Seeking Tuberculosis Public Health Nurses

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I have an upcoming interview for a PHN I position in a California county TB Prevention and Control Program. I have no previous PHN experience. So far, I understand that I would carry up 15 cases that would entail daily community/home visits for 1-2 weeks, which would then taper off as appropriate. 

I have some experience working home health and left due to poor work-life balance from frequent overtime to complete charting.

Can any current or past TB PHNs shed light on how they balanced their case load? Do you often have to work more than 8 hrs/day to finish charting? Are you paid OT? How long did it take for you to get a full case load? Is there a certain number of patients you have to see daily or weekly?

Another concern I have is the risk of exposing my immunocompromised family members to TB. 

Any input you can provide is much appreciated!
 

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Specializes in Vents, Telemetry, Home Care, Home infusion.

CA TB resource info:

https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/TBCB.aspx

CA requires RN to obtain  a Public Health Nurse certificate.

I'm only familiar with PA Public health nurses schedule: as state employee, they only work 8hrs.  Rarely adjust hours to followup patient but out of field by 5PM due to safety.  Paperwork done during work hours. LOTS of phone calls tracking down clients and checking that meds being taken. Latent TB may need daily  or weekly observation depending on drug cocktail.  

Hope this helps you and CA PHN sees thread to describe their work conditions.

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Specializes in Public Health, TB.

I just retired from a local health department in Washington State, so I can offer my experience. We had a union, and we worked 8 hour days, Monday through Friday. Overtime was rare, and needed to be authorized (unless an emergency, of course). The standard of care for active TB disease is directly observed therapy. That is, every dose is observed. Many health jurisdictions used community health workers to help with dose observation. Once a regimen is established and shown to be tolerated, observation can be done electronically, using a secure phone app, like emocha. 

The main role of the RN is as a case manager: assuring meds are tolerated without significant side effects, arranging for labs and X-rays, assisting with housing and home isolation, helping with transportation to appointments, and doing a contact investigation and testing and treating contacts as appropriate. 

Yes, there is a lot of time spent making phone calls!

As far as bringing home infectious material, TB not transmitted by touch, it is airborne. Active TB patients will become noninfective with effective treatment. You will be fit-tested for an N95 for indoor contact, or use a CAPR or PAPR. We did many visits outside, when respiratory precautions are not needed. 

So you may carry a 25 patient load, but not all are in isolation, most will cooperate with treatment, and you will have help. 

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Thank you NRSKarenRN and nursej22!

I do have a CA PHN license but have not yet been able to transition to public health.

Do you recommend working was a PHN?

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Specializes in Vents, Telemetry, Home Care, Home infusion.

One advantage as Public Health Nurse: No home care OASIS documentation!

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Specializes in Public Health, TB.

Public Health nursing can be very rewarding, but also frustrating because of limited resources and trying to overcome health inequities. The hours are nice and I had nice benefits. Pay was quite a bit lower that acute care nursing. I didn't much care for picketers calling us "baby killers" during COVID vaccine clinics.

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Hopefully I am not too late to offer my feedback. I also work in the TB dept with my local county Health Dept. I work in immunizations as well. My hours are 8hr days. We do leave on time except on occasions to accommodate pts to get covid/flu shots. We hold those clinics after hours so pts can make it and this will end up as overtime. As far as infection control goes to protect family members at home, I make sure I wear the PPE, wash hands before leaving work and then I wash hands again when at home, take a shower before interacting with anyone to keep them safe. 

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