Resolve

Around the world there are so many ways to celebrate a new year – the Chinese New Year, the Persian New Year, the Arabic New Year, and the new year celebrated around the world on January 1.

In the midst of all the predictions and energy and glitter is a new way to celebrate: Resolution ’12. This web-based project, begun last year by the Rev. Charles L. Howard, Penn’s own university chaplain, encourages people to make New Year’s resolutions that are in the service of others.

“We were trying to experiment with how we could challenge people to put more good out there in the world,” Rev. Howard said.

I have added my resolution at www.resolution12.org, and I invite you to do the same. I encourage you to think in terms of community, of civic engagement, of global connections. As Pulitzer Prize-winner Ellen Goodman poignantly wrote:

“We spend January 1 walking through our lives, room by room, drawing up a list of work to be done, cracks to be patched. Maybe this year, to balance the list, we ought to walk through the rooms of our lives … not looking for flaws, but for potential.”

That potential could be in your resolution, or in mine, or in the resolve of someone we never have met. It could start with Resolution ’12.

Milestones

We at Penn Nursing are proud to share our 125th anniversary with another landmark nursing institution, the Visiting Nurse Association of Greater Philadelphia. Until its inception on March 2, 1886, “no one had ever heard of such a thing as nursing the sick poor [sic] except in hospitals,” recalled founder Mrs. William Furness Jenks. The work of visiting nurses was hard, often taking them to “run-down areas which housed the city’s workers” and where such contagions as typhoid, diphtheria, and tuberculosis were rampant.

The efforts of these pioneering women – indeed, all were women – and their visiting nurse counterparts around the country formed the foundation of home nursing and community nursing as we know them today.

The history of the VNA of Greater Philadelphia has its home here at Penn Nursing, in the premier center for nursing history in the world, the Barbara Bates Center for the Study of the History of Nursing. The Bates Center -- notably celebrating its 25th anniversary this year -- houses the records of the Visiting Nurse Society, and a vast collection of materials from nursing history.

The entire Bates collection – a rich array of written materials, artifacts, and photographs from nursing history -- encompasses nursing education and healthcare institutions, non-profits, and nursing luminaries. The Bates Center is open to scholars across all fields and non-academic researchers interested in nursing. It brings nursing history to life, and is a jewel of our School and our discipline. Happy anniversary to us all!

New Window on Nursing

During his visit to Penn Nursing earlier this month, Lancet editor-in-chief Dr. Richard Horton left us with a promise to write about the work we are doing here. A man of his word, he devoted his November 19th editor’s column to “Nursing, but not as you know it.” Dr. Horton called Penn Nursing: “. . . the country’s leading research-intensive nursing school that stands as an equal with its biomedical counterpart.” He lauded our LIFE (Living Independently For Elders) program, calling it proof of “the social value of academically led practice . . . Rarely will one witness such a successful juxtaposition of practice and research, care and inquiry.” These are extraordinary statements, particularly from the editor-in-chief of one of the world’s most esteemed medical journals.

Although nurses have historically been at the forefront of science and health, it is always particularly potent to see how the accomplishments of nurse scientists are viewed by our esteemed colleagues in medicine. What Dr. Horton saw in our programs are examples of how nursing makes a difference and how keen our faculty are to translate knowledge into care, action, and policy.

The Next Revolution

This week I was thrilled to have as a guest at Penn Nursing Dr. Richard Horton, editor of the internationally renowned medical journal The Lancet. He spent three days meeting with nursing and medical faculty, students, and University leadership. One of the main topics everywhere was how the healthcare professions can come together to respond justly and equitably to global health needs and, to achieve that, how they need to be educated together. On Wednesday Dr. Horton gave an inspiring presentation to a crowded auditorium here in Fagin Hall titled “A Bonfire of the Professions: Prospects for Global Health.”

The dean of Penn’s Perelman School of Medicine and I jointly hosted the lecture, which is indicative of how nursing and medicine are connected in a deep partnership, opening up opportunities for advances in health that cross continents and span seas.

Dr. Horton speaks passionately about the need for a patient-centered “revolution” in healthcare. “We are living through a healthcare crisis in the world today,” he said this week. He urged the healthcare professions to take heed that child survival, maternal health, and the infectious diseases malaria, tuberculosis, and AIDS are still rampant in the parts of the world that are the poorest and have the fewest healthcare resources. He emphasized: “The current status quo simply cannot continue.”

I had the distinct pleasure to work with Dr. Horton and international colleagues on the 2010 report “Health Professionals for a New Century: Transforming Education to Strengthen Health Systems in an Interdependent World” from The Lancet and the Institute of Medicine.

In it, we advocated that “all health professionals in all countries should be educated to mobilize knowledge and to engage in critical reasoning and ethical conduct so that they are competent to participate in patient- and population-centered health systems as members of locally responsive and globally connected teams.”

To reach this vision, Dr. Horton is once again turning to Penn Nursing and to the University. He has proposed that Penn join The Lancet in a commission that would lead to “transprofessionalism,” uniting nurses, midwives, community health workers, and doctors to address global needs and inequities in healthcare.

That is a fantastic approach to global health today. We look forward to partnering with The Lancet in realizing some of the pioneering recommendations proposed in “Health Professionals for a New Century.”

Seven Billion

This is my hope as the world’s population welcomes its seven billionth citizen today:

First I want to wish the world’s seven billionth citizen a safe and happy birth. A safe birth is still too infrequent in today’s world where healthcare remains inadequate in many parts of the globe. If the seven billionth citizen is a girl child, I hope she grows into safe womanhood in a world that appreciates her, a world that provides her with a safe living environment, work that is satisfying and stimulating, and recreational opportunities that offer her a healthy life. I hope the seven billionth citizen is successful at creating a healthier world for women, who are at the core of healthy families, successful communities, and productive societies.

Welcome, and know that you can change the world.

The Next Nurse Scientists

This fall, the many wonderful students we welcomed to Penn Nursing included our first cohort of Hillman Scholars in Nursing Innovation. These academically talented, committed, and foresighted students are planning careers as cutting-edge leaders and researchers. With the generous support of the Rita and Alex Hillman Foundation, we have begun mentoring these five inaugural scholars along a streamlined BSN-to-PhD pathway.

Led by our own Terry Richmond, PhD, RN, acclaimed for her expertise in nursing education, the program’s diverse and demanding curriculum incorporates interdisciplinary education with research career development and guidance starting at the undergraduate level. Students work closely with faculty mentors and collaborate with established research teams in Penn Nursing’s renowned research centers.

This is a program of national importance. It is no secret that we are facing a severe shortage of nursing faculty in the United States. The average age of nurses graduating with a PhD now hovers near 45 years old, and data from the American Association of Colleges of Nursing show that 77 percent of nurse faculty are over the age of 50 years.

We expect that our Hillman Scholars in Nursing Innovation will complete their PhDs within seven years of entering Penn Nursing, giving them decades to develop and mature a program of research and advance nursing knowledge. Their program of study is designed to prepare them as innovative nurse leaders who will drive the future of nursing, healthcare, and the health of society. The first cohort of Hillman Scholars in Nursing Innovation and their research interests are:

• Kaitlin Best, critically ill children
• Whitney Eriksen, cognitive dysfunction and autism
• Hayley Germack, health of immigrant populations
• Linda Kang, health policy and the nursing workforce
• Kaori Sakanashi, vulnerable non-English-speaking immigrants.

These future nurse leaders have big energy, big talent, and big plans. They are working side-by-side with our premier Nursing faculty and are being integrated into our broad and rich research community, which crisscrosses the world. I wholeheartedly agree with our scholar Kaori, who said that this initiative presents “a once-in-a-lifetime opportunity.” For all of us here, starting young nurses on a journey to becoming the scholars of the future is a dream come true.

Women's Health and the World's Cities

Women are more likely to walk where they feel safe. That may be intuitive, but we now have the science to prove it. A new study in the American Journal of Preventive Medicine demonstrated that women throughout the United States, in cities and in suburbs, are more likely to walk where they feel safe and have access to sidewalks and other community resources. Simply stated, more walking and more physical activity mean better health.

In urban planning in particular, consideration of women’s health and social needs is more important than ever. More than half the world’s population – approximately 3.5 billion people -- live in cities. By 2030 this number is expected to increase to almost 5 billion.

People move to urban areas seeking new opportunities, new options, freedom in choices, and better resources. Women in particular believe that they can improve their economic status and social position and find better opportunities for their children by seeking work and education in the cities. However, even as urbanization offers opportunities, the health of women in urban settings is challenged.

Unfortunately, the effects of urban development and gender have received little attention. In Women’s Health and the World’s Cities, my collaborators Eugenie L. Birch and Susan M. Wachter and I called on scholars and practitioners from the fields of urban planning, global studies, and health sciences to consider urban planning from the perspective of women’s health and to examine the effect of urbanization on women and their health.

Urban planners must consider five forces in planning and developing urban areas in order to improve women’s lives:

1. Developing cities with women’s needs in mind. Women want to live in safe environments with better lighting, lower population density, and space that permit connections and allow them to provide the care that their roles demand to meet the needs of their children, friends, partners, elders, and other family members. This means providing access to resources for their children’s needs as well as elders’ needs. Improving conditions in or replacing slums, where many women newcomers to the city live, must be part of urban planning and development.

2. Focusing attention on the sociocultural context and religious mores that drive, and often dictate, women’s movements, educational and working options, and housing needs.
Developing urban areas in religiously conservative Muslim or Jewish communities or in socially strict societies requires different criteria and guidelines that determine the physical and social capitals and hence the space configurations.

3. Including women’s voices in planning decisions. Women should be key players in the policies and plans used for the development of communities. Involving women in policies related to urban planning and development ensures that their perspectives, needs, and voices are included in designing spaces with women’s needs in mind.

4. Developing a conceptual framework that provides a structure for systematically investigating gender and impact -- or lack of it -- on urban environments as well as on health and well-being. This would drive the design and translation of research programs into gender-sensitive urbanization development plans.

5. Understanding that all of these empower women and give them voice.

Contemporary urban planning must address questions that reflect the differences between men and women in urban living and the differences in health outcomes among those who live in urban areas with differential incomes. As the 21st century unfolds, urban planning must be sensitive to defining and investigating the nature of gender disparities that are characteristic of those who live in urban areas. Careful urban planning provides a momentum to empower women and to enhance the quality of their lives. More accessible education, healthcare, and resources bolster women’s abilities to fulfill their caregiving roles.

Preventing urbanization’s spatial, social, and health risks for women through careful advance planning will be far more effective and productive than intervening after the fact.

Afaf Ibrahim Meleis, PhD, DrPS (hon), FAAN, FRCN, is Margaret Bond Simon Dean of Nursing and Professor of Nursing and Sociology at the University of Pennsylvania School of Nursing and co-editor of Women’s Health and the World’s Cities with Eugenie L. Birch and Susan M. Wachter.

Firsts & Innovations

What does it mean to be first? Thought leadership, trailblazing, going where no one has gone before. These all describe nursing at Penn. From the start, nursing at Penn has meant being at the cutting edge, doing things differently, breaking new ground for science, for the benefit of our patients and our communities, and for future leaders in nursing. What was it like before nurses developed the evidence to manage symptoms, identified the best models to prevent illness, or helped patients through transitions and complex healthcare decisions? In short, where would healthcare be without nursing research? Nursing at Penn has led the way in these areas and many others.

Nursing at Penn always has meant thinking outside the box in our classrooms and our laboratories, at the bedside and the bench, about the very young and the very old, about the sick and the well. Nursing at Penn means influencing the world through ideas, through actions, and through policy changes.


As we open our celebration of 125 years of nursing at Penn, I share with you just a few of our innovations which have made a difference in the health of our world:

• The first nursing doctorate in the Ivy League
• The first privately funded center for nursing research in the country
• The first school at Penn and one of the first in North America to be named a World Health Organization Collaborating Center
• The first operating room nurse in the nation
• The first nurse anesthetist in Philadelphia
• The first nurse to receive the MacArthur Fellowship, known as the “genius” award
• Some of the first endowed chairs for nursing in the country
• One of the first aerospace nurses in the NASA program

Our contributions to nursing and to health are exponential. With that in mind, I invite you to celebrate 125 years of nursing at Penn by helping us assemble a list of 125 innovative faculty, students, and alumni. Share your ideas at nursalum@pobox.upenn.edu and become a fan of Penn Nursing Alumni on Facebook for weekly updates on 125 Innovators and Ideas!

125 Years of Nursing at Penn

One hundred and twenty-five years ago -- one year before the founding of the National Institutes of Health, several years before the discovery of penicillin, and many decades before the establishment of Medicare -- the Hospital of the University of Pennsylvania was breaking boundaries in nursing education.  Since the creation of the Hospital of the University of Pennsylvania Training School for Nurses in 1886, one of the first formal nursing education programs in the country, and the founding of the University of Pennsylvania School of Nursing in 1950, Penn has been home to dedicated healthcare professionals, innovative scientists, and inspiring leaders in nursing.

To commemorate this milestone, the Nursing Alumni Association of the Hospital of the University of Pennsylvania commissioned alumna and artist Kathleen Shaver to create an art installation. “The History of Nursing As Seen Through the Lens of Art” in the Ware Lobby of Fagin Hall will be formally unveiled this weekend. The event launches a year-long celebration of 125 years of nursing at Penn.

All year we will pay tribute to the greats in nursing education who devoted themselves to HUP and to Penn.  We hope you will join us! For a preview of the art installation, a listing of 125th celebratory events, and a look at the history and future of Penn Nursing, visit www.nursing.upenn.edu/125th

Nursing Through Time

I am delighted to announce the launch of an exciting new website developed at Penn Nursing: Nursing, History and Healthcare at www.nursing.upenn.edu/nhhc. The site provides a lens through which scholars, students, clinicians, journalists, policymakers, and consumers can understand the historical roots of many issues and challenges faced by the nursing profession.  It is that profession that has devised ways and means of delivering health care services to the American public throughout the years. The website also addresses a wide range of current topics vital to comprehending and broadening our understanding of healthcare and nursing concerns, including the role of professional nurses, nurse shortages, workplace problems, and public health issues.

This website received significant funding from the National Institutes of Health, the National Library of Medicine, a Scholarly Works in Biomedicine and Health grant, and the University of Pennsylvania Research Foundation, as well as support from the American Academy of Nursing’s expert panel on nursing and history and our School’s Barbara Bates Center for the Study of the History of Nursing.  The site was created by our nurse historian Jean C. Whelan, PhD, RN, under the initial direction of our late Professor Karen Buhler-Wilkerson, PhD, RN, FAAN.

Connect with Us

We are delighted that many of you know our school, our distinguished faculty, and our inspiring students. We want you to get to know us better and know even more about us! Penn Nursing is delighted to announce our new social media platform. With outlets on Facebook, Twitter, LinkedIn, YouTube, and Blogger, there are engaging new ways to stay connected with Penn Nursing. We welcome your comments and ideas, and hope you will engage in our expanding online communities.

Connect with Penn Nursing at www.nursing.upenn.edu/connect

Games!

I just finished reading Jane McGonigal’s remarkable book Reality Is Broken, the selection for this year’s Penn Reading Project. Ms. McGonigal’s book gives a completely different meaning to all kinds of game-playing including reaching, connecting, interacting, judging, engaging, competing, teaming, problem solving, and planning, among many other concepts very familiar to nursing practice. The book’s subtitle “Why Games Make Us Better and How They Can Change the World” is a concept that we are exploring at Penn Nursing. One of our strategic goals as a school includes the use of innovations, games, and entrepreneurship as vehicles for developing and providing care that is more congruent with a future of technology, informatics, limited resources, collaboration, and community focus. We are proud to have on our faculty a game and innovation champion, Dr. Nancy Hanrahan, who will guide our School community in integrating these ideas into our work. As the University celebrates the Year of Games: Body & Mind, we invite you to share your ideas for incorporating aspects of gaming into nursing education.

My dream? To have a blockbuster game developed by our nursing students. This game (or games!) would popularize nursing as a very visible career choice and could encourage players to make healthy lifestyle choices as a driver for well-being. Our bright students can do it.

What do you think are the best ways to make it happen?

Women’s Health is Everyone’s Business

Empowerment and health are intricately connected and one of the goals of our discipline is to empower individuals and communities to have a voice and to care for themselves. For women in particular, empowerment through good health enables women to reach their full potential, to manage their own lives, and to influence key decisions that shape their lives and families. Empowering women through good health requires equitable access to healthcare, and new preventive healthcare provisions outlined in the Affordable Care Act demonstrate that women’s health is everyone’s business.

The Affordable Care Act calls for important women’s preventive healthcare including mammograms, screenings for cervical cancer, and prenatal care to be offered at no cost to the patient. Notably, the Affordable Care Act also addresses the unique health needs of women throughout their lifespan in eight critical areas:

• Well-woman visits
• Screening for gestational diabetes
• Human papillomavirus testing
• Counseling for sexually transmitted infections
• Counseling and screening for HIV
• Contraceptive methods and counseling
• Breastfeeding support, supplies, and counseling
• Screening and counseling for interpersonal and domestic violence

These guidelines, developed by the Institute of Medicine and supported by the U.S. Health Resources and Services Administration, will give women the benefits of comprehensive preventive services without the burden of co-payments, co-insurance, or deductibles starting in August 2012.

Recognition of the importance of women’s health is cresting. In April, the fifth Colloquium of University Presidents, meeting here at the University of Pennsylvania and hosted by President Amy Gutmann, addressed what universities and the United Nations can do to empower women to change the world.

“Women have the potential to be the world’s most powerful catalysts for change,” the group emphasized, and advocated that the United Nations consider women’s health a matter of global importance by stimulating “innovative programs for vulnerable women and girls . . . [working] to end violence, improve universal access to healthcare and education, eliminate gendered poverty, and improve employment opportunities of women.”

With the prominence of the health of girls and women in the Affordable Care Act, the U.S. is already engaged in creating healthier and more productive families, communities, and societies because the health of the female population is rightfully a priority.

Universities, particularly schools of nursing in our education of healthcare professionals, have a vital role in ensuring that women are well aware of their rights for healthcare, that we join women in developing a strong voice to ensure they have these rights, and that they are exercising the best practices to keep themselves healthy. There is perhaps no more important ingredient to empowerment than good health.

Safe Womanhood

Women are half of the human race. By empowering them through health and educational opportunities, we increase their personal potential to contribute to the economic, political, and social advancement of societies. What society would not benefit from such contributions?  Nurses, the largest healthcare workforce in the world, see women intimately as patients, as pregnant women, as mothers caring for their children, as managers of health, and as daughters caring for their extended families. Therefore, nurses have the knowledge, the power, the voice, and the expertise to work toward safe womanhood and to advocate for women’s health, for human rights, and for having options in life.

Women must be equal partners with equal voice to have an impact on decision-making, policy-making, and development. The marginalization and disempowerment of women hinders them from their rights as human beings to reach their full potential to flourish and effectively contribute to their societies.

At the University of Pennsylvania School of Nursing, we have established a Center for Global Women’s Health. The Center will contribute to global research in women’s health scholarship, education, practice, and leadership using an equitable and human justice framework.

The opening of the Center corresponds with the United Nations’ initiatives for the empowerment of women globally and with national attention to women’s health from President Obama and Secretary of State Hillary Rodham Clinton.  They have made girls and women central in U.S. global health programs.
 
Penn Nursing Professor Marilyn Sommers, PhD, RN, FAAN, is director of our Center for Global Women’s Health. Her research focuses on trauma, particularly injuries from rape, sexual assault, and domestic abuse. Last fall, she won the Inaugural Writing Award for Excellence in Research from the Journal of Forensic Nursing for her article “Health Disparities in the Forensic Sexual Assault Examination Related to Skin Color.” Dr. Sommers has conducted path-breaking research finding that injuries are more detectable on lighter skinned women than on darker skinned women, irrespective of race, using current exams for sexual assault injury.
 
With such innovative research, the Center for Global Women’s Health will chart new directions in the domains of safety from violence and harm, equity, empowerment, advocacy, health promotion, and disease prevention. The ultimate goal is to attain safe womanhood, which provides the context and the impetus for healthier and safer families and societies. In short, making women safe and healthy makes the world safe and healthy.

A Hard Look at Modern Slavery

One of the most important books relating to women’s health is Half the Sky, by Nicholas D. Kristof and Sheryl WuDunn. The book is viscerally painful and a clarion call to the world  to empower women and girls and end the gross injustices against them. The depictions in Half the Sky of the oppression of women and girls in developing countries around the globe do  not gloss over the harsh realities of sex trafficking, brutality, and tyranny through systematic rape – all of which affect the health of women at the deepest levels.

But, Half the Sky also offers stories of hope and inspiration by showing how even a little help can dramatically transform the lives of women and girls.  This book provides evidence that if women have the opportunity, they can raise the standards of living for their families and their communities. If women and girls are educated, healthy, and able to live without fear of violence and oppression, they can help stop the vicious cycle of global poverty.

Right here in the U.S. cases of  these human rights violations have been reported in all 50 states, Washington D.C., and some U.S. territories.  By some accounts, as many as 300,000 children in America are victims of sex trafficking each year.  Nicholas Kristof recently wrote an article about the major trafficking problem in the U.S. involving “homegrown American runaways.” These are 12- or 13-year-old girls from troubled homes who are lured by pimps into sexual slavery and are threatened with violence if they try to escape.

This week, the U.S. State Department releases “Trafficking in Persons” -- a comprehensive account of the efforts of governments worldwide to combat human trafficking. The U.S. government uses this annual report as a key diplomatic tool to encourage partnerships and increase determination to fight forced labor, sexual exploitation, and other forms of modern-day slavery.

Half the Sky and “Trafficking in Persons” are not the casual beach reads of the summer. Instead, they are two of the most important chronicles of our times.

The Power of Nursing Science

Nursing is a discipline that affects people one-by-one, community-by-community, and nation-by-nation. As nurses, we take seriously our moral commitment to the world to work toward the health and well-being of individuals and populations.

I recently participated in an initiative called the Global Advancement of Practice and Research in Nursing (GAPRIN), which was co-sponsored by the U.S. Department of State and the National Institute of Nursing Research (NINR).  I was one of two leading U.S. academic nurses invited to travel with a delegation to Bangladesh where nurses, for the first time, were invited into the boardroom to join discussions with health care leaders from around the word. Our purpose was to empower and catalyze nurse leaders to guide others in creating an evidence based culture and a more person centered approach to health care.  We met with governmental officials, academicians, and clinicians to discuss the importance of building strong nurse training programs in research and clinical practice that evolve into lifelong career paths for nurses. The outcome was remarkable.

In developing nations like Bangladesh, the concept of nursing research is novel, even unheard of. After hearing about the significance of nursing research in producing the evidence for quality care, the Executive Director of ICDDR,B (International Centre for Diarrheal Disease Research, Bangladesh), Dr. Alejandro Cravioto, committed $25,000 for competitive proposals in nursing research – the first such funding for nursing research in Bangladesh. The NINR and the U.S. Department of State will support nurses in Bangladesh in developing research programs as well as in empowering nurses to use evidence in their practice.

Together we will start to build an aspect of nursing that is critical for Bangladesh and for every country in the world – the capacity for nursing science.

Welcome to the Golden Age of Nursing

We were so proud to have Dr. Donna Shalala, a revered public servant and current president of the University of Miami, speak to our graduates at Commencement last week. As chair of the Committee on the Future of Nursing for the Institute of Medicine, Dr. Shalala emphasized that healthcare systems around the world are poised to benefit from the expertise of nurses at a higher and more expansive level than ever.

With the passage of the 2010 Affordable Health Care Act, the discipline of nursing is front and center. We must seize the moment by investing in nurse scientists and advancing the scholarly field of nursing science. Scholarship in nursing is vital for developing and translating best practices for quality care. The objective of a research career is to provide the evidence for equitable, quality healthcare for all populations. Of course the ultimate goal is to develop policies and practice standards that positively influence the care of all people.

To achieve that, academic and practice institutions must uphold and fortify their research mission.

On a recent visit to Universidad de Costa Rica, I spoke about creating a culture of scholarship. In sum, the keys are:

• Practice – Having an engaged and well-supported practice program
• PhD Education – Preparing nurses for the highest level of competency and integrity
• Passion for the Discipline – Inculcating a strong identity and integrating research and practice
• Post-Doctoral Education – Supporting novice scholars
• Protecting Researchers – Providing time, mentorship and support
• Productive Communities – Creating environments that value scholarship, mentoring, and intellectual engagement
• Partnerships – Creating local, national and global relationships, and clinical-academic partnerships
• Policies -- Knowing and influencing healthcare priorities and research agendas and using media to market findings.

We are on the threshold of the Golden Age of Nursing. Today’s graduates are beginning their nursing careers at the best possible time. Let us ensure that every door is open to them and to every nurse scientist.

“Give the Profession a Little Swagger”

Nurses will be the leaders in our reformed healthcare system. That was the clear and motivating message from Dr. Donna Shalala, our wonderful Commencement speaker yesterday.

With three million nurses in the United States, Dr. Shalala said, nursing professionals “hold the power and influence to make those numbers speak” in the new era of healthcare. She is in a position to know: Dr. Shalala, former U.S. Secretary of Health and Human Services and current president of the University of Miami, has spent her career working tirelessly for health, knowledge and empowerment for all people. And last year, she chaired the Committee on the Robert Wood Johnson Foundation Initiative on the Future of Nursing at the Institute of Medicine. The committee reported on the crucial role of nurses in healthcare reform.

Yesterday, Dr. Shalala told our Penn Nursing graduates that their expanded role under the 2010 Affordable Health Care Act should “elevate nursing to its proper leadership place in the health care pantheon.”

She called on our graduates to claim a leadership role in health care reform: to ensure that their voices are heard “on rounds and on the record,” to demand “full partnership with physicians,” and to “give the profession a little swagger.” I couldn’t agree more.

“I strongly believe a Golden Age of Nursing is right in front of us,” Dr. Shalala said, “if we seize the moment. It will not come to us. All of you must go and get the future of nursing – it will take guts, heart, and a lot of skill.”

Our graduates are ready not only to meet this charge, but to lead the way.

Global Health in a Connected World

Here in the U.S., domestic health care reform is at the forefront of public and political discourse.  But ours is not the only health care system that faces such challenges as access, equity, and quality. On Friday, Penn Nursing will host a discussion of “Global Health in a Connected World.”

Colleagues from Penn’s School of Medicine who share my passion about global health will join me to talk about the role of public and private institutions - governmental, educational, and philanthropic - in shaping global health systems.

Even as we delve into this topic here on campus, our Penn Nursing faculty are playing important roles in health care around the world.

As I write, Dr. Wendy Grube is with a cohort of Penn Nursing students in Thailand, where nurses and midwifery comprise 70 percent of all health personnel. Our students are in a course comparing healthcare systems in the U.S. and Thailand within the context of culture, politics, economy, and environment.

The group travelled from Bangkok where they explored urban health-related issues and services, then North to Chiang Mai to better understand regional diversity. Wendy writes:

“This morning we went to visit an orphanage for abandoned children. Many of these have lost parents through death, but many are there because their parents are currently unable to care for them. HIV is a significant problem in this region, as is drug dependence. As an aside, the area at the far north of Thailand (the Golden Triangle, including neighboring Laos and Burma) was at one time the largest opium poppy-producer in the global market. This orphanage is government-subsidized, and the budget is quite limited. But the children appear healthy and happy, although starved for affection. They actually ran to the students, taking their hands to walk with them . . . they snuggled into laps and climbed all over us.”

Such enriching experiences prepare our students for the global reach of the nursing profession they are about to enter. The benefits continue after the conclusion of the course: Students have the opportunity to cultivate international nursing collaborations with fellow students at Thailand’s Mahidol University, and together construct new paths toward reducing healthcare inequities on a global scale.

Photo: Making herbal compresses, a Thai traditional medicine.

Meet the Nurse Scientist

The nursing profession has changed by leaps and bounds in recent decades. Advanced practice nurses have prescriptive rights and run their own practices. Nurses are as involved in research as their physician counterparts. We bring our philosophy of well-being and quality of life to research from cardiology to oncology to population studies to bioethics, and every facet of health you can think of.

As the nursing profession has changed, so has the perception of nurses and our chosen profession. The widely anticipated “top docs” issue of Philadelphia Magazine includes nurses for the first time this year, with stories on nursing perspectives on health care reform and what the nurse-patient relationship should look like. The May 4 issue declares nursing “a science-based profession, not a frilly one.” That is music to my ears. I invite you to read for yourself at:

http://www.phillymag.com/health/articles/what_nurses_wish_you_knew/

http://www.phillymag.com/health/articles/obamacare_yes/

Preparing the Professions

The world we live in, as we all know, is getting smaller due to new technologies, modes of communication and patterns of population movements that crisscross the borders between disciplines and countries. These patterns have brought new innovations as well as challenges to healthcare, making it imperative to become more interdisciplinary and global. All of that places new demands on healthcare and has also challenged the status quo in education among the professions of medicine, nursing midwifery, and public health. To meet the needs of the new millennium, we have realized that we must challenge ourselves to also crisscross the borders of our minds with new knowledge from other professions, to integrate this knowledge to prepare new generations of healthcare professionals who are interprofessional and interdisciplinary.

The Lancet Commission, a group of cutting-edge thinkers from across the disciplines and the globe, has called on us to create “a new era of professional education that advances transformative learning and harnesses the power of interdependence in education, as well as to leverage knowledge advanced globally.” I proudly served with others in this group which is urging professions to learn from each other’s discoveries and challenges to shape professional education for the future and to transform the healthcare system. The objective is to meet the Millennium Development Goals for quality healthcare.

The Carnegie Foundation, The Robert Wood Johnson Foundation, the Lancet Commission, and the Institute of Medicine all produced many reports that inspire us with challenging recommendations. Let’s use these recommendations to create a future. Let’s pool and integrate our expertise for a future of better healthcare and a more humane and just healthcare system.