Finding My Niche in Public Health – What I Do in My Day Job

I don’t often talk about what I do – like my paycheck job, the job that pays for food, rent, and children’s college tuition. But today, because it is my biggest and busiest day of the year, I want to talk about what I do. Because I have found my niche — as a nurse in public health working with patient navigators and community health workers.

I have always loved that I am a nurse. I have always worn the title RN or Registered Nurse with deep pride. First because I couldn’t believe I actually made it through school;second because I love the profession. It challenges my weaknesses and gives voice to my strengths.

But though I have always loved being a nurse, I’ve not always been a good nurse. There was the fear factor that I would do something wrong in my early days, there was an insecurity in my skill set, a sense that I still didn’t really know where I fit as a nurse.

While living overseas in Pakistan and Egypt I worked sporadically – private duty cases, teaching childbirth education, and accompanying women during labor and childbirth.

When we moved to the United States I began working as a visiting nurse, going into homes and caring for patients who had just been released from the hospital. I was restless. I knew that clinical nursing was only half the picture of what I wanted to be doing.

It was during that time I made a job change and discovered public health. Public health allowed me to use my clinical skills as well as my creativity in developing programs and presentations to use in communities. I learned more about the big picture of health and why it matters. It allowed me to focus on underserved communities, communities that don’t have as many resources like immigrant and refugee communities, like poor minority communities. I began to understand more about working with people who have the greatest need and where, with the least amount of money, you can make the biggest impact. I ended up specifically working in preventative health screening – breast, cervical, colorectal, and prostate screening. Connecting patients to doctors and clinics so that instead of waiting until a cancer lump grew and the cancer spread, the patient would be screened early; so that instead of coping with chemotherapy and drastic life changes, they would have a minor procedure.

I found my niche in a space where I began educating community health workers and patient navigators, helping them see their natural abilities as valuable and adding clinical knowledge and other skills so they could work in their own communities and effect change. These men and women were bilingual and multicultural, but often without opportunities for higher education they struggled to find a place where those skills mattered.  They are from all over the world and had made their way by various paths to the United States. They hail from Spain and Brazil, Portugal and Dominican Republic; Puerto Rico and China; Bangladesh and Somalia; the Sudan and Haiti. And they are finding their own niche in a country that is far different from the countries and places where most of them grew up.

So today we hold a conference that allows these patient navigators and community health workers to come together and learn, to come together and present what they are doing, to come together and be celebrated, to realize that they are a valuable part of our health care system.

But back to the niche – an amazing thing has happened through this process. I realize that the skills of communicating and negotiating across cultures are used regularly in this job. Those skills I felt would lie dormant and not be used again now allow me to build relationships and connections, encourage and voice understanding of the experiences of both patients and community health workers. Because all of us are outsiders that have gone through the process of adjusting to an unfamiliar world, working to carve out a niche where we can use who we are to make a small difference in the lives of some of the most vulnerable in our communities. 

If you are interested in hearing from some of the people I work with about the amazing work they do take a look at this video that we are showing today at the conference. It’s about 8 minutes long and includes both animation and stories from the community health workers. It was created by my son, Micah.


12 thoughts on “Finding My Niche in Public Health – What I Do in My Day Job

  1. Marilyn, I love this…thanks for sharing! I’ve got a long, personal, still-in-process story of how God is currently guiding me into a new “niche” in my own life. I won’t go into great detail here…but, basically, after nearly 15 years of being a fulltime stay-at-home mom for my 4 kids, I’ve been seeking Him over the past year or so, asking “What’s next?” A few months ago, He clearly answered me…yet in the middle of a very intense and scary (though, thankfully, short-lived) set of circumstances. It was in receiving much-needed, hands-on, care and compassion in that dark and desperate place, that God gently whispered, “This is what I want you to do.” In other words, He was asking me to care for others in the same way I was receiving care right at that vulnerable moment…it was very powerful. The future is exciting and scary all at the same time. I’m not sure how this will all play out…but I’ve taken the first steps in following, and I have total faith in the One who is leading me.


    1. Oh – I want more!! Would love to have an email conversation about this. I know so well how this goes – the whole process of restlessness, getting a thought, having God confirm it … and others and then tentatively moving forward knowing it may not be earth shattering to others but to us…it is!


  2. Marilyn, this mom is so proud! And as Micah’s Grandma, too. What you are doing is amazing, and I am so grateful for how God is using you in this very important work.
    Love you much!


    1. Thank you so much Mom! It was a great conference. The physician who spoke is over 80 and an amazing man – so happy I was able to get him!


  3. Wow! I knew you were remarkable and a wealth of compassion and knowledge. Didn’t completely know how it all worked! So glad I’m your cousin and so proud – of Micah too. What a fabulous presentation. Thanks for this. Love you lots.


  4. You and Micah did a great job explaining what we do as public health! Looking further than the non-compliant label. I’ve been enjoying all of your blogs.


    1. So fun to hear from you. I think of you and some of the talks we had so long ago – would love to catch up. I love that we are still in the same kind of work and glad you liked what Micah did. He lives in LA and edits for a TV series so I feel really fortunate to have him. He’s done a few others as well for me. They are all really great – As soon as we get all of them on Vimeo I’ll send you the links. I think you’ll like them – definitely know you’ll appreciate the message. Some of the reason I do this film is so that we can highlight the work artistically – that speaks much louder than trying to convince the policy makers that what we do is important!


  5. Ooh, I like this Marilyn. It was only recently that I realized you are an RN (when I was browsing some of your old blog posts I think). And now, I see even more why you would love Call the Midwife, as Jenny falls more and more in love with the nursing profession, not just midwifery. Really neat to see all your skills used there. There have been small instances of this type of thing in my life, of thinking I wouldn’t use such and such skill again, so I understand just a little bit of the thrill when you get when you DO use it.


    1. It’s so interesting isn’t it – how we look back and see how all of these stepping stones came together and we reached the pond…maybe not a great metaphor. Thought of you all afternoon. We have a large Cambodian community about 45 minutes north of Boston. We had a presentation at the conference called Journey of Healing – it is a program begun byy a few women and men in their late 20’s – it is to reconnect youth to both Cambodian culture and to a greater understanding of the pain and suffering their parents went through in the Khmer Rouge era. The parents struggle because they still have residual trauma and the disconnect when their kids get into gangs, do poorly at school, don’t respect the culture – it’s all too much. This program is developmentally geared for teens and helps them understand more of their family and collective history using art, dance, stories etc. It is amazing. I’ve worked with this community before but never heard about this program. I wanted to weep – the deep suffering made more profound by the parents feeling they are losing their children feels too much to bear. Yet here is a program that instead of getting overwhelmed with the pain, reaches into it to help reconnect families and bring about a greater sense of belonging. You would have loved it…of course – you are living it!


      1. It is so wonderful to hear of programs making positive change like this. The Cambodian people as a whole all have PTSD, and it’s even been passed on to their children (this is the first population researchers have seen it in). It’s very sad. What you’re talking about here, sounds so burdensome, to lose your country and then have to start over in a new country only to feel you are losing your children. So glad to hear someone is focusing on that. There’s an NGO called Children in Families that does some really amazing work here in Cambodia, and I just interviewed the founder and am going to write a series about it. I’m often discouraged at the state of brokenness among families here, and this interview was so encouraging because she was describing solutions to the problems here that lie WITH the Cambodian people. I love that, Cambodians helping Cambodians. Glad your day went well, and hope you can rest now!


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