Florence Nightingale or Sherlock Holmes?

Did you know that the Stickney Township Public Health Department has its own detectives? No, they don’t catch bad guys in the usual sense, but they are heroes. They are the Stickney Public Health nurses who track disease outbreaks in our community, hunt down their cause and provide education to inform and prevent future issues.

“The thing with public health is that, if we are doing our job well, people don’t realize that the job is being done,” asserts Sharon Foy, director of nursing. “If public health wasn’t here, the outbreaks of communicable diseases and other health issues would go unnoticed until they reached a crisis point.”

“We see a lot of diseases that are food related,” she goes on to explain.“As well as bacterial and viral infectious diseases, STDs—anything that is communicable.”

Food Borne Diseases Peak

“Especially if it is food related, we need to establish what people ate and where it came from. Sometimes it is casual food handling on the part of the public. Is this an individual case? Was someone maybe not careful in the kitchen or is this something they got somewhere else? Sometimes it’s a commercial source,” explains Foy. “Information comes from people who are getting sick. We need to know where they ate, what they ate and where it came from. Many times businesses are not the culprit, but because they distribute the food they get blamed.”

First Line of Defense Against Ebola & Zika

Even though the Stickney Township community may seem far removed from such threats, as people travel so does disease.

“Recently tests were run on pregnant women who had returned from traveling out of the country to make sure that they didn’t have Zika. We were happy to report that they didn’t,” says Foy.

Stickney Public Health exchanges information with the Illinois Department of Public Health (IDPH) and the Center for Disease Control (CDC).

The greatest amount of disease information comes in the form of data provided bythe state.Medical labs are required to report evidence of communicable disease or conditions such as high lead levels in individuals. The information is forwarded to local health departments by the state. When an area resident is affected,the local department investigates to determine the source of the illnessand, hopefully, to put a stop to it. This data is reported back to the state, which then helps the CDC to track and compile results.

Data aside, Director Foy wants patients to understand that “we’re here to educate them and to answer as many questions as we can so that they don’t just feel like this is one sided. We’re there for them, too.”

It Takes An Experienced Healthcare Team

Reflecting upon her own experience when she first started in a SPHD clinic,Foy remembered that the person who hired her was pleased that she had floated in her previous position in a hospital setting.

“One day I might be in the ER, ICU, Rehab or GI, where ever they needed me. I could be flexible and function in different settings,” she says.

Today, that type of experience iswhat she looks for in her team.

Investigating starts with gaining people’s trust, often the biggest hurdle for the Stickney Public Health nurses. Public Health Nurse Celeste Brown describes a recent challenge.

“A patient was in the hospital and family members were the only contact. They were very reluctant to give any information. They wanted to know how we had gotten their mother’s name and why we were asking for information. It’s a fine line that we walk. We don’t want to invade people’s privacy, especially while they are ill.

You have to finesse it. But, by explaining what our role was and also by educating them so that they could deal with the health situation as best as possible, they eventually became very helpful and cooperative.”

Director Foy describes the challenge this way: “It’s gaining someone’s trust. People don’t know why we are calling, they are very taken aback that we have information about them, and they don’t know who we are.We are calling on a phone, so they can’t see us face toface, and it’s very scary for someone as to why we are calling about a communicable disease. They may not want anyone to know that they are sick.”

“In the communicable disease area, 95 percent of the patients we deal with are by phone,” says Public Health Nurse BeataStrama. “However, some patients are familiar with the clinic and prefer to come in to be interviewed.

Cultural and language barriers can be a challenge. Nurse Strama describes a recent incident with an Asian woman who had tested positive for hepatitis.

“After initially hanging up on me, I was later able to explain through a friend why I was calling and ultimately the patient felt comfortable coming in and dealing with me,”she explains.

Local Health District vs. County – Size Matters

One of the strengths of working at the township level is that ability to coordinate with other township services.

“The health district is small enough to care, but large enough to function as a collaborative team,” Foy explains.“If we see a case of West Nile, we can talk to the Environmental Health Services to coordinate the Township’s mosquito spraying activities. If our team is in a senior’s home where they may suspect abuse, coordination with the Township’s Adult Protective Services team may be needed, the clinic may refer a senior requesting home nursing services, etc...” All departments work well together.

Getting The Lead Out

In one case there was a three year old who had a high level of lead in his blood stream, yet there was no evidence of a typical source of lead from the construction of the home. It wasn’t until she discovered that the boy’s father painted cars for a living that Judy was able to find the source. Dad would come home after a long day and put his shoes, which had paint on them, in a pantry. The child would crawl on the floor and was being exposed to lead by playing aroundhis father’s shoes.

Other sources of lead Nurse LaMantia has discovered include lead weights from fishing, certain types of make-up, pottery imported from other countries and types of candy from Mexico.

Lead levels requiring follow up and case management are set by the State of Illinios. Depending on the level, repeated tests may be required. Though no amount of lead in a child’s blood is normal, only elevated levels require follow up with the family and their physician. Follow up may be short or long term. Nurse LaMantia does home visits and also monitors the lead levels of pregnant women.

Public Health Nurse Susan Shinkus has a different challenge in her detective work. She often follows up on reports of sexually transmitted diseases. This involves contacting patients to ask extremely personal questions including their sexual orientation and who their partners have been.

“Nothing is worse than calling someone up because the ER has reported an STD and they don’t know it,” she says.“Names of partners need to be gathered. Identities must be handled with extreme sensitivity. It’s confidential. However, we can offer education that they may not be able to get elsewhere.”

Public Outreach Projects

“For years we’ve been going out into the community beyond the clinic to take blood pressure,” says Public Health Nurse Celeste Brown, the nurse who runs the hypertension awareness program. “I go to schools during open houses when the parents and grandparentsare coming in, we go to libraries and farmers markets. Afterwards, we follow up by calling patients whose blood pressure is above a certain level and encourage them to see their doctor or a doctor at one of our clinic sites.”

Home visits for senior residents are a result of referrals from social workers, doctors and family members.

“Our goal is to keep seniors in their homes as long as they can with as much independence and dignity as possible,” adds Nurse Shinkus. “We’ll offer diabetes education, medication management, take blood pressure and promote health.”

“There are many times when we’ll coordinate with the case workers for other Township services, such as Meals on Wheels, transportation needs, etc,” says Nurse LaMantia. “We’re aware of the services that are out there and can get them the appropriate help as a part of our ‘well visits.’”

Part Florence Nightingale, part Sherlock Holmes, the nurses of the Stickney Public Health Department provide services to area residents in a manner unlike that of any other government agency. Feel free to contact them with health related questions or concerns.

HOME HEALTH SERVICES

COMMUNICABLE DISEASE SURVEILLANCE AND INVESTIGATIONS

VISION AND HEARING PROGRAM

SCHOOL NURSING SERVICES

PREGNANCY TESTING AND COUNSELING

DENTAL SERVICES

PODIATRY SERVICES

Copyright 2017 Stickney Public Health District