Inquiry for PH listserve

[Kristine Gebbie]

In considering this question, please bear in mind that it is extremely important
to separate organizational line reporting structures from professional standard
setting and quality oversight.  Public health is by its very nature
interdisciplinary, and nurses are among the valuable contributors to the
mission, doing so in interdisciplinary teams of all sorts.  Any insistence that
'nurses can only report to a nurse' does a disservice to the professionalism of
every nurse, but a disservice to the public health process.  On the other hand,
it is important that all professionals within public health have access to
professional leaders in their own disciplines for purposes of establishing or
improving standards of practice, clarifying questions that arise, and making
quality improvement.  In larger agencies, there may be an entire office of
professional standards, with leadership for medicine, nursing, dentistry, health
education, environmental health.  In smaller agencies, one or more senior
members of each profession may fill this role, formally or informally.  In the
US Public Health Service (and I think in the military branches as well) the role
of senior professional is a term appointment, for someone rotated out of other
duties.  Hope this helps--

"Sullivan, Susan" wrote:


> I have interest in talking to PHNs at local health departments re the

> structure of their reporting and supervision.  I have noticed within the

> agency I work that some issues seem to arise because of non nurse leadership

> of programs.... although our agency has over 450 nurses employed, we are

> fragmented and working in diverse  programs with no centralized nursing

> leadership....so many PH nurses and nurses in PH clinic settings are being

> managed by non-nurse supervisors....I am wondering about the legality of

> this (in CA especially) and from a practical standpoint how do other

> community health nurses deal with such a reporting structure., especially

> when they are put in situations where they may feel that in the interest of

> the patient  "things should be handled differently" based on their nurse

> instincts, experiences, understanding of community practice standards and

> nurse practice acts, as well as knowledge of legal issues. But there is no

> central nursing authority to notify or consult.

> Have others experienced such environments and survived?  Thoughts? Comments?

> Susan S. PHN

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