Making a Difference through Public Health Nursing

The saying "Become the change you want to see in the world," could easily be the slogan for advanced degree public health nurses.

Whether developing crisis plans, setting citywide health policy or lobbying legislators, their mission is to create systematic ways to make communities and the people who live in them healthier.

For nurses who want to change the system from within as leaders in their field, the doctor of nursing practice (DNP) degree with a concentration in advanced public health nursing is excellent preparation, says Susan Swider, Ph.D., professor and director of the Advanced Public Health Nursing (APHN) program at Rush University School of Nursing in Chicago, Illinois.

As part of their graduate work, students in the APHN program research common health problems that have a significant impact in certain communities, such as asthma, teen pregnancy or sports-related concussions. Then they develop interventions to address them, and evaluate their effectiveness.

For example, one graduate looked at data that indicated her state had an increase in sexually transmitted infections, Swider says. "She looked into the literature to see what had been done to help young adults. She developed an intervention in one county for when people came in for STI testing that involved talking about risky behaviors. She did some marketing to encourage people to get into the clinic more often, and then figured out a way to measure its success." The state plans to replicate this program in other counties.

Students also are taught how to construct a budget, pitch a program to a board of health, train the nurses and other public health staff who will carry out the intervention — and so on.

"It's all about looking at a population and figuring out what to do, then doing it," Swider says.

Cathy Catrambone, Ph.D., RN, associate professor at Rush University School of Nursing, calls this being a "system thinker."

"Nurses are uniquely qualified to do this because they already have a comprehensive view of the patient and the science," she says. "All they need is to be able to look critically at the system that they're in, and analyze data and apply current research. They'll see what changes need to be made, and they'll be the person to help lead those changes."

This is how public health nurses tackle the major epidemics that make headlines, such as the Zika virus. In those cases, nurse leaders might assemble a team of key people, help set policy and action plans and design metrics to measure outcomes, Catrambone says.

Leadership training is a big part of the Advanced Public Health Nursing degree.

"My graduate education prepared me to be a leader," says Catrambone, who earned a Ph.D. at Rush. In addition to teaching, Catrambone was elected president of the Honor Society of Nursing, Sigma Theta Tau International in 2015 — an international nursing organization with 135,000 members in 91 countries. Its mission is advancing world health and celebrating nursing excellence in scholarship, leadership and service.

"My graduate degree in nursing is what prepared me to move an organization forward strategically," she says.

Advanced degree public health nurses are also uniquely qualified to lobby legislators and inform the public about the health impacts of public policies, across all sectors of government and society.

For example, as a Board member Catrambone worked with the Respiratory Health Association in Chicago for years to make Chicago and Illinois smoke free in public places. She is currently working for smoke-free parks and housing, and focusing on efforts to reduce youth smoking rates.

In 2011 Swider was appointed to President Obama's Advisory Group on Prevention, Health Promotion, and Integrative and Public Health headed by the U.S. Surgeon General. Its mission is to advise on the best ways to implement the National Prevention Strategy — a guideline released in 2011 designed to increase the number of Americans who are healthy at every stage of life.

If you're an RN considering graduate school, how do you know if Advanced Public Health Nursing is right for you?

"If you're a person who has a particular area in which you want to make a difference by bringing the best of science from the practice setting and implementing change to improve individual health and the health system, you would be a good candidate," Catrambone says.

The three-year, part-time program is taught online, so nurses across the country can participate. Students do clinical work in their own community.

Rush University School of Nursing's DNP program was ranked fifth in the country by U.S. News & World Report, 2017 edition.

Originally published in the Chicago Tribune special section Nursing In Action on April 11, 2016.