A public health nurse leader encounters barriers to shifting to a population-focused practice. The reasons peers are not supportive are most likely related to which of the following?

• A. Agency colleagues' push for nurses to focus on population initiatives.
• B. Costs associated with staff training and revision of documents.
• C. Lack of support from funding sources.
• D. Opinions that nursing should focus on the provision of direct client care and services.

Answer: (D)

Shifting to population-focused practice often meets resistance from colleagues who strongly identify nursing with direct, one-on-one client care. When the professional image of nursing centers on bedside services and individual treatment, ideas about focusing on groups, communities, prevention, and system-level changes can feel outside the traditional role. Those who hold the belief that nursing should be about direct care are likely to question or oppose broader population initiatives, because they see them as diluting or redefining what nursing is supposed to do.

While costs, training needs, and funding support are real barriers in implementing any new practice model, they reflect resource and organizational constraints rather than the underlying attitudes about nursing’s role. Likewise, if agency colleagues were actively pushing for population initiatives, that would likely ease the transition rather than hinder it. The core barrier here is the view that nursing’s essential focus should remain on direct client care, not population-level work.