Objective The objective of this study was to analyze public health nurses' perceptions of empowerment and advocacy within a child health screening and surveillance program in West Ireland. Design and Sample This study combined both qualitative and quantitative research methods. A purposive sample of 9 public health nurses (PHNs) (phase 1) participated in 2 focus groups and a purposive sample of 43 clients attending the child health screening service completed a questionnaire (phase 2). Measures Focus groups and Questionnaires were used. Results Thematic content analysis revealed that PHNs in the study did not perceive themselves to be empowered in their work. They attributed this to workload, lack of professional advocacy, and restricted access to power and opportunity, while also identifying the need for continued managerial support and feedback. Conclusions The results suggest that PHNs need to be empowered in order to facilitate client empowerment. PHNs struggled with empowerment and client advocacy. There is a need for professional development for PHNs in order to support them to more critically engage with empowerment and self-efficacy in their work. This needs to be done within organizational structures that support PHNs to critically analyze the role of advocacy and empowerment in their practice.