Last year, the Legislature passed L.D. 1108, An Act to Restore Public Health Nursing Services, and it appears that the Maine Department of Health and Human Services is committed to its implementation. Applications for public health nurses are being sought and reports suggest that some nurses are being hired.

This hiring process is a first step toward rebuilding the public health infrastructure in Maine. There has been a growing recognition of the importance of these workers as the number of field nurses fell over the last decade from 88 to about 12.

My experiences as a preventive medicine physician and previously as a public health nurse taught me that our health system, no matter how sophisticated, cannot work without skilled hands in the community. Addressing opiate addiction in rural Maine is one example of the need for and benefits of these nurses.

Maine ranks in the top three states for the rate of babies born with a drug withdrawal syndrome caused by opiate exposure. The number of drug-affected births is about 1 in 12 births in the state. Babies in withdrawal may experience irritability, breathing problems, seizures and difficulties feeding, and they are at a higher risk of death.

These symptoms may occur 24 hours to four days after birth. A routine public health nurse home visit can assess the child, advise the mother and improve long-term health and bonding. To these families, the public health nurse becomes an important link to essential maternal substance abuse treatment, a safe environment, parenting and community support. Mothers struggling with addiction can be stabilized at home and referred to care as needed. This care saves the costs of re-admission to hospitals and neonatal intensive care.

Public health nurses connect community members to health resources, social support and law enforcement. I will be watching to be sure that the Maine DHHS continues to implement L.D. 1108 and gets these nurses into communities.

Sharon McDonnell, BSN, M.D., MPH

Yarmouth

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