Here's a typical day: an hour or so of hands-on clinical care that may include a newborn assessment, a child's health screening and a counseling session with a teen. Then it's off for a home visit and an afternoon coalition meeting in the community to help create walking trails for the elderly. Later, a trip back to the clinic to meet with a family about nutrition and to inform a patient about his HIV status.

Does this sound like a challenge? Carole C. Jakeway, RN, MPH, chief nurse for the Georgia Department of Human Resources, Division of Public Health, and Olivia A. Erbele, MS, RN, assistant chief nurse, know the rewards and challenges of working as a public health nurse.

"No two days are alike," Jakeway said. "It's very exciting day to day and offers a diverse range of experiences."

Those experiences include working with community health issues, frequently on the leading edge of policy-making and creating programs to serve the community. Public health nurses also can be involved in environmental health projects, from managing the health implications of a chemical spill to providing treatment and assessment for a health risk, such as a recent outbreak of salmonella in Cobb County.

Public health nurses' practices go beyond the four walls of the clinic; they work directly with community leaders to improve health care delivery to the underserved. They teach nutrition, wellness, emergency preparedness and health management classes to schools, business and church groups. They reach out to the young, the middle-aged, the elderly and to families.

"People always call on us for information," Erbele said. "We have more than 40 programs, from family planning and immunization, to hypertension and WIC. We're a resource for the communities we serve."

Erbele has been working on a three-year program in Hall County that provides access to health care for the uninsured in the area. She spearheaded a survey to determine the impact of the uninsured, then found physicians in the community to champion the project, which has now been adopted by the Hall County Medical Society.

After lining up funding sources, the program is beginning to enroll patients in the practices of three physicians who have agreed to work on the project.

"It's very rewarding to see this program come to reality," she said.

Each of Georgia's 159 counties has clinics. They are managed by the 19 health districts in the state. Each district is overseen by a physician who serves as the director of the district office.

Public health nurses are permitted by law, enacted in 1989, to order and dispense certain drugs under the supervision of a delegating physician.

Positions in public health nursing are available for RNs, LPNs and NP. The department frequently hires recent graduates as well as experienced nurses, providing additional training at the department's expense.

"Public health nurses have a great deal of autonomy and variety in their jobs," Jakeway said. "It's a wonderful way to build a broad career foundation."

For information about public nursing, visit www.ph.dhr.state.ga.us.