The Health bulletin [serial] - University of North Carolina at Chapel Hill

October, 1951The Health BulletinIN-SERVICE EDUCATION FOR PUBLIC HEALTHNURSESBy Maetha Rebecca Swindell, Supervising NurseDistrict Health DepartmentElizabeth City, N. C.IThere has long been a recognition ofthe need to give Public Health Nursesmore security in their role of assistancein clinics. The first step in the developmentof such a program would be theselection of an area where such servicecould be concentrated. With this inmind, the Nursing Consultant fromChildrens Bureau was asked to come toNorth Carolina to help develop theseplans and the clinic selected for demonstrationwas the Orthopedic Clinic heldeach month in Elizabeth City, N. C.This clinic which serves the northeasternsection of the state comprisingthe following counties: Dare, Currituck,Camden, Pasquotank, Perquimans,Chowan, Gates, Washington and Tyrrell,has been in operation for manyyears under the sponsorship of theAmerican Legion and American LegionAtixillary, the Crippled Children's Divisionof the State Rehabilitation Service,and the local Health Department. Dr. R.B. Raney, (Chief) of Orthopedic Service,Duke Hospital, Durham, N. C, is theMedical Director, and the nursing staffof the District Health Departmentrender the clinic nursing service. Recentaddition of physical therapy personnelfrom the State Board of Health hasbeen included in the service.In the fall of 1949 the first nursingconference was held to formulate plansfor in-service institutes and in May1950 Miss Coggans from the Childrens'Bureau, Miss Ruth Council and MissLilly Fentress from the Crippled Children'sDivision, State Board of Health,met with the nursing staff that coversthis clinic. This fore-runner conferencebrought out the following points: (1)The Public Health Nurse is not securein this clinic due to lack of knowledgeof orthopedic terms; (2) teaching methodsand content; (3) clinic operationsand the specific place of the nurse inthe clinic. These basic needs we wouldrecognize as applicable to all clinics,and the principles as applying to allservices the same.It was brought out in group discussionthat the over-all emphasis of reviewshould be on the total growth anddevelopment of the child. To developthis program the following points wouldbe kept in mind:1. Selection of an area where servicecould be concentrated.2. Determine with nurses how needsmay be met.3. Plan for staff education that willmeet the need.4. Outline of staff education program.5. Evaluation to see if this may beused or is applicable to other clinics.Since the selection of area had alreadybeen made, the next step was todetermine from the nurses themselveswhat their needs were, for only withthis information could ways and meansbe devised to meet those needs. I wouldlike to discuss the general feelings expressedby the nurses.Better methods of case finding werefelt to be of great importance. If thenurse is to recognize the deviation fromthe normal, she must be entirelyconfidentin recognition of the normal. Thepreventive aspects of orthopedic nursingwould certainly require betterknowledge of the Evaluation of theNewborn, for which no better sourcecan be used than Dr. Ethel Dunham'ssplendid book with which every nurseshould be completely familiar. Not onlyin the orthopedic clinic itself but infield and other clinic services the importanceof good history taking, withspecial emphasis on birth history(length of labor, presentation, size,forceps, bleeding, etc.) needs to be