DOI: 10.1097/01.NNA.0000339479.57843.6a
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PMID: 18997549
Issn Print: 0002-0443
Publication Date: 2008/11/01
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Excerpt
Previously as director of nursing at the department, Carla supervised the placement of nurses and the institutional growth of healthcare services in the county, including the school nurse program. Carla has been responsible for the development of programs and services including the creation of a Diabetes Center of Excellence, home visitation for first-time parents, expansion of services in satellite clinics, and expansion of community health services. When asked what outcome she was the most proud of, Carla reported that she felt challenged and inspired when she was able to lead her staff to be creative on limited resources. "The autonomy of public health nursing practice provides the opportunity to cultivate the creativity," said Carla. One example of this is the midwifery practice that provided prenatal care and education through the health department and perinatal delivery services in collaboration with a local hospital. Babies delivered through this program many years ago, are now of school-age and are beneficiaries of another program led by Baumann's team, the school nurse program. In the school-based clinics, health department nurses deliver primary care, immunizations, medication administration, and a large amount of health education both with parents and students.
Evidence-based practice is not a new phenomenon in public health nursing. The development and justification of programs and services in the public health arena has been data driven for many years. Through tracking stellar outcomes, the Madison County Health Department was selected to pilot the Health Access Nurturing and Development Services program for the state of Kentucky, focused on providing nursing assessment, education, and support for at-risk, first-time moms and babies. The pilot was funded through a grant from the state using tobacco settlement dollars, another creative source of funding, and included resources for the development of an electronic database to provide data.
In providing leadership for programs and services for an evolving population of patients, Carla reports that providing continual communication to the executive director of the Health Department and Board of Health as some of her partners in service, has been key. One of her recommendations for nurse leaders in challenging existing systems when leading change is to identify your constituents and decision makers and implement a communication plan to keep them informed and to solicit support. Carla was selected as a Robert Wood Johnson Executive Nurse Fellow in 2004 and, through this experience, was able to refine her communication and leadership skills and expand her network to include public health nurse leaders from throughout the United States, which has also provided additional resources for benchmarking and collaboration. One of the most valuable outcomes of Carla's interaction in the RWJ program was the time provided during the fellowship for personal development, something not always prioritized in the busy and resource-strapped public health environment.
To inspire change in her organization, Carla has provided leadership in the health department related to the structure and approach to organizational performance improvement.
