Public health nurse

After discharge, all infants were followed by a team composed of a pediatrician with subspecialty training in Child Development, a public health nurse, and a social worker. In order to maintain contact with the foster families and relatives who had responsibility for the care of the infant, team members made regular home visits and had frequent telephone contact with the infants caretakers. During the first 3 months of placement, infants were seen (an average of twice per month) for follow-up visits at home or in the UCLA Child Development Clinic. Phone conferences with caretakers were held on a biweekly basis. During the foil owing 3 months, clinic and home visits were tapered to once per month and phone contacts were made biweekly. 

Instruct patients receiving nevirapine to discontinue nursing, consistent with the recommendation by the US Public Health Service Centers for Disease Control and Prevention that HIV-infected mothers not breastfeed their infants to avoid risking postnatal transmission of HIV. 

Commission for the Prevention of Youth Violence (CPYV) (2000) Youth Violence. Medicine, Nursing and Public Health Connecting the Dots to prevent Violence. Chicago Commission for the Prevention of Youth Violence, IL pp.1-45. 

In 2001, the agency released a public health advisory to hospitals, nursing homes, and other health care facilities about the hazards of mix-ups between medical gases, which are prescription drugs. In one case, a nursing home in Ohio reported four deaths after an employee mistakenly connected nitrogen to the oxygen system. 

Donabedian A. 1969. Quality of care Problems of measurement II. Some issues in evaluating the quality of nursing care. Am J Public Health Nations Health 59 1833. 

Kalb KB, Cherry NM, Kauzloric J, et al. 2006. A competency-based approach to public health nursing performance appraisal. Public Health Nurs 23 115. 

In the culminating activity for the course, students prepared and presented a poster based on professions to which they had been introduced during the semester, excluding medicine, nursing, and pharmacy, the most popular medical careers at UWG. For each career choice, students described the role played in public health, employment opportunities in the state of Georgia, and the requirements to gain admission to programs that would prepare individuals for these professions. This exercise considerably broadened the students perspectives on career choices related to human health, one of the main objectives of this course. It also introduced them to an important method of scientific communication very early in their careers. 

A plan for the use of the mass media for the purpose of disseminating public health messages in the postimpact phase in order to avoid health problems (e.g., water safety, food contamination) should be developed in advance. Nurses and other disaster responders may need training in how to interact effectively with the media. (See chapter 5 for further discussion.)... 

Changes in government structure in disaster response and in the public health system may create opportunities for nurses to act in new, yet-to-be defined roles. Nurses must actively seek out positions of leadership in health policy and disaster management. 

This chapter explores the issues and challenges related to defining the role of nurses in a disaster situation. Disaster nursing leadership mandates that nurses have a sound knowledge base in critical management areas, as well as in health policy and public health. The chapter presents suggestions for educational needs, research initiatives to further the science of disaster nursing, and political advocacy issues. Nurses must capitalize on... 

MRC volunteers include medical and public health professionals such as physicians, nurses, pharmacists, dentists, veterinarians, and epidemiologists. Other community members, such as interpreters, chaplains, office workers, and legal advisors, can fill other vital support functions in the units. MRC volunteers supplement existing local emergency and public health resources. 

The ANA Code of Ethics for Nurses helps set forth a framework for dealing with the ethical implication of nurses response in a public health crisis. 

Ideally, the division of responsibility would be based on what makes the most sense in terms of the optimum functioning of the public health system. In practice, there are overlaps and gaps in the division of responsibility. Even more troubling for someone trying to fathom public health policy, each state is free to adopt its own regulatory scheme, making it difficult to make simple statements about what the law allows or requires nurses—or other health professionals—to do in a public health crisis. In the discussion in the second portion of this chapter, the reader is cautioned to seek professional advice on the law in his or her own state. 

Case Example An outbreak of an infectious disease leads public health officials to believe that a bioterror attack has occurred. To avoid panic in the public, however, they have made no public announcement of their suspicions. They have requested, however, that nurses be on the alert for new cases of the infectious disease and to report it to them immediately, along with certain information about the patient. A nurse asks her supervisor if she can legally make such reports. 

Ethically, the restriction of movement of a potentially infectious person is highly problematic. It violates the core of the ANA Code of Ethics, respect for the inherent dignity of individuals—the nurse s primary commitment to the patient (ANA, 2001). In the event of a public health emergency, a nurse may have a corresponding obligation to the community. The nurse should work to resolve the dilemma in such a way to ensure patient safety, guard the patient s best interests and preserve the professional integrity of the nurse (ANA, 2001, p. 10). 

Case Example Because public health officials suspect a stealth bioterror attack, they request that hospitals secretly test all of their new patients for the suspected contagious disease. The patient is to be notified only if he or she tests positively for the disease, and he/she will be offered standard medical treatment. Reports are to go directly to public health officials. Can a nurse legally or ethically participate in such a program ... 

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