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Keywords:

  • nursing history;
  • nursing workforce;
  • public health nursing practice

Abstract

In 1916, when Annie Brainard published this paper, there was an ongoing discussion in the journal about specialization versus generalization of public health nursing (PHN) work. This discussion revolved around issues such as the size of communities (rural versus urban), population density, and cost effectiveness. For geographically large rural communities with low population density, specialization could be costly, while for urban, densely populated communities specialization based on scientific knowledge could have a stronger impact on population health. As Brainard indicates in this paper, specialization in PHN was not about additional education, but rather concentration of effort. Early specialization usually focused on tuberculosis, baby care, and school nursing. In this article, Brainard argued that there was a need for both specialist and generalist public health nurses, and co-operation was needed between the two groups to avoid costly duplication of efforts.