About Us

Letha Fisher MSN, RN, CHC

Director, Public Health Nursing

Public Health Nursing is a core foundation within the Virginia Department of Health and nurses are critical in the overall execution of health promotion, disease prevention and community health and wellness across the entire lifespan. This office is under the leadership of Letha Fisher MSN, RN, CHC. Fisher’s clinical experience and extensive background in leading healthcare quality improvement, risk management and clinical process improvement spans over 25 years and across both private and public healthcare settings. She has a master’s degree in nursing from Jefferson College of Health Sciences and a bachelor’s degree in nursing leadership from Old Dominion University. She is also certified in healthcare compliance and regulations from the Healthcare Compliance Board and is a Lean Six Sigma Green Belt.  Letha is a member of the Virginia Nurses Association, Member of the Honor Society of Nursing, Sigma Theta Tau, International, American Health Quality Center, Healthcare Compliance Board, Virginia Public Health Association and is an American Red Cross Nurse.


VDH Vision

Our Vision: Healthy people in healthy communities

VDH Department of Nursing – Philosophy

Public health nursing is the practice of “promoting and protecting the health of populations using knowledge from nursing, social, and public health sciences” (APHA, PHN Section, 1996). Public health nursing practice is guided by the Core Public Health Functions (Institute of Medicine, 1988) the 10 Essential Public Health Services (Division of Public Health Services, HRSA, 2004), Scope and Standards of Public Health Nursing Practice (Quad Council of Public Health Nursing Organizations & American Nurses Association, 1999), the Nurse Practice Act (Code of Virginia, Title 54), the Code of Ethics for Nurses (ANA, 2001) and PHN Competencies (ASTDN, 2003).

Partnership is a hallmark of public health nursing practice. Subscribing to the Healthy People 2010 goal of ‘Healthy People in Healthy Communities’, public health nurses work with and among communities (individuals and organizations) to achieve the outcome of population health. Public health nurses recognize that health is a social as well as an individual responsibility and work collaboratively with individuals, families, groups and communities to assure conditions in which people can be healthy.

The specialty of public health nursing focuses the nurse’s practice on population health, with nursing interventions at the individual/family, group and community levels. The tenets of the ecological model infer that health and well-being are affected by interaction among the multiple factors that determine health. A primary role of the public health nurse is to assess the determinants of health, utilize appropriate resources, remove access barriers and identify, develop, and/or implement appropriate health care services at all levels of prevention.

Definition of Terms:

Population – viewed as persons/individuals, families, groups and communities, comprised of internal biological and behavioral characteristics and external physical, environmental, social, and political factors.

Health – a complex, dynamic state of well-being, shaped by the “interconnectedness of the biological, behavioral, physical and environmental domains” (Institute of Medicine, 1993, p 51).

Ecological Model – a variety of elements (e.g., laws, policies, cultural beliefs and social norms and influence, income, health, living and working conditions, behavior, age, gender and biological factors) that contribute to health and illness at the individual and population level (McGinnis, 2002 & IOM, 2002).

Caring – assistive, enabling, supportive or facilitative behaviors toward or for the person/individual, family, group and community to promote health, prevent disease and facilitate healing (Hitchcock, Schubert, & Thomas, 1999).