Immunization Healthcare nurses have all bases covered
Immunization Healthcare Branch nurse practitioner Ann Morse (left) speaks to Sailors about immunizations at a health fair. The Health Fair was part of a long-range plan to improve the overall health and wellness of Sailors.(U.S. Navy photo by Lt. j.g. Mckensey Smith)
From the bedside to the battlefield to the classroom and beyond, nurses have always had a prominent role in the history of military medicine.
Nurses of the Defense Health Agency’s Immunization Healthcare Branch (IHB) carry on the nursing mission through education, policy development, adverse event management, research, and training.
“Our primary role is being patient advocates,” said Tara Reavey, a registered nurse and chief of Program and Policy Management for IHB. “No matter where you are, your heart always goes back to the patients and the staffers who are pounding the pavement, and making sure they’re taken care of.”
Since IHB serves a global population, much of its work with health care providers or patients is done through telehealth service or electronically. A nurse or nurse practitioner is on call 24/7 to field clinical questions through the Immunization Healthcare Support Center.
With the Centers for Disease Control and Prevention, the IHB utilizes a Collaborative Adverse Events Reporting System (CAERS) to perform a clinical review of all military-related Vaccine Adverse Event Reports (VAERS) for the assessment of medical interventions, outcomes, and potential for IHB intervention.
“Our goal is to ensure clinicians and patients have access to 24/7 assistance with immunization questions and adverse event management,” said Catherine Skerrett, a nurse practitioner at IHB’s San Antonio Regional Vaccine Safety Hub.
Ann Morse, a nurse practitioner in Portsmouth, Virginia, and part of IHB’s National Capital Region hub, works with the Atlantic Fleet, Military Sealift Command, and Navy Medicine East, among others. She provides training and consultation with a wide range of patients, providers and families mostly through the Immunization Healthcare Support Center and HELP (Health Experts onLine Portal), a telemedicine portal run by Naval Medical Center Portsmouth medical staff and serving all of the Services within NAVMED EAST.
“We love taking care of patients,” Morse said. “We love alleviating concerns and answering questions, no matter who it is.”
Tom Rampy, an RN at IHB’s San Antonio hub who teaches at the Medical Education Training Campus, echoed that notion, saying he owes his students “the knowledge that they can reach back to IHB with any concerns or issues.” Rampy primarily works with the Navy Preventive Medicine Technician Course and teaches a two-day course each quarter centered on the Eight Standards for Military Immunization.
A lot of work is being done to address vaccine hesitancy, said Laurie Housel, a nurse practitioner at IHB's Fort Bragg, North Carolina hub. That includes outreach through events like a new parent support group, outreach lectures, and the development of a toolkit for health care providers to provide counseling to vaccine-hesitant parents before their babies are born.
"There's a lot of misinformation out there,” Housel said, “and it can be very difficult for families because they hear conflicting things. We understand that."
Suzy Walker, an RN and Immunization Healthcare Specialist, IHB’s “boots on the ground” providing direct support to MTFs, works with the Navy accession site at Great Lakes, Illinois, and Soldier Readiness Programs at Fort Leonard Wood, Missouri, where she provides immunization training and consultation, and assistance with procuring sometimes large amounts of vaccines. Walker spent 27 of her 30 years in the Air National Guard working around immunizations, which she says gives her a kinship with the providers in the clinics she visits.
“You can’t tell me anything that would shock me,” Walker said. “Having seen so much in my career helps me relate better to the people going through it now. It feels great seeing when everything clicks and everyone understands the full scope of what they’re doing.”
The research component of nursing also plays a big part in the IHB mission, as "better understanding leads to better outcomes," said Connie Lohsl, RN with IHB's Vaccine Safety and Evaluation Section. That includes clinical and epidemiologic studies to improve safety, effectiveness, and acceptability of vaccines.
Among the research projects currently ongoing is looking at whether physical exercise is more effective at relieving post-immunization injection-site pain than ibuprofen, and testing to help identify sensitivities to vaccine components.
IHB nurses and nurse practitioners also help conduct in person Standards for Quality Immunization Practice and Immunization Program Leaders courses. The courses, developed by RN Dana Donaldson and the IHB Curriculum and Content Development Office, are geared toward health care providers directly involved in immunization activities, to provide the best experience possible to each patient.
“When you’re educating health care professionals, you’re still giving back to those patients,” said Donaldson, who put herself through nursing school as the single parent of two young children. “If you always err on the side of patient safety – imagine the person you’re caring for is the person you love most in the world – you will always succeed no matter what.”