Voice, Fall 2012 by Boston College

william f. connell

school of nur sing Fall 2012

voice

Thinking globally, exploring locally An American-Swiss exchange

From the Dean

Dear Friends, Health care questions are on everyone’s minds in the fall of 2012, raised against a backdrop of historical events that include the U.S. Supreme Court decision to uphold the constitutionality of the Affordable Care Act and a presidential election that, regardless of its outcome, will significantly shape health care in the United States.

Photograph: Gary Wayne Gilbert

Fall 2012 news 4 New grants, faculty honors, and nurse leaders at the 2012 reunion

features

What interventions bring the best outcomes? How do we ensure a system that is affordable, efficient, and universal? How do we pay for it? What can we do to diminish health disparities?

6 Dean takes on prominent research role

As these issues are debated, faculty of the William F. Connell School of Nursing are educating future nurse leaders who will be prepared to help answer critical questions about our health care system.

7 Pioneering prevention

I hope you enjoy reading this issue of Voice, which features a story on a cross-cultural, interdisciplinary global health course the Connell School hosted last summer. I am sure you will find reports on this year’s reunion honoring CSON alumni who are health care leaders inspiring, and I am quite sure you will enjoy getting to meet our new associate dean for graduate studies and new faculty.

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Susan Gennaro named to National Advisory Council for Nursing Research New associate dean probes adolescent risks

8 Thinking globally, exploring locally An American-Swiss exchange

12 Turning hunches into research Connell faculty advance hospital nursing science

16 Welcome, new faculty

This is an exciting time to be a nurse, and to recognize the many ways in which our faculty, alumni, and students are really making a difference.

Yours,

18 Faculty publications

achievements Nurse practitioners under pressure Evaluating human patient simulators

Susan Gennaro Dean corrections

dean Susan Gennaro editor Maureen Dezell managing editor Tracy Bienen

Voice Cover:2

contributors Jane Dornbusch Alicia Potter Debra Bradley Ruder

photographers Jared Charney Caitlin Cunningham Gary Wayne Gilbert Josh Levine Lee Pellegrini

Voice is published by the William F. Connell School of Nursing and the Boston College Office of Marketing Communications. Letters and comments are welcome: csonalum@bc.edu Communications Specialist William F. Connell School of Nursing, Boston College 140 Commonwealth Avenue Chestnut Hill, MA 02467

It was Ashley Thibodeau ’12 who summarized the experiences of 10 CSON students who are helping to deliver community health care in Haiti in “CSON Students Present Research at Symposium,” on page five of the Voice summer 2012 issue. Clinical Assistant Professor Stacy Garrity (not Garrety) team-taught a graduate course in nursing ethics with Richard Ross, S.J., the subject of the profile “Nursing for Others: A Jesuit Priest at the Connell School” (pages 14–15). Ye, L., A. Malhotra, J.T. Arnedt, M.S. Aloia, “Gender Differences in Adherence to Positive Airway Pressure Treatment in Obstructive Sleep Apnea,” Sleep: Journal of Sleep and Sleep Disorders Research 34 (2011): A309.

On the cover: Students from Boston College and Swiss universities Haute Ecole de Santé Vaud (HESAV) and Haute Ecole de la Santé La Source (ELS) visit the Massachusetts General Hospital Ether Dome during Global Healthcare: Meeting Challenges and Making Connections, a four-week international exchange course at the Connell School last summer. Photograph: Caitlin Cunningham Top: Dean Susan Gennaro, Ann Riley Finck ’66, and Genevieve V. Foley ’66 at the CSON reunion. Photograph: Jared Charney Middle: Swiss students Anne-Sophie Reymond and Nacef Wesselbel consider ethical decision making during the Global Healthcare course. Photograph: Lee Pellegrini

Bottom left: Professor Dorothy Jones, director of Massachusetts General Hospital’s Munn Center for Nursing Research. Photograph: Josh Levine

Bottom right: Assistant Professor Viola Benavente. Photograph: Caitlin Cunningham

Fall 2012

News hrsa grant: diabetes management Boston College has partnered with Brigham and Women’s Hospital on a two-year initiative, funded by the U.S. Department of Health and Human Services’ Health Resources Service Administration (HRSA), to evaluate whether expanded diabetes management services at the hospital will shorten patient stays, lower rehospitalization rates, and reduce average blood sugar (glucose) levels measured in the lab test HbA1c. The project, “Diabetes Management for Surgical Patients: A Team Approach,” funds graduate students in Boston College’s Connell School of Nursing and Graduate School of Social Work to work with hospital physicians and nurses to design educational programs that include didactic and practical training for an interdisciplinary health care team, according to Jane Ashley, a Connell School associate professor with 25 years’ experience in education and 30 years of clinical practice. Ashley is managing the project with Patricia Underwood, M.S. ’08, Ph.D. ’11, a veteran nurse practitioner and research fellow in the endocrine division of Brigham and Women’s, who approached Boston College looking for a collaborator with an expertise in education.

Kelleher Award recipients: Mairead Hickey ’72, Genevieve V. Foley ’66, Ann Riley Finck ’66, and Elizabeth Brown ’85. Photograph: Jared Charney

reunion 2012: nurse leaders

Patricia Underwood, M.S. ’08, Ph.D. ’11, and Associate Professor Jane Ashley. Photograph: Lee Pellegrini

price foundation grant benefits kiln program The Price Family Foundation has pledged $540,000 over three years to sustain and expand the Connell School’s Keys to Inclusive Leadership in Nursing (KILN) program. KILN recruits and supports students from underresourced backgrounds, and encourages their development as future nurse leaders. The Price grant will provide financial, mentoring, and other critical supports to 50 undergraduate and graduate nursing students.

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faculty honors Among Connell School of Nursing faculty who earned accolades recently were Barbara Wolfe, professor and associate dean for research, and Assistant Professor Lichuan Ye. The American Psychiatric Nurses Association presented Wolfe with its Recognition of Service Certificate at the association’s 10th annual Clinical Psychopharmacology Institute. Ye received an Educational Projects Award from the American Sleep Medicine Foundation.

Some 100 Connell School alumni, faculty, family, and friends turned out on June 1 for Reunion 2012. Dean Susan Gennaro presented the fourth annual Dean Rita P. Kelleher Award to Mairead Hickey ’72, executive vice president and chief operating officer of Brigham and Women’s Hospital. Named for the Connell School’s first faculty member and longtime dean, the award is given to a nursing school graduate who exemplifies the Boston College nurse: a nursing leader who contributes to the field with intelligence, knowledge, compassion, and care. Also at the reunion, the Alumni Association honored Terry Fulmer, M.S. ’77, Ph.D. ’83, dean of Northeastern University’s Bouvé College of Health Sciences, with the William C. McInnes, S.J., ’44 Award for Professional Excellence. The presentations were followed by a discussion about health care leadership with Hickey and Boston College Magazine editor Ben Birnbaum, then a reception. www.bc.edu/csonreunion

Terry Fulmer, M.S. ’77, Ph.D. ’83. Photograph: Jared Charney

Fall 2012

Dean Susan Gennaro named to National Advisory Council for Nursing Research BY JANE DORNBUSCH

onnell school of nursing dean susan

Gennaro was appointed last spring to the National Advisory Council for Nursing Research of the National Institute of Nursing Research, a division of the National Institutes of Health (NIH) and the primary federal agency that supports nursing research. U.S. Secretary of Health and Human Services Kathleen Sebelius named Gennaro to the 15-member council, which focuses on health promotion and disease prevention, improving quality of life, eliminating health disparities, and addressing end-of-life issues. A passionate supporter of nursing research, Gennaro has long been involved with the institute, as both a grant recipient and a member of a study section doing initial grant reviews. The Connell School dean “has been a leader in the field for some time,” said National Institute of Nursing Research Director Patricia A. Grady, Ph.D., RN, FAAN. “She is known to us because of her important research on women in the perinatal period and on the health of women and children.” Gennaro’s leadership in education and scholarship was a factor in her appointment too, said Grady. The dean, who holds a doctorate from the University of Alabama, came to CSON in 2008 from New York University, where she was the Florence and William Downs Professor of Nursing Research at the College of Nursing. She is also the editor of Sigma Theta Tau’s Journal of Nursing Scholarship. Gennaro said that, although she has enjoyed her study section work, she looks forward to the new role. “It’s a different opportunity,” she said. “One is picking grants; the other is setting priorities and setting the course. It’s a broader view [of trends in nursing research].” Among the research projects funded by the nursing institute are a screening program that can help identify new mothers at risk for postpartum depression; a study that looked at family support and asthma outcomes in

Voice

pioneering prevention New associate dean probes adolescent risks BY ALICIA POTTER

adolescents; and a report describing how grandmothers involved in child rearing are at risk for high levels of stress and, consequently, poorer health. “It’s helpful to see the direction in which things are going, to see the bigger picture of what helps to inform health care,” said Gennaro. “There is a difference between having an airplane view and a helicopter view of the future of the science. I think that this change in perspective—from my individual research or research in this field to the wider questions about what research needs to be encouraged—is important.” That broader view, she said, could in turn inform her role at the Connell School, as she works to shape the course of nursing research at CSON and to secure funding for that research. The council meets three times each year at NIH’s Bethesda campus to discuss grant applications, review the institute’s extramural programs, and make recommendations about its intramural research activities and grant funding. The meetings involve “a lot of healthy dialogue,” said Gennaro, who attended her first in May. “All perspectives are heard, and there’s a lot of engagement. I find that very exciting. . . . It’s not a place where people come to battle for their answer. They come with perspectives to reach a shared vision.” Serving on the national advisory council will demand much of the dean. The panel’s two-day meetings in Bethesda are “jam-packed,” Gennaro says, as is the preparation for them; each council member reviews dozens of grant proposals and reports on several applications. Additionally, she says, there is “a lot of thinking and reading that isn’t ‘assigned,’” per se, but that is essential to staying well informed. Gennaro is certainly up for the challenge. “Doing new things, seeing new people—it takes a lot of energy. But it’s never boring,” she said. “Just like nursing.” ✹

or 20 years, m. katherine hutchinson,

Ph.D., RN, FAAN, worked as a neonatal critical care nurse. But the experience of caring for infants with congenital syphilis and HIV in the late ’80s and early ’90s moved her in a new direction. While pursuing her doctorate, Hutchinson began to research adolescent and young adult risk behaviors, focusing on parental influences on sexual risk activity and HIV prevention. Named CSON associate dean and professor late last spring, Hutchinson brings this patient-familycentered balance of practice and scholarship, as well as an academic leadership background, to her new role at the Connell School. A former associate professor at New York University’s College of Nursing and founding director of the University of Pennsylvania’s nursing undergraduate honors program, Hutchinson now oversees all CSON graduate programs and leads its doctoral program. Born and raised outside Philadelphia, Hutchinson says she knew from an early age that she wanted to be a nurse. She received a B.S.N. from Michigan State University College of Nursing and a master’s and Ph.D. from the University of Delaware. She did postdoctoral work at the University of Pennsylvania School of Nursing, joining the faculty there in 2001. She is a Fellow in the American Academy of Nursing. Since 2005, Hutchinson has collaborated with researchers at the University of the West Indies on an NIH-sponsored project in Kingston, Jamaica, testing a family-based HIV risk-reduction intervention for adolescent girls and their mothers. She is slated to present the study’s final findings at the 2012 State of the Science Congress on Nursing Research in Washington, D.C. But her partnership with the university hasn’t ended: She is currently conducting a pilot study aimed at devising an intervention for boys.

Photograph: Lee Pellegrini

Hutchinson describes her research as “an extension” of her two decades of clinical practice. “I’m continuing to work with parents and families as a way to have a positive impact on people’s lives,” she says. Frequently involving students in her studies, Hutchinson came to NYU in 2007, at a time when its College of Nursing was revamping its Ph.D. curriculum to emphasize rigorous course work and research training. With a strong doctoral program already in place at CSON, her goal is to work with faculty to expand opportunities for hands-on research, scholarships, and National Research Service Award grants. “I’m looking forward to providing our students with the best training possible to launch their own research trajectories and make substantial contributions,” she says. “It’s always exciting to watch a student develop into an investigator.” ✹

Fall 2012

Thinking globally, exploring locally

ouring the ether dome at massachusetts

General Hospital the morning of June 28, a group of nursing and pre-med students were absorbed in a historic moment. But it wasn’t the first public demonstration of ether used as a surgical anesthetic, which took place in the celebrated amphitheater in 1846. It was breaking news headlines crawling across the students’ smartphones, reporting that the United States Supreme Court had upheld the Affordable Care Act. After reading the news that the controversial law to expand health care coverage would stand, several students applauded. The students visited the hospital landmark on the nextto-last day of Global Healthcare: Meeting Challenges and Making Connections, a four-week course that brought together 26 students and 30 faculty from Boston College and two nursing schools in Lausanne, Switzerland (along with one from the University College Dublin School of Nursing), on the Connell School of Nursing (CSON) campus. English- and French-speaking students and faculty spent most of the month exploring issues at

An American-Swiss exchange BY DEBRA BRADLEY RUDER

Donna J. Perry (right), global nursing education manager at Massachusetts General Hospital, shows students the Ether Dome painting that depicts the first public surgery using the anesthetic ether. Photograph: Caitlin Cunningham

Photograph: Levine Voice 8 Josh

Kim Edouard ’14 and Haute Ecole de Santé Vaud student Faty Sarah Diamuini rehearse a classroom presentation. Photograph: Lee Pellegrin

Jam-packed days Sixteen Swiss students from Haute Ecole de Santé Vaud (HESAV) and Haute Ecole de la Santé La Source (ELS) and 10 from Boston College —including six nursing students (five of them undergraduates), three from the College of Arts and Sciences, and one from the Woods College of Advancing Studies—took the intensive course, which met from June 4 to 29. Course material was organized around four themes—palliative care, violence,

“Anything we can do to foster critical thinking and enhance students’ powers of observation will make them better health care professionals.”

—Colleen Simonelli

the forefront of global health—quality and safety, ethics, violence, and palliative care—particularly as they affect vulnerable populations. A three-credit elective supported by the Connell Fund, Global Healthcare is designed to expose students to a range of practices and public health challenges, especially in the United States and Switzerland, and to broaden their perspectives as future health care professionals working in a world with vast social and medical problems. It is a centerpiece of a formal collaboration that the Connell School and the University of Applied Sciences Western Switzerland signed in November 2010, agreeing to exchange teaching and research faculty, jointly develop international academic programs and scientific research projects, and work together on academic publications and research of mutual interest. “It’s vital for students to understand the world’s problems,” said Colleen Simonelli, the clinical associate Alfred DeMaria, state epidemiologist and medical director for infectious diseases at the Department of Public Health, leads students through the department’s Hinton State Laboratory.

professor who developed the curriculum with other Connell School faculty and Swiss colleagues. “Anything we can do to foster critical thinking and enhance students’ powers of observation will make them better health care professionals. I’m grateful to the faculty and other speakers who participated. They recognize the importance of educating our young people to be global thinkers.” She said planning is under way for next summer’s version in Switzerland, which will be open to 16 students and four faculty from Boston College.

health care, and ethics—that gave faculty and guest speakers opportunities to share insights from their clinical and scholarly work. CSON Assistant Professor Melissa Sutherland, for example, described the emotional and health consequences of intimate partner violence (aka domestic violence) and an “aha” moment, when she realized it is a risk factor for sexually transmitted infections. She urged students to “ask the right questions of your patients—‘Have you been hit, slapped, kicked, punched, or choked?’” and to look at the patient, not the chart, when posing these questions. Clinical Instructor Terri LaCoursiere Zucchero recounted some of her work with homeless people in Hawaii, many of whom “suffer from chronic illnesses, substance abuse, mental health disorders, and the consequences of living outside, even though Hawaii is beautiful and considered to be paradise,” she said.

Fall 2012

Sahaan Sozhamannan ’13 and Anne-Sophie Reymond of Haute Ecole de la Santé La Source evaluate health care providers’ role in ethical care issues. Photograph: Lee Pellegrini

Mélanie Imesch of Haute Ecole de la Santé La Source and Liz Miller ’14 consider the role governments play in health care policy, access, quality, and cost. Photograph: Lee Pellegrini

Haute Ecole de Santé Vaud student Alexandra Meylan in class.

Haute Ecole de Santé Vaud student Nacef Wesselbel tours the Department of Public Health. Photograph: Josh Levine

Photograph: Lee Pellegrini

A typical day involved two or three lectures on campus, often led by one of 24 CSON or five Swiss faculty members, as well as trips to Boston-area teaching hospitals and laboratories, the Massachusetts Department of Public Health, swissnex Boston (a “science consulate” that promotes global intellectual exchange), or the Veterans Affairs (VA) medical center in West Roxbury. At the VA center, Vanessa Coronel, a patient safety nurse, described the hospital’s efforts to prevent patient falls—and her own nightmare as a new nurse: “I left my patient sitting in the bathroom and didn’t lock the chair when I left. When I came back, the patient was on the floor,” she said. “I want you to learn from my mistakes. Please make sure you lock the wheels.” Students on the site visit observed tools the government-run system has developed, such as a wireless barcode system to make sure patients get the right medications. They saw other innovations, among them a kit for fending off delirium and several short training videos in a VA series that demonstrates common clinical errors. Judith Vessey, a nurse scientist and Leila Holden Carroll Professor in Nursing, explained how an organization builds a “culture of safety” and stressed the importance of open communication. “Think of patient safety as a team sport, and the patient is part of the team,” she told the group.

10 Voice

“I’ve never learned anything like this,” said Sahaan Sozhamannan ’13, a premed student, as he toured an inpatient floor at the VA. “This course gives a clinical outlook we don’t get in microbiology class. This is closer to what we’ll be doing as doctors.”

Cross-cultural learning With students and faculty from both sides of the Atlantic in attendance, opportunities to compare and contrast health systems in the United States and Switzerland arose often. Students looked critically at such areas as life expectancy (81 in Switzerland versus 78 here), spending (both systems are among the world’s most expensive), and assisted suicide (generally legal in Switzerland; allowed in only three U.S. states). “The most important difference is that the Swiss health care system is universal; every person who is living in Switzerland more than three months must have health insurance,” observed La Source Professor Blaise Guinchard. “For a nurse, that means that we accept always all persons in a hospital. We don’t ask for the credit card before caring.” Although the classroom topics were generally heavy— children with cancer, health care disparities, human trafficking, and the like—there was plenty of upbeat chatter in English and French during breaks. Evenings featured social gatherings, optional excursions, and

homework assignments such as readings and reflections on the course work. The class culminated with skits the students developed and performed to convey each of the major course themes. The Swiss students, many of them first-time U.S. visitors, seemed to relish the opportunity to study in Boston and experience Fenway Park, a Duck Tour, and other signature Beantown activities—despite tempestuous weather that went from raw to sweltering, soggy to crystalclear, within days. American students enjoyed being with them, and the group worked around their differences in language and customs. “My favorite memory was the fire drill during the first week,” recalled Liz Miller ’14 who lived in Walsh Hall with the visitors. “The alarm went off, and the [Swiss] girls were frantic. I tried to explain that we just had to leave the building for a couple of minutes, but they couldn’t grasp the idea. Each girl grabbed her brand-new shoes, cigarette stash, passport, and laptop before finally leaving. We all enjoyed a good laugh afterwards.” By being in the dorm, Miller noted, “I was able to learn about the Swiss and their culture, even though I speak only English. It was easy to connect because we were around the same age and had similar interests.” Student feedback on the course indicates its debut was a success. Sarah Webber ’14 said Global Healthcare

illuminated the varied roles that nurses perform around the world, including providing relief to disaster-stricken places like Haiti. “We’ve also learned about the role nurses can play in policy making in the hospital system,” Webber says. “We already know that you’re the patient’s biggest advocate, but you need to be their advocate in the system as well. This course helps you see the big picture.” Kimberly Edouard ’14 said the classroom experience “went beyond all of my expectations. We got to see how passionate the faculty are about their work.” She also valued the trips to Mass General, Boston Children’s Hospital, Dana-Farber Cancer Institute, and the VA medical center. “Visiting the hospitals in Boston was inspiring,” Edouard reports. “We had an inside look at the different environments where we will be working.” Haute Ecole de Santé Vaud student Nacef Wesselbel said the Global Healthcare classes “were really interesting, and the visits and activities helped us to integrate into American life. I’ve appreciated the American mentality because you respect foreigners, even though they do not master English very well.” Added Gabriela Skalova, another student at the school, the program “allowed me to have a new and broader vision of patient care, and I was able to discover a new city and its wealth. This month, I lived a wonderful, rewarding life experience.” ✹

Fall 2012

Turning hunches into research connell faculty advance hospital nursing science BY DEBRA BRADLEY RUDER PHOTOGRAPHS BY JOSH LEVINE

Is it safe to leave a patient’s IV tube in during daily chemotherapy treatments? Does stopping tube feeding while turning a patient raise the risk of aspiration? How can we improve our post-operative discharge phone calls? Could nurses have more effective conversations with patients who have received “bad news”?

hese are among the questions that

Clinical Associate Professor and nurse scientist Susan DeSanto-Madeya is helping fellow nurses at Beth Israel Deaconess Medical Center (BIDMC) in Boston answer—with research. Whether she’s mentoring colleagues at the bedside or teaching students in the classroom at the Connell School of Nursing (CSON), DeSanto-Madeya wants current and future nurses to pay closer attention to nursing science, to turn their hunches

into questions and investigations, and to gather evidence that enhances nursing practice. “Nursing research is about making sure patients and families are receiving care that enhances their quality of life, despite illness,” says DeSanto-Madeya, who has a joint appointment as the Beth Israel Hospital Nurses’ Alumnae Association Endowed Nurse Scientist at BIDMC. “It’s about advancing our knowledge. Nurses bring unique qualities and knowledge to the patient care area.” While many CSON faculty pursue their research interests at health-care organizations, DeSanto-Madeya is one of a half-dozen scholars, mentors, and teachers working in formal collaborations between the Connell School and some of greater Boston’s most renowned hospitals. Bridging the gap between bedside and classroom, they help hospital nurses design, execute, and document studies; produce results that demonstrably affect care; and share what they’ve learned. “They can come back to campus and give ‘Yesterday, when I was in the hospital’ examples to students,” says CSON Dean Susan Gennaro. “And to the hospital nurses they can say, ‘One of my students brought in this article on the same topic that we’re interested in.’ It goes both ways.” “They’re in these hospitals,” Gennaro adds, “because we are all committed to improving health care in the United States.”

Professor Dorothy Jones, director of the Yvonne L. Munn Center for Nursing Research at Massachusetts General Hospital.

More than 15 years of growth

Clinical Associate Professor Susan DeSanto-Madeya, Beth Israel Hospital Nurses’ Alumnae Association Endowed Nurse Scientist.

12 Voice

The Connell School’s oldest and largest nursing research partnership is with Massachusetts General Hospital (MGH), where Professor of Adult Health Nursing Dorothy (“Dottie”) Jones directs the Yvonne L. Munn Center for Nursing Research. Jones has advised nurse scientists at Mass General since the late 1980s, when she was brought in to confer with staff about perioperative procedures and the patient experience. Her position has evolved significantly. In 2007, she was named the first director of the Munn Center, which supports nursing science and research that promotes quality, cost-effective patient care. “Today, we have more than 45 doctorally prepared nurses at MGH, about 80 percent of them from the Connell School,” she says. “Many have led research initiatives affecting patient care delivery.”

The Munn Center’s seven-person staff fosters research in areas such as symptom management, elder care, ethics, and work environments for nurses. In one evidencebased project, for example, clinical nurse specialist and CSON doctoral student Lillian Ananian has collaborated with MGH physician Paul Currier to create an educational program to help clinicians lead family meetings in the medical intensive care unit (ICU). Although nursing research is on the rise, many hospitals have only one or two nurse scientists on board, according to Jones. Funding is often a challenge. When she meets with visitors or colleagues from other parts of the country, “I tell people that what we’ve accomplished at Mass General has taken over 15 years to develop and has advanced because of organizational support and visionary nursing leadership.”

Fall 2012

“We’re trying to make nursing research an integrated part of [nurses] practice. It’s really about making sure the nurses are asking, ‘What’s the evidence and best practice for improving patient care?’” —ANN wolbert BURGESS

Searle helped clarify their projects: “What’s your aim? What are the assumptions? Can you reframe the question? What does the literature report? Focus groups can provide strong pilot data.” “We’re trying to make nursing research an integrated part of their practice,” Burgess says. “It’s really about making sure the nurses are asking, ‘What’s the evidence and best practice for improving patient care?’”

Spreading knowledge Professor Ann Wolbert Burgess with Robin Cunningham, a clinical educator at Newton-Wellesley Hospital.

Conducting research is energizing, Jones observes. It reminds nurses why they chose the profession: to make a palpable difference in the lives of patients and families.

What do you notice? Connell School faculty are jump-starting research among the nursing staff at other Boston-area hospitals as well. “We’re at the beginning stages,” reports DeSantoMadeya, one of two part-time nurse scientists at Beth Israel Deaconess Medical Center. Since joining the teaching hospital in 2011, she has sought to demystify research by offering “how-to” classes, presentations, and educational displays, and by striking up conversations with nurses in which she asks, “Are there things you question or notice in your daily practice that you’d like to explore or change?” “It’s about meeting the nursing staff where they’re comfortable,” DeSanto-Madeya says. “There’s still mystery and fear behind conducting research, but there are many ways to use research to inform practice.” DeSanto-Madeya has guided individuals and teams working on quality improvement, evidence-based practice, and full-fledged research projects. In one project, nurses explored whether cancer patients undergoing daily chemotherapy treatments could continue using

one plastic intravenous tube instead of getting “stuck” each time. “There was no evidence to support leaving the IV in or taking it out in the outpatient setting,” DeSanto-Madeya points out. “A lot of nursing practice is based on the nurse’s past experience and how ‘it has always been done’ within an institution.” In this case, the team surveyed other organizations and spoke with their own patients before developing a standard of care they are testing now. They send patients home with educational materials, and with their tubes capped and taped securely to their arms.

Advancing nursing practice On a July morning, two dozen nurse managers gathered for a research methodology workshop at Newton-Wellesley Hospital—part of a new collaboration between CSON and the hospital. Professor Ann Wolbert Burgess, a psychiatric and forensic nurse scientist who has published extensively, was leading a six-part educational series on nursing research with Eileen Searle, a CSON doctoral degree student, and June Andrews Horowitz, a Connell professor with expertise in postpartum depression. The participants identified research questions on topics like simulation training, safe medication practice, patients’ cell phone use, and thermometry. Burgess and

Publishing in peer-reviewed journals is the brass ring of research, and CSON faculty have had success guiding their hospital-based mentees toward that goal. Assistant Professor Melissa Sutherland, for one, helped nurses at McLean Hospital in Belmont design and execute a study management of patients with (or at risk for) metabolic syndrome, a weight-related condition that raises the risk for diabetes and heart disease and is associated with some antipsychotic drugs. The paper, coauthored by Paula Bolton, M.S. ’83 among others, appeared in the Journal of Psychosocial Nursing and Mental Health Services in March 2012. Nursing scholarship has also moved forward at Brigham and Women’s Hospital (BWH), where Associate Professor Katherine Gregory and Assistant Professor Lichuan Ye serve as Haley Nurse Scientists, a partnership between the hospital and CSON that fosters clinical nursing research (see Voice, summer 2011). Ye, who studies sleep disorders, is collaborating with BWH nurses to better understand sleep patterns among hospitalized patients

and to spread the word internally about the importance of shut-eye. Gregory, meanwhile, coauthored two papers this year based on nursing science investigations she helped lead at Brigham and Women’s. One, titled “Tub Bathing Improves Thermoregulation of the Late Preterm Infant” and published in the Journal of Obstetric, Gynecologic & Neonatal Nursing in March/April 2012, reported on nursing research showing that late preterm infants washed in hospital tubs had warmer and more stable body temperatures than those who were sponged off. “This is one of the first studies tailored to nursing care for this patient population [born between 34 and 37 weeks of gestation], and it now guides practice here at Brigham and Women’s Hospital,” says Gregory, a former neonatal ICU nurse who studies gastrointestinal health in premature infants. In a second project, Gregory urged BWH neonatal nurse Jo Ann Morey to study a class she has taught for years to prepare women who are expecting to have a baby cared for in the neonatal intensive care unit. The results were published in the American Journal of Maternal Child Nursing in May/June 2012. “I walked her through the process of developing a study, like finding the right things to measure and how to measure them,” Gregory notes. “And lo and behold, her class does make a difference.” As Dean Gennaro sees it, the faculty are continuing a tradition of nursing science that goes back to Florence Nightingale, accelerated during the 1980s, and is now woven into the fabric of the nursing profession. Gennaro, who serves on the National Advisory Council for Nursing Research, (see article on page 6) expects the demand for evidence-based practice will grow in the United States. “We know that nursing research contributes to patient satisfaction and cost savings and improved outcomes,” she says. “It’s an exciting time to be a nurse and a nurse scientist.” ✹

Eileen Searle, doctoral student.

14 Voice

Fall 2012

Welcome, new faculty BY JANE DORNBUSCH

Their specialties range from psychobiology to women’s health, palliative care to Latina health, and mental health to family nursing practice. Meet the newest members of the Connell School of Nursing faculty.

Stewart Bond, Ph.D., RN, specializes in symptom management and palliative care for cancer patients. He holds a master’s in theological studies, with a focus on pastoral counseling and ethics, from Vanderbilt University, as well as master’s and doctoral degrees in nursing from the University of North Carolina at Chapel Hill. He comes to Boston College from Vanderbilt, where he was first the John A. Hartford Foundation Claire M. Fagin Fellow and most recently a research assistant professor in the nursing school. His recent research has focused on treating neurocognitive symptoms, including delirium, in cancer patients, especially older ones. “In particular, I’m trying to prevent functional and cognitive decline in that patient population,” he says.

Photograph: Caitlin Cunningham

Joyce Edmonds, Ph.D., M.P.H., RN, looks at nursing through a wide-angle lens, identifying broad trends by observing individual patient behaviors. With a master’s degree in public health from Oregon Health Science University as well as a Ph.D. from Emory University’s School of Nursing, she specializes in community-based maternal and child health services. Edmonds comes to CSON from UMass-Boston’s College of Nursing, where she was an assistant professor. She has also worked as assistant chief nurse for the Georgia Department of Public Health and traveled to Bangladesh to conduct research for her doctoral dissertation on women’s choices of birth attendants. Currently, she’s researching the “unnecessarily high C-section rate” in the United States.

Ellen Bishop, M.S., FNP-BC, came to nursing from the world of finance. She was working as a marketing client manager at Investors Bank & Trust Company in Boston on September 11, 2001, and decided in the aftermath of the terrorist attacks to reexamine her priorities. She returned to school, earned a master’s degree in nursing from Regis College, and became a family nurse practitioner, working most recently at Cape Ann Medical Center. Along the way, she also did clinical teaching and discovered an affinity for mentoring young nurses. “It’s such a rewarding experience to watch someone blossom from being afraid of everything to being ready to graduate,” she says.

Photograph: Lee Pellegrini

Photograph: Gary Wayne Gilbert

Assistant Professor Viola Benavente, Ph.D., RN, CNS, has spent years in direct patient care, teaching, and research. She earned a master’s degree in nursing from the University of Texas School of Nursing at San Antonio in 1994 and a doctorate in nursing science from the University of Pennsylvania in 2010, then did a postdoctoral fellowship in Seattle at the University of Washington. One of CSON’s first Latina faculty members, Benavente’s major research interest is promoting the cardiovascular health of Latinas, a burgeoning demographic group that has yet to be adequately studied, she says. She also works with the Women’s Health Initiative, studying health concerns of Hispanic ethnicity and language preference on adherence to a low-fat diet.

Sandy Hannon-Engel, Ph.D., RN, CNS, PMHNP, a psychiatric nurse practitioner, comes to her new teaching position from the MGH Institute of Health Professions. A former mental health nurse practitioner at Pembroke Hospital who taught at the Connell School from 2005 to 2007, Hannon-Engel graduated from UMass-Boston with a degree in human services, but decided that nursing would allow her to “help people in a more holistic way.” She went on to earn a master’s in nursing from Rivier College in 1998 and her doctorate from Boston College in 2012. Her primary research interest is in the neurobiology of eating disorders. Photograph: Gary Wayne Gilbert

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Photograph: Caitlin Cunningham

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Faculty publications

Joyce Edmonds

M. Katherine Hutchinson

Natalie McClain

m. Colleen Simonelli

Edmonds, J., M. Paul, L. Sibley, “Determinants of Place of Birth Decisions in Uncomplicated Childbirth in Bangladesh: An Empirical Study,” Midwifery (2012). DOI: 10.1016/j. midw.2011.12.004

Nadimpalli, S.B., M.K. Hutchinson, “An Integrative Review of Relationships between Discrimination and Asian American Health,” Journal of Nursing Scholarship 44, no. 2 (2012): 127–135.

Amar, A., N. McClain, C.A. Marchetti, “Child and Adolescent Victims of Trauma” in Child and Adolescent Behavioral Health: A Resource for Advanced Practice Psychiatric and Primary Care Practitioners in Nursing, eds. E.L. Yearwood, G.S. Pearson, J.A. Newland (Oxford: Wiley-Blackwell, 2012): 396–413.

Guimons, M.E., M.C. Simonelli, “Development of the Obstetric Nursing Self-Efficacy Scale Instrument,” Clinical Simulation in Nursing 8, no. 6 (2012): 227–232.

Holly Fontenot Fontenot, H.B., J.W. Hawkins, J.A. Weiss, “Cognitive Dissonance Experienced by Nurse Practitioner Faculty,” Journal of the American Academy of Nurse Practitioners (2012). DOI: 10.1111/j.17457599.2012.00726.x

Susan Gennaro Gennaro, S., “Ideas and Words: The Ethics of Scholarship,” Journal of Nursing Scholarship 44, no. 2 (2012): 109–110.

Allyssa Harris Harris, A.L., “ ‘I Got Caught Up in the Game’: Generational Influences on Contraceptive Decision Making in African–American Women,” Journal of the American Academy of Nurse Practitioners (2012). DOI: 10.1111/j.17457599.2012.00772.x

abstract

Cognitive dissonance experienced by nurse practitioner faculty Nurse practitioner (NP) faculty struggle with conflicts of self-identity brought on by unrealistic workloads and discrepancies between requirements and rewards, Clinical Assistant Professor Holly B. Fontenot, Professor Emeritus Joellen W. Hawkins, and a collaborator from Florida Atlantic University found in a study published in the Journal of the American Academy of Nurse Practitioners. Research shows that intense pressure on nursing faculty to be productive teacher-scholars and active clinicians contributes to feelings of conflict and tension, and in turn, to the overall attrition of younger nursing faculty members. To gain further insight into NP faculty members’ motivations, Fontenot, Hawkins, and their colleague conducted an online survey that asked NP faculty members about their expectations around academic positions and requirements for promotion, tenure, or bonuses; their experiences with cognitive dissonance; and their ideas for coping with it. The survey garnered a small but revealing sample, and the collaborators described the qualitative data, in particular, as “extremely rich.” Of the 42 quantitative respondents, 88 percent maintain their clinical careers, with the majority practicing eight hours per week. Among the 44 qualitative responses, NPs indicated that while they find satisfaction in teaching and mentoring, they are frustrated with demanding work priorities and feel torn by expectations around pursuing multiple roles—practice, research, teaching, and service. “How many ways can they cut me and still expect me to function in all?” wrote one respondent.

Danny Willis Willis, D.G., L.S. Beeber, “A Clinical Translation of the Research Article Titled ‘Altruism in Survivors of Sexual Violence: The Typology of Helping Others,’ ” Journal of the American Psychiatric Nurses Association 18, no. 3 (2012): 156–158. Manfrin-Ledet, L., D.G. Willis, D. Porche, “Violence Research,” in Encyclopedia of Nursing Research, 3rd ed., eds. J. Fitzpatrick and M. Wallace Kazer (New York, N.Y.: Springer Publishing Co., 2012): 531–533.

Robin Wood Wood, R.Y., C. Toronto, “Measuring Critical Thinking Dispositions of Novice Nursing Students Using Human Patient Simulators,” Journal of Nursing Education 51, no. 6 (2012): 349–352.

abstract

Measuring critical thinking dispositions of novice nursing students using human patient simulators Novice nursing students make individual gains in their critical thinking abilities after using human patient simulators (HPS) to learn health assessment skills, report Associate Professor Robin Y. Wood and former Assistant Director of the Clinical Learning Center Coleen E. Toronto in a study published in the Journal of Nursing Education. The researchers note that, while it’s widely accepted that using HPS in new and realistic clinical scenarios improves critical thinking, there is a lack of research-based evidence to support this belief. Wood and Toronto’s study randomly assigned 85 second-year nursing students to an experimental or control group based on their exposure to a two-hour HPS practice session prior to a course competency examination. The California Critical Thinking Disposition Inventory (CCTDI), a measure of reasoning skills, was administered before and after the competency test. Wood and Toronto found no differences between the experimental and control groups on the overall or seven subscale CCTDI mean scores. However, within-group differences for the HPS practice group were notable for overall scores. “Experimental group students performed significantly better on the post-test than they did on the pre-test,” Wood and Toronto observed. Students within this group also scored higher on subscales of “truth-seeking,” which indicates an ability to courageously ask questions and be unbiased, and “judiciousness or maturity of judgment,” which points to discernment in problem solving. An analysis of the preliminary data suggests that individual students achieve disposition gains through the use of HPS. The researchers plan to follow the cohort for two years to assess the long-term critical thinking outcomes associated with HPS practice.

Fontenot, Hawkins, and their collaborator concluded that the respondents showed evidence of cognitive dissonance when reflecting on their requirements versus their rewards, such as the lack of value placed on clinical achievements in tenure evaluations. The researchers recommended that “reviewing expectations, as well as creating a clinical track for faculty who practice, are options that NP program administrators might explore.”

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william f. connell

non-profit org. u.s. postage paid boston, ma permit #55294

school of nur sing 140 commonwealth avenue chestnut hill, ma 02467 www.bc.edu/cson

voice Join the Connell School at our upcoming Pinnacle lectures fall 2012

spring 2013

Orchestrating a Career for Leadership angela barron mcbride Distinguished Professor and University Dean Emerita, Indiana University School of Nursing

lee woodruff Coauthor of In an Instant: A Familyâ&#x20AC;&#x2122;s Journey of Love and Healing with her husband, ABC News anchor Bob Woodruff, who was critically injured in Iraq in 2006

Thursday, November 1, 2012, 5:00 p.m. Yawkey Center, Murray Room Womenâ&#x20AC;&#x2122;s health expert and author of The Growth and Development of Nurse Leaders Angela Barron McBride will discuss the career stages of nursing, how nurses can develop into leaders, and the benefits of mentoring.

Wednesday, April 10, 2013, 5:00 p.m. Yawkey Center, Murray Room Journalist and author Lee Woodruff has written works of fiction and nonfiction. She and her husband cofounded the Bob Woodruff Foundation, which provides resources and support to injured service members, veterans, and their families.