Thinking about the role nurses might play in turning the tide on the pandemic has made me reflect on my relationship with my community as a public health nurse, and the unexpected role social media has taken in my professional life in the past year. I experienced amazing success, improving community connection and access to appropriate health information and resources, by using the internet and social media during the pandemic.
As the pandemic began, my maternal child health colleagues and I were suddenly thrust into disease control public relations. Frantically answering calls from the community with the CDC website open on our desktops; searching for answers as we listened to questions. None of us believed we would be removed from our regular positions for more than a few weeks; after all, our family services clients needed us.
A Fractured Public Health Community
After ten months on tracing and outbreak teams I was returned to maternal child health, with a promotion to Perinatal Services Coordinator. As a nurse, my first step into this new position was, of course to follow the nursing process, and assess. I found communications between many services disrupted, leaving providers unsure which services were still available, and how they were being provided. At the same time, the demand for services was increasing as families experienced increases in domestic violence, substance use disorder and drug overdose. The need for community services, food banks and shelters increased dramatically, especially as virtual care was offering providers a closer view of client needs related to social determinants of health. It was also January, and public roll-out of Covid vaccination was expected shortly.
Where to Begin?
I decided to meet the community, clinic staff, and home visiting teams where they already were- online. I immediately recreated the Maternal Child and Adolescent Health (MCAH) website, (which had not been updated for years), improving health messaging and access through the site to community resources. I produced a weekly newsletter providing community clinic staff and home visitors with updates on community resources and best health practices, as well as reminding them (weekly) of the resource represented by the updated MCAH website. Finally, in an effort to reach the broader community of families in the area, I began posting on the Department of Health Services (DHS) facebook page. Posts focused on maternal, child, and teen health and resource information, and were directed to the community.
Hey Public Health Services, have you looked at your website recently?
A right banner on each MCAH webpage now offers links to community resources, for everything from food to housing support and diapers. Each page states a pledge to equity and safety using community social services. Four main sections fill the center of the landing page, one section addressing the needs of women and pregnant persons, one addressing infants and children, one meeting the needs of teens, and one supporting accessing healthcare and finding a medical home. Web pages offer information on family services including home visiting services, breastfeeding supports and birth control access. The website has fast become a resource for providers, community partners, and home visitors. A community service partner recently reported that she referred a new community resident to the website which met her need for resources, including signing up for public health insurance and finding a medical home for her family.
Does Anyone Even Open Weekly Newsletters?
Since inception, the MCAH newsletter has supported perinatal medical practitioners, community service providers and home visiting staff with timely evidence-based health information, and community resource updates. Subjects of the weekly newsletter include best practice for talking with clients about Covid vaccination, resources for perinatal mental health support, social determinants of health, self care for providers, and combating social media disinformation. Informatics from the newsletter platform report 40-50% of recipients open the weekly newsletter and the most frequent readers are clinic staff and providers, and home visitors. Each newsletter is archived on the “news” page of the MCAH website, where it is subject searchable.
The Reach of facebook
Social media resources from state MCAH, the CDC, and other trusted resources provide excellent facebook posts. However, community response is greater when public health messaging is personal. As the Covid vaccination program rolled out in our county we started to see vaccine hesitancy. In an effort to normalize the vaccination, I put out a call (via email) to public health staff asking them to share their vaccination stories. I received a surprising number of very personal stories, describing the relief of receiving a vaccination, complaining about the side effects, describing the process of deciding to get the vaccine. Some even included photos, and all authorized me to share their story on facebook, as written, de-identified. The first vaccination story reached over 3,000 viewers, 6 times more than my best previous post. We can’t evaluate whether the posts influenced vaccination uptake in the community; we can say we reached thousands with a positive vaccination message.
Public Health Nursing and Covid
The opportunity for public health nurses to reach community partners and members through social media, newsletters and web presence is huge. When nurses, still one of the most trusted occupations in America, can reach their community with resources, health information and updates, and even health stories from their community, the possibilities may be dramatic; perhaps even helping to turn the tide of the pandemic.