Public health nurses are unsung heroes, an often overlooked but absolutely necessary part of health care — ask any primary care nurse or doctor. In addition to providing important educational, preventive, diagnostic and treatment services to individual patients and families, public health nurses are vital to the health of the Lewiston-Auburn community. Even if we, as individuals, never see a public health nurse, we benefit from their work. We need to make sure we do not lose them.

Public health nurses provide their critical health care services in the real world, not in medical offices or hospitals. They work in schools, businesses, public clinics, and especially in patient’s homes.

During my four decades as a family physician in Auburn, my patients and I depended on the wide range of important services they provided, including in-home services to pregnant women; breast feeding education and support; and home assessments and care for newborns and the homebound elderly.

Public health nurses provide important in-home care for children with special needs. They also provide immunizations, both through clinics and at home.

Many patients in my practice have benefitted from access to education and monitoring, resulting in better control of chronic illnesses and fewer complications.

Public health nurses provide key in-home services to the disabled and to those recovering after hospitalizations — often allowing patients to avoid nursing homes or institutional care. Public health nurses also help identify, treat and prevent the spread of serious infectious diseases, such as tuberculosis, gonorrhea, syphilis and HIV/AIDS.

Public health nurses help identify the source of community food-borne outbreaks. Public health nurses improve the health of our community when they identify and report unsafe housing, such as those with lead contamination or fire hazards.

Some instances from my years in practice stand out.

Imagine being the elderly woman who avoided a nursing home and was able to return home safely to be with her husband after a hospitalization for bowel surgery, because the public health nurses were able to help her with medication and dressing changes.

Or the gentleman with both schizophrenia and chronic cognitive disability from a head injury who is able to live semi-independently, despite diabetes, thyroid disease and hypertension, because of regular public health nurse visits.

Think of the pregnant woman whose husband is deployed and whose pregnancy complication is identified early enough to be treated, only because of a public health nurse visit.

Picture the family who has been exposed to TB and needs nine months of treatment to prevent the spread of TB in the community, and is able to complete the full treatment with the help of the public health nurses.

Imagine the benefit when important but unmet basic needs, such as shoes that fit or winter clothing, are identified by the public nurse and then successfully addressed.

Imagine the benefit when young children are protected from an unsafe and abusive environment because the public health nurse identifies the problem.

Consider how many people were protected from a devastating epidemic during the 2009 H1N1 (swine flu) influenza outbreak because public health nurses set up and staffed more than 200 public immunization clinics in Maine.

The cost of care for the illnesses public health nurses can prevent can be staggering. Nursing homes cost $200-$300 per day. A day in the newborn intensive care unit is $2,000 to $3,000. The cost of treatment for a TB patient is about $20,000. A hospital stay for complications of influenza costs between $20,000 and $50,000. Compared to this, the costs of public health nurses and their services are insignificant.

Whether we are rich or poor, healthy or ill, young or old, we all benefit from the work done by public health nurses. Maine has a budget surplus this year, so cuts to public health nursing are not just bad for Maine, they are unnecessary.

I urge all Maine’s senators and representatives to support full funding and staffing for public health nursing. Maine needs its public health nurses.

Peter Elias, MD, founded and managed Family Health Care Associates in Auburn in 1978. He retired from active primary care practice in December 2015.

Peter Elias

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