What is it like to be a nurse in Public Health?

[wheresthecharge]

I know I have an interest in primary care, but I actually have minimal exposure to nurses' roles in public health and community. I know the opportunities are broad, so my questions to anyone working in these specialties:

1) What does a typical day/night look like for you?

2) What are the pros and cons of your role?

3) What steps did you take to get into the specialty?

Other stories, tips or comments are much appreciated as well!

[thelittleRNwhocould]

I am not directly in public health nursing, but I do work as a community health nurse (staff nurse at a Federally Qualified Healthcare Center (FQHC). We serve uninsured, underinsured, and medicaid/medicare. We have a large hispanic patient population (roughly 30%) and a small French-speaking population (~5%). Our facility provides a range of services to individuals. Our largest component is essentially family practice, but we also have prenatal, mental health (psychiatrist and several therapists), internal medicine, peds clinics, etc. In my role as a nurse I am responsible for patient education, immunizations, office procedures (giving depo-provera, toradol, ear-washes, PPD placement/reading, etc). We assess any patient who is high BP, chest pains/SOB, potential stroke, allergic reaction, etc. and call report to the ED. Our MAs/CNAs are the ones who room the patients/take vitals and perform ECGs. We do a LOT of STI treatment and education (trich is very common, but we see a decent amount of gonorrhea and the occasional chlamydia).

A large portion of my role as a nurse also focuses on the medication management/insurance side of things. I have my own desk, where I call patients to clarify medications/inform them of results, triage over the phone, submit prior authorizations for medications, speak with pharmacies, etc. We handle a lot of other miscellaneous stuff, as well. One of my co-workers refers to us as detectives - and it's a pretty accurate description sometimes.

The flow of my day really just depends on our patient schedule and who shows up to their appointments. Sometimes I am busy running around doing the more patient-oriented care, and then when I get a quiet moment I do a lot more of the paperwork/insurance/medication management. Overall, I find my job pretty enjoyable and fulfilling - I've found my niche in nursing (I hated hospital nursing from the very start of clinicals). It's not that the job isn't stressful (I honestly wanted to cry today... it was a very long, crazy day), but it's a kind of stress that I find doable. I also love the screening/health maintenance/preventative/chronic management aspect vs. acute care.