The Public Health Nurse Shortage and COVID-19
Public health nurses — PHNs — like Director of Shelby County TN Health Department, Alisa Haushalter, are currently working 15-to-18-hour days responding to the threat of the novel coronavirus pandemic.
In Norwich, CT, PHN Susan Dubb is the only PHN in the Uncas Health District, which serves over 100,000 citizens. Dubb is also the only person in the district contact-tracing to help track the virus’s destructive path.
Pennsylvania faces its own shortage of PHNs due to decades of budget and staffing cuts, leaving a public health workforce that is ill-equipped to meet the magnitude of today’s public health crisis.
Nursing shortages are occurring all around the world.
In the next fifteen years, the global nursing deficit is expected to reach 12.9 million, and currently, in America, we already face a nursing shortage of one million. PHNs make up a majority of the public health field, so this increasing lack of nurses yields understaffed public health sectors and overworked PHNs we do have, like Haushalter and Dubb.
Public health nurses treat entire communities rather than individual patients, so their work during the current pandemic is focused on contact tracing, coordinating community coronavirus testing plans, and making antibody tests available.
Their job is to protect the entire population, so the goal is to stop the spread of the disease at large while bedside nurses focus on patients who have already become infected.
What’s causing the PHN shortage?
While there is no single factor at the root of this shortage, there are some indicators as to why our public health departments lack the nurses we need:
- Government funding
- Nurses reaching retirement age
- Public health departments lacking visibility
As with most systematic challenges, financing is a factor. Funding for the Center for Disease Control response programs has decreased in recent years, along with other national public health care systems that respond to public health emergencies. Individual states have also been cutting public health funding leaving state, city, and county health departments unprepared to respond to public health emergencies like COVID-19.
The retirement of nurses already in the public health field is another reason for the gap between the public health workforce we need and the public health workforce we have available.
- 25% of public health nurses were of retirement age by 2016
- One million American nurses are expected to retire in the next ten to fifteen years.
Typically, public health work is done behind the scenes.
PHNs are often not represented on TV shows or in hospital settings; they are nurses who work at government levels instituting policies and strategies to protect the public from infection and disability.
Only in public health emergencies like the HIV epidemic, opioid epidemic, and COVID-19 pandemic, do people see how vital PHNs are to wellness. We now have a surge of need without the resources to support that need.
PHNs are the ones implementing public health procedures designed to protect us all.
Public health nurses are responsible for the following current safety guidelines:
- Contact tracing
- Social distancing
- Quarantining
- Testing for the novel coronavirus
- Testing for virus antibodies
The community health sector is expected to grow by 11% and nursing itself to grow by 12% by 2028.
This year, the World Health Organization declared 2020 to be “the year of the nurse and midwife,” giving attention and appreciation to the healthcare workers needed on a global level.
University leaders are spreading awareness of the need for funding and recognition for nurses and public health at all times, not just during an emergency. Ann Kurth, PhD, RN, CNM, MPH, Dean, and Linda Koch Lorimer Professor at Yale University School of Nursing and Yale University School of Public Health are urging Congress to increase budgets for public health workers and nurses.
Nursing schools are incentivizing nurses to conveniently continue their education online with some accelerated programs specifically designed for working nurses who want to specialize in public health.
Today’s emergency status is only one of many examples of public health nurses in action. Community and public health nurses protect the population from a wide variety of health threats, from infectious disease to substance abuse. Current bedside RNs may want to further their careers in the public health field, working to protect the field itself and the communities it serves.
With the global population on the rise and public health nurse numbers dwindling, they are needed more than ever.