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Healthcare Insights from the Frontlines: A Nurse’s Pursuit of an MPH

Lynet Kituku, an ER nurse and an online MPH student, reflects on how her studies are reshaping her approach to patient care.

By day, Lynet Kituku is an ER nurse caring for individual patients at a Level 1 trauma hospital in St. Louis, Mo.; by night, she is an Online MPH student at the School of Public Health contemplating the health of populations.

Kituku’s sister, 14 years her elder, was the first nurse in the family. She administers vaccines, discusses family planning, and helps deliver babies at a community health clinic in Kenya, where Kituku grew up. Seeing how much joy the job brought her sister, Kituku decided she wanted to become a nurse too. After earning her bachelor’s degree in nursing from Daystar University in Nairobi, she worked for several years in emergency departments in Kenya before resettling in the United States, where opportunities for registered nurses are more abundant and better compensated, she says.

While Kituku found what she was looking for at Howard University in Washington, DC, it was not long before she knew she was ready to pursue further education and apply her healthcare expertise in another arena. Nursing, particularly in an emergency department, can be exhausting, says Kituku. “It drains you physically and mentally.”

As a nursing student in Nairobi, Kituku dreamed of working in the intensive care unit but opted for the ER when the extra year of study for ICU credentials proved too costly. While she has more savings after immigrating to the US, she still needed an affordable graduate program. She found the Online MPH program at SPH and, with less than a week remaining before the deadline, submitted her application. Upon her acceptance, she began the program in spring 2024.

Reflecting on the past year, during which she often completed assignments after working 12-hour shifts, 3-4 days a week, Kituku says, “It has been great! Sometimes the reading can be a lot, but it opens your mind. I am not the same person I was a year ago. Now, I look at patients and how they are presenting into the emergency department differently.”

Kituku especially appreciated Modules 1 and 3 of the program, which introduced her to basics of quantitative and qualitative research and provided her the opportunity to explore a specific research method of her choice in greater depth. She is a big fan of math and biostatistics, so she chose to focus on metanalysis. While the large amount of data involved can be intimidating, she says she likes the efficiency of the approach.

Kituku encourages others in healthcare to consider studying public health. The field opens a lot of doors, she says. “You can understand [data] analysis. You can go through a research paper and gather information.”

Kituku shared with SPH how her experience in the Online MPH program has changed her view of healthcare.

Do find that the public health concepts you are learning in the Online MPH program apply to your work in healthcare, and conversely, do you ever apply things you have observed at work to your studies?

Yes, I am now able to appreciate how [good health] does not just happen, it starts with the social determinants of health. My role as a nurse is to educate—to educate patients on why they need to do this or why they need to do that. Ultimately, it is their decision whether to do it or not, but I have learned that I need to emphasize education. I think [health] equity is something that we can support by ensuring that insurance options are accommodating. Right now, they are not. Insurance is very expensive, and most people are not able to afford it. If we had policies that would dictate what insurance could actually charge people, it could work for everyone.

Could you give an example of how the social determinants of health might impact the reasons patients show up in the emergency department?

Many of the patients… are not following up with their doctors regularly to just check what is happening to their body because they have not been taught that this is something they need to do. Even when they have diabetes or hypertension, for instance, they still do not follow up with their primary care doctors. The other problem is that they are not able to afford these services—they are not able to afford insurance to cover visits with their primary care doctors. They probably take their medication, but they do not end up getting checked for complications. A patient diagnosed with diabetes may come back to the ED and now they have ulcers, they need an amputation, or it is affecting their vision. [All because] they did not know the importance of preventative care, and they did not have enough resources and funds to cover visits to a primary care doctor.

Did you see something similar happening in Kenya, or is the system there different?

I would say it is the same, especially with insurance. How I grew up is, most of these [health] conditions are associated with aging and so that is when you start following up with a doctor—when you start having these conditions, not before. There is a lack of education to encourage people to go to the hospital for just a regular checkup, and then, once they have a chronic condition, to follow up with a healthcare provider to try to minimize any adverse effects that could happen later in life.

If you could wave a magic wand and solve one public health problem. What would it be and why?

It would be [health] insurance policies. Sometimes you get really sick people in the emergency [department], and then sometimes you get people who are not as sick and could just go to urgent care and get all the care that they need from there—but they do not have insurance, so they are forced to stay in the waiting area. We have been having really long wait times in the emergency department in St. Louis. You will find someone waiting for 12 hours, 15 hours, for something that could have been solved at an urgent care, but they are not able to go because they lack insurance. The emergency department, how we operate is we cannot say no to you. We will give you the care. We will give you the prescription. I will not know whether you are going to be able to refill it, but you can always come back with whatever crisis you are going through.

Learn more about Boston University School of Public Health’s Online MPH

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