Public health nurses work in a wide variety of settings. Some are employed by the government and work in health administration at prefectural and municipal public health centers and health centers, others are occupational health nurses, who work as occupational health staff at companies, and others are Yogo teachers (school nurses) who work to preserve the physical and mental health of students and faculty at schools. This list is ever-expanding. Their roles, the people they serve, and the types of tasks they perform differ between workplaces. The following is a list of places where public health nurses work organized by categories from the Report on Public Health Administration and Services published by the Ministry of Health, Labour and Welfare.
Health centers are government agencies located in special wards or municipalities. Public health nurses who work there are employed by that municipality (as administrative workers) and work as public health specialists. They work with community members of all ages, from infants and young children to pregnant women, adults, elderly adults, and people with disabilities, with a wide range of health levels. Unique aspects of their job include providing comprehensive counseling on health and welfare that is accessible to residents and is community-oriented, and engaging in community building. They provide various services intended to promote community health, including infant checkups and support for parents, educating adults about prevention of lifestyle diseases, motivating elderly adults to live a healthy lifestyle, and educating elderly adults about how to avoid needing long-term care. Through these services, they work to build community in a highly personalized way.
Public health centers are established by prefectures, special wards, designated cities (in the Local Autonomy Act), core cities (in the Local Autonomy Act), and cities designated by ordinance (in the Community Health Act). Public health nurses who work there are employed by that local government (as administrative workers) and work as public health specialists. In addition to providing counseling and assistance to people receiving care for intractable diseases, tuberculosis, or other conditions and people with mental illness, they coordinate with municipal public health nurses to assess and study the health issues faced by the community as a whole, structure the community’s healthcare system, and implement solutions. Unique aspects of public health centers are the wide-reaching, highly specialized tasks they perform to fulfill the purpose for which they were established, which may include involvement of the prefectural or other government that runs the center in implementation or oversight of policies designed to address health issues.
Public health nurses who work at companies or factories are called occupational health nurses. Occupational health nurses form teams with other professionals such as occupational health physicians and health supervisors and work to preserve and promote the health of company employees and employers. These teams implement various measures for protecting workers’ health, ensuring a safe working environment, and overseeing work tasks. Japan started to focus on issues such as industrial accidents and accident prevention during its period of rapid economic growth from 1955 to 1973. However, the issues becoming important today are prevention of lifestyle diseases and management of depression and other mental health challenges that have arisen due to factors such as economic stagnation and the increasing proportion of irregular workers. Emerging infectious diseases are also becoming a constant threat outside Japan, so prevention of infection during overseas travel has also become an important issue.
Public health nurses work in various departments of hospitals and clinics, including regional medical liaison offices, health guidance offices, and discharge planning departments. Public health nurses in regional medical liaison offices discuss and coordinate support plans and measures for patients with other relevant parties inside and outside the hospital and offer counseling and guidance to patients and their families. Public health nurses in health guidance offices perform various screenings for lifestyle diseases and other medical conditions, provide health guidance and health education after those screenings, and help employees stay healthy. Public health nurses in discharge planning departments coordinate and consult with relevant institutions such as government agencies or home nursing stations to help patients and their families transition comfortably to continuing care at home after discharge.
The main purpose of community comprehensive support centers is to assist community members such as elderly adults and people with disabilities with health and daily living. They are core organizations that comprehensively work to improve community health and welfare and are primarily established by municipalities. Public health nurses at community comprehensive support centers serve as case managers for elderly adults with the primary aim of preventing them from requiring long-term care, and advocate for elderly adults and people with disabilities. They also coordinate with other organizations such as municipal health centers to build comprehensive community care systems in their region and perform other related tasks. Coordination within the diverse regional landscape of health, medical, and social welfare-related organizations and strengthening of the local network is considered important for comprehensive community care systems. Public health nurses work to connect those organizations or serve as a coordinator between them.
Social welfare facilities that employ public health nurses can be broadly categorized as facilities for elderly adults and facilities for children. Social welfare facilities for elderly adults include social welfare councils, senior activity centers, and geriatric health services facilities. The public health nurses at these facilities work to promote the health of elderly adults and offer comprehensive counseling services while also supporting the families of elderly adults. Social welfare facilities for children include childcare centers as well as residential homes and daycare centers for children with disabilities. Public health nurses work with childcare workers and other staff to keep the children are healthy and ensure their environment is safe. In recent years, it has become more common for child guidance centers to employ public health nurses as well. The public health nurses there care for children who have PTSD or disabilities due to abuse and provide information to and liaise and coordinate with other relevant organizations.