A More Vibrant World: From the Whole Patient to the Whole Population, the Vital Connections between Public Health and Nursing to Address the Big Picture

Chris Rudski

Chris Rudski

Master’s Student, Online Population and Health Sciences Degree Program; Registered Nurse, Rogel Cancer Center Infusion, Michigan Medicine

I did not know a thing about public health until I became a nurse. I remember sitting in a nursing class skimming a brochure about the online Master of Public Health program. I couldn’t help daydreaming about how this could change my work, being able to help entire neighborhoods and communities—maybe even entire cities—stay healthier. It was the beginning of a calling that I just couldn't quite hear at the time.

Nurses are trained to assess and care for the whole patient. They must tune into not only what makes a patient healthy or ill but also the patient’s mental health and the factors of their personal and family life. Each patient is dynamic and complex and can change from one interaction to the next. This is part of what makes nursing so challenging and rewarding.

Nursing is the relationship with the patient.

Nurses focus less intensively on disease alone but more intently on forming relationships with patients and leveraging those relationships to promote and maintain health. Previous to my nursing career, I was a teacher. Human relationships have always been very important to me and something that drives my work. Nursing is the relationship with the patient. Without a personal connection, there is little room for improving health outcomes for a patient. This does not mean you become your patient's best friend. But that nurse-patient connection is the foundation of what we do.

Public health shares a lot with nursing. Nurses have that up-close relationship, and public health professionals—including many nurses—have a wider view. But all nurses are taught more and more to see the “big” pictures—population health, reducing unit waste through better practices, being mindful of key performance indicators in health care.

We are trained to focus on the patient in front of us, but this can have drawbacks that public health helps us address. When we focus too closely on clinical factors, life outside the clinic setting can blur and we can miss important details. From the air we breathe to the water we drink and the people we meet, health care and communities are constantly intersecting, as are the fields of nursing and public health.

Michigan’s online MPH allows me—a full-time nurse with a family—to keep my job and support my family while phasing into a new career built on my strengths. And the degree is providing new perspectives on that shared space between nursing and public health. As an oncology (cancer) nurse working at an infusion center where people receive chemotherapy treatments, my patients are already in some stage of illness. Some are expecting a return to full health and others are here for palliative treatment.

As a public health professional in training, my goal is to shift my focus from clinical settings where we treat disease to a community focus where we work to prevent disease through health promotion and education.

I think a lot now about the roads that bring my cancer patients into the center. Were they exposed to food or water sources that, over a lifetime, caused disease? Did they use tobacco or spend too much time with unsafe sun exposure? What role did their genes play? As a public health professional in training, my goal is to shift my focus from clinical settings where we treat disease to a community focus where we work to prevent disease through health promotion and education. My MPH is already enhancing my BSN nursing degree, and it will continue to do so.

For a cancer patient, every drip of infusion therapy is life-saving. It is an honor to serve the brave, strong people who spend hours and sometimes days with us at Michigan Medicine fighting their disease. We laugh together and we shed tears. I’ve lost patients along the way, and I think of them every time I scan my badge to start a shift. Now, I can’t help but think about which factors could have changed their diagnosis. Perhaps some would not have needed Michigan Medicine in the first place. For me, serving my patients and my community as best I can means stepping beyond the doors of the cancer center to explore public health.

The coronavirus pandemic has changed everything. While much of each shift is business as usual, there are new layers on top of normal responsibilities. Handwashing and PPE are more important than ever. And of course, our understanding of infection control has had to evolve beyond our already intense protocols.

They are using their time at home to do good for others.

I see great unity in what people are doing to address the pandemic. Lately, it’s been easy to focus on the fractures of daily life, on the difficulties, pain, and separation the pandemic has caused. But it has also forced us to learn and grow in ways we hadn’t imagined. My coworkers and I—alongside many other essential workers—go to work each day because we have people to care for. In grocery lines and other public spaces, people are taking great measures to protect themselves and the workers, like using PPE and following social distancing guidelines.

I also see support everywhere I look. Whether it’s a kid’s chalk drawing on the sidewalk saying thanks or an inspired homemade mask, the creative expressions and genuine health interventions from people all over the world are amazing. They are using their time at home to do good for others. We feel that support every day, and the masks and other interventions are helping fight the disease. This sense of expanded community in the face of a pandemic gives me hope that we will soon be living in a richer, more vibrant world.