Last December, Jaimee L. Watts-Isley, a DNP candidate at the University of North Carolina at Greensboro, was listed as one of 13 Students Who Rocked Public Health in 2019 for her work to identify and address issues surrounding retention and recruitment of public health nurses (PHNs) in NC local public health departments. Here, she describes her efforts in more detail. Follow along each month as we profile all 13 Students Who Rocked Public Health 2019.

Before I even began the Doctor of Nursing Practice (DNP) program at UNC-Greensboro, I knew there would be a final project due as part of the requirements to graduate. I never would have imagined that my project would end up being the initial part of a three-phase statewide study aimed at understanding and addressing North Carolina’s ever-growing public health nursing shortage.

The first year of the DNP program passed faster than I could have anticipated. It was August, the beginning of my final year and I still had no concrete proposal ideas. I knew it had to be something that would not cause “project fatigue” — a minimum of 300 hours had to be committed towards this project alone to graduate. I was stuck. Then a chance encounter happened.  

After offering to fill a vacant seat on a local public health nursing committee, I was introduced to Dr. Susan Little, a DNP who at that time managed a public health nursing unit at NC DHHS. I emailed her and was beyond elated when she responded that she wanted to talk with me about a project idea. The following week I sat in a coffee shop with Chief of Nursing Phyllis Rocco, Dr. Little, and other public health nursing professionals discussing goals and timelines for a project they were excited to get off the ground. They shared that public health nursing leaders across NC were alarmed at the number of public health nursing (PHN) jobs lost over the past eight years, and local health departments (LHD) staffing data only verified their growing concerns. I learned that this issue was not isolated to our state and that PHNs in California had recently conducted a quality improvement project to address the rapid shortage of PHNs in rural areas of their state. PHN leaders in NC heard about their work and it sparked the inspiration for our project.

We got started right away. Phyllis and Dr. Little had already formed a practice advisory committee, which included themselves along with Dr. Ellis Vaughan and Dr. Ola Aloba. We originally reached out to PHN leaders in California and received permission to use their survey tool, which we hoped to adapt to meet the specific needs of NC. But I felt strongly that our study needed a validated survey tool (the Casey Fink Nurse Retention Survey which had been utilized by hospital nurses in a magnet hospital in Colorado) and the committee agreed. I emailed Dr. Fink and Dr. Casey with my request to use their survey along with some modifications. Their response was quick and encouraging; they agreed to let us use their tool and asked to be kept up-to-date on our progress.  

We launched an aggressive Twitter and Facebook media campaign to gain interest in our project. We gained national interest. We did this because the public health nursing shortage was not a problem specific to NC, and we expected other states may be inclined to tackle a similar project.

Survey invitations went out by email, sent by NC DHHS to 1900 PHNs. We received responses from 672 PHNs, a whopping 35% response rate. Through the responses, we learned that PHNs in NC are proud of their work and their impact on community health. There were high levels of satisfaction with managers and colleagues as well as work schedule flexibility. I was not surprised to learn that recognition was the areas with highest dissatisfaction. It is all too common for nurses to go unrecognized for their work. Salary was another area of discontent along with limited career advancement.

As this project progresses to phase II, I am continuously in awe of what we are accomplishing. Phase II is being spearheaded by Claire O’keeffe, a UNC-Greensboro doctoral student in the succeeding cohort.  Phase II will focus on PHN leadership and recruitment. For me this project solidifies the foundation for my future research and work in public health and nursing.

Read About More Students Who Rock:

• Students Who Rocked Public Health 2019
• Students Who Rocked Public Health 2018
• Students Who Rocked Public Health 2017
• Students Who Rocked Public Health 2016
• Students of Public Health: Student Voices and Profiles