TRIBUTE The University of Texas Health Science Center at San Antonio School of Nursing | 2017
Future Nurse Researchers PROFESSORS MENTOR UNDERGRADUATES IN UNIQUE PROGRAM
DEAN’S MESSAGE DEAR FRIENDS,
Every day, nursing knowledge impacts health and health care around the world. Alumni, faculty, and students from the School of Nursing are conducting research to improve the overall health of our patients. Nurses take active roles in monitoring health care systems, participating in ground-breaking research, and initiating solutions that improve patient outcomes while reducing patient and nurse stress. The School of Nursing is transforming health care through advanced nursing science with its two doctoral programs: the Doctor of Nursing Practice (D.N.P.) and the Philosophy in Nursing (Ph.D.) degrees. These terminal degrees prepare our graduates to lead systemic changes in all areas of the health care arena. This edition of Tribute highlights three such graduates and the impact they are making on the health of their communities. As we continue to educate some of the finest nursing students, our graduates can be found making a difference around the world—conducting research, providing patient care, leading community partnerships, and educating patients and students. The School of Nursing is preparing nurses with a passion for inquiry and promoting new models of care leading to new knowledge generation. While alumni, faculty, and graduate students have been engaged in research for many years, we have now made it a priority to engage undergraduate students in the research experience. These students are helping to make an impact even before they complete their undergraduate degrees. Our School of Nursing is only one of three in the UT System offering a Bachelor of Science in Nursing with Research Distinction. Thank you for supporting the School of Nursing. You help us achieve our vision—to make lives better by promoting health as an act of social justice.
Eileen T. Breslin l Ph.D., RN, FAAN
Dean and Professor Dr. Patty L. Hawken Nursing Endowed Professor School of Nursing
NURSING STUDENTS PARTICIPATE IN NATIONAL POLICY SUMMIT Four students from the School of Nursing participated in the American Association of Colleges of Nursing Student Policy Summit in March in Washington, D.C. Henry “Hank” Bullock (from left), M.S.N. student; Amber Rogers, Accelerated B.S.N. student; Leticia Ybarra, Ph.D. student, and Bryan Ralloma, Traditional B.S.N. student, traveled to D.C. with Dean Eileen Breslin, who funded their travel through the Dr. Patty L. Hawken Nursing Endowed Professorship. The students attended didactic program sessions focused on the federal policy process and nursing’s role in professional advocacy. The three-day conference also included Capitol Hill visits and a Congressional reception.
TRIBUTE 07 ADVANCED NURSING SCIENCE Doctorally educated nurses meet varied demands of complex health care systems
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11 SUNRISE PROGRAM Mentoring program offers invaluable research experience to undergraduate students
16 A PERFECT PARTNERSHIP New internship program provides experience, employment to students
18 BREAKING BARRIERS
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Faculty researcher dedicated to preventing cancer in Korean Americans
20 IMPROVING VETERANS’ HEALTH CARE Dittmar endowment honors military service of two fathers
24 ALUMNAE PROFILES Three graduates improving industry in diverse ways across the country
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24 School of Nursing Office of the Dean 7703 Floyd Curl Drive, San Antonio, TX 78229-3900 210-567-5534
02 DEAN’S MESSAGE 04 ACCOLADES AND WELCOME 05 GROUND-BREAKING
NURSING RESEARCH
22 HONOR ROLL
ON THE COVER Cristina Cruz (left), Bachelor of Science in Nursing student, is being mentored by Frank Puga, Ph.D., assistant professor/ research, on a research project studying how social support affects the mental health of pregnant women with opioid use disorders. They are part of the Summer Undergraduate Nursing Research Immersion Experience, which is known as SUNRISE. The program encourages students to pursue graduate degrees and to join the next generation of nursing researchers. Story on pages 11 – 15 Cover photo by Noell Vidaurri, Creative Media Services
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23 LEAVING A LEGACY 30 ALUMNI UPDATE 30 LIFELONG LEARNING 31 KEEP LEARNING 31 CONNECT WITH SOCIAL MEDIA
The University of Texas Health Science Center at San Antonio School of Nursing | 2017 3
ACCOLADES KARINE CROW, PH.D., RN, FAAN, was inducted as a 2016 Fellow of the American Academy of Nursing (AAN) at the academy’s annual policy conference in Washington, D.C. This year the AAN selected 164 highly distinguished nurse leaders from 50 states, the District of Columbia and 28 countries as its 2016 Fellows. Dr. Crow is director of international programs and holder of the Roger L. & Laura D. Zeller Professorship in Nursing. Her development of culturally congruent curricula for nurses in higher education addresses health disparities and health equity among American Indian and indigenous populations. M. DANET LAPIZ BLUHM, PH.D., RN, has been named a Collaborative Academic Research Member on a multi-state project called Veterans’ Action League, which is leading a dynamic two-year conversation empowering veterans to have an active voice in guiding veteran health care delivery. This national project examines what information veterans need and want to make informed decisions about their health care. In addition, Dr. Lapiz Bluhm was recently awarded a Teaching Excellence 2017 Presidential Award in recognition of dedication to teaching and mentoring students.
LISA D. SIEVERS, M.S.N., RN, and colleagues from the 2015 cohort of the National League of Nursing (NLN) Leadership Development Program for Simulation Educators had their “Faculty Development Toolkit for Simulation Resources” published by the NLN as an online resource. After identifying a lack of common language/terminology to outline the progression of expertise of simulation educators, Sievers and her co-authors established common operational categories of faculty development and used them to organize resources that support progression toward expertise. She received a Texas Higher Education Coordinating Board grant as a result of her involvement and learning during her NLN leadership year. NORMA MARTINEZ ROGERS, PH.D., RN, FAAN, received the 2017 Diversity, Inclusion, and Sustainability in Nursing Education Lectureship Award from the American Association of Colleges of Nursing. The award is sponsored by Nurse.com by OnCourse Learning. Dr. Martinez Rogers is recognized for more than 20 years as a leader of cultural diversity and inclusion. She founded Juntos Podemos (Together We Can), a peer-to-peer mentoring program for nursing students that assists with retention. Dr. Martinez Rogers also founded the Cultural Inclusion Institute.
WELCOME CINDY SICKORA, D.N.P., RN, has joined the School of Nursing as vice dean for practice and engagement. This position provides transformational leadership and guidance for the faculty practice plan and administers the clinical enterprise in the school. Dr. Sickora previously served as associate dean of community and clinical affairs for the Rutgers School of Nursing in Newark, New Jersey. She also served as the founding director of the Jordan and Harris Community Health Center and CEO of Rutgers Community Health Center, the only nurse managed Federally Qualified Health Center in the state of New Jersey.
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SAVITRI SINGHCARLSON, PH.D., RN, FAAN, has joined the School of Nursing as vice dean for faculty affairs and diversity. This position provides a supportive infrastructure to enhance the academic and behavioral environment that will support diversity of the school’s faculty, engage faculty from the initial appointment through the promotion and tenure processes, and enhance professionalism and faculty development. She served as department chair and professor of the Department of Nursing at California State University Monterey Bay and assistant director of Nursing Research/ Faculty Mentoring/Global Nursing for the School of Nursing at CSU Long Beach. As a Fulbright Scholar, she worked with oncology nursing leadership in Kerala, India.
The University of Texas Health Science Center at San Antonio School of Nursing | 2017
CHARLES HOAG, B.S.N., RN, has joined the School of Nursing as the clinic manager for the school’s clinical enterprises. He oversees the Employee Health & Wellness Center, the Student Health & Wellness Center, community partnerships and campus wellness activities. Hoag is responsible for collecting, compiling and analyzing data and information for the Delivery System Reform Incentive Payment (DSRIP) Program and other contract and grant reports related to DSRIP. He brings to the university 12 years of managing four ambulatory care clinics, 24 years of service in the U.S. Air Force, and more than 30 years as a registered nurse.
DISCOVERY
GROUND-BREAKING NURSING RESEARCH ON HIGH RELIABILITY ORGANIZATIONS By CATHERINE DUNCAN
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he first nursing research performed by frontline nurses on the effectiveness of High Reliability Organizations (HROs) has been published online in Research in Nursing and Health and will appear in the June printed version. Emerging literature—primarily from the U.S. Department of Veterans Affairs— shows that health care systems that apply the HROs framework can improve the safety and efficiency of patient care because all workers are involved in detecting and reporting operational problems before they result in safety risks. The innovative study is co-authored by Kathleen R. Stevens, Ed.D., RN, FAAN, professor of nursing, and the research was performed in multiple sites associated with her Improvement Science Research Network, a national research network focusing on improvement science. The 28 co-authors on the study are the principal investigative clinicians who implemented the study at their hospitals across the country.
Kathleen R. Stevens, Ed.D., RN, FAAN
The study is named the STAR-2 Study because it builds on the pilot study—Small Troubles, Adaptive Responses (STAR), which was part of the Interdisciplinary Nursing Quality Research Initiative funded by the Robert Wood Johnson Foundation. “During the STAR study, Robert Ferrer (M.D., M.P.H., John M. Smith, Jr. professor and vice chair of research of family and community medicine in the School of Medicine) and I learned that even though improvements were needed in health care quality, efficiency TRIBUTE
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and patient safety, hospitals struggle to make these improvements,” she said. “With STAR-2, we proposed the need to understand systems operations in hospitals as they affected frontline nurses.” Dr. Stevens said they decided to have frontline nurses gather information on operational failures, which are breakdowns in the system processes that hinder care, erode quality and threaten patient safety. “Previously, nurses were passive participants in the identification of system failures that affect their ability to deliver safe and effective care,” she said. “Detection by nurses of such failures provides real-time information about system operations to improve organization reliability.” Data was collected from 774 nurses working in 67 adult and pediatric medicalsurgical units in 23 hospitals around the country. Nurses systematically recorded data about operational failures encountered during 10 work shifts over a 20-day period.
The University of Texas Health Science Center at San Antonio School of Nursing | 2017 5
Nurse scientists from across the United States conducted the STAR-2 Study—the first study conducted with frontline nurses on the effectiveness of High Reliability Organizations. 1. Galveston, Texas 2. Loma Linda, California 3. Manchester, New Hampshire 4. Washington, D.C. 5. Denver, Colorado 6. Omaha, Nebraska 7. Miami, Florida 8. Stony Brook, New York 9. Mobile, Alabama 10. Aurora, Colorado 11. Midland, Texas 12. New Orleans, Louisiana 13. Atlanta, Georgia 14. New York, New York 15. Birmingham, Alabama 16. Columbus, Ohio 17. Pasadena, California 18. Reading, Pennsylvania 19. Mansfield, Texas 20. Beaumont, Texas 21. Desoto, Mississippi 22. Evansville, Indiana 23. Columbia, South Carolina
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ARTICLE? http://onlinelibrary.wiley.com/ doi/10.1002/nur.21791/full DOI: 10.1002/nur.21791
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The nurses reported operational failures they saw related to problems in equipment/supplies, physical unit/layout, information/communication, staffing/ training, medication, and an other category for failures that don’t fit in the other five categories, Dr. Stevens said. The nurses used a Star Pocket Card that was specially designed to fit in their pockets. The card contains structured checklists so nurses can easily record the type and frequency of the operational failures. “Using the STAR Pocket Cards, the nurses recorded information about the operational failures involving nursing practice they saw during their 12-hour work shifts,” she said. In total, 27,298 operational failures over 4,497 shifts reflected a rate of 6.07 operational failures per 12-hour shift. The highest rate was reported in the equipment/supplies category (1.59 per shift) followed by information/ communication (1.08), medication (1.06), other (.92), staff/training (.90), and physical/ layout (.50). “This study truly was the first to have frontline nurses providing real-time detection of operational failures that detract from clinical care,” Dr. Stevens said. “This research expanded on our previous knowledge showing
The University of Texas Health Science Center at San Antonio School of Nursing | 2017
the prevalence and array of operational failures across the country that thwarts the efficiency and safety of patient care.” When nurses experience an operational failure, they do a workaround which means they depart from established practice and figure out a solution to bypass the problem, she explained. “A workaround increases the opportunity for safety issues to arise. Nurses are smart and adaptive. It is okay to keep the system going, but you must send these operational failures to management so they can get fixed. Management must be willing to fix them.” At each hospital, the principal investigator shared the results of the study. “The teams were able to work together to figure out solutions to the operational failures. The solutions were tailored to each unit. “By encouraging participation from all members of the system, there was a shift in thinking. These organizations started becoming High Reliability Organizations with organizational mindfulness,” Dr. Stevens said. “The success of the research is based on acknowledging the true ownership of the system is held by nurses. By giving nurses the tools to strengthen the system, they can reduce operational failures while improving patient care and safety.”
DISCOVERY
TRANSFORMING HEALTH CARE THROUGH
ADVANCED NURSING SCIENCE By TERI SPEECE
PhD
School of Nursing doctoral programs prepare nurses to make lives better by leading systemic changes in the health care arena.
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A church community eating healthier, exercising and working to lower the blood pressures of its members. A care model for better communication with and engagement of dementia patients. A solution to the chronic lack of treatment of rural children with asthma. These are just some examples of the impact that is possible when nurses advance their skills by obtaining a doctoral degree at The University of Texas Health Science Center at San Antonio. “There is a great need for doctorally educated nurses because of the increasing complexity of health care systems,” said Sara Gill, Ph.D., RN, IBCLC, FAAN, associate dean of graduate studies for the School of Nursing. “Our doctoral programs offer opportunities for nurses to improve these health care systems by earning a terminal degree that is either research-based or practice-based.” The Doctor of Philosophy (Ph.D.) in Nursing program is a research-based degree that prepares students for careers as nurse scientists and faculty. “The point of the program is to improve health through clinical science research,” Dr. Gill said. “It’s crucial to have a body of qualified nurse scientists who use research methods to discover ways to advance patient care.” The Ph.D. program, which began in 1992, has graduated 46 nurses since 2003 and continues to build a pipeline of TRIBUTE
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academic nurse scientists to research systemic health issues and teach future generations. The Doctor of Nursing Practice (D.N.P.) program is designed to prepare nurses to become specialized, advanced leaders in one of three areas: advanced practice nursing, executive administration or public health. “I describe the D.N.P. as using quality-improvement techniques to make system-level changes in complex health care systems so that we provide effective, efficient, patient-centered care,” Dr. Gill said. The D.N.P. program has produced 32 graduates since it was launched in 2011. Gill stresses that the D.N.P. is an excellent alternative for nurses who want to advance their education but stay in clinical practice. “With the D.N.P. option, your terminal degree does not have to be research-based,” she said. Read on for examples of transformative health care changes explored within the doctoral dissertations of three recent Ph.D. and D.N.P. graduates who represent the next generation of change agents in health care.
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More Than a Leap of Faith Alumna improves heart health at church through education, screenings, faith By TERI SPEECE
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or many patients with high blood pressure, taking steps to eat right, be active and take their medications can be a challenge. Venetia Cantrell, D.N.P., M.S.N., B.S.N., FNPBC, found an effective way to change behaviors for one group by addressing their health where they practice their faith. Dr. Cantrell, a 2016 graduate of the Doctor of Nursing Practice Program in the School of Nursing, launched a three-month project with 124 members of her church to measure the effectiveness of combining faith and health education to improve blood pressure. Participants were predominately African American, an ethnic group with the highest prevalence of cardiovascular disease. “I wanted to choose a subject that was close to home, and I have high blood pressure,” said Dr. Cantrell, who turned to the Health & Wellness Ministry of Covenant Community Church in San Antonio for help. The team incorporated ideas from the Centers for Disease Control’s “Million Hearts” public health initiative into the church’s program, which already offered monthly blood pressure screenings. The team distributed weekly fliers with meal ideas, heart health facts and scriptures about wellness. They began monthly fellowship events with guest speakers, who discussed risk factors and prevention. The church also incorporated healthier dishes into all fellowship meals. “We wanted our members to eat a little healthier. That was originally a six-month trial, but it’s still going today.” The project also concentrated on encouraging physical activity by walking the church parking lot and dancing. “I was able to get a line dance instructor to teach us steps to gospel music. We had a big turnout for that,” said Dr. Cantrell. One of the simplest additions—providing wallet-size cards to members with their screening results—empowered many participants to take better control of their condition. “One member said that, as a result of taking her numbers back to her doctor, she was able to get her medication adjusted to better control her blood pressure,” she said. Dr. Cantrell’s results demonstrated notable improvements in most of the participants’ blood pressure readings and health habits. More importantly, participants enthusiastically report continuing
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Venetia Cantrell, D.N.P., monitors the blood pressure of a member of the Covenant Community Church in San Antonio.
“I have personally benefited from the information, concern, and encouragement the ministry has provided to me … I have used the information to exercise and eat better and, in the process, lost twelve pounds … Although I have given up many of the salty foods that taste so great, it is all worth it when I get a blood pressure check and my numbers are consistently lower than before … On the fourth Sunday, members may dread going into the foyer, but we all know that the ministry is out there for our benefit.” Robert “Woody” Woodfork Project participant
to practice good habits, said Carolyn Poole, a registered nurse who leads the Health & Wellness Ministry. “Many members come up to me to report what their pressures are and what they are still doing to change their diet—getting rid of canned goods, buying fresh or frozen vegetables and getting off the salt,” said Poole. “It became very enlightening for a lot of them, because when they started adhering to the treatment plan, their numbers started to improve,” said Poole. “They could see the results.” Dr. Cantrell said the experience taught her that a lot of people do not understand normal blood pressure range, but they want more information. “They say things like, ‘Oh, that’s how my blood pressure has always been; that’s normal for me.’ Just to be able to educate people about cardiovascular disease was wonderful, and to work with them, actually see results and get positive feedback, that was great,” she added.
The University of Texas Health Science Center at San Antonio School of Nursing | 2017
DISCOVERY
Giving Patients a Voice Research sheds light on caring for, communicating with dementia patients By TERI SPEECE
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PhD
retchel Gealogo, Ph.D., RN, remembers the moment when her dissertation topic was born—during a night shift on a hospital medical-surgical floor. “I had a patient with a fractured arm who also had Alzheimer’s disease,” said Dr. Gealogo, a 2015 graduate of the Ph.D. program at The University of Texas Health Science Center at San Antonio. “She had been agitated all day, but she couldn’t really verbalize that she was in pain.” Dr. Gealogo put a few clues together—notes from the previous shift, drawn curtains in the room, and the patient’s increased agitation—and tried a different approach. “I asked her, ‘Are you uncomfortable?’ and she said, ‘Yes, I’m really uncomfortable.’ ” Dr. Gealogo was able to treat the patient’s pain and help her sleep through the night. “The next morning, she said to me, with tears in her eyes, ‘I know that I’m losing it.’ I cried all the way home,” said Dr. Gealogo. “It was a big ‘aha’ moment for me. I wanted to study more about how patients tell us they’re in pain and what we’re supposed to be paying attention to.” Dr. Gealogo’s dissertation, “A Light in the Dark: Development of a Conceptual Model for Person-Engaged Dementia Care,” proposes a care model based on the premise that dementia patients are health care consumers who should contribute to their health care decisions—and that the role of health care providers is to help them. To develop her model, Dr. Gealogo spent four months gathering data at a successful community-based adult day center. She rode the bus in the mornings, participated in activities, and interviewed patients, families and staff. The center was popular with participants because it employed an innovative model called parallel programming, in which patients of different cognitive ability levels are engaged together instead of being separated. TRIBUTE
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For her dissertation, Gretchel Gealogo, Ph.D., RN, gathered data from dementia patients with the goal of improving the quality of care by health care providers and the patients’ ability to contribute to their health care decisions.
Alumna earned all degrees from UT Health Science Center San Antonio B.S.N. May 2009 M.S.N. May 2011 Ph.D. May 2015
“Take a bingo game,” she said. “At one table, you have folks who need a lot of assistance, so a staff member is there to help with their cards and chips. At another table, you have fully functioning participants, and they may even be helping out lowerfunctioning participants. But everybody’s doing the same activity. It’s inclusive.” Dr. Gealogo, who now serves as a postdoctoral fellow/research coordinator at Seton Dell Medical School Stroke Institute, believes that person-engaged alternative models can be used in many patient populations, and her job as a nurse is to help engage patients in their care, no matter how difficult that may be. “At the end of the day, there’s a patient in that bed; a patient with some capacity to contribute to his or her care or intervention. We have a duty to help them do that,” she said.
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In her final project to earn her Doctor of Nursing Practice degree, Wren Deavers, D.N.P., used knowledge gained from leadership courses to improve the treatment of children with asthma in rural Texas. Photo courtesy of Karin McCannon Photography.
Leading the Charge for Change Graduate uses leadership, evidence-based practice to improve asthma treatment in rural Texas By TERI SPEECE
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hen Wren Deavers, D.N.P, APRN, CPNP-PC, completed her doctoral education, she was surprised to find that it not only made her a better nurse practitioner—it made her a better leader. “The program had many leadership courses, which seemed odd at first. But they really helped me,” said Dr. Deavers, a 2014 graduate of the Doctor of Nursing Practice (D.N.P.) program. “Nurses don’t always recognize themselves as leaders. But we need to see ourselves that way to become change agents in health care.” Dr. Deavers also learned a process called evidence-based practice (EBP), in which clinicians identify a problem, determine possible solutions by integrating clinical knowledge with scientific research, and translate findings into sustainable improvements. Her skills were tested in her final
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The University of Texas Health Science Center at San Antonio School of Nursing | 2017
D.N.P. project at a school-based health clinic in rural Texas, in which about 15 percent of the district’s 650 students had been diagnosed with asthma and were chronically undertreated. “I noticed that many of the kids didn’t know when their last asthma follow-up was, and they had grown accustomed to their symptoms as being normal,” said Dr. Deavers. The nearest practice was 30 miles away, so she suspected that regular follow-ups were a challenge for the parents. A research review revealed that rural kids with asthma were more likely to be hospitalized than urban kids. She determined that the most sustainable improvement she could initiate was to collect asthma action plans for affected students to help them manage their symptoms at school. “It’s a good tool that not only helps the patient, it helps the parents manage symptoms at home,” she said. Dr. Deavers also convinced the district’s administration to change its policy to require action plans for every asthma student. “Sustainability is one of the crucial things I learned. As health care leaders, we can’t fix something permanently unless the solution is simple enough to be maintained.” Currently, Dr. Deavers plans to put her skills to use for another patient population—kids with Down syndrome. Dr. Deavers is currently partnering with a speech language pathologist to disseminate research into emerging methods of improving speech intelligibility. Her goal is to provide information to the medical community about these speech methods so they can educate parents. “As a mother of a son with Down syndrome, I can see how important this research is, and I want to help the medical community improve outcomes for Down syndrome patients,” said Dr. Deavers. “As a D.N.P., I can use the process I learned to help bring it into practice a lot sooner.”
DELIVERY
SUNRISE
MENTORING PROGRAM TARGETS UNDERGRADUATE STUDENTS, CREATES NEXT GENERATION OF NURSING RESEARCH LEADERS By CATHERINE DUNCAN
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eaders in the School of Nursing saw firsthand that underrepresented minority students, who are often firstgeneration college scholars, face hurdles unknown to other students. Darpan Patel, Ph.D., assistant professor/research, said the nursing school knew it needed to help guide these students toward successfully completing their undergraduate degrees and then enrolling in graduate school. Because of its designation as a Hispanic-Serving Institution, the School of Nursing successfully applied for a five-year, $2.5 million Title V grant from the U.S. Department of Education to expand its Student Success Center. The grant allowed the school to create a Summer Undergraduate Nursing Research Immersion Experience, which is known as SUNRISE. SUNRISE provides opportunities for traditional-track undergraduate nursing students in their fifth semester to participate in two, eight-week summer research sessions mentored by faculty members from the School of Nursing. Selection for the program is done through a competitive application and interview process. “This program creates a mentor-mentee relationship between our faculty members and students,” he said. “They are with their mentors in a structured program for two consecutive summers. The students participate in weekly activities as a group, but the majority of their time is spent in the mentor’s research group.” Students in the SUNRISE program are expected to make meaningful contributions to science with national presentations and inclusion in peer-reviewed publications. TRIBUTE
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“These undergraduate students are charged with conducting original research and collecting data that will be shared with their peers and experts around the country,” Dr. Patel said. Funding from the federal grant covers the students’ travel and conference costs so they can make presentations on their research. Dr. Patel and David Byrd, Ph.D., associate dean for admissions and student services, traveled last summer with the first four SUNRISE students to the University of California, San Francisco, to show them graduate school opportunities outside of Texas. “Our SUNRISE students had the opportunity to visit the top National Institute of Health funded nursing school in the United States,” he said. They also were introduced to Victoria Flores, M.S.N., B.S.N., RN, who is a Ph.D. student there. Flores completed her undergraduate nursing education at the School of Nursing. “Victoria told them that no matter their personal history or upbringing, hard work perseveres and that by working hard they can succeed like she has,” Dr. Patel said. “We want to plant the seed to show them they are capable of attaining things they previously didn’t think were attainable.” By offering the SUNRISE program, the nursing school is hoping these students will continue on to receive their master’s and doctoral degrees. “We are creating the foundation for future nurse researchers,” he said. The following four stories highlight the first SUNRISE students and mentors. The University of Texas Health Science Center at San Antonio School of Nursing | 2017 11
UNDERGRADUATE RESEARCH PROGRAM UNVEILS NEW CAREER PATH FOR STUDENT
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fter obtaining her first bachelor’s degree in biology at The University of Texas at San Antonio, Cristina Cruz admits she began working on her Bachelor of Science in Nursing at the UT Health Science Center San Antonio with a very narrow view of research and nursing. “I learned nursing is a much bigger and more complex world than I ever imagined,” she said. “I had no idea that my background as a biologist would be a great foundation for conducting nursing research.” Her current participation in the School of Nursing’s SUNRISE program now has her setting her sights on a career in research by attaining her Ph.D. in nursing research. Frank Puga, Ph.D., and Lisa Cleveland, Ph.D., RN, CPNP, serve as Cruz’s mentors for the SUNRISE program. Her research topic is “The Relationship Between the Social Environment, Stress and Health Outcomes in Pregnant Opioid Using Women.” “Although Cristina already had experience in labbased research, she is now gaining more diverse research skills and incorporating more of a holistic view of how behavior affects health,” Dr. Puga said. “The SUNRISE program ties into these nursing students’ curriculum. This gives Cristina and the other undergraduate students the opportunity to take what they are learning in the classroom and bring it into their research.” Cruz said she is excited about their research project studying how social support affects the mental health of pregnant women with opioid use disorders. For the project, they are interviewing women and administering surveys to characterize the types of stressors these women face. “Many of the women we work with experienced trauma in their lives. They have uncertainty about the pregnancy and maintaining custody of their child,” she said. “We are measuring social support and stress experienced by these women and the effect this has on their mental health.” Dr. Puga said that by looking at the stressors and the outcomes, they can determine how social support can help. “We can then determine what evidencebased practices should be implemented in communities to help these women. We can use research to develop interventions that can help women and their infants be healthier and happier.”
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“We can use research to develop interventions that can “Although Cristina help women andalready their had experience in lab-based research, she is infants be healthier now gaining and morehappier.” diverse research skills and incorporating more of a holistic view of how behavior affects health,” Dr. Puga said. “The SUNRISE program ties into these nursing students’ curriculum. This gives Cristina and the other undergraduate students the opportunity to take what they are learning in the classroom and bring it into their research.”
Cristina Cruz, Bachelor of Science in Nursing student, works with faculty mentor Frank Puga, Ph.D., on a research project studying how social support affects the mental health of pregnant women with opioid use disorders.
The University of Texas Health Science Center at San Antonio School of Nursing | 2017
DELIVERY
“The SUNRISE program is a chance to expand my education beyond what is normally offered at an undergraduate level in the area of research.”
B.S.N. student Aisha “Eesh” Silva and faculty mentor Lisa Cleveland, Ph.D., RN, are conducting research with the goal of reducing mortality rates of Latina women by understanding the relationship of early childhood trauma, depressive symptoms and opioid use.
STUDENT RESEARCHER CONDUCTING STUDY TO HELP STRUGGLING MOTHERS, BABIES
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orn and raised in San Antonio, Aisha “Eesh” Silva wants to assist the underserved in her hometown. After earning her associate’s degree from St. Philip’s College, she decided to pursue her Bachelor of Science in Nursing from the School of Nursing. Acceptance into the nursing school’s SUNRISE program is confirming Silva’s decision to go on to earn a graduate degree so she can be a pediatric nurse and a nurse researcher in the community. “The SUNRISE program is a chance to expand my education beyond what is normally offered at an undergraduate level in the area of research. This is my best opportunity to get an inside look at how research that shapes our clinical practice is done and an intimate look into a researcher’s thought process,” she said. Lisa Cleveland, Ph.D., RN, CPNP, and Frank Puga, Ph.D., serve as Silva’s faculty mentors for her SUNRISE research project, “The Relationship between Early Childhood Trauma, Depressive Symptoms and Opioid Use in Latina Women.” TRIBUTE
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This research project is part of a larger study Drs. Cleveland and Puga are conducting entitled the Maternal Opioid Morbidity Study (MOMS), which is being funded by the Texas Health & Human Services Commission. Texas has the highest maternal mortality rate in the country which means these women die during pregnancy or within a year of giving birth, Silva said. Maternal opioid overdose death is the second leading cause of death in Texas—second only to maternal deaths caused by a cardiac event. Upon discovering this, Silva said she decided to focus her research on learning more about this population so targeted interventions could be developed to reduce mortality rates for this population. “By interviewing and surveying these women, we can learn how to help future mothers and their babies. Research can help us make a difference,” she said.
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RESEARCH GEARED TO REDUCING MUSCLE WASTING CAUSED BY PROSTATE CANCER TUMORS
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hen Derek Wallace was accepted into the SUNRISE program, the nursing student brought 15 months of laboratory experience in an oncology lab and a physiology lab. Wallace, a seventh-semester traditional track Bachelor of Science in Nursing student, said he thoroughly enjoyed his lab experience and has always had a fascination with research. When he heard about the nursing school’s new SUNRISE program, it sounded like the perfect fit for him. “The SUNRISE program is totally different than what I did before. In my previous experience, I was given a task to do,” he said. “In the SUNRISE program, I’m tasked with developing a research question and designing experiments to answer that question.” In his research project, Wallace worked with his faculty mentor, Darpan I. Patel, Ph.D., to plan the research project, perform experiments, conduct statistical analysis, and disseminate the findings. “This is truly collaborative. Dr. Patel is a true mentor rather than a boss,” he said. Their research, “Attenuating Prostate Cancer Induced Cachexia with Exercise and Nexrutine®,” concentrates on studying the cytokine (inflammatory) signaling of prostate cancer tumors that leads to cachexia, which is the clinical name for muscle wasting.
“We are looking at two non-pharmaceutical interventions— exercise and Nexrutine® which is the extract of cork tree bark—to prevent or delay muscle wasting due to prostate cancer,” Wallace said. “If we can reduce this debilitating side effect of cancer, we can significantly improve quality of life.” Dr. Patel said pharmaceutical interventions have proven to be ineffective and have adverse effects. “Cachexia is a complex condition with multiple physiological pathways involved. Prescribed medications typically target just one protein in one pathway. In my lab, we study the effectiveness of exercise and Nexrutine® in modifying all the physiological pathways associated with cachexia. Nexrutine® and exercise appear to be more effective and target multiple pathways. Once we figure out what these interventions are doing to the muscle in animal models, we can measure their effectiveness in cancer patients with cachexia,” he said. Wallace said their research can be translatable to other populations suffering from cachexia, like patients with COPD, advanced cardiovascular disease and other cancers. Once their research is completed, their findings can be the basis for recommending patients at risk for muscle loss exercise and take Nexrutine® in order to battle muscle wasting.
“This is truly collaborative. Dr. Patel is a true mentor rather than a boss.”
Derek Wallace, who will earn his B.S.N. in 2018, is mentored by Darpan I. Patel, Ph.D. Wallace’s research concentrates on the inflammatory signaling of prostate cancer tumors that leads to muscle wasting.
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The University of Texas Health Science Center at San Antonio School of Nursing | 2017
DELIVERY
FILIPINO PROFESSOR, STUDENT STUDYING EFFECTS OF TYPHOON HAIYAN ON MOTHERS, CHILDREN
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efore he and his family immigrated to the United States from the Philippines in 2012, Bryan Ralloma helped care for his grandfather who had Parkinson’s disease. “I helped feed him, bathe him, and played the piano for him. I don’t think I am a very good piano player, but he thought I was the best,” Ralloma said. “Although I had been a dental student back home, the experience with my grandfather helped me to see that I wanted to go into a profession where I could offer holistic health care. I decided to pursue a career in nursing so I could alleviate the suffering of those who are sick.” After taking prerequisite courses at San Antonio College, Ralloma transferred to the UT Health Science Center San Antonio to attain his Bachelor of Science in Nursing. M. Danet Lapiz Bluhm, Ph.D., RN, associate professor, met Ralloma just days after he arrived in San Antonio. “It was wonderful seeing a Filipino who has her Ph.D. and is teaching at a major university. She is a lifelong learner who earned her degrees on four continents,” Ralloma said. “You don’t see a role model like that every day.” Dr. Bluhm helped Ralloma navigate nursing school and told him about the SUNRISE program at the School of Nursing. After being accepted as a SUNRISE undergraduate researcher, Ralloma began working with Dr. Bluhm studying the health consequences of prenatal maternal stress following exposure to a natural disaster. “In 2013, the northern part of the island of Cebu, where Bryan is from, was devastated by Typhoon Haiyan. We speak the same dialect—Visayan—as the residents, and we thought we could give back to our homeland by learning from women who were pregnant during Haiyan,” she said. Dr. Bluhm said they are interested in determining the psychological and physical effects on mothers who were pregnant and the children delivered after the typhoon. “We are partnering with nursing schools in the Philippines. They are sending faculty and staff to interview mothers to determine their health issues and their offsprings’ developmental progress,” she added. By gathering this data, this mentor-mentee team wants to create evidence-based recommendations. “We must figure out the types of support these women need after a natural disaster. Our research can be used to inform community-based interventions to promote resilience when similar devastating disasters occur in the future,” Ralloma said.
“Our research can be used to inform community-based interventions to promote resilience when similar devastating disasters occur in the future.”
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Bryan Ralloma, B.S.N. student, is working with mentor M. Danet Lapiz Bluhm, Ph.D., RN, to study the health consequences of prenatal maternal stress following Typhoon Haiyan in their native homeland of the Philippines.
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The University of Texas Health Science Center at San Antonio School of Nursing | 2017 15
By CATHERINE DUNCAN
A
Perfect
Partnership NEW METHODIST INTERNSHIP PROGRAM PROVIDES EXPERIENCE, EMPLOYMENT TO NURSING STUDENTS
new partnership between the School of Nursing at the UT Health Science Center San Antonio and the Methodist Healthcare System is offering undergraduate students the opportunity to attain invaluable experience during a paid internship that culminates in employment as a registered nurse. The Nursing Internship Program at Methodist Healthcare System was created in the fall of 2015 after Cynthia O’Neal, Ph.D., RN, associate dean for undergraduate studies, traveled to El Paso with Jamie Lingsch, M.S.N., RN-BC, vice president, clinical and professional education, for Methodist Healthcare System, and Annie Garcia, chief nursing officer of Methodist Texsan Hospital, to learn about an internship program there. “We came back to San Antonio very enthused about implementing an internship program. Within a few months, the program was underway, and the first students were interviewed. The first nine undergraduate students were accepted to the program late that fall. They started the internship program in January 2016 and completed it in May when they graduated,” Dr. O’Neal said. Celeste Castillo, B.S.N., RN, who was in the first internship class in January 2016 and graduated that May, said the experience was ideal for her. “I knew I wanted to work for the Methodist Healthcare System when I graduated with my B.S.N. I received an email from the nursing school about the new internship program, and I knew this was for me.”
LEFT Celeste Castillo, B.S.N., RN, was one of
the first participants in the Nursing Internship Program at Methodist Healthcare System. After completing the internship during her final semester, Castillo began working as an RN in the Cardiac/Telemetry/Medical Surgical Unit at Methodist Specialty & Transplant Hospital in San Antonio.
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The University of Texas Health Science Center at San Antonio School of Nursing | 2017
DELIVERY
Castillo’s internship and her current RN position is in the Cardiac/Telemetry/Medical Surgical Unit at Methodist Specialty & Transplant Hospital in San Antonio. “This internship gave me the opportunity to get to know the people, the system and the protocols. After I graduated and passed my NCLEX (National Council Licensure Examination), my transition into my new job was a smooth one. I would highly recommend this opportunity to nursing students,” she added. Undergraduate students in their seventh semester can apply to the program. Nursing school faculty and Methodist nurse managers interview the prospective participants who are all highachieving students. “During the interview, the nurse managers and nurse educators question them about their interest in particular units, five-year goals, work styles, and ability to handle stress,” Dr. O’Neal said. “The key aspect is making sure they are going to be a good fit with the unit.” Although the program initially only included three Methodist hospitals, now all seven area hospitals are participating in the internship. Participating units include intensive care, orthopedics, general medicine, surgery, telemetry, pediatrics, operating room and obstetrics. Students earn a stipend of $3,500 for the 260 internship hours, which are in addition to course and clinical hours required for school, during their last semester. This allows each student to complete their immersion hours with the same preceptor (a B.S.N.prepared nurse) as the internship preceptor, their leadership/ management hours in the same facility, and their RN competencies and orientation objectives during the internship. The students sign a contract requiring a two-year commitment to Methodist Healthcare System after they graduate. They are hired into an RN position at the end of the internship in the unit where they interned. The number of internships is rising. In 2016, there were nine in the spring and 10 in the fall. Spring 2017 has reached 13 participants, she said. “This has been an incredible vehicle for us to expand our great relationship with Methodist Healthcare System. It is wonderful to get to know the nurse managers,” Dr. O’Neal said. “And, Methodist knows we are vetting the best and brightest from our graduating class.” Lingsch said the internship is helping develop Methodist’s workforce. In 2011, the Institute of Medicine issued “The Future of Nursing’s Campaign for Action” report. This statement included a goal of increasing the proportion of nurses with a baccalaureate degree from 50 percent to 80 percent by 2020. “We knew we needed to expand our relationships with university partners. Other professions offer internships that are beneficial to all,” she said. “By building on our existing relationship with the UT Health Science Center San Antonio, we wanted to capitalize on their nursing students’ final semester of school,
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Leaders from Methodist Healthcare System and the School of Nursing celebrated the completion of the first class of the Nursing Internship Program. The initial class began the internship in January 2016 and completed it in May 2016. Back row (from left): Cynthia O’Neal, Ph.D., RN, associate dean for undergraduate studies, School of Nursing; Brandi Elliott; Rachel Scott; Jaime Wesolowski, president and CEO, Methodist Healthcare System; Susan Griffin, chief nurse executive, Methodist Healthcare System; Robert Daniel Hernandez; Jamie Lingsch, vice president clinical and professional education, Methodist Healthcare System; and Annie Garcia, chief nursing officer, Methodist Texsan Hospital. Front row (from left): Marcela Gonzalez, Macy Suplick, Reanna Keithly, Selina Sonora, Celeste Castillo and Najette Scott. Photo courtesy of Bil Sullivan Photography
when they could complete their final degree requirements while becoming a part of a unit.” Lingsch said the internship provides multiple benefits to the students. “Their additional clinical experience helps them better prepare for NCLEX. Their critical thinking skills have been honed during the internship. And, this program really helps jump start their careers. They are really far ahead of their peers. They enjoy a smoother transition from student nurse to registered nurse,” she said. Methodist hospitals get an employee who is engaged and ready to become a part of the team, Lingsch said. “But, the patients are truly the biggest winners. They are cared for by a well-educated registered nurse who is familiar with the hospital, the health care team and the procedures.” Shanae Rhodes, B.S.N., RN, began her internship in August 2016 and completed it shortly after graduating in December. Rhodes interned in the Medical Surgical Unit at Northeast Methodist Hospital. Rhodes said the internship was invaluable to her because of the amount of confidence she gained during the experience. “Before the internship, I hadn’t felt as confident about my clinical skills. Because I felt like I was a part of the team, I was comfortable about asking questions. It made me feel like part of the work family,” she added. Instead of working after graduation as a graduate nurse, Rhodes chose to take time off to prepare for the NCLEX. On Feb. 1, she learned she passed the national licensing exam. In March, she returned to the Medical Surgical Unit as a registered nurse. “I hope the program keeps growing,” she said. “The internship allows you to get to know the hospital and the team. You gain the confidence and clinical experience to be able to take great care of your patients.”
The University of Texas Health Science Center at San Antonio School of Nursing | 2017 17
BREAKING BARRIERS
Research dedicated to cancer prevention for Korean Americans
By TERI SPEECE
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magine you knew you were predisposed to certain types of cancers—but you found it so hard to find a physician, communicate your symptoms, understand medical advice and pay the costs of screening that you ended up doing nothing about it. Moonju Lee, Ph.D., M.S.N, RN, assistant professor in the School of Nursing, is tackling this issue. Her research addresses emigrants from the Republic of Korea, a rapidly growing U.S. population with some of the highest incidences of colorectal cancer worldwide, yet some of the lowest rates of colorectal cancer screening. “According to the American Cancer Society, colorectal cancer is the most commonly diagnosed cancer among Korean-American men and the second most common cancer in Korean-American women,” Dr. Lee said. “But, their cancer screening rates are extremely low compared to other Asian American ethnic groups and the overall U.S. population.”
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“It’s very hard to find Korean-American data, because most national statistics represent Asian Americans or Asian Americans/Pacific Islanders in aggregate, except in California and Hawaii, where they do break them out,” she said. “But individual Asian groups have different health issues, languages, immigration histories and demographic profiles.” Dr. Lee’s research into Korean-American health behaviors arose from 17 years’ experience in critical care oncology nursing, six years of research and clinical work in community health and her personal experience emigrating from Korea 20 years ago. For her Ph.D. from the University of Arizona, she completed her dissertation on barriers to and facilitators of colorectal cancer screening among Korean Americans aged 50 and older. That study involved conducting a survey in the Greater Los Angeles area, mainly Los Angeles and Orange counties, which contain the highest number of Korean Americans in the United States.
The University of Texas Health Science Center at San Antonio School of Nursing | 2017
DIVERSITY
Moonju Lee, Ph.D., M.S.N., RN • B.S.N., Ewha Womans University, Seoul, Korea • M.S.N./CNS, University of Virginia, Charlottesville, Virginia • Ph.D., University of Arizona, Tucson, Arizona
LEFT After 17 years in critical care oncology nursing, Moonju Lee, Ph.D.,
RN, is conducting research to benefit South-Korean emigrants who have some of the highest incidences of colorectal cancer but also some of the lowest rates of colorectal cancer screening.
Her current study builds on that data using surveys and individual interviews to confirm the previous results and also explore sociocultural beliefs about cancer screening and the experiences of U.S. health care services utilization among Korean Americans in Dallas, Houston, Austin and San Antonio. Dr. Lee conducted 500 surveys and 18 in-depth interviews. Dr. Lee is currently analyzing survey data but has found important themes from her analysis of the interview study: HEALTH CARE PROVIDERS AREN’T RECOMMENDING SCREENINGS. This finding is prevalent in both California and
Texas, with every one of the 18 Texas participants citing they had never received colorectal cancer screening recommendations from their doctors. While data indicates the lack of insurance coverage to be a factor, even the participants who had insurance coverage said they did not receive a recommendation—a finding Dr. Lee hopes to explore further in future research. She suspects a significant difference in communication styles between American doctors and Korean doctors may contribute to this result. “A Korean physician’s communication style is to force by telling their patients, ‘You have to do your cancer screening.’ In Korean culture, doctors are an authority, and when the doctor tells them to do something, they say, ‘No matter whether I can afford it or not, I have to do it,’ ” she said. “In the United States, many physicians present it as a choice: ‘If you want, you can have your cancer screening done.’ They leave the decision-making to the patient,” said Dr. Lee. “This difference in communication styles is an important factor contributing to patients’ decision-making. So the patient says, ‘If I don’t have any symptoms, why do I need to be tested?’ ” THE U.S. HEALTH CARE SYSTEM IS COSTLY AND DIFFICULT TO NAVIGATE. Most Korean Americans work for small businesses,
which do not provide health insurance. Those who have insurance privately or through the U.S. Patient Protection and Affordable
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Care Act rarely used it for several reasons, including difficulty navigating the U.S. health care system and language barriers. “Basic communication is possible, but Korean patients often don’t fully express their feelings or their symptoms, and they don’t fully understand what the doctor is talking about,” Dr. Lee said. Interview subjects also said they are intimidated by the unfamiliarity of the U.S. health care systems, have difficulty finding health care providers in their network, or find it hard to go to multiple places for services such as checkups, radiology and blood work. “The system is very different from Korea’s, where it is one stop for many services. They can do radiology, blood work, pharmacy, specialists—everything in one building on the same day. They are very complete and speedy,” she said. Other participants cited the unavailability of specialists when they needed them. “One of the saddest stories I heard was from a lady who fell and had a fracture. She went to the ER, but they said she had to wait a few weeks or months for an orthopedic specialist. She didn’t go to the doctor for six months,” said Dr. Lee. “She finally went to Korea to get treated.” IT’S EASIER TO GO HOME FOR HEALTH CARE. Dr. Lee’s research also revealed many Koreans prefer to travel back to Korea for routine checkups, screenings and even medication over trying to navigate the U.S. system. Korean travel agencies advertise medical tour packages offering a cafeteria-style list of services, including health examination, blood work, radiology, and various screenings for $500 to $1,500. “The packages include many options such as dementia checkup, brain MRI, and many cancer screenings,” she said. Some participants also said they used Korea’s national health insurance program as an alternative to U.S. health care. “It’s much cheaper and easier to get health care services in Korea compared to the U.S.,” Dr. Lee said. “Even if they don’t have Korea’s National Health Insurance plan, they can pay cash to get services.” In addition to furthering her research, Dr. Lee’s goal is to develop robust health promotion programs to reduce health disparities in this group and build a healthy Korean-American community using community-based participatory research.
The University of Texas Health Science Center at San Antonio School of Nursing | 2017 19
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ADVANCING VETERANS’
HEALTH CARE Dittmar Endowment Honors Fathers’ Military Service
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The University of Texas Health Science Center at San Antonio School of Nursing | 2017
DEVELOPMENT
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of the veterans we are now serving are Vietnam vets who have chronic health issues. They are quite familiar to me because of my father’s experiences.” Vicky’s father, John Sweeney, was a Green Beret in the Army, served in both the Korean and Vietnam wars, and continued his career in the military. Dale’s father, Douglas Dittmar, served in the Army during World War II but did not see combat. Both men taught their children the importance of serving their country and being patriotic. The Dale and Victoria Dittmar Nursing Endowment was established in 2015 to honor their fathers’ memories and their service and to further the advancement of health care for all veterans. “Dale and I have always been really passionate about veterans’ health care issues and service to our country,” says Vicky who has been a nurse for 30 years. “My father had some traumatic experiences while serving, and although he was never diagnosed, he suffered quite a bit from post-traumatic stress. With the ongoing growing war on terrorism and working at the VA with my clinical students, the ability to recognize issues relating to PTSD and brain injuries is something that is very important to Dale and me.” Furthermore, their youngest son, Brandon, 26, is currently serving in the Air Force and on his first deployment. Their other son, Andrew, 29, lives and works in Houston. Both boys received scholarships which helped pay for their college educations leaving the Dittmars with the financial means to give back some of their good fortune. “We have been blessed,” Vicky says. “We didn’t need the money for our own children’s education, so why not turn around and make it easier for someone else, particularly nursing students. It was a pretty easy decision to make.” As the first recipient of the endowment and part of a military family herself, Adelaide Emery, M.S.N., B.S.N., is grateful to the Dittmars and also is concerned about veterans’ health care. She earned her M.S.N. in 2013 and her B.S.N. in 2004 from the School of Nursing. “My brother and grandfather were in the Army and my father was in the Air Force,” says Emery, who currently is the operating room manager at Methodist Texsan Hospital. “I want to make sure that anyone who fought for our freedom receives good health care.” Emery completed the School of Nursing’s post master’s family nurse practitioner program in August 2016. Ultimately, the benefactors of the Dittmars’ generosity will be the veterans who are treated by the well-trained nurses from the UT Health Science Center San Antonio, such as Emery; and Vicky will continue to mentor and inspire them to do so.
1 Douglas Dittmar served his country in the U.S. Army during
World War II. 2 John Sweeney was a Green Beret in the U.S. Army during the
Korean and Vietnam wars. 3 Dale (from left) and Vicky Dittmar, M.S.N., RN, visit with
Adelaide Emery, M.S.N., RN, who was the first scholarship recipient of the Dale and Victoria Dittmar Nursing Endowment. The couple created the endowment to honor their fathers.
By SALWA CHOUCAIR
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hen she enters the Audie L. Murphy Memorial VA Hospital to work with nursing students in partnership with The University of Texas Health Science Center at San Antonio, Assistant Professor Vicky Dittmar, M.S.N., Class of 2001, feels like she’s at home. This sense of home stems back to her childhood— specifically, her father’s military career. It also is the main reason she and husband Dale Dittmar chose to establish a nursing endowment to benefit students who share their desire to help military veterans. “I’ve been working at the VA for four years, and it’s been very rewarding for me,” says Vicky, clinical faculty coordinator for the School of Nursing’s Dedicated Education Unit (a model of clinical teaching) in partnership with the VA. “Whenever I walk in the doors at Audie Murphy, I feel like I’m at home. Part of it is because many
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The University of Texas Health Science Center at San Antonio School of Nursing | 2017 21
HONOR ROLL OF DONORS PLANNED GIFTS
Estate of Anonymous Kristine Arlitt Patricia Kay Avant Anne Fishburne Briscoe Barbara Greene Carol Huebner Judith Hutcherson Gladys Lynch Mary Pena Judith & William Pesetski Philip and Jean Piccione Martha Redman Susan Rovira Shirley Sterling ENDOWMENT SUPPORT
David and Ginger Baer Family and Friends of Jennifer HerinSelvester Gary Baldwin Eileen Breslin and William Israel Anne Fishburne Briscoe Rudy and Barbara Gomez Family and Friends of Rudy Gomez Ronald and Karen Herrmann Carol and Michael Huebner Family and Friends of Carol Huebner Gladys Lynch Family and Friends of Mary Faye Montgomery Friends of the Nursing Alumni Scholarship Walter and Siew Pang 22 TRIBUTE
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Judith and William Pesetski Philip and Jean Piccione Karen Presley Family and Friends of General Bobby W. Presley Ronald Reed
Carrol Doolen Heinz Gunga Yolanda Hall Frances Jean Kelley Roberta Luedke Robert Meyer Linda Miller Christine Nicholas John Ntagha Jacqueline Rock Marian Rodgers Corrine Sherman Nancy Smith Christine Treiber Joan Trimble
Beverly Wheeler Women’s Overseas Service League Barbara Wulfe
January 1, 2016 – December 31, 2016
Patricia Sigma Theta Laura BanksTeri Grubb Livingston Reed Tau/Delta Rebekah Alpha Chapter Louise Beldon Judy Maltas Guzman Elaine Marshall Sigma Theta Tau Donna Block Barbara Haley International John Melvin Jennifer Caffery Betty Halff Nancy Smith Methodist Carolina Canales Marie Halff FRIENDS OF Healthcare Smoothie King Irma Patty Hawken THE SCHOOL Ministries @ Louis Carpinteyro Catherine Healy OF NURSING of South Pasteur Phyllis Chelette Irwin and Betty Aetna Texas, Inc. Isabell Stoltz CHRISTUS Helford Foundation Julie Meyer Santa Rosa Carol Swartz Debby Hepburn Alamo Jacqueline PRESIDENT’S CHRISTUS Susan Thornell Karen Herrmann Drafthouse Mickley COUNCIL VNA Cinema Joan Trimble Betty Howard Melissa Mireles Estela Avery HomeCare American Carol Huebner Trinity Gary and Barbara Banker Graciela Association University Brenda Jackson Carolyn Michael and Cigarroa of Colleges KRTU Radio Janet Jeannin Mueller Irene Black of Nursing Nanette Clare Station Frances Jean Gwen Notestine Donna Block Army Nurse Ashley Collins Barbara Ulrich Kelley Victoria Paparelli Margery Block Corps Helen Coronado Richard Mary Walker LIVING PatientAssociation Eileen Breslin CPS Energy Kendrick, III Sandra Weeks ENDOWMENT Centered and William Brenda Belville Jo Ann Crow SCHOLARSHIP Sandy Klein Joan Westgor Outcomes Israel Brenda Cabaza Robin Ford Patricia L.D. Ormsby Research Virginia Davis Janie CantyNURSING Dillard Armstrong Institute Charitable John Franklin, III Mitchell ADVISORY John Franklin, III Foundation, Association Jimmy Earl Betty Halff Chick-Fil-A COUNCIL of Pediatric Frost National Inc. Pierce Ronald and Medical Center Michael Aguirre Hematology Bank Adrianne Linton Percy Richard Karen Mary Jane Clark & Oncology Betty Andrews Alicia Gallegos Linda LopezAlicia Rowley Herrmann Josefina Cochetti Nurses Carol Andrews Toni Goldsmith George Kikumi Sarles Betty Howard Sam and Kay Candace Curlee Estela Avery Paula Gray Eileen Lundin Marilyn Carol and Bashara Del Rio Tortilla Walton Gregory Ling Mason Barbara Banker Schrantz Michael Michael and Factory Huebner Louise Beldon Odette Denisa Kevin Moriarty Patricia Cordier Carrol Doolen Judith Morton Jacquelyn Lark Ford Gregg Muenster Duplantis Talitha Gonzalez Victoria Paparelli Rebecca Garcia Pamela Gray Thomas and John and Carol Growney Jane Powell Darlene Linda Grumbles Maria Cristina Gilcreast Jo-Anne Rodriguez Karen Huffman Gruning Katherine James Lukose Jim Halloran Schwesinger Shirley Menard Carolyn Seale Kathleen Harr Palmer and and Carol Joanne Hilliard Judy Moe Lee Klose Bonita Howard April Nguyen Phyllis Siegel Nancy Janice NickiePaul and Marie Smith Hurd Green TWO STUDENTS TRAVEL TO COLOMBIA Smith Foundation Darrell O’Dell Neill Walsdorf Maria-Adelita FOR EDUCATIONAL EXCHANGE PROGRAM Eric and Angela Philippine Jacinto Nurses Weissgarber Brenda Jackson Association of Cecelia Acosta-Cruz, Traditional B.S.N. student, and Sarah Barbara Wulfe Jonas Nursing San Antonio, Grimmer, Accelerated B.S.N. student (middle in black scrubs), Excellence Inc. NURSING Fund spent spring break in Bogota, Colombia, as part of an educational Ronald Reed EXCELLENCE Richard FUND exchange program with the Universidad Manuela Beltran. San Antonio Kendrick, III Mildred Babcock Chamber of During this eight-day trip, they spent mornings in the classroom Gemma Commerce Carolyn and afternoons doing clinical rotations with their Colombian Therese Shoffner Kennedy Bierschwale counterparts who also are in the photo. They were able to learn Pamela Kittrell Lewis and Betsy Buckner about the culture and health care system in Colombia. Nancy Thorne Janna Lesser Frederick Coonan Mary Walker Adrianne Linton
The University of Texas Health Science Center at San Antonio School of Nursing | 2017
DEVELOPMENT
Methodist Healthcare Ministries of South Texas, Inc. Idalia Miller Melissa Mireles Mission Pharmacal Company Patricia Moss Don Moye Karen Mueller Gregg Muenster Bonnie Munroe Laura New Gwen Notestine Amparo Ortiz Kathleen O’Shea Victoria Paparelli Evelyn Patterson Jimmy Earl Pierce Patricia Pliego Stout Bill Rasco Ann Richardson Lorena Rodriguez Norma Martinez Rogers Enomie Rosenthal San Antonio Medical Foundation Laura Sanchez Schnitzler Cardiovascular Consultants, PLLC Joanie Schwartz Jocelyn Selig Marie Smith South Texas Money Management, Ltd. Jocelyn Straus Carol Swartz Dana Wheeler Terracina Julia Thompson Wendy Tillotson University Health System Maria Wellisch WellMed Medical Management, Inc. Angela White
Barbara Wulfe Anita LopezHerlinda Zamora Saldana Julie Luke ALUMNI Judy Maltas MEMBERSHIP Wendy Martin Betty Andrews Elia Matheny Carol Andrews Karen McMurry Samantha Shirley Menard Ashtiani Claire Mitchell Kelly Balser Judy Joyce Batcheller Moczygemba Leobardo Miriam Moerbe Benavides Michael Moon Carolyn Christine Morelli Bierschwale Marilynn Donna Bruns MujezinovicBetsy Buckner Womack Lynn Bullard April Nguyen Patricia Cordier John Ntagha Christina Carolyn Cunningham O’Connor Lilia Alice Pappas DeBenedetto Jimmy Earl Christian Doll Pierce Alesia Eaton Stephanie Gabriel EkorRandall Tarh Frederika Clarence Flint Rivera-Torres Victoria Flores Martha Sanders Laura Galvan Katherine Schwesinger Tricia Garcia Leslie Smetzer Alexandra Nancy Smith Gillespie Alexandria Genivy Gomez Smoots Talitha Gonzalez Elaine Staton Barbara Govan Linda Grumbles Shannon Stewart Sandra Nola Strickland Hagendorf Ramita Yolanda Hall Suwaldangol Linda Karen Svetz Harrington John Tindall Barbara Joan Trimble Haywood Barbara Ulrich Melissa Dolores Varona Hernandez Rosalinda Hobbs Karen Vazgec Jennifer Sharon Hohon Weakland Bonita Howard Candyce Willis Patricia Huff Robbin Karen Huffman Winchester Roni Hutson Nathanial Zabel Maria-Adelita Jacinto Brenda Jackson Nancy Jackson Tonia Jackson Charmaine Kathen Gemma Kennedy
Your Legacy Our Future With planning, you can help sustain the work of the nursing program far into the future. Strategic gift planning allows you to find a way to address your financial goals while creating a legacy of great impact. The endless possibilities range from a simple beneficiary designation on your retirement program to a plan that will provide an income to you and a future gift to the School of Nursing. Your gift may provide: • A life-changing scholarship for nursing students • A memorial endowment to honor a loved one • Support of an outstanding faculty and specialty program or any area that is of greatest interest to you. If you would like to learn more about creating a plan that will provide support for future generations, we are here to help. For more information, contact Melissa Mireles, director of development for the School of Nursing, at 210-567-5534 or mirelesm4@uthscsa.edu. The best way to give depends on your own personal situation and should be discussed with your professional adviser.
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ALUMNI PROFILE > PATRICIA A. PATRICIAN, Ph.D., RN, FAAN
SURPASSING A
CHILDHOOD GOAL Army Nursing Veteran Continues to Serve Profession as Professor BY SALWA CHOUCAIR
Retired Col. Patricia A. Patrician, Ph.D., RN, FAAN, served in the U.S. Army Nurse Corps for 26 years.
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As long as she can remember, she wanted to be a nurse. After 26 years in the U.S. Army Nurse Corps, retired Col. Patricia A. Patrician, Ph.D., RN, FAAN, continues to live out her dream today as the Donna Brown Banton Endowed Professor at the University of Alabama at Birmingham (UAB) School of Nursing. “I always knew that I wanted to be a nurse since probably age five. That was always my goal,” said Dr. Patrician, who was influenced early on by two aunts who were nurses. “Like most nurses, I wanted to serve others and to serve humanity.” Her passion for nursing has remained consistent whether serving as a staff nurse, head nurse, chief or professor, and she doesn’t have plans to slow down anytime soon. Since joining the UAB faculty in 2008, she enjoys teaching and mentoring students and continuing her research on staffing and outcomes, practice environments for staff nurses, and nursing sensitive indicators. Her dream began in her hometown of Nanticoke, Pennsylvania, a poor coal mining community where her father was a coal miner. She attended Wilkes University in Wilkes-Barre, Pennsylvania, and received her bachelor’s degree in nursing. A single mom at the time, she discovered that the military could provide her with the security she needed for her daughter and the opportunities she wanted for herself. She joined the U.S Army as an officer at the rank of second lieutenant, after a recruiter gave her a tour of the Walter Reed Army Medical Center in Washington, D.C. “I was impressed by the military nurses I saw,” recalled Dr. Patrician, who eventually served as the chief of nursing research service at Walter Reed from 2002 through 2004. “I was impressed at how advanced and how professional these nurses were. I felt like it was the right place for me.”
The University of Texas Health Science Center at San Antonio School of Nursing | 2017
DEDICATION
Dr. Patrician, M.S.N., Class of 1988, now serves as the Donna Brown Banton Endowed Professor at the University of Alabama at Birmingham School of Nursing.
With three assignments spent in San Antonio, Dr. Patrician considers the Alamo City her second home. She received her master’s degree in critical care nursing from the School of Nursing at the UT Health Science Center San Antonio in 1988. Learning the role of the clinical nurse specialist through that program was a great experience, she said. “Becoming an expert in one aspect of critical care was a unique part of the program, and a unique part of the clinical nurse specialist program at the time was choosing between an administration or an education minor. I chose education, but I took an administration course that served me well later in my career.” In fact, several elements of her master’s program impacted her career including the clinical education experience she gained while monitoring undergraduate
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students; the curriculum design course which challenged her to introduce a new course into a curriculum; and mentors, such as Don Johnson, Ph.D., RN, and Carol Ledbetter, Ph.D., RN, FAAN, who cared about and made an impact on her career. “I continue to stay engaged with the Health Science Center through colleagues, newsletters and magazines. I am especially proud of the work that the School of Nursing is doing with its nurse-managed clinics. I just think it’s wonderful for a school of nursing to help the local community and teach nursing students at the same time.” Dr. Patrician sees the future of her chosen profession as full of opportunities and is just as excited about being a part of it today as she was at age 5.
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ALUMNI PROFILE > BARBARA ARANDA-NARANJO, Ph.D., RN, FAAN
Barbara Aranda-Naranjo, Ph.D., RN, FAAN, has served in numerous nurse leader positions locally and nationally. Her diverse experience includes participating in a health mission trip to Oaxaca in Mexico.
FULFILLING HER MOTHER’S PROPHECY Living the dream while helping others
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DEDICATION
By SALWA CHOUCAIR graduation from Incarnate Word Academy in Houston. After being accepted into the School of Nursing at the UT Health Science Center San Antonio, she chose to complete her bachelor’s degree in nursing which she did in 1979. “It was a rigorous program,” she recalled. “It was difficult because I was away from home, and from every level, academic and cultural, it was stressful. There was no one for me to emulate, and it made me doubt myself. I didn’t pass my fourth semester, but a professor, Julie Meyer, M.S.N., Class of 1976, was instrumental in listening to me and encouraging me to complete the program. I even returned home. My mother didn’t understand and sent me to our family doctor. He assured me that I could do it, and told me how much I was needed in health care, and I needed to hear that. You need someone who has already made it to say, ‘You can do it too.’ ” Dr. Aranda-Naranjo reapplied to the School of Nursing and completed her B.S.N., but that experience of self-doubt, she said, made her a more reflective practitioner. “In nursing, you deal a lot with patients’ failures or decisions they have made that haven’t been the best for their health,” she said, recalling her work with HIV/AIDS patients in the early 1980s. For example, during physicians’ training, a colleague who was director of the HIV center was asked, “Why should we help these people? Don’t they deserve it (HIV/AIDS)?” She has never forgotten her colleague’s response. He picked up the fat around his stomach and said, “Do you see this? When I have my heart attack, you will have to take care of me, and I’m a doctor. I should know better, but we all have to support each other.” Dr. Aranda-Naranjo said, “I remember that, and I know it takes someone to walk through it with them. It shows how fragile we can be as human beings and how courageous we can be when we work together and support each other.” Dr. Aranda-Naranjo advises current and future nursing students to be ready for global health care because whatever happens in the world from a health perspective, impacts everyone. The best way to help a person, family or community be healthy is to give them the tools to make the right decisions within their own environment. “If you are going to be tired at night, be tired for something good. If people aren’t helping, others can’t live their dream, and everyone should have the opportunity to live at least some part of their dream.” From her time as a child helping those in need in her neighborhood to her work as a public health advisor on a national level, Dr. Aranda-Naranjo has left her mark on community health and nursing, just as her mother predicted she would.
Dr. ArandaNaranjo, B.S.N., Class of 1979, with husband retired Chief Master Sergeant Sonny Naranjo.
T
he daughter of a migrant worker, Barbara ArandaNaranjo, Ph.D., RN, FAAN, looked every day at a picture taped inside her closet of a little girl dressed like a nurse. She was about 8 years old when her mother cut the picture out of a magazine and told her that one day she would be a nurse. Today, Dr. Aranda-Naranjo is the associate provost for civic engagement at the University of Incarnate Word in San Antonio following a career in public health spanning 38 years. She has served in many roles over the years including as the nurse manager of a family practice on San Antonio’s west side, assistant director of a community HIV center, clinical professor with the UT Health Science Center San Antonio, and senior public health advisor at the Office of Global Health Affairs with the U.S. Health Resources and Services Administration. No matter her role, however, she has remained consistent in listening to the needs of the community. A quality honed as a child in her Houston neighborhood quietly watching and helping her mother, aunts and uncles take care of their neighbors in need. “My mother was a great influence,” says Dr. ArandaNaranjo who is one of nine siblings. “If anyone had a problem, she was there to help them. She instilled that in me. When people were sick in our neighborhood, she would send us to take them chicken soup; if an elderly neighbor needed to have his hair combed, one of us would go; if someone wanted to be wheeled outside who was bound to a wheelchair, we went to help.” These early experiences became the foundation on which Dr. Aranda-Naranjo built her nursing career. She attended St. Edwards University in Austin upon her high school
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ALUMNI PROFILE > VICTORIA M. FLORES, M.S.N., RN
Road Less the
Travelled Graduate finding new path in non-traditional role
By SALWA CHOUCAIR
W
hile traditional nursing roles continue to be in demand, today’s nursing students have a variety of work environments from which to choose when it comes to putting their skills and education to use. Victoria M. Flores, who received her B.S.N. in 2013 from the School of Nursing, found her perfect match in a non-traditional nursing role with a biotech company in San Francisco. She works in the company’s environmental health and safety department as an occupational health nurse serving 20,000 employees. “The community I serve now is my workplace,” says Flores, who received her M.S.N. from the
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University of California San Francisco (UCSF) School of Nursing in 2016 and currently is enrolled in its doctoral program. “I’ve really enjoyed the opportunity to focus on preventative health and to look at measures we can take to keep our employees healthy and happy. During my master’s program, I had the realization that as adults, we spend a large part of our lives at work, and that is where occupational health nurses have the opportunity to intervene and spread healthy habits.” Flores is focusing her doctoral research on exploring correlations between physical activity and upper extremity injuries specific to computer workers or office dwellers.
DEDICATION
Photo courtesy of Elisabeth Fall Photography
With the changing workplace and how technology drives the workplace, there are new approaches we need to take to keep people injury free and healthy at work.” —Victoria M. Flores
“With the changing workplace and how technology drives the workplace, there are new approaches we need to take to keep people injury free and healthy at work.” From the moment she switched her career path to nursing, Flores has learned to embrace stepping out of her comfort zone. After spending an internship with a cardiologist in San Antonio, she fell in love with health care and changed her undergraduate major from engineering to nursing. She followed that up with leaving her home state of Texas and her family in Devine, to attend UCSF. Although Flores was encouraged to experience a different educational system by Dean Eileen Breslin, Ph.D.,
RN, FAAN, of the School of Nursing, she admits that she was scared. “Looking back, I didn’t fully understand what she meant when she gave me her advice, but now I appreciate seeing the world and health care through a different lens,” Flores says. “I think it’s important to be open to new experiences and to where nursing may take you. You don’t necessarily need to follow a traditional route; it is good to be open to the opportunities that may present themselves and use your nursing skills and nursing education.” With so many options in health care on the horizon, taking the road less travelled for nurses such as Flores will just keep getting easier.
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A MESSAGE FROM YOUR BOARD PRESIDENT DEAR FELLOW ALUMNI, The Nursing Alumni Association continues to engage our alumni throughout the year. Last summer, we continued our Converse with a Nurse Series and invited alumna Talitha Gonzales, B.S.N. Class of 2013, RN, and community member Linda Beninga, B.H.A., RN, to speak with our Accelerated B.S.N. class about “Professionalism in Nursing.” Talitha shared her insights on defining professionalism in the nursing profession, providing advice that was learned on the job and examples of navigating professional issues. Fun was had by all at the universitywide alumni mixer at La Fonda on Main. Alumni from all five schools and their guests enjoyed an evening of mingling, Mexican food and margaritas! University representative John Kaulfus shared details about the opening of our newest building on campus, the Academic Learning and Teaching Center (ALTC). Last fall, we held our first Nursing Alumni Picnic on campus. A huge thank you to Smoothie King Louis Pasteur location for sponsoring an afternoon of BBQ, face painting, balloon art, music and prizes! Nursing Ambassadors Kaycee Kaminski and Alexis Wahlen provided tours to guests of the ALTC.
Dean Eileen Breslin hosted the Lifetime Member Dinner at Oak Hills Country Club. This special evening was an opportunity to recognize these members for their leadership and investment in our school. The evening was a great success as members shared their paths after graduation. This winter, we hosted another Converse with a Nurse event. Alumna Laura Valdes, M.S.N., B.S.N. Class of 2000, RN, teamed up with Vanessa Meling, Ed.D., director of academic enhancement in our Student Success Center, to speak to nursing students about “Building a Professional Profile: Tips on Resumé Writing & Interview Skills.” I’m proud to announce we kicked off our Alumni Mentorship Program this year. Alumni mentors have been connected with nursing students and are helping students navigate the transition into the professional workforce. If you would like to become a mentor, please contact Melissa Mireles at mirelesm4@uthscsa.edu. Your involvement in our School of Nursing Alumni Association is imperative to its success. Please renew your membership or join us as a new member; your support ensures a bright future for your alma mater and the students following in our footsteps. Thank you for your continued friendship and support. Sincerely,
DON’T DELAY! Join Today Your Nursing Alumni Association Your Alumni Association membership is the perfect way to:
Be informed
Network
Support your alma mater
Get involved
Odette V. Denisa, M.S.N., RN, ACNP-BC President, School of Nursing Alumni Association
The Nursing Alumni Association Wishes to Thank Smoothie King for Sponsoring The Alumni Picnic.
JOIN AT
makelivesbetter. uthscsa.edu/ sonalumni or call 210-567-5534.
Lifelong Learning Reaccredited
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The School of Nursing’s Department of Lifelong Learning has been reaccredited by the American Nurses Credentialing Center’s (ANCC) Commission on Accreditation for a term of four years, the longest accreditation term available. ANCC accreditation is the most widely accepted accreditation in the world and is granted to organizations and educational institutions that meet stringent requirements for offering evidence-based activities using the ANCC’s criteria for planning, implementation and evaluation. The DLL is one of only 12 ANCC-accredited providers in Texas and the only ANCC-accredited provider in the UT System. The department offers both live and online continuing education for nurses and annually hosts the Cultural Inclusion Institute in April, Geriatric Conference in June, and Conference for Community Engagement and Healthcare Improvement in September. The department provides an online RN Refresher Course offered in the spring, summer and fall. For more information, go to the link at left or contact Sherece McGoon at mcgoon@uthscsa.edu or (210) 567-5850.
The University of Texas Health Science Center at San Antonio School of Nursing | 2017
TRIBUTE SCHOOL OF NURSING | 2017 DEAN
Eileen T. Breslin, Ph.D., RN, FAAN EDITOR AND PUBLISHING DIRECTOR
Catherine Duncan Director of Communications Office of Institutional Advancement PRODUCTION MANAGER
Melissa Mireles, M.A. Director of Development School of Nursing CREATIVE DIRECTOR
KEEP LEARNING The Department of Lifelong Learning offers continuing professional education to meet the needs of all nurses. Online and Live Continuing Education
RN Refresher Course
Events with CE Courses
nursing.uthscsa.edu/CE
nursing.uthscsa.edu/ RNrefresh
nursing.uthscsa.edu/events
nursing.uthsca.edu/keeplearning
Jennifer Bittle Creative Design Manager Office of Marketing, Communications & Media CONTRIBUTING WRITERS
Salwa Choucair, Catherine Duncan, Rosanne Fohn and Teri Speece DESIGN AND PRODUCTION
Causality, Brand Marketing for Good Causes SENIOR DIRECTOR OF MARKETING
Kris Elders Doyle Office of Institutional Advancement Photos provided by Noell Vidaurri, Creative Media Services Printing provided by UT Print
CALLING ALL ALUMNI!
© The University of Texas Health Science Center at San Antonio, 2017. All rights reserved.
MEET, GREET, RECRUIT AND GET HIRED AT OUR NURSING
CAREER FAIRS
ARE YOU SEEKING TOP TALENT FOR YOUR PRIVATE PRACTICE, COMPANY OR ORGANIZATION? Join us for the opportunity to recruit the cream of the crop during two Career Fairs to be held this fall and spring on the campus of the School of Nursing. Hosted by the school’s Student Success Center, the events bring employers to campus to meet with undergraduate and graduate students and alumni. Exhibit space is available at the Gold, Silver and Bronze sponsorship levels to alumni in practice, employers or companies interested in securing a table where they can meet with potential recruits. Each level offers unique benefits. For more information or to reserve your spot, call 210-567-5892 or email HolbrookD@uthscsa.edu.
SPECIAL THANKS TO OUR GOLD SPONSORS for the fall 2016 and spring 2017 Career Fairs.
NAVY RECRUITING DISTRICT
San Antonio, TX
nursing.uthscsa.edu
The University of Texas Health Science Center at San Antonio Office of the Dean, School of Nursing - Mail Code 7923 7703 Floyd Curl Drive San Antonio, TX 78229-3900
We will always educate healers. We will always search for answers. We will always work to make lives better.
We will always be The University of Texas Health Science Center at San Antonio, although now you will see us using a shorter name, UT Health San Antonio. We are healers, educators and scientists, working together for the benefit of all, today and always. Learn more at WeMakeLivesBetter.com.
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