Friday, April 10, 2009

Public Health Layoffs During Public Health Week

At a time when it is universally agreed that the fight against communicable and infectious disease is an absolute necessity, right here in New England the city of Worcester, Massachusetts is choosing to dismantle its public health infrastructure, laying off its public health nurses during the celebration of Public Health Week.

Public health nurses provide case management for patients with active tuberculosis, provide crucial surveillance of communicable and infectious disease, and perform a myriad of tasks that help to protect citizens from harm and injury. Worcester's short-sighted decision is seen as potentially catastrophic, and I share with you below the text of a press release from the Massachusetts Nurses Association:


WORCESTER, MASS — As the City of Worcester prepares to celebrate National Public Health Week, the city manager has recently announced the elimination of nearly all funding for public health services and the layoff of nearly all the nurses who provide public health protection to the state's second largest city.

The public health nurses serve all the people of Worcester, providing vital preventive services to immunize against, track and manage over 150 infectious diseases, including tuberculosis, hepatitis, salmonella, the flu and West Nile Virus. The cuts in services and staff leave the city vulnerable to the unwarranted spread of infectious diseases. It will also deprive the city's most vulnerable children and adults of access to immunizations and other health screening services.

The decision by the City of Worcester to lay off all six of its public health nurses, along with the chief public health nurse and secretary for the department, is a shortsighted and dangerous decision that will shred the health care safety net for the city's 172,000 residents. The layoffs, which were announced last week, will take effect on April 17.

While everyone understands we are in a fiscal crisis, this decision places hundreds, if not thousands, of our residents at risk for harm and leaves the most vulnerable in our city stranded without necessary care," said Anne Cappabianca, chair of the bargaining unit of the Massachusetts Nurses Association, which represents the Worcester public health nurses. "The public has a right to know what they are losing and what they will be exposed to as a result of these cuts."

Fact Sheet on Public Health Nurses

► A public health nurse is a special type of registered nurse who focuses on providing health promotion and protection to an entire community or population. There are currently six public health nurses serving a population of more than 172,000 residents in the City of Worcester.

► During the past year the nurses investigated 300 communicable disease cases, including tuberculosis cases at local colleges and high schools, requiring tuberculosis skin testing of hundreds of individuals.

► The nurses track at least 100 residents each month that may have been exposed to TB and are now living in the community. They make more than 35 visits each month to the homes of those residents with active TB to ensure they are receiving proper care and are taking their medication. In so doing, they prevent the spread of this highly infectious disease while at the same time assist those infected in getting well. Without the services provided by the public health nurses, these patients are less likely to follow their treatments, and are therefore at much greater risk to become more seriously ill, and much more likely to spread this disease throughout the community.

► In preventing the spread of disease, public health nurses are responsible for immunization of vulnerable segments of our population against the spread of disease. For example, more than 2,000 vaccines were administered to children and adults during the last 10 months by the public health nurses.

► The nurses also provide all varieties of childhood immunizations to those who can not afford them, such as children living in family homeless shelters, etc.

► Worcester public health nurses also play a vital role in the city's disaster response plans. During the ice storm in December 2008, the nurses staffed the shelters at Burncoat High School and Doherty High School to provide care to victims, including fragile elderly residents.

"In addition to the loss of existing services, the elimination of the public health nurses prevents the city from initiating a number of health and wellness programs planned for the recently established wellness clinic in the department. These programs included screening services for diabetes, hypertension, kidney disease as well as obesity.

"In the long run, all of these programs save money and save lives, while increasing the wellness of all our citizens," Cappabianca said. "Those who suffer the most from these cuts are those in our community for whom these services matter most. In abandoning these programs, particularly all our services related to disease surveillance, we jeopardize everyone in our community unnecessarily."

Founded in 1903, the Massachusetts Nurses Association is the largest professional health care organization and the largest union of registered nurses in the Commonwealth of Massachusetts. Its 23,000 members advance the nursing profession by fostering high standards of nursing practice, promoting the economic and general welfare of nurses in the workplace, projecting a positive and realistic view of nursing, and by lobbying the Legislature and regulatory agencies on health care issues affecting nurses and the public.
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