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Public health nurses have served valiantly on the front lines of the COVID-19 pandemic for the past two years, saving lives through contact tracing, educating people about selfisolation and quarantining, vaccinating communities, and interpreting for their communities vacillating guidance from the Centers for Disease Control and Prevention (CDC). They have worked long hours and assumed new and unfamiliar roles without adequate staffing. I include school nurses in my definition of public health nurses because school nurses take on similar roles to improve population health. They improve health care access; engage school communities, parents, and health care providers to promote wellness and improve health outcomes for children; and address social needs and the social determinants of health for the families and communities they serve.
Yet, the government's decision to underfund the public health infrastructure for more than a decade has undermined the ability of public health professionals to respond to the pandemic as robustly as they could have.1 These funding shortfalls have meant that as public health nurses have devoted their efforts to mitigating the pandemic, they have watched long-standing efforts to address maternal health care and other vital programs lose ground.2 Working in underresourced communities, many public health nurses have witnessed firsthand the devastating and unequal toll that the pandemic has taken on poor and marginalized communities. They find themselves under siege from a segment of the public and some political and media figures who have threatened, cursed, and attacked them.3 Frustrated parents have criticized school nurses when their children have been subjected to quarantine and isolation. In addition, acute care nurses' more visible contributions have received more attention than public health nurses' efforts to combat the pandemic.
THE FIELD IS STRESSED
In many cases, their stress has reached a breaking point: a CDC survey released in July 2021 found that more than half of people working in public health at the state, tribal, local, and territorial levels during the pandemic reported symptoms of depression, anxiety, suicidal thoughts, and post-traumatic stress disorder.4 Many public health nurses are retiring or seeking higher-paying jobs in other health care settings. Within the public health workforce, participation by nurses has fallen faster than that of other professional groups.5
We must commit to a better future...