Public health nurses (PHNs) are on the frontline of the public health crisis the world now knows as the COVID‐19 pandemic. They serve on mobile strike teams investigating case‐contacts, deliver education on self‐isolation and quarantine through hotlines and home visits, and interpret the rapidly shifting guidance from the Centers for Disease Control and Prevention (CDC). They are reliable and proven responders during infectious disease emergencies, providing safe, effective, and nondiscriminatory care to the communities in which they serve. Yet, despite their critical role, PHN positions have been underfunded, left vacant, eliminated, or replaced over the past three decades. Combined with outsourcing services to agencies that lack the public health mandate and institutional experience necessary to provide public health services to communities, the erosion of the PHN workforce has made us all more vulnerable to both chronic disease and emerging infectious disease threats.
National, state (territorial and tribal), and local public health departments have lost 55,000 public health workers since the Great Recession of 2008, and PHNs constitute the largest professional segment of this group (Trust for America's Health, 2019, April). The consequences of this nearly 25 percent reduction in the public health workforce has resulted in years of short staffing in health departments where, now, at a time of intense demand has compromised their ability to both mount an effective response against the coronavirus outbreak and maintain the routine essential functions of a health department (Centers for Disease Prevention & Control [CDC], 2017). In some communities, non‐essential public health services unrelated to the prevention and mitigation of COVID‐19 are currently suspended, including monitoring of tobacco and electronic nicotine sales and regular inspections of food establishments. Moreover, the skeleton crew our country assigns to primary and secondary preventive services is being diverted. During a well‐documented crisis in maternal health care, the Nurse–Family Partnership Project, an evidence‐based program that serves over 38,000 of the highest risk moms in 41 states, has seen diversion of their nursing workforce to COVID‐19. The impact of the withdrawal of trusted and established care to families who are at highest risk for our most pressing public health problems—maternal and infant mortality, intimate personal violence, child abuse and neglect, mental health and substance use disorders—will scale back any recent progress made in these areas. The collateral harm from withdrawing these services will undoubtedly compound the societal impact of COVID‐19. We can anticipate that many of the public health problems that we already faced before the pandemic are going to be exacerbated, and public health nursing will remain part of the solution to address these challenges. Please click here to read more.