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Discussion

Rough transition to PH from ED

Hi nurse friends!

So I've been reading this site for a long while... all the way through nursing school and my first year as an RN in the ED. This is my first post.

I've recently (as in a week ago) accepted a position as a public health nurse in my local health department. This is an administrative role and I am directly responsible for communicable disease case investigation and surveillance including TB/STDs, as well as supervising WIC and the school nurse program. I am also on a few committees like the Epi team and Child Fatality Prevention. I am loving it so far and I really want to do well in this position.

However, this is a newly formed department as the county has broken away from a three county consortium to form its own independent health department. I am the first and only PHN. I have no public health experience aside from a community health practicum in my last year of university.

There has been no orientation or training to speak of and there are no systems in place for anything...recordkeeping, procedures, protocols or forms for creating records of investigation. We are currently reviewing policies to identify gaps and shortcomings. I report directly to a population health director who is not a nurse.

I do have several off site state consultants that I can ask for help but I am so afraid that I am going to screw up and fail to meet some regulation or another, just because I am unprepared. We have some deliverables due by the end of the month and it really hasn't been explained clearly to me how to fulfill these deliverables. I have wanted to work in public health since before I even became a nurse and landing a job like this was a huge goal for me.

I just need advice and resources honestly. I'm a persistent, creative, and tenacious individual and I WILL find a way if one exists. I am excited about being a part of forming this organization from the ground up and I really just want to do a good job. Any and all feedback is welcomed!

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    Hm.. Are you a member of your state's public health association, or the American Public Health Association? If you are the only nurse and there is not another nurse (even one perhaps at the 3 county consortium) you can ask these questions, likely there will be a mechanism in your state association (or if you have a state public health nurse association, even better) where you can connect with peers who can hopefully help provide you with advice. Public health is so different in every state, advice from even a neighboring state might not be the way things are done at all in your area.

    If you are a member of APHA, there is definitely help to be found in the public health nursing section. https://www.apha.org/apha-communities/member-sections/public-health-nursing

    Good luck in your new role!

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    Thank you for replying! I am going to take your advice about getting involved with a professional association. One of my consultants invited me to the quarterly meeting for the public health nursing association for our region this coming Friday so I am going to attend and hopefully make some contacts through networking. I know that once I get my bearings a little more that I am going to be great at this!

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    Hi there - I've gone back and forth between public health (I was also an Epi nurse, investigating communicable disease reports) and the ED.

    I would recommend reaching out to your State epi folks (in coordination with your boss the population health director of course), and/or start basing your policies/procedures/forms on what the consortium was using...don't recreate the wheel. All your case definitions and control measures come from state regulations....and surely your state has a database for entering and extracting communicable disease report info??

    As for the nursing side of things - how to counsel patients/families on treatment and transmission prevention in individual cases - your best friends are: 1) the Red Book, 2) the Control of Communicable Diseases Manual, and 3) nurses, midlevels and MDs in your neighboring jurisdictions.

    I live in Arizona. Here's a link to "Forms for investigation of reported cases or outbreaks" - we don't fill out these paper forms by hand, but we conduct the interview and enter data based on these questions after a doctor or lab reports a case. Is this the kind of stuff you're trying to get a handle on?

    https://azdhs.gov/preparedness/epidemiology-disease-control/index.php#investigations-forms

    Good luck, sounds like an interesting and exciting new job!!

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