SPRING 2017 A TRIBUTE TO DR. BRASHERS STANDARDIZED PATIENTS MARROW-MINDED HONORING CANCER WARRIORS
Better Together
11.29.16 / Tim Cunningham (CNL ’09)—an assistant professor of nursing, assistant director of the School’s Compassionate Care Initiative, and a professional clown and actor—captivated with his solo performance at UVA’s Ruth Caplin Theater last fall. His act offered a glimpse into his longtime work with Clowns Without Borders, through which he has peddled laughter, humanity, and compassion in 20 countries over the past 14 years. This summer, Cunningham will lead a clown camp as part of UVA's Heritage Theatre Festival, and a “Find Your Funny” course at Omega Institute in Rhinebeck, New York. Photo: Dan Addison.
Virginia Nursing Legacy is published twice a year by the University of Virginia School of Nursing and Nursing Alumni Association using private funds. issuu.com/virginianursinglegacy EDI TORS
Jenny Abel Christine Phelan Kueter CON T RIBU TORS
Andrea Ceniceros Jessica Eustace Karol Kozak Kelly Williams McCaskill Nicole Thomas ALUMNI COUNCIL COMMUNICAT IONS COORDINATOR
Matt Lemieux (CNL ’11, PNP ’15) DESIGN
Communication Design Inc. Send feedback to nursing-alumni@virginia.edu
UNIVERSITY OF VIRGINIA SCHOOL OF NURSING Established in 1901 nursing.virginia.edu SADIE HEATH CABANISS PROFESSOR OF NURSING AND DEAN Dorrie Fontaine, RN, PhD, FAAN Alumni and Development Office P.O. Box 801015 Charlottesville, VA 22908-1015 (434) 924-0138 (434) 982-3699 FAX School: (434) 924-2743, (888) 283-8703 COVER:
The LegoBot Challenge is part of an interprofessional training activity at the School of Nursing (see p. 8). The brick configuration is a registered trademark of the LEGO Group of companies, which does not sponsor, authorize, or endorse this publication. Photo by Coe Sweet.
SPRING 2017
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Profile: Kim Albero (BSN ’06, DNP ’18)
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Better Together
12 A Tribute to Dr. Brashers 15 Standardized Patients 16 Decisions That Hit Below the Belt 18 Students Research E-Cigs, Bone Marrow Donation 19 Honoring Cancer Warriors 20 Nursing Alumni Association 28 Profile: Katie Sutton (BSN ’16)
FROM THE DE AN
Keeping ’Bots at Bay
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he book currently on my bedside table— Humility Is the New Smart,1 by Darden School of Business Professor Edward Hess and Katherine Ludwig—captures for me the beauty embedded in so much of what we do here at the School of Nursing, and as nurses more generally. In an era of increasingly intelligent devices and systems that are already assuming ownership of many of our jobs (including a growing number of professional ones), the book offers a Paul Revere–style call to action for humans to “take our cognitive and emotional skills to a much higher level” lest we be outmoded by a growing array of high-tech talent.2
JANE HALE Y
This issue of Virginia Nursing Legacy— which celebrates the sizable impact that an interprofessional approach has on students’ teamwork skills— highlights how UVA students and clinicians are keeping themselves relevant: through purposeful, thoughtful, practical, sustained practice in collaboration. And the University of Virginia’s much-heralded interprofessional education programs, founded by the inimitable Tina Brashers, MD, are, at their core, defined by humbleness. But what, exactly, does humility mean? First, what it’s not. Humility is not meekness, serial acquiescence, or going along to get along. Rather, it’s a realistic self-knowledge that creates openness to new ideas and ways of being—what Hess and Ludwig explain
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as the antithesis of “obsessive individualism.” To me, humility is also, in equal parts, a quieted ego, a closely managed self, and a facility in emotional connection and authentic search for connectedness. To keep the ’bots at bay, we must do what they cannot: become better thinkers, listeners, relators, and collaborators. Sounds a lot like what nurses do every day, doesn’t it? It also sounds like the undercurrent that flows constantly through our classrooms, flavoring how we teach and interact, what we value, what students learn, and how they care. An emerging emphasis on team care in this era of messy healthcare reform requires us to prepare nurses skilled in seeming opposites: to be unassuming, but unafraid to opine; to both advocate and compromise; to listen as well as speak, and be heard; and to, beyond all else, be profoundly respectful and humble even—especially—in the face of otherness. It’s just what Professor Brashers has done during her three decades as a critical part of our nursing and medical schools, influencing the thousands who’ve taken her message on the road in their own practices. We are fiercely proud of, and immensely humbled by, her work and her legacy.
Dorrie Fontaine, RN, PhD, FAAN Sadie Heath Cabaniss Professor of Nursing and Dean 1 Hess, E. D., & Ludwig, K. (2017). Humility is the new smart: Rethinking human excellence in the smart machine age. Oakland, CA: Berrett-Koehler. 2 www.darden.virginia.edu/batten-institute/research/ publications/humility
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From Dad to Grad: Conway Scholarships Ease CNLs’ Tuition Burdens BY CHRISTINE PHEL AN KUE TER
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“... the stressors of changing careers and attending school were greatly reduced knowing that I wouldn’t be faced with absolutely crippling debt upon graduation.”
T HE DAILY PROGRESS/RYAN M. K ELLY
ike all good English majors, Ryan McFadden (CNL ’15) worked a series of interesting if disparate jobs before considering a nursing career: Graphic designer. Landscape architect. “Guy Friday,” laughs wife Ashley. But after nearly four years as a stay-at-home dad (daughter Sunny is now seven and son Atticus, five), McFadden again shifted focus. He enrolled in the University of Virginia (UVA) School of Nursing’s Clinical Nurse Leader (CNL) master’s program with the help of a Conway Scholarship, which allowed him to graduate with half the school debt he would have otherwise. He now works as a pediatric nurse in UVA Hospital’s pediatric intensive care unit. Now, many more will enjoy opportunities similar to McFadden’s thanks to a new $5 million gift that has renewed the Conway Scholar program. Awards from the new funds are set to begin in 2018 and will support 110 new nurses over five years. This latest contribution from Washington, D.C., philanthropists Joanne and Bill Conway mirrors a 2013 gift, and will expand the program to more underrepresented and minority applicants—providing a broader path into nursing for those with at least a bachelor’s degree in another field. “The Conways’ steadfast support means our school’s doors are open even wider than before,” says Nursing School Dean Dorrie K. Fontaine, “and this purposeful, thoughtful inclusion and diversity will ultimately benefit us all.” UVA’s CNL program, Virginia’s first, is ranked No. 2 in the nation by U.S. News & World Report. Concurrent with their first year of academic courses, students immediately begin clinical rotations, with much of their nearly 1,000 hours of experience done in small groups and
under the one-to-one mentorship of a veteran nurse preceptor. The program costs roughly half to a third of those at other top nursing schools; still, some CNL students graduate from UVA with between $40,000 and $50,000 in debt burden. That, says McFadden, is a worry the Conway Scholarship eases. “As a father of two preschool-aged children, the stressors of changing careers and attending graduate school full-time were greatly reduced knowing that I wouldn’t be faced with absolutely crippling debt upon graduation,” acknowledges McFadden. +
Ryan McFadden (CNL ’15) was a stay-athome dad before returning to school to pursue nursing.
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Associate Dean for Research (ADR)
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IN BRIEF 2016 10.2 Professors Arlene Keeling (BSN ’74, MSN ’87, PhD ’92) and Barbra Mann Wall won a plethora of awards at the 33rd annual American Association for the History of Nursing conference, held in Chicago. Michelle Hehman (PhD ’16) received the Teresa E. Christy Award for new nursing history investigators. 10.17 ACNP students Affitin Anderson (DNP ’18), Nick Nelson (BSN ’17), Shelly Rush-Evans (BSN ’15, MSN-NP ’17), and Melanie Sims (DNP ’18) tended to hundreds of patients’ health needs as volunteers at the annual Remote Area Medical clinic in Grundy, Virginia. 10.19 CNL ’17 students Sarah Church, Jennifer Manes, Rachel Shaw, and Tess O’Connor won a best poster award at the Virginia Rural Health Association Conference for their work on the human papillomavirus. 10.22 Clinical associate professor Elayne K. Phillips was appointed by Governor Terry McAuliffe to the Virginia Health Workforce Development Authority. 10.24 The #HoosInclusive photo campaign drew dozens of nursing students together in support of compassion, respect, and humility. 1 11.1 Professor Pamela A. Kulbok received the American Public Health Association’s 2016 Ruth B. Freeman Award in honor of her four decades of work as a public health nurse. 11.7 Assistant professor Camille Burnett was elected vice president of the National Nursing Network on Violence Against Women International. 2 11.12 Beta Kappa, the UVA chapter of the nursing honor society Sigma Theta Tau International (STTI), inducted 103 new members.
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11.22 Associate professor Kathryn Laughon (BSN ’98, MSN ’01), with her team of UVA forensic nurses, was feted by Charlottesville’s Sexual Assault Resource Agency with its Annual Annette DeGregoria Grimm Award. 12.10 A first-ever community partners celebration drew more than two dozen representatives to the School, including Charlottesville Fire Chief Andrew Baxter (BSN ’94), the Sexual Assault Resource Agency’s Rebecca Weybright, Region Ten’s Mary Williams, and David Durovy and Becky Blanton from The Homeless Entrepreneur program.
2017 1.23 All 38 of the School of Nursing’s classroom doors received small signs with a big message, “Respect Lives Here,” as part of the School’s Inclusion, Diversity, and Excellence Achievement initiative. 1.24 After more than five decades of teaching and research, professor Ann Gill Taylor (BSN ’63, Curry ’75), the Betty Norman Norris Professor of Nursing since 1996, retired. Taylor joined the faculty on Sept. 1, 1964, and founded the former Center for the Study of Complementary and Alternative Therapies in 1993. During her tenure, she oversaw 28 federally funded grants, published more than 118 papers and book chapters, and made more than 200 presentations around the world. 3 1.25 Barbara Reyna joined the faculty to launch the School’s newest master’s tracks: the neonatal nurse practitioner (NNP) and the acute care pediatric nurse practitioner programs. Reyna (an NNP) will teach in the programs along with Susan D. Almarode, an NNP in UVA Medical Center’s neonatal intensive care unit. 4 2.7 Associate professor Cathy Campbell received a 2017–18 Global Fulbright US Scholar Award to study the cultural context of death and dying and the palliative care skills and practices of South African and Thai community health workers (CHWs). Starting this summer, Campbell,
nursing.virginia.edu
The School seeks nominations for a dynamic individual to provide strategic direction for its programs of research, and close mentoring to faculty and students. A member of the Dean’s Council, the ADR oversees the School’s four research centers and initiatives while maintaining his/her own program of funded research. APPLY: jobs.virginia.edu (position #0620433) QUESTIONS? Contact Christine Kennedy, associate dean for academic programs and ADR search committee chair, at cmk4k@virginia.edu.
a palliative care expert, will interview 120 CHWs to make cross-cultural comparisons between the two countries’ practices. 2.10 In recognition of her “lifetime achievements in and contributions to research, and for mentoring future nurse researchers,” associate dean Christine Kennedy received word of her induction into STTI’s International Nurse Researcher Hall of Fame at a ceremony in Dublin, Ireland, this July. A pediatric nurse practitioner, Kennedy studies the influence of illness, media, and culture on young children’s developing health behaviors, and has garnered more than $11 million in research funding over the past four decades. 5 2.20 Thanks to a generous donation from Betsy and Robert H. Swindell III (College ’82), parents of Katie Swindell (BSN ’18), a pair of preemie “Sim Twins” arrived at the School, the latest additions to the Clinical Simulation Learning Center’s now nine-member family of hightech, high-fidelity patient simulators. 6 3.14 While holding its place among the top 3 percent of US nursing schools again in 2018 (8th among public institutions), the School’s Doctor of Nursing Practice program notched up three spots to 15th, while the Psychiatric-Mental Health Nurse Practitioner program held its no. 7 rank, according to U.S. News & World Report’s annual guide to the country’s Best Graduate Schools. Also ranked are the Pediatric Nurse Practitioner (no. 12), the Adult-Gerontology Acute Care Nurse Practitioner (no. 14), and the Family Nurse Practitioner (no. 17) programs. For the third year in a row, UVA’s Clinical Nurse Leader master’s program was lauded as the second best in the country. +
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PICTURING RESILIENCE
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Last fall, the School’s Compassionate Care Initiative held its first photo contest. Entrants were asked two questions:
“How do you stay resilient?” “What does resilience mean to you?”
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The winning responses are above. 1 April Livingston (CNL ’17) 2 Ashley Weimorts (DNP student) 3 Ambereen K. Mehta (Assistant Professor, School of Medicine) 4 Danielle Roques (BSN ’17)
ST UDEN T IN FO C U S
Caring for Those Who Serve Kim Albero (BSN ’06, DNP ’18) BY JE S SIC A EUS TACE
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“I wanted to gain the knowledge and skills required to care for those who risked their lives to defend our freedom.” COUR TE SY OF K IM ALBERO
NP student and alumna Kim Albero credits the start of her nursing career to a deep sense of patriotism. After the 9/11 attacks and the subsequent wars in Iraq and Afghanistan, she was drawn to care for veterans. “I wanted to gain the knowledge and skills required to care for those who risked their lives to defend our freedom,” says Albero. After completing her BSN at the University of Virginia in 2006, Albero served in the US Navy Nurse Corps, caring for those wounded in Iraq and Afghanistan. In 2010, she deployed to Afghanistan as a flight nurse, and although she wasn’t prepared for the emotional endurance the work would require, caring for wounded soldiers has been the most rewarding part of Albero’s nursing experience. “The most fulfilling moments were when I saw patients who left the hospital with amputated limbs return on prosthetics, looking strong and healthy,” Albero recalls. “I loved being one of the
friendly faces that provided reassurance during their long journey home.” As her time as an active-duty Navy nurse came to a close, Albero felt a tug from her UVA roots. “The exceptional faculty and staff at the School of Nursing gave me the best start to my career,” she says. “Ten years after I walked down the Lawn to receive my diploma, I decided it was time to return to pursue my DNP.” Among the biggest perks of returning to UVA: the chance to study again under Dr. Valentina Brashers. “If I am thoughtful, if I am curious, if I am passionate, it’s due in no small part to Dr. Brashers,” Albero reflects. “She taught us how to be well-prepared, clinically competent professionals who impact change by identifying opportunities to improve the care of our patients.”
Albero served as a flight nurse in the US Navy before returning to UVA for her doctorate in nursing.
Looking ahead, Albero hopes to use the interprofessional skills she has gained at UVA to care for veterans as a family nurse practitioner. “My focus is on patients with a dual diagnosis of pain and depression resulting from service-related injuries,” Albero explains. “I want to improve access for veterans by coordinating interprofessional care through a primary care medical home.” Most of all, Albero hopes to make each patient feel like family: “I want to treat each veteran with the highest possible care ... [and] to be an agent of change.” +
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BETTER
Together Interprofessional education, three decades in BY CHRISTINE PHELAN KUETER
Valentina Brashers calls it the “poof” factor. “Poof,” and a doctor’s directives are invisibly, deftly done. “Poof,” and the IV line, catheter, blood draw, and medication are promptly administered. “Poof,” and nurses sweep in, do whatever the heck they do, and everyone moves on. Clean, efficient, separate. Boom. But on her first full day as a young physician, Brashers— overflowing with knowledge of pulmonology and asthma’s disease process—couldn’t administer an IV drip because the clinic’s nurse had gone home. And “poof,” an idea was born. “Many of the things that nurses and nursing students do for patients had been invisible to me,” recalls Brashers, a University of Virginia (UVA) nursing professor since 1987, an attending physician, and founder of the Center for ASPIRE, UVA’s interprofessional education (IPE) hub. “I realized I had very little knowledge about what nurses were trained to do. I also realized that there was real value to a team approach.”
“Are engineers building bridges while they learn how to use a calculator? Do lawyers define a case while still reading the laws? Medical residents and nursing students provide the bulk of patient care while learning at the same time. No one else does that. So we need networks and organizational structures that support their education and practice.”
At the outset, Brashers’ logic was simple: Establish multiple required opportunities for medical students to learn basic patient care skills from veteran nurses, emergency medical technicians, and respiratory therapists in an interprofessional learning environment. But what happened since the concept’s Interprofessional Education | noun | infancy has been \in-'tər\ prə-'fesh-nəl \e-jə-'kā-shən\ nothing short An interaction “when [students from] two or more of a revolution professions learn about, from, and with each other to enable effective collaboration and improve in nursing and health outcomes.” medical education, —World Health Organization1 with UVA leading the charge. Pack Leader lthough IPE began at UVA in the early 1990s—more than a decade before its explosion in academia in the mid-aughts—the concept goes back much further. Even in the 1960s, the Institute of Medicine, or IOM (now the National Academy of Medicine), had recognized IPE as a key to efficiency in patient care. But with its 1999 report To Err Is Human—the first to identify communication gaps as a major cause of medical errors—IPE earned its rightful place as a driver of safety, too. Four years later, the IOM’s Health Professions Education report documented the need for a “collaboration-ready workforce,” bringing a growing chorus of support from academic governing bodies like the American Association of Colleges of Nursing and the Association of American Medical Colleges. Though laudable, early IPE mandates were also foggy. How, exactly, do you teach cohesion? How do you know
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—VALENTINA BRASHERS
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when you’ve achieved it? And once a spirit and practice of collaboration exists, how do you measure and strengthen it? Thanks to Brashers’ early advocacy, UVA lay ahead of the IPE curve through much of the 1990s, even with its spotty and decentralized approach. This was when UVA medical students received basic training from nursing instructors, and nursing students regularly interacted with pharmacists, respiratory therapists, chaplains, and physicians. But even by the early 2000s, nursing and medical students rarely crossed paths. It wasn’t until School of Nursing Dean Dorrie Fontaine’s 2008 arrival that goals crystallized: Create regular, required courses in which nursing and medical students learn in the same space and from one another. Formally establish IPE as a curricular thread in both schools. Create a rubric to measure interprofessional competencies. And ask nursing and medical faculty members to integrate IPE into their courses. “We went from doing IPE as a side interest to a major role,” recalls Brashers with a laugh, “almost overnight.” By 2011, IPE flavored both the nursing and medical schools at UVA. Together, nursing and medical students discussed provocative case studies and practiced end-oflife conversations. They convened for patient simulations and study related to medication adherence, emergency responses, difficult discussions, and transitions in care. In Jeffersonian style, they dined while discussing one another’s roles and perspectives. A $750,000 grant from the Josiah Macy Jr. Foundation in 2011 was followed by the 2013 establishment of the Center for ASPIRE, a joint venture between UVA’s Schools of Nursing
and Medicine and Health Sciences Library. In 2014, a grant of more than $1 million from the Health Resources and Services Administration further expanded the effort. Today, IPE is as common as the white coats clinicians wear.
Measuring IPE: Know Your Terms ITOSCEs = Interprofessional Teamwork Objective Structured Clinical Examinations Interprofessional simulations and scenarios CCBPMs = Collaborative Care Best Practice Models Situation-specific behaviors considered “best practice” for collaboration CBOATs = Collaborative Behaviors Observational Assessment Tools Checklists of observed behaviors
TSS = Team Skills Scale Measure Self-assessment of one’s teamwork Twice savvy, taken before and after IPE PE’s surge is activities (1–5 scale) concurrent with its painstaking measurement. That process begins by creating a checklist of the hoped-for behaviors critical for the scenario at hand (Did they introduce themselves? Ask open-ended questions? Listen thoughtfully?). Simulated scenarios are then acted out, tested, and tweaked. Once the simulations are cemented, students are assessed in real time by observers watching for specific skills. Even the actors themselves—from UVA’s bank of “standardized patients”—grade the students. The resulting metrics reveal profound before and afters. In one two-year study of 457 UVA nursing and medical students exposed to interprofessional simulations, students’ collaboration skills improved 33 to 37 percent. Graders noted a 46 to 49 percent improvement in teamwork. And nearly 100 percent of students “strongly agreed” that the workshop helped them see the value of teams in providing safe and effective patient care.2 “Some medical students told us they always wanted to work with nursing students because it more realistically simulates what happens,” asserts Brashers. “Others called the exercises a ‘bridge over barriers.’” Today, student-led initiatives like the HeArt of Medicine course—a workshop in which nursing and medical students practice end-of-life conversations with simulations involving dying patients and their families—round out a plethora of
I
UVA School of Medicine professor Tim Short counsels participants prior to an interprofessional simulation involving an elderly mother and son struggling with dementia. 10
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THE ROOM OF
ERRORS How many errors can you spot? SEE PAGE 14 FOR ANSWERS
70%
400,000 Number of deaths per year due to medical errors4
PHOTOS: S TACE Y E VANS
Proportion of medical errors—the nation’s third leading cause of death—due to poor communication among members of healthcare teams3
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Dr. Valentina Brashers, set to retire in June 2017, is among the School of Nursing’s most beloved professors of all time. On the faculty of both the Schools of Medicine and Nursing, she has taught more than 6,000 students during her three-decade tenure at UVA. In addition to establishing the Center for ASPIRE (UVA’s IPE hub) in 2013, her legacy lives on in her students, who spoke to the magnitude of her impact in their own words.
A Tribute to Dr. Brashers
“She broke topics down so that we could not only understand, but remember and critically apply them.” The notes Sean Convoy (MSN-NP ’06) took in Dr. Brashers’ courses have traveled around the globe—to Japan, Iraq, and Guantanamo Bay, wherever he was serving in the military at the time. While the sole psychiatric provider at a navy hospital in Okinawa, he recalled this graphic from his notes—along with a pearl of wisdom from one of Brashers’ pulmonary lectures—that ultimately helped save the life of a patient. “Absent Dr. Brashers’ passion and expertise, that patient could very well be dead,” Convoy writes. “This is Dr. Brashers’ legacy. She is the physician who trains advanced practice nurses.”
“I try to model my own teaching after her style.”
COE SWEE T
“A patient guide and mentor”
“There is not a day in my career that I do not think of Dr. Brashers.”
“She didn’t take roll, but everyone came ...”
“[Her] textbook and notes have made it through each of my moves ...”
“She taught intimidating material in a way that made it interesting, fun, and easy to learn.”
formal and informal interprofessional offerings for students to practice and learn together. Simulations offer potent practice time with immediate feedback, preparing them for the infinite variety of real people and situations yet to be encountered during clinical rotations and clerkships. And students aren’t the only ones benefiting. Twice-ayear Train-the-Trainer Faculty Development Programs bring together dozens of professors, clinicians, and administrators from within and outside UVA looking to establish, amplify, and assess their own IPE programs. Activities drive home lessons in a fun, informative way, like the LegoBot Challenge, originally developed by two University of Cincinnati 12
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psychologists, in which teams are timed to assemble a brick figure using one person’s observations and ability to convey details.5 Other training activities include the Room of Errors— in which doctors and nurses have seven minutes to identify preplanted errors in a mock hospital room, independently at first and then collaboratively, to accentuate the value gained by multiple perspectives. In the “bad behavior BINGO” game, participants observe a video of clinical situations and categorize actors’ skills on a game card. But make no mistake: the work underlying IPE is stonecold serious. And its promise, UVA researchers say, whittles costs, begets shorter hospital stays, reduces staff burnout
“I scheduled my postgraduate education specifically [so I would have Dr. Brashers again].”
“The best teacher I’ve ever had”
“She asked, ‘So, what?’
COE SWEE T
and then gave you the ability to answer ...”
“I appreciated ... COUR TE SY OF SUS AN MURPHY
her pictures of her summer fishing trips ...
Susan Murphy (BSN ’14) writes: “The doctor [who] helped me become a nurse ... spent her time transforming healthcare, being brilliant, and probably daydreaming occasionally about mountains and trout while I was a twentysomething ... fortunate enough to have found a job [with the alumni and development team]. ... As I toyed with the idea of a career change, this liberal arts grad thought, ‘Surely, if anything can scare me off it would be pathophysiology!’ But I was hooked as soon as I became one of Dr. Brashers’ students.”
She tried to tell us that there was more to life than school. Her sense of balance was an example ...”
“In my 23 years of education ... my hands-down favorite.”
“Loved hearing her stories as a country doctor, and how she referred to ham as ‘pink salt.’” “I am proud to carry on her torch as a teacher and lover of patho ...”
“Thank you, Tina, for all you have done for us!!!!!!” and attrition, minimizes mistakes, and decreases the wastefulness of unnecessary procedures. “At its heart, a lack of interprofessional competency is actually an ethical breach,” explains Brashers. “Teamwork improves care. The data is so overwhelming that to not practice as a team is actually unethical.” A Door, Propped VA graduates who’ve had the benefit of interprofessional learning say its lessons stick. As a medical intern, Pranay Sinha (Medicine ’14) and his peers often sought refuge in a private workroom set aside
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for physicians, accessible only by card swipe. The barrier left nurses peeking through the glass and knocking feverishly when needing to discuss a patient—a situation Sinha, now a resident at Yale New Haven Hospital, calls “insane.” When, instead, he propped the door with a trashcan, face-to-face interaction among nurses and physicians on the unit improved, and phone pages declined precipitously. And while the solution’s simplicity belies its effect, Sinha says the idea “arose out of all those IPE courses.” “Once you’ve been in an interprofessional atmosphere,” says Sinha, “you’re surprised by how the traditional structure of medicine works against the natural collaboration
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“... working together, we can really help the whole person.” —TARA ALBRECHT
of nurses and physicians.” A stinging early encounter with a frazzled medical resident formed the approach Katelyn Rybicki (BSN ’11, CNS ’14, DNP ’17) took to her nursing practice. A nurse in UVA’s Medical ICU, Rybicki—one of Brashers’ first teaching assistants and now a DNP student—continues to instruct beginning medical students in basic skills, and says negative encounters can get “the wheels turning about IPE.” Training under Brashers, she says, “really shaped my early perspectives [in terms of] figuring out others’ roles and [viewing] my own role as being as important as others’.” “We all [doctors, nurses, and others] have the skills [to contribute to] the care and success of the patient,” Rybicki adds. Others feel IPE’s lessons broaden their practice perimeters. That was true when the caregiver of an elderly patient of Alex Wolf (DNP ’16) recently collapsed into exhausted tears. Wolf sought counsel from his hospital’s chaplain, not to hand off the issue but to see “what [he himself] could do to support the patient moving forward” by getting advice. To Wolf, it’s one of IPE’s biggest takeaways. “I’ve worked on teams where everybody thinks everyone else is great, but then they divvy the pieces of patient care separately, rather than working on them together,” says Wolf, a palliative care nurse practitioner at Augusta Health in Fishersville, Virginia. “Sometimes that’s appropriate, but a big part of being on a great team is being able to learn from your colleagues, and act on their recommendations.” And among IPE’s greatest champions are those who are urging forward its study and momentum. Tara Albrecht (BSN ’05, MSN ’09, PhD ’11)—one of Brashers’ early disciples and among the first students to experience UVA’s more integrated approach to IPE—says the interprofessional approach she learned at UVA runs deep, and “touches every aspect of [her] career.” “My time at UVA made me realize, when I wasn’t even a nurse yet, how we each come from a slightly different view, and how, working together, we can really help the whole person,” says Albrecht, today a ANSWERS TO PAGE 11 nursing professor at (1) Urinary bag needs to be below bed Virginia Commonwealth level. (2) Roll of tape can cause University (VCU) and an bedsores. (3) Dressing is soiled and oncology and palliative needs changing. (4) Toilet chair is care nurse practitioner improperly and dangerously positioned. (5) Empty glove box at VCU Medical Center needs to be replaced. (6) Food and in Richmond. “I can’t medical waste must be properly even imagine how I’d disposed of. (7) Incorrect securement practice without my for device on leg. (8) Nasogastric interdisciplinary team. For tube improperly positioned. me, IPE is as ingrained, as vital, as a stethoscope.”
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Old Hands, New Ideas oday, IPE continues to expand, even in what will shortly be the post-Brashers era. And although IPE is nothing new to John Dent and Beth Quatrara (MSN ’97, DNP ’10), ASPIRE’s new clinical directors, they, with faculty members Julie Haizlip and John Owen, are laying novel groundwork for the center’s next act. A lot is in the pipeline. Haizlip is developing a burnout survey with UVA’s Darden School of Business and considering a phalanx of online IPE tools and tutorials. Quatrara is creating a smattering of new simulations focused on patient handoffs. Owen is making plans to expand ASPIRE’s off-Grounds reach and establishing new models for IPE “short courses.” Dent, for his part, is planning to spread a new way to round. Rounding with Heart involves roving groups of clinicians—social workers, pharmacists, physical therapists, doctors, and nurses—who enter a patient’s room en masse to discuss the plan of care with the patient. Concerns are aired, questions answered. With a visible and cohesive team, care plans are crystal clear. Sound revolutionary? It actually is. On 4 East, where the novel practice has become routine, attrition is the lowest across the entire hospital. “We used to have the highest turnover, and now we’ve got the absolute lowest,” says Dent, who adds that patient satisfaction on the Rounding with Heart unit has reached new highs. “That’s a direct result of our interprofessional approach.” And with UVA graduates taking IPE on the road, its future is bright. Chelsea Becker Hutchinson (Medicine ’14), now a general surgery resident at the University of North Carolina, knows to use colored (not white) towels for patients upset by body fluid stains. She realizes that sitting with a patient to grieve is as important as explaining a prognosis. And she is fully aware that colleagues—especially nurses—inspire some of the best ways to care. “It’s incredibly valuable, having someone else’s perspective,” says Hutchinson. Sinha agrees: “The larger point to me is that we need to give one another the benefit of the doubt,” he says. “I think I have more perspective about what it’s like to be a nurse, and that really helps me not project my frustrations, and to make nurses my allies. Which they absolutely are.” +
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1 WHO. (2010). Framework for action on interprofessional education and collaborative practice. Geneva: World Health Organization. http://whqlibdoc.who.int/hq/2010/WHO_HRH_HPN_10.3_eng.pdf 2 Brashers, V., Erickson, J. M., Blackhall, L., Owen, J. A., Thomas, S. M., & Conaway, M. R. (2016). Measuring the impact of clinically relevant interprofessional education on undergraduate medical and nursing student competencies: A longitudinal mixed methods approach. Journal of Interprofessional Care, 30(4), 448–457. 3 Institute of Medicine, 1999. 4 Lown Institute. 5 The psychologists are Brandon Reddy and Anne Byrnes (Small Group Behavior, May 1975).
BY THE NUMBERS Standardized Patients
S
tandardized patients (SPs) are an intermediate step for nursing and medical students; they’re real flesh and blood, rather than high-tech humans, but they don’t actually suffer from the ailments they portray. But make no mistake: there is nothing pretend about interacting with an SP, who might add a phalanx of props (wheelchairs, moulage, and hospital gowns) to the litany of groans, moans, and exhortations as they convey their predicaments. During simulations, SPs not only help students practice conducting physical assessments, taking patient histories, and communicating effectively, but at the University of Virginia, they are graders too—trained to document specific behaviors to ensure in a measured way that learning is taking place. +
1994 Year UVA formalized its SP program
500+ Patient roles in the program’s “case bank”
9 12
Cases with an interprofessional focus
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Cases portrayed by SP Keith Hammon in 2016, including back pain, addiction, stomach pain, and anxiety
Graduate nursing courses that use SPs in simulations
4
Average number of training hours UVA’s SPs receive
141
Charlottesville resident Keith Hammon (Curry ’72), an SP at UVA since 2012, appreciates when students “see one another more as equals rather than in a pecking order.” And he should know. The former elementary school principal says doctors and nurses are not unlike teachers and administrators. Despite being at the head of a school, he explains, “principals are really only as good as the people around them.”
SPs at UVA
250
Hours SP Keith Hammon spent teaching and assessing in 2016
6 BSN and CNL courses that involve SPs for simulation
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IMPAC T: NURSING RE SE ARC H
1 7
IN MEN ARE DIAGNOSED WITH PROSTATE CANCER
SOURCE: AMERIC AN C ANCER SOCIE T Y
Decisions That Hit Below the Belt BY CHRISTINE PHEL AN KUE TER
A
He will then test the effects of a novel decision aid delivered by tablet computer and administered by nurses. The study will include 63 African-American men, 94 Caucasian men, and 1 Asian man. Half of the participants will receive the decision aid, while the other half will receive established protocols of care (informational brochures and oral counsel from clinicians). Subjects will be queried about stress, pain and risk tolerance, their hopes for treatment, and preferences related to quality of life versus longevity. Jones’s chief aims are two: determine whether patients who receive the decision aid experience less decisional conflict, uncertainty, and regret—thereby achieving a greater quality
COE SWEE T
prostate cancer diagnosis brings a bevy of questions: Is incontinence inevitable? How long will it be until the catheter is removed? Will out-of-pocket costs crush me? Will I ever have sex again? But for some patients, even knowing what questions to ask is difficult. What they lack, says associate professor of nursing Randy Jones (BSN ’00, MSN ’02, PhD ’05), is a measured way to personally assess their own circumstances—a method to consider their priorities and make treatment decisions with their eyes wide open. Enter the decision aid. As healthcare systems increasingly put patients in the driver’s seat—what hospitals often call “patient-centered care”—tools like the one Jones is creating with a $2.2 million grant from the National Institutes of Health will help patients and their loved ones better weigh risks, benefits, and potential side effects so they aren’t plagued by regret. “Often, we hear patients say, ‘I wish I could’ve done things differently,’” explains Jones, “or, ‘I wouldn’t have stayed on chemo if I’d known about these side effects.’ Others say they felt pressured by their healthcare provider to pursue aggressive treatments, or didn’t want to let others down by giving in to cancer, and pushed on for a little longer as a result,” ultimately regretting that choice. Jones’s four-year, threesite study will include 158 interviews with subjects diagnosed with advanced prostate cancer at the University of Virginia’s Emily Couric Clinical Cancer Center, Virginia Commonwealth University’s Massey Cancer Center, and the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University.
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Professor Randy Jones’s NIH-supported study will evaluate a decision aid, delivered by tablet computer and administered by nurses, for patients facing a prostate cancer diagnosis.
of life; and see whether patients’ decision-making partners report less treatment regret and a higher quality of life. He also hopes to better understand whether the decision aid has a greater impact on certain racial groups, like African-Americans, who, Jones says, may be more likely than patients of other races to make decisions in
conjunction with a family member. That’s an important question, because African-American men are more than twice as likely as whites and Hispanics to be diagnosed with the disease, but are less likely to be involved in active decision making regarding treatment. +
New and Noteworthy Rafael Romo
1
ASSISTANT PROFESSOR OF NURSING AND ROBERTS SCHOLAR
$319,000 National Institutes of Health minority supplement grant
1
“Prognostic Information and Decision Making Among Older Adults With Mild Cognitive Impairment”
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This two-year study focuses on the experience of healthcare decision making among older adults with this precursor to dementia. Randy Jones (BSN ’00, MSN ’02, PhD ’05)
2
2
ASSOCIATE PROFESSOR OF NURSING
$49,919 Cancer Control and Population Health grant “Determinants of Quality of Life in Proton and Conventional Radiation Therapy Patients: A Feasibility Study”
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This one-year study will examine proton and photon therapy, the patients who tend to be the best candidate for each, and each modality’s effect on radiation-related quality of life. Jessica Keim-Malpass (MSN ’05, CNL ’08, PhD ’11)
3
ASSISTANT PROFESSOR OF NURSING AND MEDICINE
5
$30,452 Cancer Control and Population Health grant “Towards Enhanced Inclusion and Family-Centered Pediatric Clinical Trials” This yearlong study looks to determine how and why families with children with cancer—who tend not to enroll in clinical trials—receive and access information to understand trials’ possible risks and benefits, with a particular focus on families with limited health literacy and advanced or recurrent disease. Kenneth White (ACNP ’13)
principles of caring for patients with advanced, serious, complex illnesses in an interprofessional team setting. Data will help White develop a plan for the dissemination and licensing of the Advanced Disease Life Support program. Pamela B. DeGuzman (College ’92, BSN ’96, Darden ’00, MSN ’00, PhD ’12) 5 ASSISTANT PROFESSOR OF NURSING
$3,100 Daisy Foundation grant 4
ASSOCIATE DEAN FOR STRATEGIC PARTNERSHIPS AND INNOVATION
$57,700 Jefferson Trust grant “Advanced Disease Life Support” This study will create, test, and institute a novel, interdisciplinary program for healthcare providers on the essential
“Walkability for Breast Cancer Survivors” This participatory study will ask women undergoing breast cancer treatment to photograph barriers to and facilitators of residential walkability. They will then be interviewed about what hindered and/or compelled their exercise. Findings (including a photo gallery and vignettes) will be publicly displayed in the Emily Couric Clinical Cancer Center. +
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BY JENNY ABEL
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he School’s Distinguished Majors Program (DMP) gives emerging nurses exposure to meaningful scholarship to fortify their regular programs of study. High-achieving fourth-year students submit proposals, link up with a faculty mentor, and begin the yearlong project with a literature review in the fall culminating in a publishable manuscript and oral presentation in the spring. Two dozen wide-ranging topics are currently underway; two are highlighted here.
Young Adults: Up in Smoke?
COUR TE SY C A SE Y L AWRENCE
“Over the past 50 years, there’s been significant progress in reducing cigarette smoking in the United States,” Casey Lawrence (BSN ’17) points out, but with the emergence of e-cigarettes, that progress is in jeopardy. Citing data from the National Youth Tobacco Survey, Lawrence explains that e-cigarette use is rising sharply among high schoolers. Just 1.5 percent said they had vaped in 2011, but by 2015, the proportion shot up to 16 percent. “That’s concerning,” says Lawrence, “because e-cigarettes are still fairly novel devices, and their long-term health effects and safety are largely unknown.” E-cigarettes were first introduced to the United States about a decade ago and have only been subject to FDA regulation since mid2016. So why the increase among young people? “Curiosity, experimentation, and a desire to try appealing flavors” are a few reasons, she explains; too, “adolescents and young adults are prime targets of e-cigarette marketing campaigns.” Of course, e-cigarettes are routinely promoted as smoking cessation aids, but evidence on their safety remains inconclusive—the subject of a presentation Lawrence made in late 2016 at a Sigma Theta Tau International conference, sparking her broader interest in research related to e-cigarettes.
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Marrow-Minded That idle after-class chit-chat may not be so idle after all. For Melissa Redding (BSN ’17), it sparked an idea now at the center of her DMP research. Redding and two classmates had listened to a guest speaker to their pediatrics class talk about children with Fanconi anemia—a condition that requires bone marrow transplants for survival. The students were then invited to volunteer at a “Be the Match” table during the University’s annual Spring Fling event. “After the talk, I overheard some of my peers talking about how they would like to be in the bone marrow registry but didn’t know how,” Redding recalls. “Others were wary of the donation process. That got me thinking.” During her fourth year at UVA, Redding has been diving deep into the question of bone marrow donor registration, with a focus on college students. That focus is critical, Redding says, because the national bone marrow registry accepts donors ages 18–44, and the majority of matches and donors end up being college students. What’s more, a majority of those needing a transplant (70 percent) must find a match outside their family. Many die without ever finding a match. While the need to widen the donor pool is apparent, “there are knowledge gaps regarding the process, the risks associated, and the lasting implications of bone marrow donation,” Redding says. So she’s asking college-age students: What prevents people from registering? Better yet, what motivates people to register? Her study, under the guidance of professor Jessica Keim-Malpass (MSN ’05, CNL ’08, PhD ’11), will be among just a handful of its kind done to date. Working through focus groups, Redding is examining whether brief educational sessions (highlighting the needs and risks associated with bone marrow donation, along with information about how to register) have an impact on college students’ willingness to join the registry. Ultimately, she hopes her project will help eliminate misconceptions, expand the worldwide registry, and offer a model for other college campuses to contribute to its growth. + COUR TE SY MELIS S A REDDING
Students Research E-Cigs, Bone Marrow Donation
This spring, Lawrence, under mentor and nursing professor Pamela Kulbok, used an online survey and a representative sample of first-year university students to conduct her DMP study on e-cigarettes’ prevalence, use patterns and reasoning, and perceptions of their harm among young people. She hopes the data will help public health officials assess the influence of e-cigarettes, ultimately leading to the development of appropriate interventions.
Honoring Cancer Warriors
giving.virginia.edu/supportnursing
(800) 297-0102 or (434) 924-0138
GIVE
PHIL AN THROP Y
Mail a check payable to the UVA School of Nursing: UVA School of Nursing Alumni and Development Office P.O. Box 801015 Charlottesville, VA 22908-1015
BY JENNY ABEL
C
COUR TE SY NAWAH K ARIMI
COUR TE SY CHARLIE JOHNSON
COUR TE SY SUS AN W. BECK ER
ancer is an intensely personal journey, requiring a special work in econometrics during his career with the federal government. Despite repeated rounds of chemotherapy and brand of courage and grit in patients and families alike. radiation to treat his gallbladder cancer, he passed away It also demands a special kind of nurse, one whose in 2009, when Christine was still in motivation to help comes from within. high school. Though she came to “It’s a glaring difference— college with other plans, Christine the nurses there just to punch the was so inspired by her father clock versus those with that internal (who ran a half-marathon with his drive,” says Charlie Johnson, father daughter in the final months of to Emily (BSN ’15) and a member his life) that she transferred into of the School of Nursing Parents the nursing program. Today, she Council. “Those who take that works on the cardiac stepdown extra step, that compassionate unit at UVA Hospital. approach—the families and “Everyone’s experience with patients can just tell which nurses cancer is so difficult,” says they are.” Christine’s mother (Andy’s wife), It was a distinction the Susan W. Becker. “We saw how Johnson family noted as they bore important nurses are to patients witness to Darlene’s battle with and their families. It’s the nurses ovarian cancer. Beloved wife and who are there hour after hour, mother, Darlene passed away in while the doctors flit in and out. 2013 following four years of They were the ones who provided chemotherapy and three encouragement and always allowed increasingly aggressive surgeries. us hope.” Her relentless drive to help others The Bernats’ and Johnsons’ even amid her own illness inspired cancer stories are now united by a the family to create a scholarship third—one that also promises to in her memory. UVA was the logical bring good out of tragedy. Together, home for the Darlene M. Johnson the scholarships are supporting Scholarship, Charlie says, not only their first recipient, Nawah Karimi because of their family’s multiple (BSN ’18), whose father died from ties to the University, but because brain cancer when she was in high of the School’s emphasis on school. Today, Karimi is pursuing proactive, compassionate care. a career as an oncology nurse to The scholarship supports student become the kind of patient and nurses who have personally family advocate that she and her suffered loss from cancer, or who benefactors know is invaluable. intend to work in oncology. “Coming from a single-parent The G. Andrew Bernat Jr. household,” Karimi explains, the Scholarship shares the same spirit financial assistance was critical. and was established the same year “Dedicating myself to this career (2014) to honor Andrew “Andy” will not only give me fulfillment by Bernat Jr. (College ’80). The father helping others, but it is only fitting of Christine Bernat (BSN ’14), Andy [From top] Christine Bernat (BSN ’14) with her father, that I pursue a profession that has earned his master’s in economics Andy; Emily Johnson (BSN ’15) with her mother, irrevocably impacted my life.” + at UVA and did groundbreaking Darlene; and Nawah Karimi (BSN ’18) with her father.
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NURSING ALUMNI A S S O C I ATION
From the President
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ll good things must come to an end. It has been my honor to serve as the School of Nursing Alumni Association (SONAA) president for the past three years. I was especially honored to mark the occasion of the organization’s centennial during my tenure. The Alumni Council members spend their valuable and limited free time enhancing alumni engagement and communications, finding ways to recognize extraordinary alumni, and allocating resources like the Tabitha S. Grier Medical Assistance Fund and the Nursing Alumni Association Alumni Scholarship. I am proud to serve the School of Nursing alongside such dedicated volunteers.
COE SWEE T
Christa E. Hartch (BSN ’97) will assume the presidency on July 1, 2017. An assistant professor of nursing at Norwalk Community College in Connecticut, Christa earned her MSN from Yale University in 2002. Before her current job, she worked as a registered nurse at Greenwich Hospital Home Care, at the New York–Presbyterian Hospital (in the hematology/ oncology and bone marrow transplant units), and at UVA (in gynecology oncology). Christa has been a member and the communications coordinator of the School’s Alumni Council since 2013. She previously served on the SONAA
Judy Bilicki [left] and Christa Hartch
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Awards Committee. Christa and her husband, Greg, reside in Greenwich, Connecticut, with their children, Christian, Annabelle, and Caroline. When you see Christa, please thank her for her past and future service to the School and the SONAA! As we look forward to our second century as an association, the Alumni Council made several important changes to the SONAA bylaws and “Memorandum of Agreement” with the School related to how funds are distributed, scholarships are allocated, and recognition awards are reviewed. Please take a moment to vote on these changes (see below). Thank you for your continued support of and dedication to this extraordinary school. Sincerely,
Judy Etheridge Bilicki (BSN ’81) President, School of Nursing Alumni Association Norfolk, Virginia
Bylaws Update VIEW AND VOTE AT nursing.virginia.edu/alumni/council/bylaws At its winter retreat in February, the Nursing Alumni Council voted to adopt changes to the SONAA bylaws. To view and vote on changes, visit the address above. You may send your “yay” or “nay” vote to nursing-alumni@virginia.edu. All School of Nursing alumni are eligible to vote.
Financial Support for Alumni Nursing Alumni Association Alumni Scholarship ($3,000) WHO’S ELIGIBLE: UVA nursing alumni
returning for an additional nursing degree or certification at any institution APPLICATION DEADLINE: June 1
(funding distributed in August) WHERE TO APPLY: nursing.virginia.edu/ PHOTOS: COE SWEE T
resources/scholarships Tabitha S. Grier Medical Assistance Fund (amount varies) Matt Lemieux (CNL ’11, PNP ’15)
Susan Winslow (MSN ’87, DNP ’13)
Lemieux, Winslow Join Alumni Council
cations (including this magazine). A nurse practitioner in Virginia Commonwealth University’s pediatric emergency department in Richmond, he lives in Crozet (just outside Charlottesville) with wife Brooke Bosselman Lemieux (CNL ’11) and their two-year-old son, Meade. Matt previously worked in the emergency room at Children’s Hospital of The King’s Daughters (in Norfolk) and in UVA’s pediatric intensive care unit. A graduate of the University of Massachusetts Amherst, his nursing career was born out of training as a medic while in the US Army. +
T
he Nursing Alumni Council welcomes two new members this year: Susan Andresen Winslow (MSN ’87, DNP ’13) and Matt Lemieux (CNL ’11, PNP ’15). As the new alumni engagement coordinator, volunteer outreach, Winslow will network with fellow alumni and recruit volunteers to serve on the Alumni Council or in other volunteer roles. A resident of Williamsburg, Virginia, Winslow is currently the system director of nursing professional practice at Sentara Healthcare in Norfolk. She previously served as the director of nursing education/community services and as Magnet Program director for Martha Jefferson Hospital in Charlottesville. She also worked at the UVA Health System, Jefferson Area Board for Aging, and Martha Jefferson Home Care, and as a clinical instructor at the UVA School of Nursing and Old Dominion University. She is a former board member of the Virginia Nurses Association and the Virginia Organization of Nurse Executives and Leaders. She holds a BSN from the University of Iowa. Lemieux, as the council’s new communications coordinator, will lead a committee of alumni volunteers who advise on and evaluate alumni communi-
WHO’S ELIGIBLE: UVA nursing alumni
facing medical expenses not covered by insurance, Medicare, or Medicaid APPLICATION DEADLINE: August 1
(funding distributed in early fall) WHERE TO APPLY: nursing.virginia.edu/
alumni/resources/grier-fund
Recognizing Extraordinary Alumni
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ach year, the SONAA honors alumni for their contributions and service to the nursing profession with the Distinguished Alumni Award, the Decade Award, and the Achievement Award. Nominate an outstanding alumna/alumnus by contacting the Alumni and Development Office at nursing-alumni@virginia.edu or (434) 924-0138. Award descriptions are available at www.nursing.virginia.edu/alumni/resources. +
Get Involved! Enjoy networking with fellow nursing alumni? Want to lend your time, talent, and expertise? Interested in providing feedback on alumni engagement and communications? Join one of the following Alumni Council committees by writing to us at nursing-alumni@virginia.edu: • School of Nursing Young Alumni (SONYA) • Awards Committee • Scholarship Committee • Communications Committee • Finance Committee
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NURSING ALUMNI A S S O C I ATION
Nursing Alumni Service Trip to Burma September 11–16, 2017
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he UVA Alumni and Parent Travel Program partners with nursing alumni to create a unique service opportunity to Burma, where attendees will provide basic educational, healthcare, and other services to a large orphanage and several villages in one of the country’s poorest regions. Healthcare opportunities will be based on the specialties of those who sign up. Non-healthcare help is also needed. Learn more: cavaliertravels@virginia.edu (866) 765-2646 or (434) 243-4984
Alumni and Students Connect
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hird- and fourth-year BSN students as well as CNL master’s students joined alumni for the second annual Alumni-Student Networking Lunch on February 11, 2017. Students had the opportunity to ask alumni about their career trajectories, how they decided to pursue advanced degrees, and how to look for a healthy work environment. Many thanks to Alumni Council members and the following alumni for joining us to connect with students! Kelly Allen (BSN ’12)—DNP acute care nurse practitioner and clinical nurse specialist student, University of Maryland, Baltimore Jessica Borchert (BSN ’15)—Medicalsurgical RN, George Washington University Hospital Erin Hunter (BSN ’14)—RN, MedStar Georgetown University Hospital MICU Erin Kelley (BSN ’16)—RN, Inova Fairfax Children’s Hospital Pediatric ICU
Andrea King (BSN ’14)—RN, MedStar Washington Hospital Center Medical Intensive Care Unit (MICU); BSN-toDNP family nurse practitioner student, University of Maryland, Baltimore Tori Tucker (BSN ’12, PhD student)— Palliative care RN, Virginia Commonwealth University Interested in sharing your experience with students? E-mail us at nursing-alumni@ virginia.edu. +
Homecomings 2017
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PHOTOS: COE SWEE T
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ome to Pavilion IX to visit with nursing alumni, students, faculty, and friends before the UVA vs. Boston College football game on Saturday, October 21, 2017. Update your contact information and make sure you are on the invitation list by e-mailing us at nursing-alumni@virginia.edu. +
PHOTOS: COE SWEE T
Celebrate With Us October 21!
For more information on nursing-specific events, contact Jessica Eustace at jeustace@virginia.edu.
Classes of 1957, 1962, 1967, 1972, 1977, and 1982, and the Thomas Jefferson Society Thursday, June 1– Sunday, June 4, 2017 School of Nursing Building Tours Friday, June 2 2:30 p.m.–4 p.m. Meet in the McLeod Hall lobby for faculty- and student-led tours of McKim Hall, McLeod Hall, and the Claude Moore Nursing Education Building, including a stop in the Clinical Simulation Learning Center. 50-Year Reunion and Thomas Jefferson Society Luncheon Saturday, June 3 noon–1:30 p.m. Newcomb Hall Ballroom The BSN and diploma classes of 1967 will celebrate their 50-year reunion—and the classes of 1962 (55-year reunion) and 1957 (60-year reunion) will also be honored. All School of Nursing Thomas Jefferson Society members are invited to join as well.
Your Story: Live It, Tell It, Leave It Saturday, June 3 2 p.m.–3:15 p.m. Newcomb Hall, South Meeting Room
Classes of 1987, 1992, 1997, 2002, 2007, and 2012
Have you ever wondered how to gather your family’s stories, and what questions to ask your relatives? Do you want tools to preserve your own life story? Join Dottie Kluttz (BSN ’66), founder of Hospice Savannah’s Story Keeping program, for a fun, interactive, and thought-provoking workshop that will empower you to gather, preserve, and share your family stories.
Nursing Alumni Picnic Lunch Saturday, June 10 noon–1:30 p.m.
Thursday, June 8– Sunday, June 11, 2017
Bring your spouse, partner, children, and friends to this family-friendly event at Dean Fontaine’s home on the historic West Lawn. Join us for a barbeque picnic to celebrate Reunions! +
Nursing Alumni Reception Saturday, June 3 4 p.m.–6 p.m. Pavilion IX Bring your spouse, partner, children, and friends for this family-friendly event at Dean Fontaine’s home on the historic West Lawn to celebrate Reunions. Join us for drinks and hors d’oeuvres before your class dinner!
COE SWEE T
To register for Reunions Weekend events (including those on this page), contact the UVA Alumni Association at 1-855-UVAWKND.
PHOTOS: COE SWEE T
REUNIONS 2017
1957 1962 1967 1972 1977 1982 1987 1992 1997
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C L A S S N OTE S AND NE W S
Class Notes 1960s Sandra Kerr (BSN ’69) participated in a dance flash mob with the International West Coast Swing Flash Mob in Richmond, VA, on September 3, 2016. Pat Woodard (BSN ’69)—a longstanding volunteer, leader, advocate, and supporter of the School—received UVA’s 2017 Alumni Service Award, one of the greatest honors bestowed on alumni of the University. Chosen every spring by the UVA Young Alumni Council, the award recognizes “outstanding alumni who have gone above and beyond in devotion to the University.” 1
1980s Laurie Walker Seidel (BSN ’82, MSN ’85) and Andrea (Atanasio) Wright (MSN ’93) gave a podium presentation at the American Nurses Credentialing Center’s 2016 National Magnet Conference in Orlando, FL, on October 5, 2016. Nurses Transforming Health Care: One Mindful Breath at a Time described the results of the pilot research study conducted at Carilion Clinic (Roanoke, VA) measuring the effects of a brief, four-week mindfulness practice course on nurses’ quality of life, mindful awareness, and
burnout. Laurie is the principal investigator for this research and for a second grant-funded study on mindfulness for healthcare professionals. 2 Amy L. Feldman (MSN ’83, CPNP ’84) authored the chapter “Guidelines for Breastfeeding” in the third edition of Pediatric Primary Care Practice Guidelines for Nurses, edited by Beth Richardson (Jones & Bartlett Learning, 2017).
1990s Elizabeth Rochin (RN-BSN ’99) was appointed the vice president of nursing, education and practice for the Association of Women’s Health, Obstetrics, and Neonatal Nurses (AWHONN). In her new role, she is AWHONN’s chief nursing officer, responsible for nursing innovation, education, and practice for the national organization.
2000s Kelly (Davison) Sicoli (BSN ’04, MSN ’11) has returned to Charlottesville with her husband, Mark, and their son. Kelly, a certified nurse midwife, has started a solo midwifery practice, C’ville Midwifery (www.cvillemidwifery.com), to provide personalized and comprehensive homebirth care to area families. Mark is an assistant professor in UVA’s Department of Anthropology. 3
2010s Kellen Squire (BSN ’11), an emergency room nurse, is running to represent the Commonwealth’s 58th District in the Virginia House of Delegates. Suzie Welsh (BSN ’11) launched BINTO (http://mybinto.com), a monthly subscription service for couples who are trying to get pregnant. BINTO stands for “Bun In The Oven.” It offers customizable monthly boxes containing products geared toward couples who are attempting to conceive. Sylvanus Mensah (BSN ’15) organized a book drive for nursing students in Ghana. The chairman of the board of directors for the Medicare College of Applied Sciences in Kumasi, Ghana—a recipient of the donated books—wrote in a letter of appreciation: “We were aware that you were planning to support our institution with medical textbooks, but we were overwhelmed by the quantity you decided to send us. Indeed, these are the books we require to support academic work [in] the Department of Health Sciences. Please accept our profound appreciation for your generosity.” 4
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In Memoriam Doris W. Emerson (DIPLO ’40) Egg Harbor Township, NJ JUNE 1, 2015
Mary Jane Morris (DIPLO ’42) Charlottesville, VA FEBRUARY 11, 2017
Louise M. McNulty (DIPLO ’44) Newport News, VA JANUARY 25, 2016
Margaret Bowman Peterson (DIPLO ’46) Atlanta, GA NOVEMBER 30, 2016
Mary Ellen O’Gorman (DIPLO ’49) Joshua, TX JUNE 3, 2016
Dorothy Lipscomb Edwards (DIPLO ’50) Tappahannock, VA OCTOBER 22, 2016
Lorraine Bowers Albrecht (DIPLO ’51) Charlottesville, VA JANUARY 30, 2017
Frances Hall Lassiter (DIPLO ’52) Greenville, NC FEBRUARY 5, 2017
Patricia A. Howell (DIPLO ’54) Arlington, VA OCTOBER 30, 2016
COURTESY THE BJORING CENTER FOR NURSING HISTORICAL INQUIRY
The 22-member School of Nursing Parents Council met in November 2016. The council meets twice a year and enhances the nursing student experience by providing leadership, guidance, and philanthropic support to the School. For information about how to get involved, visit nursing.virginia.edu/about/ parentscouncil.
Carol Q. Pfeiffer (BSN ’80) San Antonio, TX OCTOBER 17, 2016
Holly Marie Kerr Edwards (PhD student, nurse, and clinical instructor) Charlottesville, VA JANUARY 7, 2017
A beloved 1942 alumna of the School, Mary Jane Morris (1918–2017) died at age 98 after a four-decade career as a nurse at UVA Hospital, a tenure as an instructor at the School of Nursing, and devoted service to the American Cancer Society’s Charlottesville chapter. We are accepting gifts in her memory for the Mary Jane Morris Nursing Scholarship Endowment, set up at the School by her former students in 1996 to honor her legacy.
“My classroom may be a community center, a soup kitchen, a homeless shelter, a neighborhood clinic, someone’s living room, an aisle at a grocery store, a quiet place in the back of a church after service, or a cool shady spot on a summer day. I tell my students that my hope is to simply plant a seed, so that wherever they go to practice nursing, the seed will grow, and they will become advocates for those that need healthcare the most.” —Holly Edwards (1960–2017)
Billie L. Boone (DIPLO ’59) Beaver, WV DECEMBER 29, 2016
Laura Mittie Weeden Moffett (BSN ’61) Tallahassee, FL DECEMBER 14, 2016
Elizabeth Gordy Arvidson (BSN ’68) Mill Valley, CA JANUARY 2, 2017
Judith Brill Sales (BSN ’74) Sequim, WA JULY 22, 2015
Spring 2017
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VIRGINIA NURSING LEGACY
nursing.virginia.edu
FAC ULT Y PUB LI C ATION S
2016 Faculty Publication Highlights
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he following publications are a sampling of the robust list of research and publications produced by the UVA School of Nursing faculty in 2016. For a complete list, visit www.nursing .virginia.edu/faculty-publications.
BOOKS & BOOK SECTIONS Thompson-Heisterman, A. (2016). Mental health issues. In M. Stanhope & J. Lancaster (Eds.), Public health nursing: Population-centered health care in the community (9th ed., pp. 782–802). St. Louis, MO: Elsevier. White, K. R., & Griffith, J. R. (2016). The well-managed healthcare organization (8th ed.). Chicago, IL: Health Administration Press.
JOURNAL ARTICLES Alhusen, J. L., Bower, K. M., Epstein, E., & Sharps, P. (2016). Racial discrimination and adverse birth outcomes: An integrative review. Journal of Midwifery and Women’s Health, 61(6), 707–720. Bacchus, L. J., Bullock, L., Sharps, P., Burnett, C., Schminkey, D. L., Buller, A. M., & Campbell, J. (2016). Infusing technology into perinatal home visitation in the United States for women experiencing intimate partner violence: Exploring the interpretive flexibility of an mHealth intervention. Journal of Medical Internet Research, 18(11), e302. Bender, M. S., Martinez, S., & Kennedy, C. (2016). Designing a culturally appropriate visually enhanced low-text mobile health app promoting physical activity for Latinos: A qualitative study. Journal of Transcultural Nursing, 27(4), 420–428. Byon, H. D., Storr, C., Edwards, L., & Lipscomb, J. (2016). Client history and violence on direct care workers in the home care setting. American Journal of Industrial Medicine, 59(12), 1130–1135.
Campbell, C. L., Bailey, C., Armour, K., Perry, R., Orlando, R., Kinghorn, P., Jones, L., & Coast, J. (2016). A team approach to recruitment in hospice research: Engaging patients, close people, and health professionals. International Journal of Palliative Nursing, 22(7), 324–332.
Quatrara, B., Turner, M., Pitts, N., Parks, C., Murphy, F., & Conaway, M. (2016). What is the likelihood of blood return using aspiration technique with intramuscular vaccine administration? Annals of Nursing and Practice, 3(5), 1058.
Coyne, B., Hollen, P. J., Yan, G., & Brayman, K. (2016). Risk factors for graft loss in pediatric renal transplant recipients after transfer of care. Progress in Transplantation, 26(4), 356–364.
Roczen, M. L., White, K. R., & Epstein, E. G. (2016). Palliative care and intensive care units: A systematic review. Journal of Hospice and Palliative Nursing, 18(3), 201–211. Romo, R. D., & Lee, S. J. (2016). Changes in social function as a trigger to screen for cognitive impairment. Journal of General Internal Medicine, 31(8), 826–827.
Debnam, K., Milam, A. J., Furr-Holden, C. D., & Bradshaw, C. (2016). The role of stress and spirituality in adolescent substance use. Substance Use and Misuse, 51(6), 733–741.
Schminkey, D. L., von Oertzen, T., & Bullock, L. (2016). Handling missing data with multilevel structural equation modeling and full information maximum likelihood techniques. Research in Nursing and Health, 39(4), 286–297.
Epstein, E. G., Hurst, A. R., Mahanes, D., Marshall, M. F., & Hamric, A. B. (2016). Is broader better? American Journal of Bioethics, 16(12), 15–17. Keim-Malpass, J., Stegenga, K., Loudin, B., Kennedy, C., & Kools, S. (2016). “It's back! My remission is over”: Online communication of disease progression among adolescents with cancer. Journal of Pediatric Oncology Nursing, 33(3), 209–217.
Suh, M., Logan, J., & Barksdale, D. J. (2016). Augmentation index and pulse wave velocity—agreement of two indicators and relationships to blood pressures. Canadian Journal of Cardiovascular Nursing, 26(3), 22–27.
LeBaron, V. T. (2016). Global cancer disparities and the need for new initiatives. Oncology Nursing Forum, 43(1), 118–120. Letzkus, L., Keim-Malpass, J., & Kennedy, C. (2016). Paroxysmal sympathetic hyperactivity: Autonomic instability and muscle over-activity following severe brain injury. Brain Injury, 30(10), 1181–1185. Metzger, M., Song, M. K., & DevaneJohnson, S. (2016). LVAD patients’ and surrogates’ perspectives on SPIRIT-HF: An advance care planning discussion. Heart and Lung, 45(4), 305–310.
Wiencek, C., Lavandero, R., & Berlinger, N. (2016). From the team to the table: Nursing societies and health care organizational ethics [Special issue]. Hastings Center Report, 46(S1), s32–s34.
ONLINE EDITORIAL Wiencek, C., & Fontaine, D. K. (2016, May 2). Defying a death-defying culture [Column]. Huffington Post. Retrieved from www.huffingtonpost.com
Spring 2017
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ALUMNI PROFILE
Furnishing Hope Katie Sutton (BSN ’16) BY CHRISTINE PHEL AN KUE TER
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ransitions can be tough. An infant’s switch from a parent’s care to daycare. A patient’s move from hospital to rehab. An elderly person’s journey from living alone to a nursing home. But the transition from trauma, mental illness, or incarceration back into one’s community is one of the hardest, particularly when substance abuse is involved. It’s those kinds of transitions that Georgia’s Healing House aims to ease. And thanks to a few champions and one tireless nursing student, it’s doing just that. Katie Sutton (BSN ’16) was interning at the Charlottesville affiliate of Mental Health America with nurse Sue Hess (MSN ’76) when she first noticed the gap in transitional housing services for women. Most programs were focused on men, too abbreviated, or based on a rigid set of personal circumstances—abuse by a spouse, for instance. There was “very little for women who experienced substance abuse or who had a breakdown and no safe place to recover,” explains Sutton, now a nurse at Georgetown’s intensive care unit. “Many of these women were in jail, would get clean, and
then have no place to go, and would return to their previous lifestyles. We knew this cycle could be broken.” Sutton began gathering information—talking to professionals from local jails, homeless shelters, and social service agencies. She and Hess rallied for space and programming. That led to a long-term rental and, ultimately— with some painstaking coordination of furniture and household items—acquisition of a 19th-century residence in Albemarle County’s Woolen Mills district that, today, feels like home. Now in its second year of operation, Georgia’s House is home to 12 women actively recovering from substance abuse. Professionals, including nursing students, act as navigators, helping the women to secure basic needs—food, appropriate clothing and shoes—along with transportation, work, financial planning, and counseling. Residents must attend Narcotics Anonymous or Alcoholics Anonymous meetings, find a sponsor, and report on their progress at weekly house meetings. For nursing students, this community health rotation offers an intimate look at how addiction affects people’s lives. It also shows “the other side,” Hess says, “which is understanding that there is hope—and what the journey of recovery looks like.” For the women, as for Sutton, the experience is profound. “Every part of nursing is related to psychiatric care,” says Sutton. “Working for Georgia’s House took me out of the UVA bubble and made me realize how much goes on that I don’t understand, but that I’d like to try to help in some capacity.” +
“Every part of nursing is related to psychiatric care.”
VIRGINIA NURSING LEGACY
nursing.virginia.edu
COUR TE SY OF SPECIAL COLLEC TIONS, UNIVERSIT Y OF VIRGINIA LIBR ARY
V IRGINI A M OMEN T S
1940s PRACTICE
MAKES PERFECT
hile the American healthcare system always called for nurses with a wide cross-section of skills, most early-20th-century nurses primarily learned the ropes through clinical apprenticeships in hospitals (complementing classroom lectures from physicians), the domain where most of a nurse’s education took place. As the century progressed, however, debate about how best to train nurses grew, reaching an apex in 1937, when the National League for Nursing Education issued its revised Curriculum for Schools of Nursing. In it, nurse educators called for a better balance of theory and clinical practice, using case studies as a method of teaching, with greater emphasis on “thinking and understanding, on social attitudes and skills.” By mid-century, nursing education began its slow move into universities, and skills laboratories—like the University of Virginia nursing lab from the 1940s pictured here—rose in importance. Still, debate persisted over the need to craft skills and practical experiences (offered by hospital programs) versus the value of theory, science, and liberal arts (provided by universities). By the 1970s, it was well accepted that the university setting was critical for nursing students’ mastery of essential concepts and theories. Over time, nursing
DAN ADDISON
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professors sought to expand practice opportunities through dedicated simulation centers—like the School of Nursing’s Mary Morton Parsons Clinical Simulation Learning Center (CSLC), established in 1990. In these centers, students practiced assessment, clinical, and interpersonal skills in real time, with immediate feedback from professors and peers. Today, the CSLC’s high-tech rooms can mimic a near-limitless variety of scenarios in incredibly realistic fashion, and its simulations play a central role in both undergraduate and graduate nursing education. +
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Calendar of Events MAY 2017 3
CCI Lecture Series: “Mindful Leadership,” with Lili Powell (Darden School of Business professor)
6–12 National Nurses Week 12
End of spring semester exams
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School of Nursing Pinning and Hooding ceremonies
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Final Exercises
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Alumni Reception in conjunction with the American Association of Critical-Care Nurses’ National Teaching Institute and Critical Care Exposition in Houston
Better Together PAGE 8
JUNE 1
Application deadline for Nursing Alumni Association Alumni Scholarship
OCTOBER
1–4 Reunions: Classes of 1957, 1962, 1967, 1972, 1977, and 1982; Thomas Jefferson Society 8–11 Reunions: Classes of 1987, 1992, 1997, 2002, 2007, and 2012 27
Alumni Reception in conjunction with the Association of Women’s Health, Obstetric and Neonatal Nurses’ Annual Convention in New Orleans
Cornerstone Bicentennial Weekend
THE LATEST EVENTS INFORMATION
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Nursing History Forum
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Homecomings: Nursing alumni celebration
Main School of Nursing Calendar: www.nursing.virginia.edu/calendar
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Nursing History Forum: “Nursing People with HIV and AIDS, 1981–1996”
NOVEMBER 3–5
UVA Family Weekend
8–11 Train-the-Trainer Interprofessional Education Faculty Development for Educators conference
AUGUST 22
5–7
Fall 2017 semester begins
SEPTEMBER
9–12 Virginia Film Festival
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Nursing History Forum
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Advisory Board and Alumni Council fall meetings
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Fourth Melton D. and Muriel Haney Interprofessional Conference on Compassionate Care at the End of Life
www.facebook.com/uvanursing
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Nursing History Forum
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Zula Mae Baber Bice Lecture with Mary Naylor
DECEMBER 15
Eleanor Crowder Bjoring Center for Nursing Historical Inquiry: www.nursing.virginia.edu/research/cnhi Continuing Education: www.nursing.virginia.edu/continuing -education Compassionate Care Initiative: http://compassion.nursing.virginia.edu
End of fall semester exams
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Admissions Information Sessions: www.nursing.virginia.edu/admissions/ information_sessions
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