with
other professions in organizing com-
munity health programs and participates
in many educational programs for lay
groups and professional workers.
In conclusion it is important to
emphasize that although the public
health nurse does not actually use nurs-
ing skills in this program, one cannot
minimize her major role in the com-
munity fluoridation water program
through her education of individual,
family, and community.
REFERENCES
1. Manual of Public Health Nursing. New York: Na.
tional Organization for Public Health Nursing, 1939.
2. Wensley, Edith. The Community and Public Health
Nursing. New York: Macmillan, 1950, p. 20.