Nursing is a varied role with many opportunities for promotion. Through experience and continuing education, registered nurses (RNs) can move into advanced nursing roles and, in doing so, work with greater autonomy and have a greater influence on healthcare policies across a variety of settings where they work, as well as influencing them on a local, state, or even federal government level. Furthermore, the option of specializing in a particular area of healthcare becomes a viable opportunity. When implementing, or influencing, policies in their healthcare setting for the wider community, advanced practice nurses use an array of data and statistics to inform their decisions, including epidemiological and environmental health analysis.
Epidemiology and environmental health
Epidemiology looks at diseases and disorders within a population, focusing on how those diseases are distributed and what may have caused them. It covers a variety of various areas including, infectious diseases, chronic diseases, and violence and injury. The premise of epidemiology is that illness and disease do not exist randomly and that by collecting data through research, both in a lab and in the field, and using it to form the public response to the disease. Information they may collect can include the number of cases of the disease in each period or area, the number of hospitalizations, and the fatality rate of the condition.
Another area of epidemiology is environmental, which considers the impact of the environment on health and whether there is an environmental cause for a disease or condition, such as pollution, housing quality, nutrition, and stress. Increasingly, it will also need to consider the impact of climate change. Information gathered on the impact of factors on the environment can be used to improve environmental health in homes, workplaces, and in the world.
Becoming an advanced practice nurse
The most common route into nursing is via a bachelor of science in nursing degree (BSN). Upon qualification, the new nurse usually works for a few years as an RN. Nursing is a lifelong learning journey, attracting those who are always keen to know more, and for those aiming for promotion, further study is likely to be necessary. This can be accomplished through a Master of Science in Nursing (MSN), which can also lead to doctoral studies with the choice of either a PhD in nursing or a Doctor of Nursing Practice (DNP). A PhD is ideal for those who are interested in moving into research-based roles to advance science in nursing, while those who are keen to remain in a practice-based career will find a DNP is likely to be a better option.
Nursing qualifications can be obtained through online study. With online courses available from top universities, they are just as thorough as their in-person counterparts and will provide the top-quality education needed for an excellent nursing career. If you are interested in a doctor of nursing practice online, a good place to consider is the online DNP at Wilkes University. The accelerated and focused course includes an epidemiological and environmental health course to consider the concepts and methods of analysis in this area and how this knowledge can be integrated into nursing practice. By gaining additional qualifications and advanced degrees, people can advance their nursing career into a range of roles, including nurse practitioner, nursing leader, and educator.
Concepts and methods in analysis
When working with epidemiological and environmental health analysis, there are several techniques used to help get an understanding of the disease or condition. Combined, they help create a comprehensive picture of the disease, informing healthcare policies on how best to proceed.
This looks at the occurrence of the disease by time, place, and person. In terms of time, it can look at the data over a prolonged period, seeing what events have impacted it; it looks at seasonal fluctuations; it considers periodic trends where diseases change every few years and, in an epidemic, where there is a sudden increase in transmission.
In terms of place, it is necessary to look at where an infected person became ill, where they were infected by the source, and where the source became infected. For the person, the descriptive method looks at factors of the individual such as their sex, age, immunization history, occupation, and anything else that may show a pattern.
The analytic method examines disease determinants to increase understanding of the causal elements. It might use the case-control method, which studies two groups, one with the disease and a similar group without the disease. By comparing them, it can be possible to determine why the disease has occurred in one group and not the other. The cohort method studies two population groups: one which has been exposed to a suspected causal factor and one which has not. This should reveal the impact of the factor and whether it is indeed a causal factor.
This is used to test a hypothesis on a disease. It sets up an experimental model and manipulates selected factors to test the hypothesis. A good example of this is a drug trial where some in a group are given a drug, and some are not, helping to determine the drug’s effectiveness on that disease or condition.
Application to advanced nursing practice
Advanced practice nurses work in a wide variety of settings. In hospitals,, they may take on leadership roles, work as specialists such as nurse anesthetists or nurse midwives, or work as nurse educators guiding the new and student nurses. Away from the hospital, they may work in research positions, take on community roles, or have their own practice as a family nurse practitioner (FNP) or adult and gerontology nurse practitioner (AGNP). While some nurses may work specifically in epidemiology and environmental health, all nurses will need to have some knowledge and may play a role in the analysis that aids our understanding of the causality of diseases and conditions and how they can be eased.
As noted above, some advanced nurse practitioners will take on research-based roles and play a key part in some of the methodologies used to advance our understanding of the causes and treatments of diseases and other conditions. However, being part of the research is not limited solely to those nurses who work exclusively in research. With their expert knowledge of their practice environment and often having a good understanding of the social, cultural, and economic background of their area, they are well-placed to participate in research relevant to their patient demographic.
When epidemiologists and environmental health practitioners formulate theories on the development of disease, they require data to help them develop their hypotheses. Much of this can be drawn from the records kept by nurses. As nurse leaders, advanced practice nurses can implement effective record-keeping systems to help streamline and improve the accuracy of the data gathering researchers in epidemiology and environmental health requires. Clinical studies and the follow-up to those involved in clinical studies can take place in various medical settings, where advanced practice nurses can play a key role in ensuring that all information is recorded and ready for analysis.
Advanced practice nurses often take on leadership positions in hospital wards and on hospital boards. These are positions of high autonomy and responsibility that allow them to influence the development of programs to benefit the health of their patients. This means they need to pay close attention to the latest discoveries from epidemiology and environmental health experts and use these to inform their programs and policies. These can range from allowing their healthcare facility to be used in new trials to implementing a particular therapy or drug based on the recommendations of epidemiologists.
Nurses who work in the community should pay particular attention to theories around disease causality as they are well-placed to run community-based programs. Increasingly, medical care is taking a holistic approach, and understanding the background factors can be key to understanding many diseases and conditions. When setting up programs, advanced practice nurses may choose to focus on aspects of diet in disease prevention or programs to help patients understand the risks of smoking, drugs, and excessive alcohol consumption. Programs working with pregnant women and new parents can help parents build a healthy environment for their children, possibly delivering life-long benefits. If working in schools, the nurse can run programs targeted at the young, helping them to build habits conducive to good health.
Nurse leaders holding senior positions in hospital wards or the hospital can play a role in the development of healthcare policies, particularly in how they relate to nursing practice. Using information from the analysis of epidemiology and environmental health, they can put in policies to help in disease management and prevention. These may include how procedures take place in hospitals to reduce the risk of disease transmission or policies on how new drugs and therapies are trailed in their facility, as well as what should be done to improve healthcare regarding new drugs, therapies, and training methods.
Not all healthcare policy is decided by healthcare professionals. Local, state, and federal governments make key decisions on healthcare. However, politicians will be advised on this, and as respected medical professionals who have kept up to date on the latest developments in epidemiology and environmental health, advanced practice nurses can lobby politicians to encourage them in effective policymaking.
Nurses are often well placed to act as a patient advocates, and this does not change after becoming an advanced practice nurse. Rather than seeing a patient as a set of symptoms, nurses will usually view them more holistically and will often have knowledge of the patient’s background. Epidemiology often looks at how diseases and conditions impact differently in various population groups, and nurses may have knowledge of the patient that can help determine if they are more at risk of complications from a disease or condition and can communicate this to others in the medical team treating them.
In the community, nurse practitioners can advocate for the community. Through their understanding of epidemiological and environmental health analysis combined with their local knowledge of their patients and their home environment, they can comprehend the implications of what is happening around them. From a particular chemical used in local agriculture to the devastating impact of poverty, nurse practitioners can advocate for their communities to encourage policies and practices that promote high health standards.
Key players in the understanding of disease
Advanced practice nurses, wherever they may work, can play a key role in our understanding of the causes, consequences, management, and treatment of diseases and other conditions. From participating in studies and providing the vital datato implementing policies and programs and lobbying politicians, nurses can make a difference.
If a career where making a difference every day is appealing, a career in nursing is well worth considering. If already an RN, then it is never too soon to start considering where this career can lead. In advanced roles, there is greater autonomy to make decisions guided by knowledge of epidemiology and environmental health that will help in the prevention and management of diseases. With online training options from top universities, it has never been so easy to undertake the study necessary for achieving further qualifications. Furthermore, this opens up an array of opportunities in leadership, education, research, and specialisms. Increasing the ability to use the concepts, methods, and discoveries in epidemiology and environmental health that will improve health on both an individual and a community level.