The Tribune recently sat down with Custer County Public Health Director Sara Bertelsen (SB), just back from maternity leave and ready to embark on a new year with new programs. The resulting interview has been edited for length and clarity.
Tribune: Let’s start with the basics – your background and qualifications, and your role at Custer County Public Health.
SB: My role is Director, so I run the Public Heath Department. I became a BSN-degreed nurse in 2015 and passed my board exams in 2016. I went to Clarkson College in Omaha NE, which is a very competitive school. It has only a 33 percent acceptance rate, and you have to maintain an 80 percent test average. It definitely prepared me not only in a nursing role but a leadership role.
Tribune: Did you start out on a public health nursing track from the beginning?
SB: I started with a community nursing course – Clarkson College did a good job giving us a wide range of exposure to nursing fields. My healthcare career started in high school, with a “health and sciences” academy. It starts junior year and goes to senior year. I started college level courses at age 15. Senior year I took CNA and EMT courses. I was very motivated from a young age – I was a certified CNA (Certified Nurse Assistant) as of graduation. I worked in a hospital and also worked for a daycare center during high school. At the hospital I got to transfer to all different floors and departments, and got to know where my strengths and preferences were.
I started my journey in women’s health nursing with the women and children’s floors – I really got my passion for women’s health there. The hospital I worked for, Nebraska Medicine, is a major hospital that handles high-risk pregnancies. They also did women’s oncology, working on all different kinds of cancers. I got to see the beginning of life and end of life while nursing there.
In order to work with high-risk pregnancies, you have to work for a year on other nursing floors or in postpartum care. I thought I was going to go into labor and delivery nursing, because who doesn’t love babies? But right before my year was up, we moved to Colorado – that changed things! I got a compact nursing license [which allows nurses to transfer their licensure to another state within the compact.] I moved to the medical center in Aurora, with hopes for still training for labor and delivery. I had a pathway choice, I could get certification in labor and delivery, breast-feeding or leadership. I went for a leadership role. It gave me more skills to develop. I loved being a team leader! I like to be able to guide a team toward a common mission. I did that for a while, then COVID hit.
Tribune: Then COVID hit. How did that change things for you and your staff?
SB: Mothers were coming in for delivery and testing positive for COVID. I had to deal with moms and babies, keeping them safe. For the protection of the babies, mothers had to be separated if their mothers were infected with COVID, we as nurses had to operate in those conditions with low quality masks. We put on a “baby fair” pre-COVID, to get moms to deliver at our maternal center. We had everything! Bouncy houses, baby seats for giveaway. It was great, and it worked until COVID hit.
That’s where my vision turned. The hospital scene changed. We were so short-staffed, they sent us to ER with psych and addiction patients, which is not what I was trained for. So we decided to move. My parents had moved to Pueblo, and we were looking for something more affordable than the Denver area, so we moved to Pueblo. My next job, I was part of Nurse Family Partnership, which is a program to guide first-time low-income mothers with their babies, from pregnancy to age 2. I loved that job – I helped some really tough cases on the east side of Pueblo.
Things shifted again when we started going back into the homes after the first COVID wave subsided. Hal and Mary Walter got us looking into Westcliffe – Mary had actually been my boss in Pueblo.
I started looking into substitute teaching, then went into school nursing from there. When the then-current nurse decided to move on, I got the full-time job – and I loved that too! I got to experience the upsides and the downsides of school nursing. I had to oversee the health of 300 kids. I revitalized the filing system, got immunization records updated, and best of all, got vision/hearing screens with the help of Custer County Public Health. With [Public Health nurse] Sherry Wyatt retiring, I interviewed here and got a Public Health nursing job.
It’s amazing, you hit everything and everyone in the community – babies, veterans, everyone. It’s a lot sometimes, with grant-writing and administration on top of patient care. Then I became the Interim Director and we had a nurse pass away, and I was pregnant all at the same time. Getting to be Interim Director was a gift, because I got to see what this is all about. I pride myself on loving my community and networking. I got to interview [for Public Health Director] and became Director just before I delivered.
The thill of leadership is, you get everything thrown at you and you overcome – I want to rebrand Public Health.
Tribune: On that note, what exactly is “public health?”
SB: Our department’s mission statement is “to promote healthy lifestyles, prevent disease, and protect health and environment.” Public Health focuses on prevention and education – that’s the heart and soul of public health. We are not just here to educate and prevent bad things from happening. We are looking to strengthen our network of healthcare professionals and wellness and care options. Frontier healthcare is really different than what I’m used to.
Tribune: What are most your most used services?
SB: Immunization is our strongest program. We are revitalizing it to offer more state-funded programs for underinsured and uninsured adults as well as children. Those interested in finding out about those programs just have to come and talk to us. We also have programs for maternal and child health, emergency preparedness, and things like radon test kits. Epidemiology, which is the tracking of diseases countywide, statewide, and nationwide. We also do substance abuse service coordination. Lastly, through public health, children can get dental work, screenings and cleanings, vision testing and new glasses.
Tribune: What new services are you planning to offer?
SB: We are working on getting free sports physicals to serve about 100 kids countywide. Also, very importantly, we are rebuilding our rabies program – we are working with law enforcement and wildlife officials on that program, educating people on what to do if they are dealing with animal bites or a potentially rabid animal. This is huge!
Tribune: What’s the biggest thing you wish people knew about public health?
SB: What we are! What we do! Where we are located (laughing)! We can’t treat medical conditions or injuries – we are not first responders. We are in the prevention business, but we are also here to support you in your healthcare journey, and we can also refer you to other resources. We want to do more healthcare coordination services, not just for children but also for adults. The Custer County Hospital District Board is looking into that too. We want to bring home health care to the Valley. We are trying to get CNA courses here at the high school. Finally, we are looking to form a Family Voices Council to help families of any age to come and voice their needs. A collaboration with Custer County Department of Human Services is possible. We are in the beginning stages of finding Custer County families – we are looking for different kinds of families and caregiver situations. We need to hear from our families on what they need.
Tribune: What are the biggest threats/challenges to public health you see upcoming?
SB: The current political climate may change the way public health operates. We have to be strategic in our efforts – we have already started preparing for this. We no longer try to go out and get a grant just because – we have to be laser-focused on what Custer County needs.
Tribune: How do policy changes at the federal level (e.g., cutting off grant proposals at NIH, etc) affect what Public Health does at a local level?
SB: Our core services have to be funded – and that’s where having a diverse staff with diverse strengths who can cross-train is so critical. We are here for the long haul, and we already talking to the commissioners acting as the Board of Health. We are very excited to be working with Commissioner Epp on BOH training and HIPAA training – we are really trying to professionalize both inside and outside the department.
Tribune: Anything else you would like to add?
SB: We want to be welcoming to the community. Please help us identify gaps in service, please attend BOH meetings, visit the public health website. We are looking for Medical Corps volunteers – we would love to see people get involved!
The Custer County Public Health Department Office is located at 10 Hermit Lane, Suite 5, in Sliver Cliff. Their website is at https://www.custerpha.com/. For more information on the Public Health Department or to set up an appointment, call 719-783-3369 or email publichealth@custercounty-co.gov.
– Elliot Jackson