I am a Public Health Nurse in Washington State. Here it is required (in most cases) that Public Health Nurses (PHNs) have their BSN. It is usually better to have at least a year's hospital experience before taking most jobs as it is an extremely autonomous practice. Med Surg is not necessarily the best practice to be in, however. Much of what we do is Maternal Child and so perinatal and peds are important knowledge to have. I have worked in big hospitals, long term care, and home health ... but Public Health is absolutely my passion. It is emotionally and psychologically challenging and you have to have good boundaries and a strong support system ... but I believe it is nursing at its core ... holistic. However, you have to believe (and sometimes use it as a mantra) that all people have the ability for growth and change!