In May of each year, National Nurses Week honors the millions of women and men who play a critical role in the nation’s health care industry. The nursing profession, whether in hospitals or private practice, includes hundreds of medical fields, from pediatric, oncologic, and palliative care to surgical and operating room nursing. 

“The role of military public health nurses is to decrease the burden of disease and injury while promoting and protecting the public’s health regardless of an austere environment,” said Army Col. Heidi Warrington, chief deployment health, Public Health Division, Healthcare Operations Directorate, Defense Health Agency. “Military public health nurses oversee mass sheltering, mass feeding, sheltering in place, infectious disease containment and treatment, and they protect the vulnerable within our communities. We are the mobile team when a disaster hits—whether infectious or an environmental threat. The public health nurses are the medical professionals that go to where the people are.”

Last winter, Army public health nurses responded to the Ebola threat in Africa and in the U.S., said Warrington, and helped develop medical protocols. “We taught health care professionals how to contain it and treat it, and we were part of the surveillance system for quality management to make sure that those standards that were developed followed within the United States at our containment centers,” added Warrington. 

While each of the military service branches provide public health services, only the Army and the Navy have uniformed public health nursing officers. Military public health nurses, with their civilian counterparts at the state and local level, have taken on sweeping public health initiatives in the U.S. and abroad for decades. Their efforts range from pushing 50 years ago to make car seatbelts a safety standard required by law to responding just months ago to the Ebola threat in Africa and in the U.S. 

Warrington said there are 330 Army public health nurses working within the Army’s Medical Command and their primary responsibility includes any DoD beneficiary. About 80 percent of an Army public health nurse’s time is spent in the community, explained Warrington, regularly partnering with civilian public health departments while also working with global partners such as the Centers for Disease Control and Prevention and the International Red Cross. 

“In the Army, our commanders know a critical capability for displaced persons, sheltering in place, and mass feeding is their Army public health nurse,” said Warrington. “The International Red Cross and the World Health Organization partner with us for big disasters, including disasters outside of the U.S. There are public health departments in every county and state in the U.S., and we partner with them. This is for service members, family members and the community, because the community is our client and that is part of the partnership.” 

Warrington reflected on the role of public health nurses in the late 1960s in identifying and promoting the public health initiative for seatbelt use. She said public health nurses, including Army public health nurses, have historically been members of county and state boards that review child and infant mortality trends in order identify an intervention that could improve health and safety. 

“Seatbelt use is a great example of a public health initiative nurses, including military nurses, were intimately engaged in,” said Warrington, who noted it often takes 10 to 20 years for a public health intervention to get fully embraced. Steps to acceptance include legislative action and years of marketing to educate the public. “Public health is about changing the behavior of our people. That is hard. And so it usually starts with a change in law, and then it continues with a change in design,” said Warrington. 

In response to the deaths of unrestrained children and infants in car crashes, she said, “We asked if the bodies were restrained, could we save their lives? So it was identified more than 40 years ago as being a significant public health threat. The trend today: children and adults don’t even think twice about putting their seatbelts on, and no car made in America is manufactured without seat restraints.”