Saturday was the first day in over 21 years that Myra Howard Johnson was not a staff member of the Bladen County Health Department. She began her career in the lowest level nurse position in North Carolina Public Health and culminated her career as Bladen County's Health Director-a position she resigned to return to her "first love," patient care.

"I am first and foremost a nurse," said Johnson in a Tuesday interview, "and that's the primary reason I chose to leave health care administration."

In announcing her decision to step down at the October meeting of the Board of Health, Johnson told the board members she wanted to get back into the front line of healthcare, working with patients. Friday, December 17, was her last day on the job.

"Nothing can make you feel as good about your chosen career (nursing) as the feedback you get from patients and their families," said Johnson. "In patient care, you know you've made a direct difference in a person's life. You can feel it in your bones, so to speak. You can see it in their faces and in the faces of their family members.

"Another thing that is so gratifying about nursing is being able to help people to become self sufficient regarding many of their health needs," said Johnson. "For example, when you attend to someone who is diabetic, they may be very nervous about the things they need to do to care for themselves, such as eating properly, or administering their own insulin.

"But as you work with them and instruct them on how to properly care for themselves, you see that they become more at ease with what they have to do. This gives you a great sense of satisfaction that you are doing something worthwhile."

Johnson said that much of her professional career has been in jobs that involved direct patient care.

"The majority of my career in public health has been in patient care. Not until I became Interim Health Director in 1997 did I have a job that did not involve direct care.

Did not aspire to be Health Director

"It never was a dream of mine to be a health director," she explained. "It just sort of happened. By that, I'm not saying that I regret it. I've grown tremendously as a person in the position. It's just that it's not me. I'm more comfortable and feel more useful caring for patients than I do administering."

A Cypress Creek-area native and 1980 graduate of East Bladen High School, Johnson said she had been interested in the medical profession since she was a child.

"My dad sort of guided me into the nursing profession," said Johnson, smiling.

She entered the Associates Degree in Nursing (ADN) program at Sampson Technical College (now Sampson Community College), where she graduated in 1982.

Her nursing career began as a staff nurse in Sampson Memorial Hospital (now Sampson Regional Medical Center), where she worked for the next 14 months. Shortly after starting to work there, she married her "childhood sweetheart" Ricky Johnson.

Had long-time interest in public health

From the time she entered the nursing profession, she had been interested in public health.

"I had an aunt who had been in public health for numerous years and she sort of encouraged me to consider entering public health," said Johnson. "I decided to apply after I had worked in the hospital for a year. A more or less set requirement of (North Carolina) Public Health is that a nurse have at least one year of experience before being hired.

"I applied to both Bladen and Sampson counties, and Bladen called first," said Johnson.

Johnson began working as a Public Health Nurse I in a general nurse position, but she soon went to Home Health, where she would remain until she became Director of Nursing in 1987 at age 25. She remained in that position until 1997.

Appointed Interim Director

She completed a Bachelor of Management degree from Mt. Olive College in 1997, and was selected by the Health Board to be the Interim Health Director that fall.

"I wasn't really looking at becoming health director when the board asked me to serve as Interim Director," Johnson said. "But after an extensive search, the board was unable to find a director. They approached me and asked if I would consider completing requirements to apply for the position of Director."

Johnson entered a Master of Science in Public Administration with a health care concentration through Central Michigan University. She graduated from the program in the fall of 1999.

Becomes Health Director

At the time she graduated, the Board of Health had still not hired a Health Director and Johnson applied. She officially became the Bladen County Health Director in November 1999.

Johnson said her biggest challenges as Health Director have been adapting to the changes, particularly those that have been implemented as a result of 9/11, such as developing the various bio-terrorism plans required by Homeland Security.

Another issue that has complicated healthcare administration, she said, is the privacy provisions of HIPAA (Health Insurance Portability & Accountability Act of 1996).

"Another challenge has been managing personalities and managing all the programs we're charged with the responsibility of administering," Johnson said.

"In today's environment, public health is very diverse. We work with everything from approving septic systems in Environmental Health to cleaning the animal shelter in Animal Control. Every division has its own unique circumstances and challenges," she explained.

"It got to the point that I often felt that I was only skimming over the issues and never having the time to fully devote to some of issues I felt to be critical," she said.

Decides to leave administration

"I've really enjoyed my time as director, but I really think it is time for me to get back into something that is more patient-care oriented," she said. "I've spent half my life and virtually all of my adult life in public health. I'm looking forward to working in a different area for a while."

"It's been a great 21 years here at the Health Department," Johnson said. "I've made some good decisions and I've made some bad decisions. But overall, I've grown, both personally and professionally. I've made lifelong friends that I will always cherish.

"I've had the good fortune of working with some of the best employees anywhere," she said, "both at the Health Department and in the other divisions of county government.

"I also have a much better understanding of how county government works and have learned to respect and appreciate the full scope of the responsibilities of our elected officials," she added.

Johnson said that she has not yet committed to another job but expects to return to work soon in a nursing position.

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