As a young girl growing up in Oklahoma City, Okla., Yvonne Green, RN, CNM, MSN, dreamed of one day becoming a nurse. Today, she serves as director of women’s health for the Centers for Disease Control and Prevention (CDC) in Atlanta. Her job involves promoting national awareness of a variety of women’s health issues, from breast and cervical cancer early detection to breastfeeding and teen pregnancy. The little girl from Oklahoma has not only achieved her greatest childhood dreams but surpassed them.
Green is one of many minority nurses who have found career satisfaction working for a federal government agency. Utilizing the training and expertise gained from working in traditional clinical, academic or research settings, federal government nurses find their jobs now allow them to impact patient outcomes on a national and even international level.
Green, who has worked in the area of women’s health for most of her career, assumed her current position at the CDC four years ago. In addition to advocating on women’s health issues, she works on education and on monitoring reports and health information for the inclusion of women and minorities. She also establishes working groups to set priorities and goals while working to sensitize researchers to the need for gendered studies.
“There are a lot of challenges and opportunities for minority nurses in the field of women’s health,” says Green, who is African American. “We’ve made great strides over the years, but there is still much work that needs to be done.”
She began her nursing career doing volunteer work at her local hospital while still in high school. After becoming a Certified Nurse-Midwife, Green moved to Atlanta and taught nursing at the university level. Her expertise in the field of women’s health led her to the CDC’s Division of Reproductive Health where she worked for 10 years before accepting her current position.
“At CDC, we strive to recognize trends and to identify issues, such as obesity, that pose a threat to women’s health,” she notes. “Our goal is to help all women lead healthier, safer lives.”
Her office publishes an email newsletter, a print newsletter and a Web site featuring current information on a variety of women’s health topics. The CDC also promotes National Women’s Health Week.
While Green impacts women’s health on a national level, she also remains committed to promoting health education in her own community. “I take our CDC brochures to local health clinics, the library, dry cleaner, flea market, and I mail them to relatives and friends on a regular basis,” she laughs.
Since most federal government projects have long-term outcomes, nurses considering a career with a government agency need to realize they won’t experience the same immediate rewards they see at a patient’s bedside.
“Working in a hospital, you see babies enter the world and help patients regain their health on a daily basis,” Green explains. “In government, the gratification is more long-term and nurses need to set short and long-term markers to gauge their successes.”
Barbara Aranda-Naranjo, RN, PhD, FAAN, has celebrated several such long-term successes in her work helping patients with HIV/AIDS. As deputy director of the Division of Community Based Programs for HIV/AIDS in the U.S. Department of Health and Human Services’ Health Resources and Services Administration (HRSA) in Rockville, Md., Aranda-Naranjo remembers the overwhelming sadness she felt working with HIV-positive pregnant women in South Texas during the early 1990s.
“Back them, we had no idea how to prevent mothers from transmitting the disease to their newborns,” she recalls. “Today, thanks to anti-retroviral therapy, it’s rare to see babies born with HIV/AIDS.”
Aranda-Naranjo, who is Hispanic, had established an impressive track record working with underserved HIV/AIDS patients in the South Texas area. She was a consultant to a Title IV Pediatric AIDS Demonstration Project and served on a number of advisory boards for AIDS organizations. She was also an associate professor in the College of Nursing at the University of the Incarnate Word in San Antonio. Her achievements caught the attention of HRSA leadership, who invited her to join their ranks.
“Barbara is very modest about her accomplishments,” says Deborah Parham, RN, MSPH, PhD, associate administrator for HIV/AIDS at HRSA. “She transformed HIV/AIDS care in South Texas, and we offered her a job where she could share her expertise with the entire nation.”
Aranda-Naranjo admits she hadn’t been aware of the many career opportunities for nurses within the federal government when she was offered the position at HRSA.
“Working at this level provides nurses with an opportunity to impact patient outcomes on a national scale,” she says. “Nurses bring a holistic approach to patient care and that expertise helps them to successfully guide and monitor [federal health] programs that have been legislated.”
Both Aranda-Naranjo and Parham work on the Ryan White Comprehensive AIDS Resource Emergency (CARE) Act Program, enacted in 1990 to fill gaps in care faced by patients with low incomes and little or no health insurance. Parham is responsible for directing the program, which provides medical care, treatment, referrals and social services to people living with and affected by HIV/AIDS throughout the United States and its territories. Working with a staff of 167, she administers a budget of $2.02 billion that funds services for some 530,000 individuals each year.
Aranda-Naranjo oversees the funding and monitoring of more than 500 Ryan White grant programs serving people with HIV/AIDS. These programs focus on providing primary care and early intervention health services.
“We fund a variety of grants to cities, states and community-based organizations that work with HIV/AIDS patients,” explains Parham. “Each of these entities is assigned to a project officer at HRSA, many of whom are nurses.
“It’s very rewarding,” she adds, “to be in a position where we can award grants to organizations that make such a huge impact on the health of HIV/AIDS patients. We are often the last and only hope many of these poor and vulnerable patients have for treatment and medication.”
Parham is one of many nurses working for the federal government who are officers in the U.S. Public Health Service (USPHS) Commissioned Corps. As one of the seven Uniformed Services of the United States, the Commissioned Corps is a specialized career system designed to attract, develop and retain health professionals who provide care to underserved populations around the world, from American Indian reservations to Third World countries. Nurses who serve in the Corps may be assigned to federal, state or international agencies.
Throughout her career, Parham admits to having many inspiring role models and mentors who encouraged her to reach for the stars--or in this case, the stars and stripes.
She followed their advice and today is one of HRSA’s key staff members. She recently made history by becoming the first African-American nurse to be promoted to the rank of rear admiral.
Parham and Aranda-Naranjo both strive to continue the tradition of mentoring by serving as role models to other nurses of color on their staff. “Minority nurses in any arena face challenges,” Aranda-Naranjo asserts. “If you’re a pioneer in your field and the road ahead isn’t paved, the journey can be even harder.”
Janice Phillips, RN, PhD, FAAN, was active in the fight against breast cancer long before she began working for the federal government. Today, her job as program director at the National Institute of Nursing Research (NINR) in Bethesda, Md., one of the National Institutes of Health (NIH), allows her to advocate for breast cancer screening and education in a way that impacts the entire nation.
For Phillips, it was a lifelong passion for research that eventually brought her to a federal career. She wrote her doctoral dissertation on research she had conducted examining breast cancer screening in African-American women of differing employment status. Her interest in research continued long after graduation, leading her to various colleges and universities where she taught nursing courses in community health and oncology nursing. While teaching at the University of Maryland, she became the first African American, as well as one of the youngest individuals ever, to receive the prestigious American Cancer Society Professorship in Oncology Nursing.
In her current position at NINR, Phillips provides technical support and funding to investigators who are submitting applications for research grants on minority health disparities and the special needs of at-risk and underserved populations. For example, she works on grant programs like the NINR Mentored Research Scientist Development Award for Minority Investigators (also known as the Minority K01 grant), which helps support independent research projects by minority nursing faculty.
In this capacity, Phillips is able to utilize her nursing research background to interface with investigators across the country to identify health disparities and implement programs to bridge minority health gaps.
Her work for the federal government has taken her around the world. Phillips recently traveled to South America to conduct breast cancer screening research and to provide education about the risks of undetected breast cancer.
“It’s very rewarding to be able to disseminate valuable screening and education information to underserved patients,” she says. “Without programs such as ours, a large segment of the population would fall through the cracks in the health system.”
Throughout her 27-year career in nursing, Phillips has served as a clinician, researcher, policy regulator, educator and nursing administrator. Her current job utilizes all of her skills.
“Working for the federal government provides nurses with a tremendous opportunity to use cutting-edge research and information to improve the nation’s health,” she emphasizes. “And nurses can help to design behavioral interventions that impact the health of their own communities.”
Leslie Wheelock, RN, MSN, began her nursing career caring for patients as a clinical nurse in the Clinical Center Department of Nursing in the Intramural Program of the National Cancer Institute (NCI). Today, she is continuing her efforts to improve patient outcomes, but instead of helping people on a one-on-one basis, she affects the lives of millions.
As associate director for communication at the U.S. Food and Drug Administration’s Division of Surveillance, Research and Communication Support, Office of Drug Safety, Wheelock works as the agency’s co-lead on the Healthy People 2010 campaign, a national health promotion and disease prevention initiative. She also works with MedWatch, the FDA Safety Information and Adverse Event Reporting Program, which focuses on ensuring medication safety.
This issue received national attention in November 1999, when the Institute of Medicine, part of the National Academy of Sciences, reported that medication errors are blamed for some 7,000 deaths annually. “We’re making a national push toward use of computerized medical records,” says Wheelock. “By utilizing information technology, the risk of medication errors will substantially decrease.”
Nurses who have a strong clinical background can take their skills to the next level by working for the federal government, Wheelock believes. “As a bedside nurse, I learned critical skills such as assessing, implementing and evaluating treatments with patients,” she says. “I still use these skills on a daily basis, but I’m applying them to issues such as medical product safety and health promotion.”
Wheelock, who is of Filipino, Portuguese, Japanese and Spanish descent, has worked for the federal government since 1998, and she claims it’s one of the best jobs she’s ever had. “Although I’m not working in direct patient care, I’m still impacting patient health outcomes,” she stresses. “My job offers me the opportunity to leverage my nursing skills in a wonderful environment where I have a lot of autonomy and can work on the cutting edge of health and medication initiatives.”
To work in the federal sector, it’s helpful for nurses to have an advanced degree. Wheelock notes that 80% to 90% of her non-nursing colleagues at the agency have their doctorates. She is currently working to complete her PhD in adult learning at Virginia Tech. Nurses interested in federal careers should also have good decision-making skills and an interest in keeping up to date with the latest health information and trends, she adds.
Perhaps the only downside is working for an entity where politics can change the scope of your job. “When the country moved from a Democratic to a Republican administration, management changed and so did many of our agendas,” Wheelock explains. “To work for the government, you need to be flexible and realize that your work may be impacted by whatever is currently taking place in the nation.”
On the plus side, the federal government offers its employees job security, competitive salaries and excellent benefits. These include the Federal Employees Retirement System (FERS), a three-tiered retirement plan composed of social security, basic benefits and a tax-deferred thrift savings plan.
“I work in a very collegial atmosphere where everyone is on a first-name basis,” says Wheelock. “Working for the government is an exciting change of pace for nurses. It gives them opportunities to expand on their skills while still impacting patient care.”
• Agency for Healthcare Research and Quality (AHRQ)
• Agency for Toxic Substances and Disease Registry (ATSDR)
• Bureau of Citizenship and Immigration Services (BCIS--formerly the Immigration and Naturalization Service)
• Centers for Medicare & Medicaid Services (CMS)
• Department of Agriculture (USDA)
• Department of Defense (DoD)
• Department of Veterans Affairs (VA)
• Environmental Protection Agency (EPA)
• Federal Bureau of Prisons (BoP)
• Indian Health Service (IHS)
• Occupational Safety and Health Administration (OSHA)
• Office of Personnel Management (OPM--federal employee health programs)
• Social Security Administration (SSA)
• Substance Abuse and Mental Health Services Administration (SAMHSA)
If you have the desire and qualifications to pursue a career with the federal government, the Internet is an excellent place to begin your information search. Most of the federal agencies mentioned in this article have Web sites that include information about employment opportunities, and many agencies are actively hiring nurses.
In addition, the following sites have comprehensive listings of current federal job openings (along with good general information about working for the government). Many positions are not listed under the heading of “nurse,” so be sure to search under other keywords such as “health,” “clinical,” “diabetes,” “cancer,” “public health,” etc.
U.S. Public Health Service Commissioned Corps
U.S. Office of Personnel Management