As we celebrate Nursing Week in the context of the COVID-19 pandemic, it is the ideal time to shine the spotlight on a small but integral piece of not only our nursing family but our pandemic response: our Public Health Nurses.
What is a Public Health Nurse?
Public Health Nurses, or PHNs, work in community-based teams to promote and protect health, prevent disease and injury, engage in health surveillance and population health assessment, and to prepare and responds to population level health emergencies.
Public health nursing practice is a key part of transforming the social systems that support health and is comprised of diverse combinations of programs and services aimed to promote and protect the health of our population.
Using a determinants of health approach and a community health assessment process, PHNs focus on primary health prevention to enable people to be healthy and well.
What do Public Health Nurses do?
Many people think of the PHN as a nurse who provides infants with their first immunizations or supports new families in their homes after a child is born.
These are part of Public Health Nursing but there is so much more. PHNs are part of school based nursing programs, provide immunizations to immunocompromised adults who have experienced chemotherapy or organ transplants, support new Canadians to meet the health requirements under the immigration process, support vulnerable childbearing women through pregnancy and beyond, offer breastfeeding support and consultation, liaise with services in acute care to provide public health information and immunizations in these environments, facilitate perinatal mental health programs, and provide duty nurse services where community members can reach a nurse seven days a week.
PHNs also provide health promotion education in a variety of settings including one on one with clients, in schools, parent and infant groups, and many other settings. You'll find PHNs on the street, in community centres, schools, clinics, homes, and in hospitals.
During our COVID-19 response, Public Health Nurses have been integral to our success in minimizing community spread of the virus. PHN teams set up call centres, clinic and drive through swabbing centres, and spearheaded contact tracing of known cases. They are the team that surges when called upon, identifying, tracking, and containing the virus.
Island Health Public Health Nurses and their work during COVID-19
Below, a Public Health Nurse, a Public Health Nursing Clinical Coordinator, and a Public Health Nursing Manager share how COVID has changed their work and what they wish you knew about Public Health Nursing.
Laurie Tonkin
Rural Public Health Nurse, Cowichan
“Public Health Nursing programs and education has given me an expanded perspective on inclusion, story telling, listening and the importance of being part of a community."
What has changed about your job during the COVID-19 pandemic?
Video conferencing, telephone conferencing, PPE and washing and wiping is exhausting! It takes longer and there is so much room for misinterpretation and misunderstanding. I have a new appreciation for face-to-face and nonverbal engagement and assessment. I'll welcome the day I can share a smile with a client instead of being behind a mask.
How do you feel you make the biggest difference as a public health nurse?
Public Health Nursing programs and education has given me an expanded perspective on inclusion, story telling, listening and the importance of being part of a community.
What have been the biggest changes in how you do your job during your career in public health nursing?
So many dramatic changes have occurred in the past 20 years. Population health and the determinants of health are not stagnant, so the work of Public Health Nursing is constantly in motion. Technology, Truth and Reconciliation, Cultural Sensitivity, Trauma Informed Practice, Gender Diversity and Inclusion, Harm Reduction and many more developed programs have contributed to meaningful Public Health work.
The most notable sequence of changes came when the Health Professions Act regulated Nursing practice in BC.
The regulations and bylaws that ensued created detailed professional specific framework. Nursing work in the area of Reproductive and Sexual Health became formalized. A formal framework for education and the acquisition of skills and knowledge was developed in collaboration with fellow nurses through out BC.
This created specialised educational pathways for nurses to receive Certified Practice in the area of Reproductive Health and Sexually Transmitted Infections. Certified Practice Nurses utilize Decision Support Tools to provide clinical guidance for the assessment, treatment and management of their clients.
Working closely with our communicable disease leaders and the BC Center of Disease Control, Public Health Nurses are constantly mentoring, collaborating, adapting skills and knowledge to keep pace with new STI/HIV treatment and testing strategies.
What do you wish more people knew or understood about public health nursing?
Public Health Nursing is work that collaborates with well people living in the community across the life span.
Jody Tkach
Public Health Nurse at Oceanside Public Health
"Prevention is what we do and it is very hard to prove that prevention works."
What has changed about your job during the COVID-19 pandemic?
My favourite part of my job is the interaction, learning and support I provide people, especially new families. COVID 19 has reduced my ability to connect with the people who need support the most. However, my office is learning to use telephone and social media to connect with parents and keep giving them the support they need and deserve. We have also done a lot of work in creating an office that is safe for people to come to for immunizations, youth clinic and adult chronic disease management and this includes wearing masks, social distancing measures, reducing the number of visitors, moving to appointments only and disinfecting rooms after every visit.
What do you wish more people knew or understood about public health nursing?
I wish people understood that we are so much more than just immunizations, which is important, but that we serve every age group. In the community where I live and work, my small office does so much amazing work! We connect with pregnant women and their families, we have group sessions for parenting and support for new parents, we provide immunizations to infants, children, youth and adults, we connect with schools and have created a peer education program for sexual health, we provide drop in youth clinic appointments that are very well used, we are a harm reduction site and support those most in need in our community and we provide many services to adults and seniors to support them with chronic disease management. Public Health works with people from every part of life and it is often overlooked and underfunded. Prevention is what we do and it is very hard to prove that prevention works. I would love for people to understand how important our work is and encourage our government to put more funding in preventing problems than treating them.
Jenny Nijhoff
Clinical Coordinator for Public Health Nursing, Comox
“Public Health Nursing is a very small piece of the health care pie, but we are sweet on what we do and we make our slice go a long way."
What has changed about your job during the COVID-19 pandemic?
My job fell heavy into coordinating new practices during the COVID-19 pandemic. I re-deployed Public Health Nurses to the Call Centre (and supported Nurses to be that call centre before it got up and running), to the Communicable disease team and to the Collection Centre. I started working with our Acute care, Mental health and community partners to develop the swabbing site (collection centre) and to action mobile testing. All the while, trying to support the Public Health office to implement safe practices so we could continue to serve our community with essential services, like immunization, perinatal support, harm reduction and Youth STI and Contraceptive management. I have relied heavily on my relational and reflective practice approaches for both self-care and in helping my nurses and I do the next right thing, as our CEO Kathy McNeil has taught us, in this challenging and unprecedented times.
What do you wish more people knew or understood about public health nursing?
I wish more people could see the dedication, commitment, and contributions that Public Health Nurses make towards health promotion and illness prevention from an evidenced-based approach, every day. The way we practice is not easily checked off in boxes as tasks but rather comes in the relationships that we build and the experiences we learn from through our intentional reflections, so it can be quite invisible to others.
Kathy Easton
Manager, Public Health, Cowichan/Westshore
“I just got my 20 year pin this year, I don't know how that happened, I feel like I've just started."
What has changed about your job during the COVID-19 pandemic?
I have never spent so much time in my office on teleconferences! It has been a whirl wind in Public Health since the end of January. I am blessed and humbled to work with my Public Health partners and the amazing teams in Cowichan Valley and Western Communities whose first response is always yes – let's try it. My teams are excited about the positive changes and opportunities that COVID-19 has presented. While the Communicable Disease (CD) program and Public Health Nurses have worked closely together in Island Health - we now are working in a more integrated way with PHNs employing their CD skills in contact tracing and monitoring. Working with the Virtual Care Team to design and implement virtual monitoring for all cases and contacts has allowed us to support more people and seems to be contributing to our effectiveness at reducing the spread of the virus. Clients check with a PHN daily, either virtually or by phone, which is making their isolation easier to tolerate and helps support people in staying home while they're potentially infectious. I can't wait for the innovations that we will discover as we move forward in this pandemic.
How do you feel you make the biggest difference as a public health nurse Manager?
“Better together" is something we say often in the community and it has never been more important as we navigate this pandemic while also supporting families and community agencies who are also struggling. PHNs are the matchmakers of health care, connecting individuals to resources in the community and connecting those resources to each other. Last week a partner organization received a donation to provide food for their families. I was able to connect them to organizations with food and with a lot of support from my team, they are now providing a grocery hamper to 75 families with medically vulnerable children across the island for the next two months. This program is allowing us to test a new food distribution system that will enable better access to food for families in our region. Recently I was able to offer health unit space to enable a new outreach team of Nurse Practitioners, Addictions Medicine Physicians, and public health to mobilize quickly to provide COVID-19 screening and support for unhoused individuals.
What do you wish more people knew or understood about public health nursing?
The Public Health Nursing team on the Island is small but has a diverse and interesting practice requiring a lot of knowledge and ingenuity. Much of what makes people healthy has nothing to do with health care, it has to do with social determinants of health, the conditions at a community level, heathy environment, good food and housing, being active and engaged with good relationships and social connections.