Becoming a Community Health Nurse

Hi JaneanneRN. I think I'm in the same boat. :-) I've been an RN for a short time (about 2 yrs) working in Telemetry in a small hospital. Although I love where I work and the people are great, I really don't think the Bedside/Acute Care Setting is where I want to be in Healthcare.

Instead of treating people when they're so ill they need to be in the hospital, I would be more interested in trying to help people either get better access to healthcare services or to live healthier BEFORE they wind up in the hospital.

I've thought this might fall under the heading of COMMUNITY or PUBLIC HEALTH nursing. I'm not sure though what qualifications are needed for these positions (I got my RN License after finishing an Assoc. Degree Program) or what settings I would be working in (Clinics, or the State's Office of Public Health?). Money is not an issue: I didn't get into nursing to get rich. I would be willing to go back to school (either for a BSN or maybe a Bachelor's in Public Health???) but I wouldn't pursue more schooling if I were to simply continue doing more bedside nursing.

The experience I've gotten doing telemetry has been very valuable. But, for the long haul, I don't think the acute care setting is where I want to be. Any help or advice would Really! be appreciated! Thanks. And if I hear anything JaneanneRN, I'll send it your way (if that's alright). :-)

Best Regards, Will

Kudos to you both for recognizing that you need a better "fit" with your nursing careers!

I've been an RN for almost 20 years and have worked a variety of places. Did my senior practicum in community nursing at a health dept. 3 days/week. I've worked in several areas of public/community health, such as school nursing, home health, and 2 different health depts. I, too, enjoy the teaching aspects and disease prevention, whether through lifestyle changes, vaccines, etc.

I don't think a BSN is required for most public health positions, but it probably depends on what you'll be doing. I'm the only one with my BSN at work, but I think experience counts for much more. I believe that if you have at least 1 year of general experience in a hospital, that should be a good foundation to build on in another specialty.

You might want to consider school nursing, especially if you like working with teens. I did this for a year and for the high school students, it was more psych nursing than anything. The home health that I did was primarily with elderly patients, with a few young adults and 1 baby in the mix. With health depts., you can see all ages and do a variety of things from satellite immunization clinics to inservices to advocacy for bike helmet laws to newborn visits to food-bourne illness outbreaks.

I'll warn you that the pay usually doesn't even come close to hospital nursing, but the trade-off is that the hours are more conducive to family life. I really enjoy working as an immunization nurse and I encourage anyone to check it out!

Pardon my ramblings - my enthusiasm overcame me!

Cindy

A BSN is required for both Community Health Nurse and School Nurse positions. However, you only need your ADN or Diploma to work in the health department clinics.

Hi Cindy! Just wanted to say thanks for the encouragement and the info. In my focus on a Public Health Clinics or State Depts of Health I overlooked Visiting Nursing. Just curious, if I did pursue a BSN are there programs that have a focus on Public Health or Community Nursing at the Bachelor's Level or are most BSN programs pretty general? Thanks again for the help! Will :-)

To find out what type of community/public health nursing is included in your local BSN program, you'll probably have to call them and ask. You might want to try and talk to one of the clinical instructors.

I graduated in 1986 and my first exposure to community health was at a homeless shelter in downtown Toledo, OH. It also doubled as my psych clinicals. This was about the time that the homeless issue was in the national news and the issue of what to do with all this former psych patients that had been released from state institutes and were supposed to be monitored at community centers, but weren't. My senior practicum was at the Ottawa County Health Dept., which is about 1 hour away from Toledo and I had 3 full days/week there for a quarter. Did a little bit of everything - shots, infectious disease follow-up, home visits, clinics, etc.

Good luck with your career decisions!

Cindy

I have been working in ICU for my entire length of nursing and have worked in a cosmetic surgery center in the Operating Room prn once a week for two years. I am wanting away from the bedside as well. After hurting my back I knew I had had enough. I love working in the ICU, but it does take a toll on your mind and body. I have applied for several positions: Employee Health Nurse, School Health Nurse, Clinical Instructor, and Utilization Review Case Manager, Clinical Coordinator Supervisor. I also would enjoy teaching clinicals. The director of the college I attended is suppose to get back to me if one of the instructors decides to quit for the spring semester this year. If not, then there is no open slot, but if she does, then I may be able to get the position. I go Monday for an interview for School Health Nursing. The pay is significantly lower than what I am use to, but happiness and health is more important. And the hours are much better, but I will have to get use to getting up early. As I am a night shift worker. It will be interesting. Good luck to you all!

I am a Community Health Nurse, have been for the last 10 years. I have an ADN, there is no BSN requirement for public health, at least not in my state. Public Health is changing alot, I recently made the decision to return to acute care related to those same changes. When I started in public health the job was largely "in the field".....we'd go out and do disease investigation, teach classes at daycares and restuarants about handwashing, have field clinics for immunizations where ever we felt there was a need, do home visits for high risk newborns. We worked 8-5 M-F. Those were the days. Nurses had alot of autonomy and alot of responsibility. We knew our public well and worked with families, schools and community where ever the need was. Not so much anymore. Public Health just isn't what it used to be. Now Nurses are not allowed to leave the clinic, ever. We no longer do any disease investigation or go out to homes to provide tx, blood draws etc. Now we stay in the clinic, which has become nothing more than a free clinic. We do half of what we used to. The hours are also changing, no longer the M-F and no evenings that you take the lower pay to get. I don't know if this is happening in public health all over, or just here, but its sad. It is about as stress free as Nursing gets tho.

I can't speak for other states, but in Washington state the BSN is typically the requirement to be a PHN. That being said, here at Spokane Regional Health District we do have PHNs that are RNs, but not BSNs. Those nurses are restricted to clinical work. I have been at public health for 15 years and have no desire to work elsewhere. During the last 15 years I did work a couple a weekends a month at a small rural hospital for 3 years, and for the last 6 years have been working every other weekend as a community health/home health nurse. I do this insane schedule because I don't want to get totally away from the clinical type skills, and because public health agencies do not pay well ... after 15 years I am making about $3-5 more than a new grad in a hospital. The work is challenging and the skill set that is used is intense, but different than that of a more clinical focus. I work with the First Steps program which is a program that is focused on maternal-child health (pregnancy through either 2 months postpartum or the child's 1st birthday depending on risk factors). In public health I have done TB, immunizations (child & adult), counseled, tested, and treated STDs, counseled and tested for HIV, lived through a Hep A epidemic (now that was intense!), trained for disasters, become an expert witness and testify in court on child abuse/neglect issues and a myriad of other experiences. It offers a level of autonomy that is lacking in other settings. It is not for everyone, but in my experience those of us who stay are passionate about what we do. Probably the best way to figure out what the requirements are for the state you live in are is to contact either a school of nursing or a public health agency and ask. Best of luck to you!

I just started working in an OB/GYN clinic that is federally funded. I have 1.5 years of labor and delivery experience. I was hired in a supervisor role and am expected to be working on BSN. Let me know if you have any questions!

Part of the problem with Public Health Nursing is that we have no "identity". Not from our nursing organizations nor ourselves. There is a growing group of us who are beginning to explore the idea of being our own specialty ... separate/different from community health. We would like to see our own certification, special interest group, etc. Part of the challenge is the different requirements and different focus' of each individual state. Here about 10 years ago we were told we were becoming obsolete ... Now we find we are back in fogue, and now is the time to build on it. What do you all thing?