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  Task Force
    2010

  Watsonian

Becoming a PHA
by Bobbie C. Strickland

I recently began my career with CDC in the inaugural Public Heath Apprentice class that started in Florida in July 2007. It was a wonderful experience and I gained the skills needed to be hired as a PHA working in Washington D.C. in June 2009.

About the Public Health Apprentice Program (PHAP):
Being in the apprenticeship program not only gave me the knowledge, skills and abilities needed to be successful, it also allowed for many networking opportunities.  When we came to Atlanta for training most of us would attend a Watsonian sponsored social. I had the opportunity to meet with many PHAs, present and former. It’s impossible to name them all, but here’s a few: Bill Watson, Jack Jackson, Joe Carter, Bill Gimson, Kevin O’Connor, Candice Nowicki, Jerry Naehr, Fred Martich, Bob Kohmescher, Valerie Kokor, Jerry Sirah. When or where else would we have had the opportunity to be amongst a group like that? Someone once said that when we were in Atlanta, at the CDC headquarters, we were treated like rock stars. This may have been the case but we knew what the reality was, we were the “low men on the totem pole”. We were okay with our place and knew that we would work hard to achieve our goals and work our way up that pole.

I enjoy being in the field and am lucky to have the opportunity to work at the local level. As I’ve heard many times, everything starts here. Every PHA I’ve talked to enjoyed their time in the field, but always remembered how tough things could get. But without those experiences they wouldn’t be in the place they are now. And, I would imagine their stories wouldn’t be as interesting either. It was wonderful to hear each of their stories and ask them questions about the experiences and about being a PHA. It provided me with even more respect for the field I had chosen to enter.

With all the people I’ve been able to meet and all of the knowledge that I’ve gained I have to mention two very influential people in my development, they are Mr. Glen Koops, the PHAP director, and Dennis Murphy, my mentor. They have been the ear when I needed to speak to someone and the person who introduced me to the people I “needed” to be introduced to.

I remember reading the recent article “From Front Line to Top Dog: PHA Trainees Reminisce” where PHAs who started out in the field together years ago told their stories during a reunion. I hope that the inaugural PHAP class is able to do the same in 10-20 years and that I’m able to reunite with my friends: Cecilia Galvan, Toyin Ademokun, Clayton Weiss, Camille Gonzalez, Kara Johnson, Jabari Paul, Marty Honisch, Donyelle Russ and Adrienne Huneke.

About my work in the field during PHAP:
I spent my first year working in two (rural) local health departments in Bradford and Union Counties, north of Gainesville Florida. It turned out to be a wonderful learning experience but it didn’t begin that way. The Public Health Apprentice Program was new  and even though the local health department had read the host requirements they didn’t really know our place or what we were suppose to do. Some people even thought we were interns. But I made it a point to prove that I wasn’t an intern and that I was as committed to the community and program goals as they were. I would be one of the “locals” and earn my place in “their” health department. If I saw an area that I could help with, I volunteered or asked to be part of the team. When I saw a local training that I thought would improve my skill set I asked to attend. I ended up wearing many hats there and things changed, I was never again called an intern and they saw the value I brought to their community.

Since I was already a Certified Health Education Specialist (CHES), I was able to assist with a variety of programs and planning with little direction (i.e. chronic disease, tobacco prevention, diabetes, abstinence, disaster preparedness, 2 community needs assessments, and planning a Women’s Health Fair). During my time there an interesting but unfortunate thing happened and I learned the most from my time in those counties from this event. We had a suspected case of TB in our rural community. It was a pregnant teen that used our facility for prenatal care. We didn’t have a TB team or TB nurse in place to handle case management or to conduct an investigation on the nearly 200 contacts. I had attended TB and TST training a couple of months earlier. This was my chance for some “action.” I became the "TB lady" for both counties (name given by residents). The health department was responsible for the community contact investigation and a TB nurse from Gainesville was responsible for the school. The nurse from Gainesville was the person I turned to when I had questions about our investigation, if I needed to know how to proceed or just wanted to run an idea by her, she was there. I learned a lot of skills during this time that would prove valuable. I collected patient data through conducting interviews/screenings, analyzed charts/reports, conducted field visits, developed a investigation baseline summary, educated contacts on the test, DOT and infection, placed and read skin tests, filled out consent paperwork, completed progress notes, and patients vitals. I initiated and held meetings with key TB personnel to plan for retests and highlighted planning areas of interest (i.e. clinic traffic flow, required paperwork, staffing and supplies). I trained with local staff and we created a TB team which included the administrator, director of operations, a nurse and myself. Through this experience I worked with staff from TB and STD in Gainesville and was introduced to George Gibbs and Randy Jefferson who where current PHAs with CDC assigned there. I talked to them about STD and asked a lot of questions which lead to my interest in becoming a DIS and to my second year transition.

I spent my second year as a Disease Intervention Specialist (DIS) in Jacksonville Florida working with Tommy Chandler, who is a legend there, and many other local staff who were very knowledgeable. I was able to "hit the ground running" because I had attended ISTDI during my first year and had gained case management experience from working TB. One of the biggest differences from TB was that I was asking the clients more personal questions and asking about their sex lives. It surprisingly didn’t bother me.

In the rural areas I served during my first year I had conducted field visits in the country driving through pastures sometimes and the only “bad” area was a small neighborhood that looked innocent enough to me. In Jacksonville there were some country areas with pastures, but I was primarily in areas where every area was considered the “bad” area and this time I agreed. I remember driving through one neighborhood and some of the people where staring and others turned to face away so I couldn’t see their face. When I got back to the office I told my supervisor what happened and he said, “Bobbie, you’re a white women in a black neighborhood, they think you’re a cop when you’re driving through in your black car with tinted windows and a case manager or parole officer when you get out of your car. If you where in a state car it would be worse, they’d think you where coming to snatch their kids.” My supervisor there mentioned a few times that he couldn’t believe I went to some of the places I did without asking someone to go with me. I remember telling him that I would ask if I ever needed to or wouldn’t stop if I felt threatened by my environment.

Other activities included working on a mobile unit as team lead, visiting strip clubs to look for clients and going to a teen detention center to conduct testing. Duval County was able to excel when it came to case management. Our determination and motivation from Tommy Chandler kept us going. We worked paper from 5 counties with only 7 DIS. Working in Jacksonville was a true field experience and I really hated leaving there but I knew it was time for my next adventure.

A new PHA in DC:

I’m working as a DIS here, but in a unique way. I’m team lead for a School Based Screening Program. We conduct presentations and CT/GC screenings in all 20 district schools. The presentations are mandatory for all 9th-12th grade students and the screenings are optional. For those who are positive we provide treatment at the school and work the cases the same way we would if it where a syphilis case.

I’m lucky to have had the chance to work for the legend or as some call him “the voice,” Mr. John Heath for a few months before he retired and heard some of his stories to store in my mental collection. It’s a different world here in DC. There are many things that stand out from the places I worked in Florida. I’m thrilled to have this opportunity and to begin my journey in a place where someone once told me, “either you make it or you don’t.”

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