Community Health Nurse: What They Do and How to Pursue this Field

community health nurse with patient
community health nurse with patient

At a Glance

What you’ll do: Community health nurses work to improve the health and wellness of individuals and communities, many of them underserved.

Where you’ll work: You may work in a public health clinic, with a non-profit or faith organization, in hospitals or large health systems, or in nursing education.

Degree you’ll need: Most community health nurse positions require a Bachelor of Science in Nursing (BSN). A few positions may be available for those with an associate degree.

Median annual salary: $75,330


Community health nurses bring healthcare to some of the most vulnerable in their community. These nurses may do health screenings at a health fair or for a faith community. They may work in a public health clinic to help determine barriers to care in an underserved community, or for a governmental body offering outreach to communities like the homeless or migrant farmworkers.

Community health nursing is often confused with public health nursing—even by those who have been in the profession for years. “I’ve spent the last three years working on rewriting the scope and standards of care for public health nursing, and I don’t think in all that time our group came to a consensus on definitions for both,” says Lori A. Edwards, DrPH, NPH, BSN, RN, president of the Association of Community Health Nurse Educators (ACHNE) and an assistant professor at the University of Maryland School of Nursing.

Perhaps the easiest way to separate the two is to think of public health nurses as healthcare professionals who create programs and help develop policy and community health nurses as healthcare professionals who implement those programs at the patient level. Public health nurses focus on population health, says Edwards, while community health nurses focus on individual, family, and community health.

How to Become a Community Health Nurse

Here’s a guide to pursue an education to become a community health nurse.

  1. Decide if community nursing is right for you.

    Do you like making a direct and visible difference in people’s lives? Do you enjoy working on your own initiative with minimal supervision? Can you handle working in situations where you may come up against frustrating systemic and financial roadblocks? And are you creative enough to find ways to make do with tight resources?

  2. Determine what education you’ll need.

    While some entry-level positions may be available with an associate degree, for the most part, community health nurses need a bachelor’s degree, ideally a BSN.

  3. Graduate from an accredited nursing program.

    Your education should be from an accredited nursing program to maximize your employment opportunities.

  4. Get licensed as a registered nurse (RN).

    Take the National Council Licensure Exam for Registered Nurses (NCLEX-RN) to earn your RN license to practice.

  5. Gain experience to earn a public health nursing certification.

    While you may be able to get work in community health nursing right out of school, having some experience in general nursing practice may increase your job prospects. And with experience in community nursing, you can earn a certification to demonstrate your expertise and knowledge.

What Do Community Health Nurses Do?

While the jobs they do can vary, community health nurses always work with people—individuals or groups—to improve health and health outcomes.

They may work with a patient recently discharged from the hospital to access healthy food, provide assistance with nutrition or daily tasks, or find rides for follow-up visits. As another example, Edwards says community nurses “may work with a faith community trying to improve the metabolic health of parishioners by doing blood sugar testing and nutrition education.”

While the jobs they do can vary, community health nurses always work with people—individuals or groups—to improve health and health outcomes.

Among the tasks you may perform as a community health nurse:

  • Health advocacy: helping patients find and access appropriate care.
  • Health screening: looking for undiagnosed conditions, like high blood pressure, diabetes, or nutritional deficits.
  • Preventive care: giving vaccines, such as flu or measles shots, testing for infectious diseases like COVID, or ensuring access to medicines for chronic conditions.
  • Direct care: providing prenatal or postnatal care in community or home settings, drawing blood for testing, or providing well-baby or well-child checks.

What It Takes to Be a Community Health Nurse

Community health nursing can be a rewarding career, especially if you have these traits and skills.

  • Autonomy: Most community health nurses work on their own, or with a small team of coworkers. They do not usually have supervision. Kaye Bender, RN, PhD, FAAN, president-elect of the American Public Health Association, says it’s a role that allows you to put your education into direct practice: “You aren’t doing what a doctor says; you are looking holistically at the patient’s needs and working to ensure they are met.”
  • Creativity: Public and community health has long been underfunded. That means that nurses working in this area need to be able to do a little with a lot. “Your job requires you to see the bigger picture: where a patient eats, lives, plays, and prays—because that’s where health begins,” says Edwards. That may mean you’re working on issues like food insecurity, as well as making sure a patient takes their meds.
  • Resilience: Edwards notes that there are often limits to what community nurses can do, due to policy or financial restrictions. It can be frustrating, she says, so you need to be able to take the hits when they come and celebrate your wins.
  • Empathy and open-mindedness: “You will encounter people who will not support their health or their family’s health in the way you think best,” says Edwards. “You have to help them do the best they can at the time, not what you want. You empower them from where they are at the time.”

Where You’ll Work

Many healthcare agencies and groups work within their communities, and that means community health nurses can be found in any number of organizations:

  • Community health clinics: Often publicly funded, these clinics tend to serve underprivileged communities.
  • Government agencies: City, county, and state agencies may use community health nurses for outreach and care for homeless populations and those in public housing, and to direct patients to appropriate resources for further assistance.
  • Nonprofit organizations: Charities and faith organizations often use community health nurses to perform health screenings or offer preventive care and health education, or to provide direct care to those for whom care is harder to access, like undocumented populations, the unemployed, or the uninsured.
  • Private homes: People who need care at home are often cared for by community health nurses who work for public or private agencies. These patients can be elderly people, those with mental impairments, or expecting or new parents.
  • Hospitals and healthcare organizations: These facilities sometimes employ community health nurses to do outreach, educate, and provide care to patients and members when they have returned home, or to help coordinate their care in the community.

A Day in the Life of a Community Nurse


Edwards has been a nurse for more than 40 years. During about 20 of them, she worked as a community health nurse, often in a mobile clinic providing care to migrant farm workers who wouldn’t otherwise have easy access to healthcare.

Her day might include caring for people who have illnesses like an ear infection or who need to have a medication check for high cholesterol or a blood pressure prescription. In migrant communities, there are also children who need vaccinations or care for injuries like sprains. Nutritional education, referral to other providers, and help accessing food, housing, and other needs are all elements of a day caring for migrant workers.

“You need to be concerned with whether there is a grocery store in the neighborhood or recreational opportunities for children,” Edwards says. “All of these things can impact a community’s ability to get and stay healthy. It’s a lot of work. You can start out working on one thing—a patient with diabetes—and end up working on something else, like teaching them about healthy eating, helping them find access to affordable insulin, and connecting them with a regular doctor.”

Education to Become a Community Nurse

While some community nurses have an associate degree, many employers require a bachelor’s degree. In general, the larger the community and organization in which you work, the more education you’ll need. You are more likely to get a job with an associate degree in a more rural setting.

Edwards says that getting a bachelor’s degree can help you get higher-paying jobs. “Work to the highest-level degree you can in the field,” she says. “That is how you will become a leader. You won’t get rich, and you may get frustrated by the lack of resources, but that is the real way to make a difference.”

Eventually, she says, going for a doctorate and teaching at the university level could afford you the best of both worlds. A PhD could allow you to keep the regular hours of a teacher while still participating in community health through the hands-on programs your students take part in.

Associate Degree in Nursing (ADN)

  • Prerequisites: Biology, anatomy, chemistry, and microbiology. For admission, most programs require a minimum 2.0 GPA in prerequisite classes.
  • Core curriculum: Coursework includes nursing fundamentals and care of pediatric, adult, and special populations, including maternity and behavioral health patients. While some programs include population health classes like epidemiology, Bender says this varies from program to program.
  • Clinical experience: Nursing students train in the community—at hospitals, clinics, or rehabilitation or long-term care facilities. They also participate in simulation and lab settings as part of their hands-on training.
  • Time to complete: 2 years of full-time study

Bachelor of Science in Nursing (BSN)

  • Prerequisites: Like an ADN, prerequisites include courses in sciences, plus math-based courses like statistics. 
  • Core curriculum: Coursework may include psychology, management and leadership, health promotion, pharmacology, and pathophysiology. While increasingly there are course requirements for public and population health, Bender says not every program includes community health-based classes.
  • Clinical experience: Hands-on training can occur in almost any setting, including hospitals, outpatient clinics, public health agencies, and long-term care facilities.
  • Time to complete: 4 years of full-time study

Online Programs

You can find programs that are at least partly online—with coursework online and labs and clinical hours in person. These programs require more self-direction, organization, and discipline than programs that are entirely in person, but they may be perfect for those who have day jobs or need to fit their studies in around caring for children.

You can find programs that are at least partly online—with coursework online and labs and clinical hours in person.

They could also be a good option for nurses with an ADN who want to pursue a bachelor’s while continuing to work. Online courses expanded during the pandemic, and many institutions are continuing hybrid options for all students.

What to Look for in a School

There are more than 2,600 nursing programs in the United States. Choosing the right one is a very personal choice, but there are some things you should look for:

Accreditation

This will ensure that the program adheres to common standards of education and quality. In addition, you’ll have to attend an accredited program to apply for federal financial aid, and most employers look for accreditation when hiring.

Post-education services

What does a program provide in terms of job placement and career counseling? How will it help you translate your degree into a job?

How well they prepare students

Ask about the rate for students passing the RN licensure exam on their first try, and how many students from the most recent graduating class have found nursing jobs.

Licensure

After graduation, students must pass the NCLEX-RN exam to obtain a license to practice.

The test is computerized, and each answer guides the computer program to choose subsequent questions.

Topics include:

  • Management of care/coordinate care
  • Basic care and comfort
  • Health promotion and maintenance
  • Pharmacological and parenteral therapies
  • Risk reduction
  • Patient safety and infection control

The number of questions can range from 75 to 265 and must be answered within six hours. There are plenty of options for test preparation help. Your school may offer resources, and you’ll find others online.

Once you pass the test, you’ll be ready for licensure by your state nursing board, which may also require you to pass background and drug tests.

Certification

Currently, there is no specific certification for entry-level community health nurses or public health nurses. However, the National Board of Public Health Examiners offers the Certification in Public Health (CPH) to nurses with at least a bachelor’s degree and five years of experience in their field.

When you qualify for the CPH credential, it could be worthwhile. A certification helps you stand out in your field by demonstrating your expertise and knowledge. This may lead to promotional opportunities or higher pay.

Salary and Career Outlook

The U.S. Bureau of Labor Statistics (BLS) reports salaries for nurses in general but doesn’t break out specialties. According to the BLS, median annual pay for nurses with a bachelor’s degree is $75,330, with the lowest 10% earning $53,410 and the highest 10% $116,230.

Nursing jobs will grow by 9% from 2020 to 2030, the BLS says, due largely to the growing number of older Americans.

Nursing jobs will grow by 9% from 2020 to 2030, the BLS says, due largely to the growing number of older Americans. Because baby boomers are living longer, they’re requiring more healthcare, often for chronic conditions such as diabetes and obesity.

Professional Resources

There are a variety of organizations that can help nurses boost their career prospects. Many hold annual conferences or provide opportunities for continuing education. Here are a few to consider:


lisa jaffe

Written and reported by:

Lisa Jaffe

Contributing Writer

With professional insight from:

lori edwards

Lori A. Edwards, DrPH, NPH, BSN, RN

President of the Association of Community Health Nurse Educators (ACHNE)
Assistant Professor, University of Maryland School of Nursing

kaye bender

Kaye Bender, RN, PhD, FAAN

President-elect of the American Public Health Association