2 Nurse Leaders at the Peak of Their Public Health Careers Resigned — Here’s Why

 

Two nurses who built careers in federal public health say they made the hardest decision of their professional lives: walking away. 

Nurse practitioners Dena Bushman and Rebekah Stewart recently resigned from the U.S. Public Health Service (USPHS) after learning they could be deployed to immigration detention facilities run by U.S. Immigration and Customs Enforcement (ICE). 

Speaking on the Love n’ Leary Podcast, both nurses described deep ethical concerns about providing care in detention centers where they felt they would have limited ability to protect patient health. 

Their story highlights a growing conversation in healthcare about moral distress, public health ethics, and the role of nurses in government systems. 

What Is the U.S. Public Health Service?

The USPHS Commissioned Corps is one of the eight uniformed services of the United States. It includes more than 5,000 physicians, nurses, pharmacists, and other health professionals who work across federal agencies such as the CDC, FDA, and Indian Health Service.

Officers typically deploy during emergencies such as hurricanes, wildfires, and disease outbreaks, along with other public health crises across the United States.In recent years, officers have also been deployed to immigration detention facilities to provide basic healthcare services to detainees.

Increase Demand for Healthcare Staff

As immigration enforcement increased in 2025, the number of people held in detention also grew. 

According to ICE data cited by NPR:

• About 71,000 people were detained nationwide across more than 200 facilities.
• Nearly 400 Public Health Service officers were deployed to detention centers to help provide medical care.

At the same time, reports from clinicians described challenges including:

• Overcrowded housing areas
• Delays in medications and treatment
• Limited resources for medical care

These concerns have been documented in recent reporting about conditions inside immigration detention facilities.

The same reporting found 32 deaths occurred in ICE custody in 2025, making it one of the deadliest years on record for detainees. 

A Dream Career at the CDC

For both nurses, joining the Public Health Service had been a career goal.

Bushman entered the Epidemic Intelligence Service (EIS) fellowship in 2019, a highly selective CDC program that trains scientists and clinicians in applied epidemiology.

She worked with the New York City Department of Health during the COVID-19 pandemic before later serving as a field epidemiology officer at the Maine Center for Disease Control.

Bushman later led work at CDC headquarters focused on sexually transmitted disease outbreak preparedness and response.

Stewart also joined the EIS program and spent years at CDC working in infectious disease programs including:

• Influenza response
• Tuberculosis outbreak investigations
• National tuberculosis surveillance

Before moving into public health, Stewart spent years as an emergency department nurse and rapid response nurse at Level 1 trauma centers.

Both nurses said they believed they had found the perfect mix of clinical practice and population health.

The Moment Everything Changed

That changed when deployments to immigration detention facilities became more common.

Stewart explained on the podcast that her CDC role was tied directly to her status as a commissioned Public Health Service officer.

Because those roles were linked, leaving the Public Health Service meant leaving her federal position.

Bushman said she was rostered for deployments to an ICE detention facility in Texas and later to Guantanamo Bay, though she ultimately did not deploy.

Both nurses said the assignments created serious ethical concerns about their participation in detention operations.

What Nurses Reported Seeing in Detention Settings

Although neither nurse ultimately served in ICE detention centers, Stewart had previously deployed to Customs and Border Protection facilities in 2019. 

She described seeing dozens of women crowded into a single concrete cell, many of them sleeping on the floor, while she had little authority to change their conditions. Stewart said one of the few improvements she was able to help facilitate during her deployment was convincing officers to allow detainees to use portable showers outside the facility. 

Other public health officers have reported similar concerns in detention facilities, including delays in care and limited resources for treatment.

Moral Distress in Nursing

The nurses described their experience as moral distress, a term used when clinicians know the right course of action but feel unable to carry it out due to institutional barriers. 

For Bushman and Stewart, the ethical conflict eventually led to resignation. Stewart left the Public Health Service in October 2025. Bushman resigned on January 6.

What Happens Next

Both nurses say they still believe deeply in public health work. 

Bushman has accepted a new role in addiction medicine, providing care to patients with opioid use disorder and helping develop new population health models. 

Stewart said she plans to continue working in health justice and community advocacy, though she is still exploring her next professional role. 

Both emphasized the importance of nurses using their voices.

Bushman encouraged nurses to:

• Speak up about ethical concerns
• Contact elected officials
• Support community organizations
• Participate in advocacy efforts

These suggestions were shared directly during the podcast conversation.

Stewart also urged nurses to think broadly about who their “patients” are, noting that nursing care extends beyond individual patients to entire communities. 

🤔Nurses, would you stay in a role where your ethical values conflicted with workplace policies? Share your thoughts in the discussion forum below!