ACT for Sandy Hook

“What can I do to help?” I understand and share the heartfelt desire to do something to heal our grieving society in the wake of the massacre of children and educators in Sandy Hook, and to ensure that such a tragedy never happens again. 

But, the unfortunate truth we know as nurses is that tragedy happens every day. It happens, as President Obama said, “in small towns and big cities all across America.”

What can nurses do to help? ACT. Advocacy, Clinical Judgment, and Transformation.

Advocacy: Our professional organizations must uniformly advocate for

·         full-time school nurses, who are often the first to identify and work with troubled students

·         fixing a mental health system that is uneven, complex, and ineffectively isolated from other areas of healthcare

·         more federal funding devoted to research on mental health, violence prevention, and healthcare disparities.

Clinical Judgment: From wars abroad to violence on our on soil, nurses so very often are the first to recognize and respond to crises, to diagnose pain, to alleviate suffering, provide comfort to those who are grieving, and to decrease other risks. And, as nurses deliver more primary care, we will be in key positions to identify those who need mental healthcare and to help patients navigate the health system to get the care they need. Therefore, use your clinical judgment to join the national and global debates and dialogues about guns that cause violence, pain, suffering, and death.

Transformation: Our education and experiences give us insights that are important to share as our country considers real change. The Affordable Care Act places nurses front and center in the U.S. healthcare system. We can own our power and lead the charge for policy changes that will create a more stable, more healthful, more peaceful society.  We must amplify our voices in the national conversation on the factors that lead to violence and how to prevent it.

I close with the words of President Obama: “If there is even one step we can take to save another child, or another parent, or another town, from the grief that has visited Tucson, and Aurora, and Oak Creek, and Newtown -- and communities from Columbine to Blacksburg before that -- then surely we have an obligation to try.”

ACT. Let that be our resolve in 2013. 

For those who need immediate assistance with trauma, go to the following website www.apna.org/TraumaticEvents for help.

New Soul, New Voice

Vernice Ferguson: A consummate nurse and colleague

After much anticipation and excitement, my new grandchild has arrived (early, at 8 lbs. 3 oz.) and I cannot wait to see who this new person is and will become.

But even as we celebrate his arrival, we often find ourselves pausing to reflect on those who would share our happiness and understand it deeply. We think of those we have lost. Sadly comes the news that nursing has lost a great leader. Vernice Ferguson, a dear friend and nursing colleague, has passed away. In Vernice, we had a unique and strong voice representing nursing, as well as representing diversity and inclusiveness in nursing.

Vernice played a very important role in our School. She served for several years on our Board of Overseers and as a senior fellow, holding the Fagin Family Chair in Cultural Diversity from 1993 to 1997. She was a frequent visitor to our School where she mentored faculty and students and was a speaker at our commencement ceremony.

From 1980 to 1992 she was the assistant chief medical director for nursing programs in the Department of Veterans Affairs. In this position she was responsible for the largest organized nursing service in the world. Prior to this assignment, she was chief of nursing at the National Institutes of Health Clinical Center.

Vernice was an honorary fellow of the Royal College of Nursing of the United Kingdom, the second American nurse so honored. She received eight honorary doctorates and two fellowships -- one in physics, the other in alcohol studies -- and was named a “Living Legend” by the American Academy of Nursing. In 2008, Ms. Ferguson received the FREDDIE Lifetime Achievement Award, considered by many to be “the Oscar of health and medicine.”

In all of her roles, Vernice was the consummate nurse and colleague who was the voice and conscience for inclusion of diversity in every aspect of the nursing mission. She challenged us to envision and create a world that was more ethical and that valued diversity in all its forms and was behind many of our initiatives in diversity that made Penn Nursing a model for the University.

As she told young nurses at the 40th anniversary of the Breakthrough to Nursing Project: “Now you can continue to trailblaze. . . . Ask yourself: What will you bring to the table [as a nurse]? What will you do to help eliminate health disparities?”

I had the honor of knowing Vernice as a friend and colleague for nearly 20 years. I learned a great deal from her leadership and commitment to diversity. And, I have been very grateful for her generosity to our School.

We will all miss her voice. I hope my grandson will find a voice that is just as strong – but, for the sake of my son and daughter-in-law, just not at 3 a.m.! I hope he will defend diversity and inclusiveness and will be intolerant of any intolerance.

I have heard often that when one soul leaves the world, a new one arrives. Perhaps a new nurse leader will be in our midst!

In the Year 2022

What should the world look like for women in 2022? It should be safe and equitable. It should be free of the trafficking and exploitation of women, and violence against them. It should ensure that women are educated, empowered, and that their voices are heard and valued. My hope is that in 2022 all women – regardless of geography – can reach their full potential and capacity to be productive members of society.

Prioritizing the health and well-being of women took center stage at the 19th Congress of the International Council on Women’s Health Issues (ICOWHI) in November. Health leaders and thought leaders from around the world met in Bangkok, Thailand, to partner for “a brighter global future.” Those leaders included Her Royal Highness Princess Bajrakitiyabha Mahidol of Thailand. ICOWHI honored the Princess for her unwavering commitment to women’s rights with the Taylor and Francis Distinguished Award for Exemplary Work on Women’s Health.

Meeting the needs and rights of women by 2022 (which is what should be) will take much effort, systematic and deliberate planning, and strategic actions. This will take a cross-section of social sectors must embrace partnerships rooted in justice and equity.

There has been some progress toward these goals and powerful examples of best practices have resulted in outcomes that many thought leaders envisioned and articulated for many years. Seemingly small efforts have yielded big gains. In several countries, the new development of having separate toilets for boys and girls has reduced the rate of school drop-out among girls after the onset of puberty. Women in Nairobi, Kenya, in partnership with local businesses, developed “Adopt-a-Light Limited” to ensure working street lights so urban women can travel safely. An urban maternal and newborn health program called Manoshi brings skilled birth attendants to women living in the slums of Dhaka in Bangladesh.

These programs have successfully brought women’s issues to the forefront, raising the consciousness of leaders and enhancing women’s opportunities to influence politics and society.

Fast forward to 2022 - by continued work toward a future of equity, safety, well-being, and productivity we may be able to make that future happen sooner for women world-wide.

I Am Malala - And I Am Walking Again!

Tomorrow is a day of importance for girls around the globe. It is the day of Malala and 32 million girls. Who are these girls? They are without education.

Since October, the world has rallied around a 15-year-old Pakistani girl named Malala Yousafzai who was shot in the head by the Taliban for going to school. She dared to advocate for access to education for girls in Taliban strongholds in Pakistan. Malala has started walking again and is continuing her recovery. The world is carrying on her fight.

The Office of the United Nations Special Envoy for Global Education has declared November 10 a day of global action for Malala and girls around the world.

The International Council of Nurses, where I have the distinct honor of serving as Global Ambassador for the Girl Child, has long been dedicated to the Girl Child Education Fund, supporting orphaned daughters of nurses in developing countries in getting back to school. Education should not be a privilege. It is a right.

In honor of Malala and every child who deserves the right to an education, please join me in the I Am Malala initiative at http://educationenvoy.org/

Elevating the Girl Child

Lynn Sommers in Greece

As personified by the courageous efforts of Pakistan's girl heroine, 14-year-old Malala Yousafzai, described so powerfully by former First Lady Laura Bush, the importance of education for girl children cannot be underestimated. As important as growing their intellect is the matter of their health. Girl children without access to education -- any children without access to education -- are very often children without access to healthcare.

I have the privilege of serving as the International Council of Nurses Global Ambassador for the Girl Child and working with nurses to identify and lead creative and compassionate strategies to improve the health of girl children.

Here at Penn Nursing, the majority of our research faculty focus on the health of under-represented populations, with women and girls prominent among them. At our Center for Global Women's Health, faculty and fellows just returned from Chalkidiki in rural Northern Greece where they worked with the isolated Roma community in a small women's health clinic. In addition to assisting with screening for orphaned or trafficked children, Lynn Sommers,  Maureen George, Kathleen Brown, and Ellen Volpe are providing education and training to community health workers in areas of critical importance to the local population.

Asthma is at a frightening high in Northern Greece, largely because of liberal pesticide use in this olive-growing region, plus a high rate of smoking. The U.S. State Department awarded funding to Dr. George, an expert in asthma prevention and management, for the Greece Health Promotion Project. The support enabled her to assist with training of 50 community health workers (including nurses, speech therapists, physical therapists, primary care physicians, rescue workers, teachers, and even teenagers and lay community members) on smoking cessation and asthma self-management at the Ormylia Foundation and the Panagia Philanthropini Center. The team is working with Brother Charles Anthony, director of the Ormylia Foundation Clinic in Northern Greece, and Penn Nursing's community partner on this project and on cervical cancer screening, asthma, smoking cessation, blood pressure screening, child development, and HPV vaccinations to prevent cervical cancer.

The Greece Health Promotion Team also is collaborating with a respected epidemiologist to create a database for child health screening for homeless children who are seen in the clinic. Before returning to Philadelphia, the team met with community leaders and high school students to discuss next steps: In May, they will again visit Northern Greece to provide further training for cervical cancer screening, smoking cessation, and first aid.

As this project gains momentum, it is helping the women and families of tomorrow by investing in girl children today. And, as the United Nations recognizes the first Day of the Girl Child, I encourage all of us who have the power of healthcare at our fingertips to consider creative ways to give girl children voice, hope, and health.

Welcoming Our Visitors

Whenever we have the pleasure of hosting visiting professors here at Penn Nursing, the benefits are exponential. This academic year, we have the distinct honor of welcoming three contemporary giants in nursing scholarship: Dr. Kathleen Dracup, Dr. Mary Elizabeth Mancini, and Dr. Susan Reverby.

Dr. Kathleen Dracup, dean emerita of the UCSF School of Nursing, shares her vast experience in scholarly and interprofessional initiatives. Her professional career spans four decades of leadership in nursing and cardiovascular nurse science. She is internationally recognized for her research in the care of patients with heart disease and its effects on spouses and other family members. I am proud to say that I mentored Kathy and that she, in turn, mentored Penn Nursing's Barbara Riegel, an expert in heart failure and self-care.

Dr. Mary Elizabeth Mancini brings her significant expertise to our new simulation center. She is professor, associate dean and chair for undergraduate nursing programs at the University of Texas at Arlington College of Nursing. She holds the Baylor Health Care System Professorship for Healthcare Research. Prior to joining academe, Dr. Mancini was senior vice president for nursing administration and chief nursing officer at Parkland Health and Hospital System.

Dr. Susan Reverby will bring to Penn Nursing her prodigious insights on women’s and gender issues as they relate to health policy. The Marion Butler McLean Professor in the History of Ideas and professor of women's and gender studies at Wellesley College, Dr. Reverby is an historian of American women, medicine, public health, and nursing. Her research on an immoral government medical study in Guatemala between 1946 and 1948 where men and women were given syphilis led to a U.S. government response from the Secretaries of the Departments of State and Health and Human Services and an apology from President Obama to President Colom of Guatemala.

That the visits of these accomplished scholars come on the heels of a new report from the Institute of Medicine on “Continuously Learning Healthcare in America” is fortuitous. The report, developed with Dr. Mary Naylor of Penn Nursing as part of the IOM study committee, details ways to achieve more cost-effective quality care by harnessing existing knowledge and technologies. As our visitors lead seminars, give lectures, and meet with our students and faculty, we all have the opportunity to continuously learn. The benefits pay forward in educational innovations, research initiatives, and more effective patient care.

Proof of the Power of Nursing

Right now, the Penn community is asking the question: How do we know that what we know is true? It is the year of proof.

With this University-wide theme, we welcomed our students and faculty to the new academic year.

On Thursday, October 18, we will honor proof in action. Dr. Terri Lipman, an expert in children with diabetes and endocrine disorders, will receive the inaugural Norma M. Lang Distinguished Award for Scholarly Practice and Policy. The award recognizes Dr. Lang, dean emerita, who had a pioneering role in demonstrating the importance of proof in nursing. Of the impact of nursing, she famously said: “If we cannot name it, we cannot control it, finance it, research it, teach it, or put it into public policy.”

Dr. Lang is an architect of healthcare quality and informatics. This field revolutionized healthcare by developing standardized terminology, classifications, quality assurance, and outcome measures for the work of nurses. The application of informatics to nursing yields a structure for information, clinical decision support, and measurement that reinforces the innumerable contributions nurses make every day to patients, families, and communities. Dr. Lang’s innovative work in quality and informatics has transformed nursing practice and healthcare around the world.

Dr. Lipman, the Miriam Stirl Endowed Term Professor for Nutrition, is internationally recognized for her research and for applying evidence-based practice to children’s health. She maintains the Philadelphia Pediatric Diabetes Registry, part of a consortium of 150 centers in 70 countries and the only one in the U.S. The registry has demonstrated a high incidence of Type 1 diabetes in African American and Latino children.

Dr. Lipman addresses that disparity through community-based participatory research with Sayre High School and the Bernett Johnson Sayre Health Center in West Philadelphia to assess and improve physical activity through dance. Supported by Penn’s Netter Center for Community Partnerships, the “Dance for Health” program aims to increase children’s activity through dance classes and to lower their risk for obesity, a key factor in Type 2 diabetes.

Clearly, the innovation and leadership of Dr. Lipman and Dr. Lang are proof of the power of nursing science. What are your experiences and stories of this proof?

Nurses: Answering America’s Biggest Question

In the New York Times and other national media, America’s looming shortage of doctors predicted under the Affordable Care Act is front-page news. But the question of how to fill an anticipated gap between growing patient needs and the number of healthcare providers has long had an apparent answer: Advanced practice nurses. As established in the Future of Nursing report from the Institute of Medicine, nurses can and should meet the increasing demand for safe, high-quality, patient-centered, and equitable healthcare services under healthcare reform. It is effective and more cost-efficient to grow the population of advanced practice nurses (APRNs) for primary care roles than physicians, with APRNs achieving the same health outcomes.

Penn Nursing, in partnership with the University of Pennsylvania Health System, will set the course to increase the number of APRNs – and therefore the base of primary care providers – in the United States. With great pride and excitement, Ralph Muller, CEO of the University of Pennsylvania Health System, and I have announced the Graduate Nurse Demonstration project.

The Graduate Nurse Demonstration, supported by the Centers for Medicare & Medicaid Services (CMS), is a national program to educate more APRNs -- nurse practitioners, clinical nurse specialists, nurse anesthetists, and nurse midwives -- who can meet the increasing healthcare demands and needs of the U.S. populations.
 Five hospitals are partnering with accredited schools of nursing and non-hospital community-based care settings as clinical sites for APRN education. The Hospital of the University of Pennsylvania, the largest clinical site for Penn Nursing, is among the hospitals selected. The leaders for this ground-breaking demonstration project are Dr. Linda Aiken, who directs the Penn Nursing Center for Health Outcomes and Policy Research, and Dr. Victoria Rich, chief nurse executive of the University of Pennsylvania Medical Center, in collaboration with many others from schools of nursing and healthcare systems in Pennsylvania.

  

In the past, the cost of clinical training has limited the ability of hospitals and other healthcare providers to accept more APRN students for clinical training. In the Graduate Nurse Education Demonstration, CMS will provide the partner hospitals with payments of up to $50 million annually over four years to cover the clinical training and preceptorship of APRNs as part of the demonstration. Payments to the participating hospitals will be linked directly to the number of additional APRNs the hospitals and their partners are able to train as a result of their participation in the demonstration.

The significance of receiving this major support is multifold:

• First, and foremost, the project is based on research by our School of Nursing investigators.
• Second, we are proud that the successful request for funding was led by our own Dr. Aiken and her colleagues in Penn Nursing’s Center for Health Outcomes and by Dr. Rich, a Penn Nursing alumna who is our school’s assistant dean of clinical practice.
• Third, this demonstration project, if successful, sets the stage for support from CMS for graduate nursing education in the future.
• Fourth, the production of this monumental proposal was supported by both Penn Nursing and Penn’s Perelman School of Medicine.
• Fifth, the proposed project was made possible through the collaboration of many schools of nursing in the Southeastern Pennsylvania Deans and Directors Association.

We are proud of all the collaborations that led to the success and funding of this pioneering demonstration project, we are grateful to have the support, and we are looking forward to fully supporting the implementation of this important initiative.

And now the work begins.

Confronting the Human Costs of Alzheimer's

Countless numbers of us have experienced the devastation of Alzheimer’s disease. As I did with my own mother, we have watched with increasing frustration as someone we love slips away day by day without comprehension, control, or comfort, and we have often felt powerless to help. Hope has been in short supply.

But it was with a tremendous feeling of hope that Dean Larry Jameson and I welcomed a group of some 50 Alzheimer’s disease luminaries to the University of Pennsylvania in June for the Marian S. Ware Alzheimer Program Invitational Summit, co-hosted by Penn Nursing, Penn’s Perelman School of Medicine, and The Campaign to End Alzheimer’s Disease by 2020. The conference, dedicated to the state of the science of Alzheimer’s disease, was sponsored by the Marian S. Ware 2006 CWG Charitable Lead Annuity Trust with support from Penn Nursing alumna and Overseer Carol Elizabeth Ware. In Penn’s historic Houston Hall, experts from academia, industry, and the care and philanthropic communities came together to map out a strategy to implement the “National Plan to Address Alzheimer’s Disease,” which was released this spring by the United States Department of Health and Human Services. Conference leaders will produce a paper with specific recommendations for the plan.

The take-home message from the meeting was one of urgency to envision and implement both long-term solutions in the form of new treatments and prevention measures as well as more supportive and holistic care options for patients and caregivers. With Dr. Jason Karlawish of Penn’s Perelman School of Medicine, Dr. Mary Naylor, the Marian S. Ware Professor of Gerontology and director of the NewCourtland Center for Transitions and Health at Penn Nursing, led the conference. Dr. Naylor’s work in transitional care holds great potential for patients with Alzheimer’s disease and their families. She and others who participated in a work-group on clinical care and health services research continually reminded their colleagues to keep in mind the human costs of the disease and the needs of patients and families from the time of initial recognition that something is wrong, through the inexorable decline in cognition and physical function, and finally to the end of life.

This conference represents a watershed moment in worldwide efforts to confront what eminent Alzheimer’s researcher Dr. John Trojanowski called the “silver tsunami” of aging in our global society. Working together, across disciplines, institutions, and geographical boundaries, we will indeed find solutions to the challenges we face throughout the full care-to-cure spectrum.

Mapping the Future of Nursing

We recently marked a historic day for nursing. The meeting “Partnering to Transform Healthcare in Pennsylvania,” part of a national effort, brought together more than 200 nurses and nursing students here at Penn earlier this month to discuss an action plan for the future of healthcare in the state. It is clear that nurses in Pennsylvania have great potential – and responsibility -- to make much-needed changes to the healthcare system.

To this end, the Pennsylvania State Nurses Association, a co-leader of the Pennsylvania Action Coalition, joined a 50-state campaign to advance the recommendations of the Institute of Medicine’s 2010 Future of Nursing report. Leading the campaign are the Robert Wood Johnson Foundation (RWJF), the Center to Champion Nursing in America, and the AARP Foundation.

Chaired by Julie Fairman, PhD, RN, FAAN, the Nightingale Professor at Penn Nursing, the steering committee of the Pennsylvania Action Coalition is developing a mission statement and strategic plan -- or “map” – to meet the IOM’s recommendations in Pennsylvania.

Time is of the essence. Pennsylvania ranks fourth in the nation among states with a population aged 65 and older, after Florida, West Virginia, and Maine, according to the 2010 Census, with similarly high rates of diabetes, hypertension, and asthma. The demand for healthcare providers of course is growing in tandem.
To meet the increasing healthcare needs of the U.S. population, the IOM report recommended:

• Increasing the proportion of nurses with a baccalaureate degree to 80 percent by 2020
• Doubling the number of nurses with a doctoral degree by 2020
• Developing nurse leaders to advance health
• Building an infrastructure for the collection and analysis of interprofessional healthcare workforce data to ensure equitable distribution of resources.
Advancing the education of nurses is particularly important. The national average for nurses with a bachelor’s degree is about 50 percent, and in Pennsylvania it is about 41 percent. Susan Hassmiller, senior adviser for nursing with RWJF, spoke not about a so-called “nursing shortage,” but about a faculty shortage. Estimates show that some 3,000 eligible nursing students are turned away every year by education programs in Pennsylvania for insufficient numbers of faculty to teach them.
As she pointed out, having more highly educated healthcare professionals will lead to safer and more effective care, and having more nurse practitioners and midwives in practice would help create a more cost-effective system.

The Pennsylvania Action Coalition will next establish regional coalitions co-led by a nurse and a non-nurse partner.  This is where the real work will take place. When you are called to participate, I urge you to join.

You have a role in ensuring more equitable care, state-by-state, in a country in increasing need of it.

A Global Woman's Story

“It is time to tell the new story.” Those resonant words from Zainab Salbi, founder of Women for Women International, opened our new Center for Global Women’s Health on Friday. The Center’s inaugural symposium offered a thoughtful prologue to the body of global research in women’s health scholarship, education, and practice that Center faculty and scholars will produce.

The Center’s first chapter is enriched by an extraordinary gift for our School, a generous endowment fund for visiting global scholars. 

The benevolent donors of this endowment, Ambassador Martin Silverstein (a member of our School of Nursing Board of Overseers) and his wife Mrs. Audrey Silverstein (a lawyer and member of our Nurse Anesthesia Board) named the endowment for a mother called Dr. Soad Hussein Hassan.

This woman was born in a small village in Egypt called Abu al Akhdar to a mother who was a farmer who never went to school and a father who worked on the Egyptian railroad. She went to a diploma nursing school and became a popular school nurse first and a successful midwife later.
Through sheer persistence and commitment to her beloved nursing profession, she managed to get a World Health Organization scholarship to attend Syracuse University, leaving her family and not seeing her children for two years, to study for a B.S. in nursing, becoming one of the first people in the Middle East to receive this degree.

Knowing that she wanted a future in educating nurses, first in diploma schools, then in university programs, and realizing a bachelor’s degree would not be enough, she got herself admitted to the school of public health in her native Egypt and was the first nurse to receive an MPH. She went on to establish schools of nursing in her country as well as others such as Saudi Arabia and Kuwait. But she continued to dream about studying for a PhD and got herself admitted against all odds to another university in her country and completed a PhD in education at the age of 56.
Being the first nurse in her country to be admitted and to receive a PhD from a university in her own country -- others received PhDs ahead of her from U.S. universities – the defense of her dissertation was a major happening and was televised.

This woman, nurse, dean, global educator, and mother met in her life many of the obstacles many women encounter: poverty, harassment, discrimination, and marginalization.  She was beautiful and hence accused of using her beauty to get what she wanted. Because she was a diploma-school graduate, she was marginalized by the young new college graduates. Because she was a nurse, she was devalued by her colleagues in other, more established colleges at the university. And because she started from very modest beginnings and was ambitious, men thought she was easy prey and chased her.

Her integrity, her aspirations, and her hard work paid off: She became the modern Nightingale of the Middle East. She retired at the age of 76 after opening and running eight schools of nursing in that region of the world. At least four of these were schools with BS, MS, and PhD programs. She mentored hundreds of nurses and was a revered leader. Her story is the story of many women and many nurses in the world. She epitomized inner strength, resourcefulness, vision, strategic thinking, commitment to excellence, and love for the discipline of nursing. She also epitomized the suffering and triumphs of women who come from modest backgrounds in the developed or developing world.

Another wonderful part of this story is that this woman, in whose name the endowment is given, is my mother!

She miraculously received a PhD without ever going to high school, was married for more than 50 years, raised two daughters, and died a few days short of her 88th birthday after experiencing Alzheimer’s disease for 10 years. Toward the end of her life, hearing me read to her from one of the 10 books she wrote about nursing, brought a smile and a glimpse of recognition.

Global women’s health is a story that connects the past with the future. We have much yet to tell.

History in the Making

When any one of our alumni shines, our entire School shares in the glow. As we open Alumni Weekend, news from several of our graduates gives us even more reason to celebrate. At a time when the voices of nurses are becoming even more important – and I believe more powerful -- than ever, Penn Nursing graduates take the lead in education, health, and science. Here are just three distinguished examples.

Divina Grossman, GRN’89, has been named chancellor of the University of Massachusetts Dartmouth. Dr. Grossman has served as Florida International University’s founding vice president for engagement, developing partnerships at local, state, national, and global levels. In this role, she also led a university-wide effort to coordinate and expand internship opportunities for students. Dr. Grossman, an expert in biological rhythms and fever management, chairs the health disparities task force of the American Academy of Nursing. Her reputation as an energetic and outgoing leader is a hallmark of our Penn Nursing alumni.

Eileen Sullivan-Marx, HUP’72, Nu’76, Gr’95, has been named dean of the College of Nursing at New York University. At Penn Nursing, Dr. Sullivan-Marx has been a professor of scholarly practice, associate dean for practice and community affairs and Shearer Endowed Term Chair for Healthy Community Practices in the Penn School of Nursing. Her leadership has been extraordinary, overseeing Penn Nursing’s practice and community mission through oversight of our School’s Program of All-Inclusive Care of the Elderly (PACE), our Living Independently For Elders (LIFE) program, our Healthy in Philadelphia Initiative, our Penn Nursing Consultation Service, our Penn Council of Nurses, and our Center for Professional Development. Of course we will miss Dr. Sullivan-Marx, but her national leadership is a reflection on her HUP and Penn Nursing education and on the excellence of our School.

And our newest graduates already are shooting stars. As he joins the ranks of our alumni on Monday, James Calderwood, Nu’12, W’12, has been selected as a U.S. Congressional intern. His work as a student demonstrates that he does indeed care to change the world. Mr. Calderwood was a medical assistant at DoCare International, which serves in remote areas of the world, and a team leader with the Agatston Urban Nutrition Initiative in West Philadelphia.  As an intern focusing on health policy, he will make his alma mater proud. We have great expectations for all our 2012 alumni!
This is a most exciting weekend when we welcome back our graduates for Alumni Weekend and draw our 125th anniversary commemoration to a close. We look forward to hearing more about the accomplishments of our alumni as Penn Nursing continues to make history. Update us on your achievements anytime at www.nursing.upenn.edu/alumni. Hurrah for the Red and the Blue!

And the Winners Are...

When the University of Pennsylvania chose the “Year of Games: Body and Mind” as the theme for this academic year, we said “Game on!” I am proud to say that Penn Nursing took the Year of Games farther than we ever anticipated. We developed the Game Solutions for Healthcare competition. The goal: To use technological innovation, games, and entrepreneurship as conduits to better health. Ten interdisciplinary teams of students, faculty, and staff took their ideas from promise to prototype.

We just announced the winners of our inaugural Game Solutions for Healthcare competition. They are:

FIRST PLACE MyDiaText, a text message goal reminder system for children aged 10-14 recently diagnosed with Type I diabetes.

SECOND PLACE Trigger Buster, a mobile educational health game to help children and their families learn about asthma.

THIRD PLACE Healthy Cities: Healthy Women, an educational, interactive, solution-based game designed to raise awareness of urban women’s health issues.

SOCIAL IMPACT AWARD Mission Reintegration, a discussion-starter game for military personnel on aspects of reintegration, interpersonal relationships, symptom recognition and management.

I am so proud of our winners, and all our teams. They have re-conceptualized game-playing as a path to health education, awareness, and treatment. These innovations could put nurses in the position of being entrepreneurs: That is value added to nursing science and nursing care.

The champion behind all these games is Dr. Nancy Hanrahan, the Penn Nursing associate professor who guided, mentored, inspired, and challenged the school community to develop so many promising games. For any new initiative, we need a champion, and Nancy has been ours.

So, what is our post-game plan? We will take the summer to consider next steps, how we are going to “level up.” 

Check back in September for the next round!

First Lady Michelle Obama Joins Forces with Penn Nursing

I am thrilled and honored that on Wednesday, April 11, First Lady Michelle Obama and Dr. Jill Biden will come to Penn Nursing to announce a major initiative on the education and the role of nurses in meeting the unique health needs of service members, veterans, and their families. Mrs. Obama and Dr. Biden are turning to nurses to identify, treat, and conduct research on post-traumatic stress disorder (PTSD) as part of their national initiative Joining Forces, which champions wellness, education, and employment among military service members and their families.

Of course the best possible care comes from the best research and our Penn Nursing scientists are established investigators in PTSD and injury science. We have here a critical mass of ongoing research projects related to PTSD and trauma, led by faculty who partner with the U.S. Department of Veterans Affairs and the military.

• Dr. Rosemary Polomano, an expert in pain management, conducts innovative research on the perceptions of pain among military personnel and on battlefield analgesia. Her findings showed that regional nerve blocks and epidurals shortly after injury led to a statistically significant decrease in pain intensity and have the potential to reduce chronic pain, a crucial finding given the high correlation between chronic pain and PTSD. 
• Dr. Therese Richmond, a leader in injury science, conducts pioneering research on the psychological effects of injury and how to address those effects. In a National Institutes of Health-funded study, she found that even among patients who had relatively minor injuries, a substantial number had PTSD and depression, which is a precursor to PTSD, a year or more after the injury.
• Dr. Marilyn Stringer, a champion of women’s health, is expanding the understanding of the care of female service people and families in a nation at war. As associate editor of the Journalof Obstetric, Gynecologic, & Neonatal Nursing, Dr. Stringer published a special section on the leadership of military nurses in advancing science and practice in women's health, including gender differences in the area of PTSD.
• Dr. Mary Ersek specializes in pain and palliative care in older adults. Her work with the NIH’s Patient Reported OutcomesMeasurement Information System (PROMISE) program and her leadership in the End-of-LifeNursing Education Consortium are improving end-of-life care for U.S. veterans.
• Dr. Salimah Meghani is working to address pain management in low-income and minority patients. Her focus on racial and ethnic disparities in pain treatment can benefit active military personnel, veterans, and civilians.

The role of nursing in bringing research to the battlefield and the bedside is imperative to serving our military and their families. The number of service people returning from two major wars requires healthcare professionals prepared to recognize the signs and symptoms of visible and invisible injuries -- consequences of physical and mental trauma -- and to develop and implement best care practices to help them and their families cope.

Beyond the Horizon

In Liberia in January, I had the honor of meeting with Liberian president Ellen Johnson Sirleaf (at right) and her countrywoman Leymah Roberta Gbowee (left). They both won the Nobel Peace Prize last year (with Tawakkol Karman of Yemen, center) for their efforts toward peace in Liberia. Now in her second term, President Sirleaf is the first woman elected as head of a country in Africa and is world-renowned for her leadership. The founder and executive di­rector of Women Peace and Security Network Africa, Ms. Gbowee is articulate, passionate, and even more engaging than her dynamic memoir Mighty Be Our Powers. During the brutal Liberi­an civil war, she mobilized groups of women from different religions to make their presence known at peace talks, to historic success.

In light of International Women’s Day, I have been reflecting on my meetings with these courageous, pioneering women. They are exemplars of devotion to women’s health and well-being. Here at Penn Nursing, with our focus on global women’s health, we aim to inspire our students with such leadership. To that end, our new global health ambassadors program offers students their own leadership opportunities in this important area of healthcare and international efforts toward peace. Under the leadership of Assistant Dean Marjorie Muecke, PhD, RN, FAAN, and Associate Director Geralyn Grosso of the Office of Global Health Affairs, our global health ambassadors work on outreach to international students and alumni, provide curriculum support, and participate in guiding such activities as the School of Nursing Task Force on Haiti and Global Health Reflections Week.

Volunteering at an orphanage in Cordoba, Argentina, inspired Natalie Ball, Nu'14, our junior global health ambassador, to choose a nursing career. She has studied abroad in Australia, New Zealand, and Peru, focusing on environmental sustainability and outdoor leadership.

Doctoral student Lisa Hilmi, Nu'97, Gr'16, is the senior global health ambassador. She has managed responses to major humanitarian crises over the past two decades for such international organizations as AmeriCares, CARE, International Medical Corps, the Peace Corps, and the World Health Organization. Earlier in her career, she managed a refugee health and HIV/AIDS project in Rwanda for CARE in Tanzania. She has authored numerous publications on disaster preparedness.

What incredible ambassadors for nursing! They represent the scope of global engagement for our students as they aspire to make the world a healthier and safer place to live.

Dumela Ma!

This is a very important week for our school, envisioned and implemented by our own Office of Global Affairs, under the leadership of Dr. Marjorie Muecke and Geralyn Grosso.

Global Health Reflections Week is full of international visitors, dialogues about healthcare in the world, and a reminder of our moral commitment to partnerships, the well-being of people, and peace. We are privileged to have some honored guests presenting and challenging us. Among them is Dr. Motshedisi Sabone, the head of the School of Nursing at the University of Botswana, hence the greeting dumela ma! Her school is our gracious partner in our community health nursing education and faculty research projects there.

Nearly 40 Penn Nursing undergraduates have had clinical experiences in community nursing in Botswana under the auspices of the University of Botswana School of Nursing and as part of the Botswana-UPenn Partnership, which marks its 10th anniversary this year.

Our undergraduate students have worked in clinics, communities, daycare centers, and orphanages, and two of our doctoral students have worked on research projects in Botswana.

There is no doubt that our nursing students are the ones who benefit, learning about cultural norms, about being resourceful, and about the international language of nursing.

They tell us that this program is one of the reasons they come to Penn Nursing and that it gives them preparation for 21st century nursing and its emphasis on cultural competence.

In a blog entry about their experience, several students shared this: “. . . . we can all learn from . . . our observations of Botswana nurses and value the cross-cultural ability of a nurse to recognize and respond to a patient’s physical, emotional, or spiritual needs to maximize quality of life at unique moments in time.”

In addition, four of our faculty have had the opportunity for collaborations on projects at the University of Botswana:

• Dr. Charlene Compher is the P.I. of a multidisciplinary team from the University of Botswana studying the prevalence of adolescent obesity;
• Dr. Loretta Sweet Jemmott works on the prevention of adolescent HIV/AIDS;
• Dr. Mary Ersek conducted a national workshop on palliative care which led to an article co-authored by faculty here and at the University of Botswana School of Nursing;
• And Dr. Victoria Rich goes annually with two of her expert clinical nurses to consult on nursing leadership and hospital management at Princess Marina Hospital.

These collaborations are exemplars of the global healthcare partnerships of the future – and they are happening right now, at Penn Nursing.

With the reflection and discussion of our global commitment and partnerships, this week is also sprinkled with international food and entertainment. It is all these experiences that make us a well-informed, dynamic, and futuristic school always ready for care that changes the world.

We Are Game

When Einstein called games “the most elevated form of investigation,” he could not have predicted the influence and reach of games today. The 21st century role of games in community-building and problem-solving is thoughtfully presented in Jane McGonigal’s Reality Is Broken, which inspired the University of Pennsylvania’s Year of Games: Body & Mind. As part of this theme, Penn Nursing launched the Game Solutions for Healthcare initiative, and I am thrilled that this exciting endeavor has hit its stride.

In January, 25 teams of student entrepreneurs went head-to-head making an “elevator pitch” – the chance to tell judges in 90 seconds about their business models -- in PennVention’s Startup Challenge, hosted at Penn’s School of Engineering and Applied Science. The winning project, called “Body Wars,” was initially developed in a community health nursing course taught by Associate Dean of Nursing Eileen Sullivan-Marx, PhD, CRNP. The game’s developers are Penn Nursing Master’s students Antonette Shaw, BSN’11, Mackenzie Mapes, BSN’11, and Kristen van der Veen, BSN’11, who won $500 in the competition. “Body Wars” is a highly interactive game using seminars, trivia, and physical activities to teach teenagers about anatomy and the effects of drugs, alcohol, and sexually transmitted diseases on the body. In April, the project will vie for an award in our School’s Game Solutions for Healthcare competition.

Professor Nancy Hanrahan, PhD, RN, who is leading our Game Solutions for Healthcare initiative, has been tapped by iMedicalApps as its first nurse reviewer. An independent online medical publication, iMedicalApps offers commentary and reviews from physicians and medical students – and now, wisely, a nurse -- on mobile medical technology and applications. iMedicalApps is widely recognized as a leader in the field of mobile health.

On April 19, we will hold an inaugural symposium and networking event to close the first year of Game Solutions for Healthcare. From 3 p.m. to 5 p.m. here in Fagin Hall, the event will include a major speaker on game innovations, presentations from our games competitors, announcements of competition winners, and the opportunity to network with other game and app innovators.

At Penn Nursing, we continue to develop health-oriented games and apps and we are exploring ways to integrate them in our teaching, research, and clinical care. I welcome your ideas as we continue our exploration.

Health by Design

At Penn, collaboration occurs fortuitously and with impact. In 2010, I had the opportunity to partner with Marilyn Jordan Taylor, who is dean of Penn’s School of Design, and City Planning Professor Genie Birch to host the 18th International Council on Women’s Health Issues (ICOWHI) conference. The topic was “Cities and Women’s Health: Global Perspectives,” one of my deepest passions. Attracting more than 350 participants from more than 30 countries, the conference proved a launching pad for new approaches to urban women’s health.

The conference inspired a book, Women’s Health and the World’s Cities, which I was thrilled to co-edit with Professor Birch and Professor Susan Wachter of Penn’s Wharton School. We are pleased to present the book on January 24 from 5:30 p.m. to 7 p.m. in Penn’s Houston Hall.

For Women’s Health and the World’s Cities, we 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.

The chapter “Transforming Urban Environments” resonates with this imperative. Penn Nursing’s Jeane Ann Grisso and colleagues identify women from Philadelphia to Manila who have led community change. “They organize, demand services, and support one another,” the authors write. “The tenacity and commitment of women leaders, in partnership with diverse stakeholders, can lead to profound urban transformation. . . . In spite of daunting realities, women in poor urban communities continue to organize to create better lives for themselves and their children.”

As urban populations continue to expand at an unprecedented rate, the demand for our communities to be responsive and adaptive to citizens’ health needs is greater than ever. This urgent need for intervention is both health-related and dependent on the fundamental systemic needs of issues like human shelter and clean drinking water. The impact of urban living is especially felt by women as gender biases, economic disparities, outmoded infrastructure, and safety threats. Reduced access to healthcare and other resources can conspire to produce dire health outcomes.

Women play critical and multiple roles in societies as mothers, leaders, students, decision-makers, voters, and workers. Health research combined with design, business, and other areas of study and expertise here at Penn are creating an increasingly influential body of work that can serve to aid and empower not only women, but the individuals and families they care for and the communities in which they live.

Sync Your Calendars

Welcome to the spring semester! It is hardly warm outside, but the intellectual energy inside Fagin Hall more than compensates. We start the term with the return of our students and we are ready to dive into a semester of inquiry and engagement.

Next month we will welcome the esteemed Dr. Angela Barron McBride, whose new book “The Growth and Development of Nurse Leaders” stands to become as seminal in our field as her 1973 book “The Growth and Development of Mothers.” She will present a Dean’s Lecture on February 28.

Each year we look forward to granting the unique honor of the Claire M. Fagin Distinguished Researcher Lecture and Award. With great pride, we honor Dr. Barbara Riegel, an expert in chronic illness and self-care, who will present the 2012 Fagin Lecture on April 5.

This academic year is significant in the history of nursing at Penn. Our 125th anniversary is in tandem with the quarter-century mark of our Barbara Bates Center for the Study of the History of Nursing, which will honor the work of nurse historian Dr. Joan Lynaugh with a symposium on April 14.

We will take interprofessionalism to another level with the April 17 symposium “Partners in Education and Practice: Stronger Teams, Better Health,” co-hosted with the Association of Academic Health Centers, Penn’s Perelman School of Medicine, and the Institute of Medicine.  The concept of interprofessionalism – bringing seemingly divergent healthcare professions together to respond to need – is more important than ever in our global 21st century.

On April 21, our LIFE practice will host the second annual “Sounds of West Philadelphia” Wellness Day. In the fall, our LIFE practice recognized internationally as being unique by Lancet editor-in-chief Dr. Richard Horton. Wellness Day is a wonderful opportunity to see why.

And, before we know it, we will close the semester with Commencement and Alumni Weekend, which will open on May 11 with the inaugural symposium for our new Center for Global Women’s Health, a most exciting endeavor and one that is close to my heart.

As always, there is much happening. As always, I hope to see you here, taking part in all that Penn Nursing has to offer.