Public Health~A Critical Specialty

karenvalk

Recently while completing an online survey, I was asked to identify my area of nursing specialization. There were many options to choose from-medical-surgical, anesthesia, emergency, geriatrics and the list goes on...but NOT listed was my chosen field of practice, public health. Sadly this is not a new experience, as public health nursing is often not the first image of nursing that comes to mind.

My love affair with public health began early while in nursing school in Memphis. Still a teenager myself, my nursing school partner and I were assigned to follow a young pregnant woman throughout her pregnancy and delivery. We made our way to the housing projects of south Memphis where we were greeted by Annie, who was close to our own age and pregnant with her second child. Our instructions were to try to impart some of the newly-learned book knowledge we had to hopefully improve the outcome of Annie's pregnancy both for her and her baby.

Despite our different circumstances, Annie welcomed us warmly on our weekly visits into her sporificely furnished apartment she shared with her mother and two year old daughter. I have never forgotten the call we received at 3 a.m. to meet her a few blocks from our dorm at the City of Memphis Hospital to witness the birth of her second daughter. She trusted us and relied on very young and green nursing students for advice and support (maybe not a good idea)! Forever impressed on my youthful mind was the realization that a person's environment, family support system and "social determinants of health" have a very significant, potentially lifelong impact on their health outcomes. Annie became one of the first of many patients whose stories are permanently etched indelibly on my heart.

After spending the majority of my career working in public health, I can say without a doubt it is uniquely challenging and rewarding though not in the same way as hospital nursing. My long-held idealized world that includes equal health care for all is exemplified by the mission of the American Public Health Association to "Improve the health of the public and achieve equity in health status." I am blessed to know generations of patients-entire families and extended families that come to us for the multitude of services that we offer. Public health is multidisciplinary-nurses work collaboratively with physicians, nutritionists, environmentalists, social workers, health educators, dental practitioners, psychologists, emergency planners-forming a team of public health professionals whose common goal is to improve the well-being of the communities they serve.

Public health nursing encompasses an increasingly wide range of responsibilities. It is impossible to be a great public health nurse and not also be a staunch advocate for the benefits of immunization. Public health nurses obtain many hours of continuing education on the latest immunization updates and then must pass an immunization exam yearly. Standards for vaccine storage, handling and administration are rigorous and require strict adherence. If you choose to receive vaccines at the health department, you can rest assured that the nurse administering them is experienced as well an expert!

Sadly we now must cope with the vast amount of misinformation and deceptive commentary on the internet and social media regarding vaccines. Left to distant memory are the times when measles, mumps, and chickenpox were part of nearly every child's life; causing great suffering and sometimes even death. Recent outbreaks of these once-common childhood diseases illustrate some of the problems brought about by the anti-vaccine movement. Children of present generations have been spared the scars of smallpox vaccination present in persons of my generation thanks to public health efforts of vaccination and the extinction of smallpox disease. Yearly campaigns to promote and administer influenza vaccine as well as dispel the many myths that exist surrounding it are vital to the mission of promoting public health-we all belong to the "herd."

Public health nurses are extremely well-versed in communicable disease management, including tuberculosis, hepatitis, HIV, and sexually transmitted infections to name a few. Conducting visits to tuberculosis patients' homes to ensure they take their medications correctly and rounding up contacts to infectious diseases are tasks with which public health nurses are quite familiar. Rampant Chlamydia rates especially among teenagers, syphilis making a surprising comeback, and gonorrhea becoming increasingly resistant to antibiotics make proper management of these infections even more critical.

Family planning and supporting women and men to ensure that all babies are wanted and planned for is another important component of public health. Contraceptive methods are continually improving in both effectiveness and acceptability, especially with the increasing availability of long-acting, reversible methods. Public health nurses are essential in the provision of accurate education regarding contraception and helping patients determine their best method and timing of pregnancies.

By no means is this a full account of public health nursing and the responsibilities it entails. I would like to encourage any nurse, whether new to nursing or seasoned and experienced, to consider public health nursing as a career. If your ambitions include making full utilization of your nursing school education, creating lifelong relationships with your patients and their families, and working collaboratively as a full member of the public health team in an effort to make your community a better place to live, then public health nursing is for you!

Karen Valk, FNP

Public Health~A Critical Specialty

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