tag:blogger.com,1999:blog-25312322678460354562024-03-05T00:37:49.798-08:00Nursing...public health styleAnonymoushttp://www.blogger.com/profile/04942413636632159360noreply@blogger.comBlogger14125tag:blogger.com,1999:blog-2531232267846035456.post-38992964926856968912013-01-30T17:54:00.001-08:002013-05-14T19:21:27.830-07:00The difficulties of managementI have a heart for those nurses who have decided to move to administrative work. This is such a difficult area of work. Especially for those of us that moved from "peers" to "managers" the transition is rough. I am so thankful for the supervisors that manage the day to day work of our agency. I struggle with how to support them as they discover the realities of managing a division. I know that they were excellent PHNs but now their skill set has to be a different one. It's a struggle and I thought I would share that here so that if you are reading and believing that this is an easy road...it's not. I still struggle myself. That's life isn't it?<br />
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If you are in that place right now take some time to examine the best things about your day. Who are you helping? Who are your "patients" now? Are you really viewing all the good work you do in a day and projecting that to a healthier and happier community around you? Try not to lose sight of the fact that you are still a valuable part of the nursing community even though your role has changed. Courage! Anonymoushttp://www.blogger.com/profile/04942413636632159360noreply@blogger.com0tag:blogger.com,1999:blog-2531232267846035456.post-31998965975060689812012-03-10T11:20:00.000-08:002012-03-10T11:30:03.810-08:00Happy Birthday Lillian!<div class="separator" style="clear: both; text-align: center;">
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<span style="font-family: Arial,Helvetica,sans-serif;">Today is the birthday of Lillian Wald, credited with the founding the field of public health nursing. Lillian Wald was born to a life of privilege yet found her calling in nursing. Summoned to help a sick woman by a little girl, Lillian walked through a battered neighborhood and into a filthy tenement house to tend to the woman's needs. Afterward Wald wrote,</span><i style="font-family: Arial,Helvetica,sans-serif;">"that morning's experience was a baptism of fire.
Deserted were the laboratory and academic work of college. I never
returned to them... I rejoiced that I had a training in the care of the
sick that in itself would give me an organic relationship to the
neighborhood in which this awakening had come."</i><span style="font-family: Arial,Helvetica,sans-serif;"> </span> <span style="font-family: 'Comic Sans MS'; font-size: 115%;"></span><br />
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Much is said today about social determinants of health and the "<a href="http://mchb.hrsa.gov/lifecourseapproach.html" target="_blank">Lifecourse</a>" perspective. This visionary nurse had it right many years ago when she helped to establish banks, libraries, vocational training and clubs all in addition to physical and mental health services. Her <a href="http://www.henrystreet.org/" target="_blank">Henry Street Settlement </a>lives on today, more than one hundred years after its inception. </div>
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In Rock County we too are involved on our own Henry Street. Our public health nurses have a home base on Henry and Riverside Street in Beloit, WI. We go out from there to serve the whole person, honoring the memory and carrying on the tradition of this great lady. </div>
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Happy Birthday Lillian!</div>
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<span style="font-family: 'Comic Sans MS'; font-size: 115%;"><br /></span>Anonymoushttp://www.blogger.com/profile/04942413636632159360noreply@blogger.com1tag:blogger.com,1999:blog-2531232267846035456.post-36805933999631595602012-02-14T06:40:00.000-08:002012-02-14T06:40:44.344-08:00Future of PHN Forum - How to fit this in a blog???I had the pleasure of attending a very interesting meeting of the minds on Wednesday in Princeton, NJ. The Robert Wood Johnson Foundation and National Network of Public Health Institutes are both organizations I have heard of and utilized as resources for the work we do in our local health department. It was a little unreal to really put people and structure around these organizations as I did at this seminar. It was a full day and I can't possibly do justice to the occasion in a blog post, but I'll summary a few of the things that hit me as I listened, learned and participated. <br />
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<li>Enumeration: We do not yet know the basics. What is a public health nurse? Where are they located? Who calls themselves by this name and how many of us are there? The enumeration group is working on the very basics of identifying and counting public health nurses in all their locales in the US.</li>
<li>Public Health Accreditation: Kaye Bender gave some insights into the value of accreditation. I see public health accreditation as in its infancy. As many other competing factors take the dollar in public health will accreditation actually result in "value added" to local public health? We are the cowboys of nursing. We take to the range and get the job done whatever it is. It's great, and also may be barrier to a thoughtful and deliberative process of accreditation...and it is very, very expensive for a super limited local health department budget. We'll see how this develops!</li>
<li>The Quad Council: Lots of discussion was held on the competency framework. I have read them, digested them and the competencies do outline the things we do and think about each day. The difficulty is that there is a huge disconnect between the competencies and identifying these in relationship to the essential services of public health. In the meantime, we keep doing the job and doing it well. </li>
<li>Why a nurse? A lot of attention was drawn to the profession's relative inability to articulate why a public health nurse should serve in their community instead of a more economical PH graduate. We ought to be better at this! Is it humility? Lack of clarity? The fact that nobody would actually believe the scope of our daily practice? Many of the nurses I work with devalue their contributions every day. We need a dose of bravado. The "Oh, it's nothing really" approach leads stakeholders to think..."Public health nursing? Oh...it's nothing....really!"</li>
<li>Education for nursing students: This is a huge area for me in local public health. With perhaps 100 or more BSN nursing students in my jurisdiction how am I to support each and every one with a competent, engaging PHN rotation while I am responsible to the taxpayers to actually provide an expertly delivered service? Crickets chirping when I ask this question! One very intriguing concept is the academic health department. This seminar allowed the chance to learn about some alternatives such as this model and also simulation of PH scenarios in practice. How could it be funded?</li>
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Wrapping up: I have had a difficult time settling on the most important information from this seminar. I will try. Our profession is in trouble. Some is of our own making. We haven't done very well at applying the priniciples of business to show the value our services add to the population. We have a product, which is health. Everyone wants it. <br />
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In public health nursing we are not data or research-rich. We have to get better at knowing what works and replicating it. On the other hand (in my opinion) the evidence based programs available, such as the nurse-family partnership are far, far too costly and data-driven for a public health agency with a generalist staff, such as my own. We keep a lot of data and share it widely. That is pretty rare from what I see in county health departments. <br />
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Yes we need funding. Yet I see other agencies chasing grant dollars without any passion for the actual work that they will have to perform. Isn't there some happy medium we could reach? We also ARE funded to do some of the work. Couldn't we do this work better instead of wishing away all of our professional lives to have more? <br />
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Finally, whether it is systems work, education partnerships, community coalitions, etc. it all still boils down to hard work and looking across the table at our public and our partners to gain understanding... and each other's phone numbers. <br />
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Cheers everyone!Anonymoushttp://www.blogger.com/profile/04942413636632159360noreply@blogger.com0tag:blogger.com,1999:blog-2531232267846035456.post-43779496961778135132012-02-07T07:11:00.001-08:002012-02-07T07:11:21.370-08:00Are you still a nurse?Doing some homework at the airport prior to boarding for the Future of Public Health Nursing Forum in New Jersey. I'm reading a brief that will be presented by Dr Susan Zahner from the UW School of Nursing faculty. One quote from a survey participant grabbed me. "I don't feel like a nurse anymore". If you manage public health nurses I see a primary role of yours - to help your colleagues see how they bring health to their clients. To see how their daily care for the community is ... Nursing! Simple? I think not! Anonymoushttp://www.blogger.com/profile/04942413636632159360noreply@blogger.com0tag:blogger.com,1999:blog-2531232267846035456.post-44160196180279113272012-02-03T08:42:00.000-08:002012-02-03T08:42:35.499-08:00What is the Future of Public Health Nursing?I'm taking a look at the materials sent for the Robert Wood Johnson Foundation Forum on the Future of Public Health Nursing I will be attending next week. I'm very interested in what this Forum will advance as key priorities in our profession. <br />
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A thought I have had over the last few months is that we have a unique role in that we accept the task of <em>"going out" </em>in our communities. I know of many professions that are trying to play a role in public health. All well-meaning and some effective in their own way. In my mind a constant and unrelenting role of nurses in our profession is hopping in the car to meet someone .... out there. Not many people in service will do that these days. Too inefficient! But is it?<br />
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Whether the task is labeled individual services or population health, it most likely will start and end with a smile, handshake or hug and a <em>relationship</em> that has said "You have value to me. I'll meet you where you're at". <br />
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Cheers everyone!<br />
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JanetAnonymoushttp://www.blogger.com/profile/04942413636632159360noreply@blogger.com3tag:blogger.com,1999:blog-2531232267846035456.post-17864761453381089992011-12-30T08:13:00.000-08:002011-12-30T08:13:08.296-08:00PHNs and the future of the fieldI can't believe I haven't been on this blog for a year! I promise to do better in 2012! I had the pleasure of learning that I have been invited to the Robert Wood Johnson Forum on the Future of Public Health Nursing in February. I still don't know why I was chosen, but this is a very nice opportunity to hear from others in the field and also add my 2 cents!<br />
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I have been thinking on this recently. What is the most important skill our nurses need to acquire to be successful in this field? What keeps coming to mind is the skill of persuasion and the ability to 'bounce back" from adversity and resistance. A kind of professional "resilience". Whether we are visiting a client one on one or engaging in a population health endeavor it is a very likely thing that we will be discussing health with someone who...well who doesn't buy it. Nursing school doesn't often teach us how to roll with the punches and press on after conflict. Success in public health requires it!<br />
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Likely we will not affect our community in a single encounter. Persuasion, persistence, positivity!Anonymoushttp://www.blogger.com/profile/04942413636632159360noreply@blogger.com0tag:blogger.com,1999:blog-2531232267846035456.post-66116742223947825302010-10-01T12:59:00.000-07:002010-10-01T13:18:13.718-07:00Getting Ready for a Job Interview?I went out this morning with my Health Officer Karen to discuss the process of interviewing for a new job. The audience was a group of final semester BSN students ready to launch into the world of nursing. Karen did a great job of sharing what makes a GREAT impression in an interview. The high points were:<br />Do a little self-reflection and realize which talents will equip you for the RIGHT nursing career.<br />Dress professionally<br />Bring a (brief) portfolio tailored to what makes YOU right for the job<br />Be positive about your past job experiences<br />Answer the questions honestly<br />Realize that even if you do everything correctly you may not win the job. In that case...follow up! You may have another shot at it in the future!<br /><br />I added my own insights from past interviews. Namely:<br />Leave any discussion of benefits, vacation, time off, etc. Until AFTER you have an offer on the table<br />Learn how to shake hands (manager tools has a great podcast on this <a href="http://www.manager-tools.com/2006/04/secrets-of-a-great-handshake">here</a>), and introduce yourself. Be enthusiastic and energetic!<br /><br />Hopefully we spoke to some future public health nurses in the room!Anonymoushttp://www.blogger.com/profile/04942413636632159360noreply@blogger.com0tag:blogger.com,1999:blog-2531232267846035456.post-13484864468984664472010-07-10T07:26:00.000-07:002010-07-10T07:38:33.322-07:00Global interests and local hospitalityThis week we have a couple staying with us from Costa Rica. What fun to their faces light up with they first saw our little acreage! The cameras came out quickly as they saw the hay field in the back. It was a reminder of the blessing of living in Wisconsin. Living in such a mountainous region makes our wide open spaces and wide-wide roads an amazing site in their eyes. We talked about local customs and the differences between our driving habits (like Midwesterner's aversion to using their car horns).<br /><br />What is very interesting is that both our guests work in Costa Rica, but their jobs are located in the states. One is a software engineer for a Dallas company. He and I sympathized with each other about the complexity of getting everyone to turn their time sheets in on time, as he handles the Texas payroll! She works for the U.S. Department of Treasury and is working with American partners in developing the infrastructure for transportation in her country.<br /><br />This week has reminded me that cultural differences are no different than other interesting conversations we face in nursing. Whether it is teaching someone to care for their child, relating ways to live healthier lives, or learning about life in Costa Rica, this is all done best over a cup of coffee, talking one to one. Listening, reflecting, relating. We are at a tremendous advantage having this firmly entrenched in our own professional culture. Viva Nursing!Anonymoushttp://www.blogger.com/profile/04942413636632159360noreply@blogger.com0tag:blogger.com,1999:blog-2531232267846035456.post-14825539117263528492010-06-01T18:29:00.000-07:002010-06-01T19:23:30.709-07:00Are you the "Family Nurse?"If you are a nurse you know what I mean! It is a special joy to be of service to our family and friends when they are getting through an especially tough health crisis. My Dad had hip surgery last February and I loved getting to know some great hospital staff. I think they loved me too, and they used me for some leverage. "Yes, Mr. Cook you need to take a pain pill. Your daughter is coming in 30 minutes." Ha!<br /><br />Some things I always recommend when asked:<br /><br />1. Get an expandable file folder (I usually buy these myself for my friends, they're cheap). This is to put information from doctors, hospitals, insurance, equipment companies, etc. in the divided areas. The amount of information on paper multiplies and gets out of control FAST.<br /><br />2. Tell them about the people that are caring for their loved ones. People like CNAs,nurses, therapists of all sorts. Try to help clarify their different roles. Ask them to get to know the nurses caring for their loved one by name. Give them some little cards and help them to write a short note of thanks to give to staff while their loved one is being cared for. Never hurts to let them know they are appreciated.<br /><br />3. Tell the family never to enter the hospital, clinic, or join a meeting without paper and a pen. They will need it more times than you know. Doctors and others can quickly draw a picture to explain something. Pictures help bridge a big gap between medical terminology and plain 'ole language. So much else.<br /><br />4. Care conferences/meetings can get very big very quickly. There are often a dozen people around the table. Counsel your friends to always start a meeting by asking for everyone to introduce themselves. Ask for their business cards, or ask them to sign in on a pad of paper with their title and contact information. This empowers the family to have the opportunity for consultation later.<br /><br />5. If it is appropriate, offer to attend the meeting with the family. Smile big! Handshakes all around! Be supportive and explain your role to the staff. You are not there to supplant the family, but maybe take notes and look for areas that need explanation. If you know the family, you can see by their expression when they are getting lost in the terminology. We can help facilitate better understanding. But be nice!<br /><br />I know there is more, maybe if you read this you can comment on other ways you have lent your nursing expertise to friends and family. It has been a special joy to bring comfort in this way.<br /><br />At Cape Coral Hospital they have a special website where you send "web well-wishes" to a patient and give them a get-well greeting. The first day Dad was in the hospital I put that site up on my facebook page and so many people sent him love and good wishes. This was a great service since cards couldn't reach him fast enough by mail to get there while he was in the hospital. A nice lady visited with a big stack of paper with sweet messages and even cool color graphics on each page. The link to the service is here if you want to check it out: <a href="http://www.leememorial.org/cards/index.asp">http://www.leememorial.org/cards/index.asp</a><br /><br />You may find it tough to be the "family nurse" at times. To me it is a great joy to help people I love through a difficult time. Courage!Anonymoushttp://www.blogger.com/profile/04942413636632159360noreply@blogger.com0tag:blogger.com,1999:blog-2531232267846035456.post-79252672208133000082010-05-27T16:09:00.000-07:002010-05-27T16:22:05.488-07:00Public Health...boring???Usually nurses that think public health is boring are imagining endless paperwork and government regulations. I love all kinds of nursing, but <span style="font-weight: bold;">nothing</span> beats public health nursing. What's exciting? Try face to face with your clients. Knocking on the door of that new Mother for the first time and wondering how the journey will unfold. Visiting a local head start and watching the kid's faces light up to see their "nurse". Helping the emerging language learner connect with vital services in the community. Deciding what your community needs for better health and then having the autonomy to plan and implement a program at the grassroots level. Watching the community in your care stop smoking, drive safer, put their babies to sleep safely, avoid disease, eat better and on and on!<br /><br />The most gratifying and terrifying moments in my nursing career have most definitely been during my career in public health! Boring Schmoring....get with it!Anonymoushttp://www.blogger.com/profile/04942413636632159360noreply@blogger.com1tag:blogger.com,1999:blog-2531232267846035456.post-28645526148468487042010-03-15T17:38:00.000-07:002010-03-15T17:46:56.230-07:00I know why they call it "March"Because you have to keep your chin up and just put one foot in front of the other to get through this month! If you don't live in the Midwest you won't know the gloom of March. It is a sloppy mess of grey skies, dirty snow and cruel hoaxes in the weather report every day. We hearty souls have it hands down in the "delayed gratification" department....unless you count brownies.<br /><br />It will happen, Spring is almost here....when all Midwesterners remember why they punish themselves for five months out of the year. Hope your tulips are up soon!Anonymoushttp://www.blogger.com/profile/04942413636632159360noreply@blogger.com0tag:blogger.com,1999:blog-2531232267846035456.post-31355566341787431812009-09-20T15:25:00.000-07:002009-09-20T16:45:58.801-07:00Go the distance in your practice!In it for the long haul? Public health nursing is a tough professional track. I heard recently of a nurse that quit before her first year was out because of the political environment in her agency. So unfortunate! Your success is, at least in part, subject to the reality of your office's political environment. How to survive and thrive? Here are my suggestions:<br /><ol><li>When you are new - pay attention! Lay back and put your own expectations aside for a while. Be a sponge, not a brillo pad. Embrace reality.<br /></li><li>Recognize and show an interest in the expertise around you. Ask for your coworker's stories of how they entered public health. Nothing kills a new employee like hearing how they know it all. Yikes.<br /></li><li>Fight your own fear and say an enthusiastic YES! to every assignment. You won't know what you're doing until you get out and do it.<br /></li><li>Fight the urge to join in cynical language you hear. There is a dark humor in nursing, but if you haven't cemented yourself in the role it may not just be blowing off steam, you may really damage your perception of your job. It's bad "self-talk" and I recommend you supplant it with positive thoughts (In the words of Stuart Smalley - "I'm good enough, I'm smart enough, and doggonit people like me!")<br /></li><li>Be prepared for a long adjustment. You can't really know what you are doing for a few years. That's unique in nursing. Give it time. The "long haul" view is exactly the same one that you will use to measure the success of your nursing interventions to families you serve.<br /></li></ol>You're in it, so give yourself the best chance to stick around for the reward of a nursing life well lived. Be patient and apply some strategy to give yourself the best chance for success.Anonymoushttp://www.blogger.com/profile/04942413636632159360noreply@blogger.com0tag:blogger.com,1999:blog-2531232267846035456.post-63035423902558584152009-09-04T15:30:00.000-07:002009-09-04T15:49:37.165-07:00Onward PHNs!PHNs are facing a difficult fall season. Usually the onslaught of vaccination is known. Not so this year! Not only does the fall promise to bring a busy season, maybe 3 times busier than usual, but a season with a vaccine that faces a tough sell to our public that needs it the most. Pregnant women and children. In the midst of this, an economy that is shrinking just as our public needs it the most. What to do? What nurses always do!<br />Assess your population: Are you asking the right question of your public? Are you evaluating what they expect from you and what they will need in a month when we receive the vaccine? Leverage those relationships that you have developed over the year.<br />Plan: What strategies are available to you to deliver vaccine? Do you have relationships with local nursing schools, EMS and other people available? Use the people around you to enhance your ability to serve the public. Poor relationships? Get with it and get better for the future!<br />Implement: Don't be afraid, we do immunization all the time! Beef up your staff. Use this time to show that you really care about their talents and abilities. Too late? Never! Ask your staff. They will help you more than you know.<br />Evaluate: Early in the process take a moment and see what worked. If it didn't, take a look at the next time. Survey your staff. Be there. They will appreciate it.<br />Redo: Hey, we get a do-over this fall! 2 doses of H1N1 most likely mean that we will get to do it.....again~ What went well? What could be improved? Do it.<br />Most of all, take courage. We have the opportunity to do, evaluate and study what works with our public. With God's grace we won't see a mutation in the strain. Remember that this may be the very best of the scenarios that we could have imagined. Use it to learn more about the interesting world of public healthAnonymoushttp://www.blogger.com/profile/04942413636632159360noreply@blogger.com0tag:blogger.com,1999:blog-2531232267846035456.post-83100538627922380292009-08-20T19:05:00.000-07:002009-08-20T19:17:30.473-07:00Great job Wisconsin PHNS!I was reminded this week of the excitement comes with new ideas. Our state public health nurse conference was held this week. Without a doubt, the most energy was generated by learning what other agencies are doing to bring health to their community.<br /><br />We are, at heart, just "regular folk" trying to make the world a healthier and happier place. It is heartening to know somewhere out there programs are being done on a shoestring and producing great results. The greatest thing is to see the next generation of nurses tackling this difficult field and enjoying the challenge!<br /><br />Congratulations new PHNs, and for those of us that have been there a while, cheer on the ones that will be practicing long after we are gone. Avoid the words "We tried that and it didn't work".Anonymoushttp://www.blogger.com/profile/04942413636632159360noreply@blogger.com0