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.

When Sexual Violence Doesn’t Make Headlines

News of violence and injustice against women consumes the headlines every day. "Liberian women battle against ‘sex for grades’ at universities." "Delhi gang rape victim’s tragic death transforms her family’s life." Stories about ". . . the plague of violence against women."

Even amidst this steady stream of astonishing wrongs, I think about every woman and girl facing violence and injustice quietly and without notice. Too many remain invisible.

Global Health Starts With Women

This week, academic leaders from around the world are coming together for the 4th annual global health conference of the Consortium of Universities for Global Health. Nearly 1,400 members of the academic community (including some 500 students) from 751 institutions in 56 countries seek to identify a multi-sector, multi-disciplinary, interprofessional approach to improving global health.

An important aspect of the conversations is that any approach to global health must start with women and girls. Taking care of women is taking care of the family which is taking care of the community which is taking care of society.

In any dialogue about social welfare and development, there is global recognition of this centrality of women. The United Nations’ Millennium Development Goals aim to improve the lives of people around the world and ensure their basic human rights, particularly women’s issues, including poverty, education, maternal and infant mortality rates, and infections. The formation of UN Women and the appointment of Melanne Verveer as the U.S. ambassador for global women’s issues by President Barack Obama are indications of recognition of the vital role of healthy and educated women.

Progress and Need

But, as Ambassador Verveer wrote, “. . . we have indeed seen progress in protecting the human rights of women. . . . [but] there is no getting around the fact that progress is fragile in many places and barely measurable in others.”

Similarly, President Obama’s recent reauthorization of the Violence Against Women Act is an important marker both of our progress and of the continuing, deeply rooted need for attention to the health of women and girls.

As we come together this week, my partners in the Consortium of Universities for Global Health will:

• Consider novel ways to make academic institutions transforming forces in global health, expanding our moral commitment to translate knowledge

• Assemble best practices from different parts of the world. Universities are not just exporters of innovation, we are importers too.

• Share a united vision of global health, one of equity and justice, the elimination of violence, the courage to tackle world problems, and truly measurable impact.

Those are headlines I would like to see.

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.

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.

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.