By Robert Scally, NurseZone assistant editor
Nurse epidemiologists are the front-line troops in the never-ending war against infectious diseases. They are often considered the Paul Reveres of the medical world, sounding the alarm when a new disease arises or formulating new strategies to fight familiar diseases.
Marsha Koopman is one such soldier, a veteran who is an expert at fighting enemies that are too small to see.
p>Koopman, RN, BSN, MHA, CIC, is a nurse epidemiologist at the University of California, Davis Medical Center in Davis, California. The microscopic enemies she has fought for the past 27 years are the biological organisms that cause infectious disease.
While dukeing it out with germs is tough, Koopman said that she is having success dealing with one larger organism: humans. Koopman said that she thinks epidemiologists are clearly winning the fight for awareness and recognition both within the medical community and with the general public.
"The thing that has changed the most over the years is that people are more aware that we exist and there is a field of nursing called epidemiology and it's because of the changing pathogens that we’re finding in our communities and in our hospitals," Koopman said. "Having attention [paid to epidemiology] has helped because people are more aware… and when we go out to educate them more people show up now for our classes."
One of the reasons for the higher profile of epidemiology nursing in recent years is that infectious diseases are no longer a problem just for patients—care givers are also now at risk, Koopman said. Hospital administrators love infection control programs run by nurses, because they help hold down costs and improve overall patient outcomes, she said.
There's good reason for the public to pay more attention to epidemiologists.
Bioterrorism, West Nile virus, severe acute respiratory syndrome and monkeypox are just few of the reasons that nurse epidemiologists have found respect and recognition.
"Public health today has taken a more active approach to fighting diseases," said Betty Jung, RN, BSN, MPH, an epidemiologist with the state of Connecticut public health department. "It's more of a disaster-preparedness approach. Instead of waiting until something actually happens, better and faster infrastructure is being set up to communicate better [with both federal and local health authorities]."
"Epidemiology is like research only on a practical level," she explained. "We use statistical procedures and that type of an approach and apply it to public health."
According to Koopman the intensity of the fight against infectious disease has accelerated during the past 30 years.
"These days it’s just one disease after another," she said. "There’s no respite, there's no time for regrouping. It’s just charging ahead from one thing to another."
Today’s pathogens are also tougher customers than they used to be, Koopman said.
Jayson Farley, RN, BSN, MPH, CRNP, an infection control epidemiologist for the Johns Hopkins Health System in Maryland, agreed.
Farley said that he thinks that drug-resistant organisms are the leading challenge currently confronting nurse epidemiologists.
"[Drug-resistant organisms] continue to be, and will continue to be, the bane of the existence of infection control," Farley said.
"Almost every pathogen now has at least some [drug] resistance," Koopman added. "Antibiotics are becoming less and less effective."
Although the workload for nurse epidemiologists may be head-spinning, the job is never boring, Koopman said.
"Every day is different," Koopman said.
What makes epidemiological nursing exciting is that it intersects with a number of scientific and medical disciplines, Farley said.
"You’re looking at things from a variety of perspectives. One of the great benefits of infection control is you’re able to work with a multi-disciplinary team," said Farley, who has worked as an epidemiologist for the past three years. "You able to work with nurses, physicians, PAs, therapists, the whole gamut within the health care system."
Education is key
While disease surveillance takes up much of the time of a hospital-based nurse epidemiologist’s time, education is the other major task. It is often the job of nurse epidemiologists to educate physicians, nurses, hospital staffs and the public about how to deal with threats to public health.
Since the number of new diseases and infection control problems has increased and become more complex, so has the job of education, Koopman said. Educating medical professionals is also made more challenging since busy nurses and doctors need to learn critical information as quickly and easily as possible, she said.
"We try to put things into sound bites," Farley said.
Due to hospital personnel turnover and attention spans limited by competing priorities, the same information often needs to be repeated multiple times, Koopman said. "You need to work smarter."
Technology for detecting and testing for diseases advanced with the advent of personal computers and better laboratory methods, but the critical mission of education has also been advanced by vastly improved technology, Koopman said.
"Thank God there’s PowerPoint," she said.
With the advent of satellite primary care clinics during the past 15 years, the U.C. Davis Medical Center’s coverage area now extends for a radius of 200 miles from the center’s main campus. Koopman said she also uses telemedicine technology for conducting interactive educational seminars with physicians, nurses and other medical staff in far-flung locations in Northern California.
Betty Jung is using the Internet to educate medical professionals about epidemiology and to help pair mentors with students who are interested in becoming epidemiologists.
Jung founded Public Health Expertise Network of Mentors, (P.H.E.N.O.M.), 10 years ago, not long after graduating with her master's in public health from Southern Connecticut State University. The P.H.E.N.O.M. program is currently administered entirely on the Web and features 24 mentors in the public health field.
Jung said she started the organization to help people who were interested in a career in public health become more informed about the field by talking directly with public health professionals.
Koopman, who spent 12 years as bedside nurse and a nurse educator, said she encourages nurses to become epidemiologists.
"I wouldn't have wanted to do anything else. I have the most rewarding career I can think of," Koopman said.
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