In Bethel, there’s a shortage of public health nurses. The situation is easing, but has been limiting what is available for people who depend on public health services in the Yukon-Kuskokwim Delta.
Three public health nurses left Bethel in the past four months, and it’s taking a while to train and bring new ones up to speed. That leaves residents in Y-K Delta in a tight spot. Public health nurses usually conduct immunizations and test for tuberculosis and sexually transmitted infections.
Timothy Struna is the Chief of Public Health Nursing at the Alaska Department of Health and Social Services. He says that the state has had to scale back prevention efforts because of the shortage.
"We haven't been able to go into the villages and meet with tribal or city council or other key stakeholders to provide more of a primary prevention message to kind of help keep the disease outbreaks, you know, from happening in the first place," Struna said.
But Struna has seen this before. A decade ago, he worked in Bethel as a public health nurse for five years. These shortages occur in phases, but he’s hopeful that they will be able to solve this one, at least in the short term.
Usually the Alaska Division of Public Health has 11 nurses in Bethel. Right now, there are four vacant positions. Bethel’s remote location and not having stores like Wal-Mart can deter some applicants. Dealing with historical trauma and hefty caseloads factor in as well. Struna says that they mitigate the burnout by not giving nurses too many cases, and by bringing staff from other offices to help when there aren’t enough nurses. He recognizes that turnover rates will always be high, but says that this is something that's become more common in the whole field of nursing.
“So we will have nurses come and they'll work for, you know, three to five years, and then they will be interested in living in another part of the state or living in another state altogether, or providing a different specialty within the nursing profession. And so I don't think that it's unique to public health nursing," Struna said.
Struna says that public health is focused on hiring locals, but in 2016, a budget cut eliminated an entry position that gave local hires a leg up in Bethel. He doesn’t know when they will bring back that position.
"It's not an option at this point, but it is certainly something that we're always trying to figure out how to bring back," Struna said.
Meanwhile, a new nurse has already started working here and another one is expected next month.