I am a public health nurse in a rural county in Missouri. My job duties are varied... tracking & investigating communicable disease, giving vaccinations, assessing children in WIC clinic and occasionally filling in as nutrition counselor, community health screenings, medication injections for community members, and various duties as assigned or needed. Personally, I also create a good deal of our visible public publicity, our forms, etc. I have also appeared on local TV.
My range of knowledge is quite broad from shot schedules (and some real tricky intricacies therein) to communicable disease treatments and testing procedures. I can also tell you about bioterrorism planning, good nutrition, the rules for WIC hemoglobin testing, etc.
I am one of those evil government employees... getting paid less per hour than your average hospital LPN. I have pretty decent benefits, but those are getting cut back and there is no way that I can afford to pay for health insurance for my family... it would cost over 1/3 of my monthly salary. I am not complaining, I love what I do, but we are truly invisible and what we do is invisible... and under-appreciated.
We fight everyday to maintain a line of baseline health for the community we serve, but the public thinks of us when they need shots, have a health violation to report, or if they need a nurse or a sports physical or and STD test (insert many etc's here)... but they don't know how what we do helps the community as a whole. We help prevent disease outbreaks through investigating reportable conditions, by vaccinating children, etc. We help support baseline nutrition by helping ensure Women Infants and Children have healthy food. We help the well elderly monitor their health by doing blood pressure checks, blood sugar readings, weight screenings and other services. We also serve as a health information resource for the schools, doctor's offices and general public. I could keep listing what we do... but that would get boring.
I have worked in Public Health for 5 years now. I have seen some incredibly sad stories and witness some really amazingly good things as well. I love it when I see parents who have kept up on their children's immunizations, knowing that these parents really care. I have seen teenagers get STDs repeatedly and end up with hysterectomies from it. I have seen tons of happy babies in WIC clinic. It can be a good day, it can be a frustrating day, each one is different and I think that is possibly the BEST part of my job.
Sadly, though, over the last 5 years, funding for what we do has continued to be cut and the costs just keep getting pushed to lower and lower levels. When I first started, we used to pretty much vaccinate all comers, but new limits on adult vaccinations came out about 18 months ago. Now, starting on 1 October, even more of our ability to vaccinate adults is being limited as the vaccine that the State of Missouri supplies to us will be hit with funding cuts from the Federal level. The cuts to the Vaccines for Children program will be sure to follow. We have pretty much been able to vaccinate any kids with a wink/nod towards "you need to go to your doctor's office next time" if a family has insurance... we will be limited to those with Medicaid or no insurance whatsoever fairly soon if the budget slashing continues apace. The only remedy we will have is for the County to purchase our own vaccine supply, which is not cheap, especially in a small county such as this one. This will lead to fewer children vaccinated and a greater disease burden on the general populace. Public health will be disarmed of one of its most successful weapons in the war against disease. Other cuts that we anticipate are to the WIC program. This will mean tightening eligibility and more hungry people.
It's convenient to talk about cutting this program or that program, especially if you can't see the effects of those cuts. You can feel like you have done something good for your constituents... the ones who can afford to give you campaign contributions. Trickle down economics works all right... but it's not the dollars that trickle down, it's the costs.