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Vulnerable populations
When Capt. Kerry Nesseler, MS, RN, joined the corps
in 1986, her first assignment was assisting in the implementation
of a prenatal clinic on an American Indian reservation
in rural Minnesota.
But before she could begin caring for the expectant
moms, Nesseler, a mother of four, found she had to earn
her patients’ trust.
“My patients were used to traveling 30 miles
to a clinic off the reservation to receive prenatal
care,” Nesseler said. “Many felt a sense
of discrimination, and didn’t think they were
always treated with respect.”
Nesseler, who has a master’s degree in maternal-child
health, used her expertise to make her new patients
feel welcome while also fostering an environment of
mutual respect.
The program proved successful in offering expectant
mothers education, home visits, prenatal care and access
to prenatal specialists.
Mobility in the corps is encouraged, and Nesseler went
from Minnesota to Atlanta to work in the Bureau of Primary
Health Care. Two years later, she transferred to the
CDC, where she worked on the national breast and cervical
cancer prevention program.
“Over the years, I’ve been able to partner
with a lot of other wonderful health care practitioners
to globally impact patient outcomes for mothers and
their children,” Nesseler said.
She cites the work of corps members in areas such as
infant mortality, perinatal transmission of HIV/AIDS
and teen pregnancies. Corps nurses assist in managing
the Title V program that provides funding to all states
for their maternal and child health programs. Corps
nurses also provide direct prenatal health services
and education in community health centers, Indian health
clinics and hospitals and the National Health Service
Corps.
Corps nurses also direct the Ryan White Title IV program
that provides grants to organizations to reduce the
perinatal transmission of HIV/AIDS. The nurses are involved
in the overall efforts to educate the public about the
risks of HIV, reduce the transmission rates, and provide
treatment and care to people with the disease.
In addition, corps nurses are involved in directing
the two “Abstinence Only” education programs
that provide funding to both states and communities.
Corps nurses also offer educational and clinical services
to school-based health clinics.
“We’ve seen a significant decrease in the
areas of infant mortality, perinatal transmission of
AIDS and teen pregnancies in the last decade,”
Nesseler said. “Our nurses are directly involved
in policy development and implementation of national
programs to effect positive health changes in these
and other areas.”
Two years ago, Nesseler was appointed associate administrator
for health professions in the U.S. Department of Health
and Human Services’ Health Resources and Services
Administration.
“In the past, this position has always been held
by physicians,” she said. >>
“I’m excited and honored to be the first
woman, as well as the first nurse, to serve in this
job.”
With a budget of $882 million and a staff of 350, she
directs a variety of health professions programs affecting
the nation’s physicians, dentists, nurses, allied
health professionals and health workforce issues.
One of Nesseler’s highest priorities is working
to increase the ranks of nurses across the United States.
She notes that by 2010, the country expects to have
808,000 openings for registered nurses.
“The secretary of the HHS is committed to alleviating
the critical shortage of nurses in this country,”
Nesseler said.
The federal budget for nursing programs is in HRSA,
the Bureau of Health Professions, which Nesseler directs.
She is responsible for overseeing funding for many programs
that will increase the ranks of nurses including the
Nursing Education Loan Repayment Program; the Nurse
Scholarship Program; the Nurse Faculty Loan Program;
Nursing Workforce Diversity; and the Nursing Education,
Practice and Retention Program.
“These programs all provide scholarships, loans
or grants to individual students and practitioners as
well as eligible nursing schools in the hopes of increasing
the number of students entering and graduating from
nursing school,” Nesseler said. “Some of
the funds are being spent on examining the workforce
environment for nurses and retention practices.”
In addition to the nursing budget, the bureau directs
the National Health Services Corps, which unites communities
with health professionals. The group provides partial
repayment of educational loans and scholarships for
health professionals, including advanced practice nurses,
who serve at approved sites. The bureau also directs
programs that help K-12 students to pursue a career
in the health professions.
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