An Uncommon Journey

UPfront Magazine - Spring 2014

It is hard to believe that this is the twenty-fourth, and last, message that I am composing for UPfront magazine. I am writing this while a snowstorm is looming in Philadelphia, a reminder that in spite of such storms, I made the decision almost 13 years ago that I would leave my 34 year’s position at the University of California, San Francisco to come to lead the University of Pennsylvania School of Nursing. And leading I did, jointly with the best faculty, staff, students and alumni. And it all went so very quickly! But when we pause to look at what we have done together, what we have been able to accomplish, and where we have landed, our journey seems much longer than twelve years.

These past twelve years have been a journey informed by many traditions of excellence which were developed by my predecessors and upon whom we were able to build; Dean Claire Fagin who set the School on the map with a focus on research and practice; Dean Norma Lang who made a difference in connecting all that with health policy; and Interim Dean Neville Strumpf who moved the School’s strategic planning initiatives forward and integrated faculty governance. All my predecessors enhanced the School’s visibility and reputation and gave us the momentum and set the stage for an incredible twelve years of innovations that made us truly a leading school of nursing globally. 

In the past twelve years we have been able to triple our endowment to $72.4 million, increase enrollment by 57 percent, renovate Fagin Hall, launch a new undergraduate curriculum, introduce graduate specialties, and develop several distinguished research centers. Our reach extends to local, regional, national and global populations and our efforts are making a difference in healthcare and in building research programs. As I reflect upon our success, I am thankful to our faculty and staff, whose accomplishments impact science, practice and policy. Their diverse interests, skills and outlooks enhance our collective scope of influence and positively affect healthcare. They are the researchers whose nationally and internationally recognized work helps to inform public health policy. They are the educators who mentor, teach and encourage students to find their voices and establish successful academic and professional careers. They are the thought leaders who look for ways to collaborate in order to develop new solutions that positively impact populations. These are the amazing, empowered and talented people who make Penn Nursing Science world-renowned.

In this issue of UPfront, we highlight how our School has positively influenced the world in four ways: by giving a voice to nursing, by enhancing inquiry and innovation, by promoting clinical judgment and by creating a culture of engagement. These tenets, developed by our faculty, student body and administration, continue to underpin our vision and strategic goals.

Forging into the Future: Innovations and Transitions

UPfront Magazine - Fall 2013

Transitions are well-known in nursing. As nurses, we care for people who move from illness to wellness or chronicity or from one stage of life to another. The healthcare system, too, will be going through a major transition as millions of Americans join the ranks of the newly insured and will be entitled to preventative and curative interventions. Increased reliance on technology in educational and healthcare systems will change the landscape. And, as millions of baby boomers age, necessitating a new emphasis on managing chronic conditions, nursing and healthcare will undergo more seismic shifts. In short, we are in the midst of many transitions.

Anticipating and recognizing these transitions, we at the School embarked on instituting many innovative changes in our educational and research programs. First, we made substantive changes in our undergraduate curriculum (now in its third year of implementation). Next we launched a new simulation laboratory integrating creative simulating experiences throughout the undergraduate and graduate programs. Our state-of-the-art Helene Fuld Pavilion for Innovative Learning prepares students for real-life nursing experiences using the most advanced simulation equipment and instruction to provide challenging but safe opportunities to review and assess their critical thinking skills, diagnostic instincts, and effectiveness.

In this issue of UPfront, we showcase many examples of innovations that advance research, practice, technology, and education – both nationally and globally – that have generated companies, patents, grants, awards, apps, and groundbreaking research.

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.

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!

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.

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.

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!