Public health nursing, more than your average day job

DOREEN LEAVITT

June 26, 2008 at 3:02PM AKST

Author’s note: I wrote the following during a village visit after starting my career as a Public Health Nurse the summer of 2001. I wanted to some day write a book or article about public health, sharing with the world my wonderful adventures in the Arctic. I was so excited with my new job as a nurse and had been on the job about six months.

Becoming a nurse was an honor for me — finishing college as a single mother was an even greater hurdle to jump.

As an Inupiaq, returning home to serve my people was my only career choice.

Becoming a public health nurse I find to be the greatest honor yet.

Caring for a whole community means we have an impact on a whole culture, town or family, without leaving out the individual.

In nursing school, I had an interest in public health. I could see the boredom in my classmates’ eyes. “But public health is so exciting!” I thought to myself.

I now practice in the northernmost region of the United States. The weather is treacherous. We are landlocked except for travel by plane. Sometimes the plane is small, and the temperature inside the plane barely rises above freezing. When we get to the villages we sometimes have to walk through snowdrifts, rabid dog quarantines and polar bear watches.

It can be just as dangerous as the conditions endured by the very first public health nurse, Lillian Wald, when she traveled through New York City’s gutters and hobo districts in the 19th century.

At times we see 100 people in a day, providing services such as tuberculosis screenings, immunizations and head lice checks.

We go to the schools and homes to treat, prevent and educate an entire community against deadly communicable diseases.

On my first village trip, I encountered an unsafe flight. The plane I was to get on didn’t look safe. There was duct tape on the wings, it was very foggy out and visibility was poor.

The pilot didn’t look a day over 18 years old.

The only other passengers beside myself were about 30 cases of soda pop and the mail. Looking at the soda pop, I knew I had my job cut out for me. Obesity and tooth decay were the first potential health problems to come into mind.

After making it to the village with immunizations and supplies in hand, the need and desire of the village to be seen by the public health nurse was overwhelming.

It can be scary knowing that you are the medical person with the highest level of training in the village. The villages sometimes don’t have regular health aide, and there aren’t physicians stationed locally. The nearest hospital can be at least 60 miles away.

Many times, my job would be to assess, screen, refer, immunize or test 15-20 patients per day unassisted.

If there is staff, we have the help of health aides and the village clinic secretary.

The clients always have many health questions, and I may not know the answer. If I don’t know, I stop and take the time to find out, all in a 30-45 minute visit, while still examining, screening and treating the patient.

We stay three to five days and try to get everything done knowing it may be months until the next visit. Our job is to forecast, refer, protect and ensure those services are done for the patient.  

We do this to protect and help the whole community. One child vaccinated against Hib meningitis will decrease the risk of transmission to an infant sibling that is too young to receive the vaccine.

One child vaccinated against measles, mumps and rubella will prevent others from getting sick.

To see medicine work this way is satisfying personally and professionally. I know I have a part in protecting a whole village, town, community and culture, and this is the best job I could have.

So next time you see a public health nurse, know that he or she is working towards a healthier community to keep you and your neighbors safe.

It may not be done one clinic appointment at a time. It may be through a public service announcement, a bulletin board, a meeting with a community coalition or a visit to a classroom at the school.

Postscript: So it is with sadness that I note my services to the North Slope end this month. I have enjoyed serving the communities and have learned so much from my travels and adventures as a public health nurse. I am keeping you in thoughts and prayers for a healthy North Slope.
 
Doreen Clark is a public health nurse who has provided service to resident in Barrow since 2001.