I had the good fortune to do a clinical rotation at the Henry Street Settlement in New York City during my last semester of a nursing program. The settlement was founded in 1893 to bring health care to impoverished immigrants on the Lower East Side of Manhattan, and this mission continues today.
My experiences there opened my eyes to a different type of nursing. Prior to this, I worked in a hospital setting, where timeliness and accuracy are of paramount importance. Days were carefully scheduled with treatments, tests, and nursing care. At Henry Street, on the other hand, it was more of a slow-moving, sit-on-the-step-and-talk kind of nursing. It takes time to insinuate yourself into this community, to get to know the patients' problems and ultimately advise and guide them. Some would agree to take their medicine only after I'd played a game of pool with them. Others had to become comfortable with me before allowing me to escort them to the clinic for the physician's weekly visit.
Public health nurses can promote a culture of trust for people on the fringes of society. They can also promote long-term health changes, if given the chance. But nurses need to be there in the first place. The work of community or visiting nurses is seen as mundane and is often an invisible process. They're not the high-profile operating or ED nurses. They're the ones who prevent the care needed in those settings.
If long-term health patterns are to change, we need more nurses providing primary care in the community. Slow talk, slow listening, and slow urging build "community caring," letting those in need know that someone-their nurse-is looking out for them.
Tessa Bachmann, RN
Westport, CT