Virginia Nursing Legacy, Fall 2015

FALL 2015

TIM C. COX

VIRGINIA NURSING LEGACY EDITOR JENNY M. ABEL SCHOOL OF NURSING EDITORS KAROL KOZAK, CHRISTINE PHELAN KUETER CLASS NOTES & NEWS EDITOR ANDREA CENICEROS ALUMNI COUNCIL COMMUNICATIONS COORDINATOR CHRISTA JANOWSKI HARTCH (BSN ’97) DESIGN ROSEBERRIES COPYEDITING GAIL HYDER WILEY PHOTOGRAPHY COE SWEET, DAN ADDISON, TOM COGILL, SEAN COX, TIM COX, LUCA DiCECCO, CHRISTINE PHELAN KUETER, LYNN WOODSON

Virginia Nursing Legacy is published twice a year by the University of Virginia School of Nursing and Nursing Alumni Association.

University of Virginia School of Nursing Alumni and Development Office P. O. Box 801015 Charlottesville, VA 22908-1015 (434) 924-0138 (434) 982-3699 FAX nursing-alumni@virginia.edu SADIE HEATH CABANISS PROFESSOR OF NURSING AND DEAN DORRIE FONTAINE, RN, PHD, FAAN University of Virginia School of Nursing Established in 1901

Main Switchboard: (434) 924-2743 Admissions & Student Services Toll-free: (888) 283-8703 Visit us online: www.nursing.virginia.edu FEEDBACK WELCOME! Please let us know what you think about this issue of Virginia Nursing Legacy by writing to us at nursing-alumni@virginia.edu or to the address provided.

Virginia Nursing Legacy is published using private funds.

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hat can you learn from a creative teacher?

If teaching is truly an act of love and care, then nurturing faculty creativity is an essential value as we strengthen the School’s noted healthy work and learning environments. In this issue of Virginia Nursing Legacy, we focus on a few of the ways our imaginative professors inspire and motivate our students, pushing them toward deeper understanding with ingenuity both in and outside the classroom.

And the results are powerful.

With our campaign for faculty support, we continue to recruit and hire only the most inspirational and creative professors, whether seasoned or novice, encouraging them to use the same spirit of energy, care, and innovation they developed in clinical settings to freely design remarkable experiences for students. We’ve revamped some of our spaces, too—like our resilience rooms—to provide the physical stage for the best teaching and learning.

a paper for the Journal of Cardiovascular Nursing celebrating the delicate relationship students often form with a sensitive, compassionate teacher.* In the article, which I wrote at my own mentor’s request, I noted that the most important question for a student will always be this: Is my teacher someone who cares about me, about my well-being, and about helping me to become the best nurse I can be?

At our School, the answer is a resounding “yes.”

Our professors are role models, expert clinicians, and scientists who cheerlead, challenge, push, applaud, and encourage UVA students toward excellence in every setting. We teach with love, care, and creativity, and that work shows in our exceptional nurse graduates, who will continue to pay forward the kindness and support they received at UVA.

But it’s not just the lecture, the class, the assignment, or the space; it’s creating the environment where learning is fun, fluid, flexible, and always student- and patient-centered. Frankly, having taught for nearly four decades, this is hard, but when it’s done well, it’s also incredibly rewarding.

Which, really, is just what the 21st century needs.

Classroom techniques that dazzle today may be gone tomorrow, but one thing that never changes is the mutual satisfaction teachers and students feel when they’re truly cared about. Seventeen years ago, I wrote

Dorrie Fontaine, RN, PhD, FAAN Sadie Heath Cabaniss Professor of Nursing and Dean

*Fontaine, D. (1998). Lessons from a mentor: A dance for two. Journal of Cardiovascular Nursing, 12(2), 29–32.

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VIRGINIA NURSING LEGACY | nursing.virginia.edu

When Less (Light) Is More

Can something as simple as a colored bulb promote sleep in the hospital?

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ospitals are full of obstacles to a good night’s sleep: unfamiliar bedding, noise, challenges with personal cleanliness, distressing neighbors, and temperature extremes among them. Yet it’s well documented that sleep is critical to healing—promoting renewal and the growth of red blood cells—and that light—too much of it, or exposure at rest and nighttime—may impede getting that much-needed rest.

Lisa Letzkus, a doctoral nursing student mentored by professor and associate dean Christine Kennedy, recently began studying a novel red-light nursing intervention that she thinks may help patients get more shut-eye during hospitalization. The project extends the work of her dissertation, “Improving Outcomes Following Pediatric Brain Injury,” which earned her the 2015 Suzi Burns Grant from the School of Nursing and UVA Medical Center.

Letzkus’ new endeavor is based on the fact that red light, more than any other color, promotes sleep. White and yellow light, conversely, tend to rouse and stimulate—and tend to be used most commonly in hospitals.

“While we nurses cannot completely control noise levels or improve insulation or the thickness of the walls,” Letzkus says, “we can control other environmental factors that promote healing and rest. And lighting is definitely something nurses can control.”

Letzkus—whose project earned her a one-year fellowship with the UVA Center for Design and Health—will study the effect of red light on sleep and sleep disturbance among adult and pediatric inpatients staying at UVA Medical Center. Using Actiwatches, wrist-worn devices that record the intensity of room lighting as well as the rhythm and duration of patients’ sleep and wake cycles, Letzkus will replace regular recessed floodlights with a single red-colored bulb on one unit. On another unit, bedside nurses

Doctoral student Lisa Letzkus dons a “hug light” necklace, which emits lowlevel red light—an intervention that she thinks could help patients get more shut-eye during hospital stays.

will wear $10 “hug lights,” necklaces that emit only low-level red and white light for quiet rounding, while caring for pediatric patients during their rest time.

Letzkus and research colleague Beth Quatrara (DNP ’10), the director of nursing research at UVA Medical Center, will also interview the patients about their perceptions of sleep and the red lights, and query unit nurses caring for them. Before their full-scale study, Letzkus and Quatrara will conduct a feasibility study with 20 adult and 20 pediatric inpatients to assess the effectiveness of the Actiwatches.

With promising data close at hand, the duo expects to develop a larger, more robust, and randomized trial in the near future. If their hypothesis proves true, Letzkus hopes the results will change the way the UVA Medical Center and other healthcare facilities are lit, especially during nighttime rounds.

Dorrie Fontaine, dean of the School of Nursing and also a scholar on sleep promotion, calls the Center for Design and Health fellowships a “true collaborative opportunity to make meaningful change, in this case ensuring sleep promotion, by tapping experts across disciplines, from the Medical Center, the School of Architecture, and the School of Nursing.”

For Letzkus, it’s a chance to reconsider best practices when building hospitals and clinics.

“There needs to be really thoughtful collaborations when buildings and hospital rooms are being developed, to revisit every possible scenario so that the patient receives the very best care,” Letzkus says. “We do need light options that work, but sometimes we don’t need the maximum amount of light, and in some things, like light, we should do with the least amount possible.”

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Worth NOTING

AACN President-Elect among New Faculty DEBORAH DILLON, assistant professor,

JENNIFER C. KASTELLO, assistant

DAVID MERCER (BSN ’97, MSN ’06), assis-

BARBRA MANN WALL, the Thomas A.

comes from University Hospitals of Cleveland, where she worked as an acutecare nurse practitioner.

professor, specializes in women’s health obstetrics and gynecology, having practiced at clinics in Idaho and California.

ASHLEY HURST, assistant professor and

VIRGINIA LeBARON (BSN ’96), assistant

the inaugural Thomas G. Bell Fellow in Biomedical Ethics in the School of Medicine, taught courses in Virginia’s Department of Religious Studies, worked on UVA Medical Center’s ethics and moral distress consult services, and between 1997 and 2009 practiced law in Atlanta.

professor, is a former Fulbright Scholar, Dana Farber Cancer Institute postdoctoral fellow, and research fellow at Harvard Medical School, where she studied pain, symptom management, palliative care, and health disparities.

tant professor of acute and specialty care, joins the teaching faculty full time after more than 20 years as a wound, ostomy, and continence nurse practitioner at UVA, with specialties in wound management, colorectal care, and skin integrity (including reducing pressure ulcers).

Saunders III Professor of Nursing, focuses on the interplay of secular and religious institutions as well as disaster nursing, and will direct the Eleanor Crowder Bjoring Center for Nursing Historical Inquiry beginning in December.

UVA Medical Center CEO Pamela Sutton-Wallace honors faculty members during the Magnet announcement in May.

CLAREEN WIENCEK, associate professor, MAUREEN METZGER, assistant professor, recently completed her postdoctoral fellowship at the University of North Carolina at Chapel Hill; she was an oncology nurse at Dana Farber, Brigham and Women’s Hospital, and Goddard Memorial Hospital, with a focus on palliative care, chronic illness, and communication.

is president-elect of the American Association of Critical-Care Nurses and brings 40 years’ experience as a staff nurse, nurse manager, clinician, and researcher at Virginia Commonwealth University’s Center for Integrative Pain Management and School of Nursing.

MAGNET UVA Medical Center Earns Top Honor for Nursing Care

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his past May, UVA Medical Center received word that it had achieved Magnet designation from the American Nurses Credentialing Center (ANCC), joining just 7 percent of American hospitals (19 in Virginia) with the honor.

Magnet hospitals—aptly named for attracting and retaining top RN talent—include healthcare organizations with “quality patient care, nursing excellence, and innovations in professional nursing practice.” Studies show Magnet hospitals have a lower risk of 30-day patient mortality and higher patient satisfaction with nurse communication, availability of help, and receipt of discharge information.

ANCC surveyors—who last spring conducted a several-day on-site review and numerous interviews with nursing administrators, managers, and staff—lauded UVA Medical Center for its exemplary professional practice, interdisciplinary collaborations, and the way UVA nurses seek new knowledge, innovations, and improvements.

ANCC reviewers gave shout-outs to two programs in particular: UVA’s Be Safe program, which enables staff to identify patient or staff safety issues and uses a realtime, problem-solving process to address them; and the moral distress consult service for RNs, the brainchild of nursing professors Elizabeth Epstein (BSN ’94, PhD ’07) and Mary Faith Marshall (BSN ’80) in partnership with the Health System’s Professional Nursing Staff Organization.

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VIRGINIA NURSING LEGACY | nursing.virginia.edu

Worth NOTING

Research associate professor of nursing PAMELA F. CIPRIANO, president of the American Nurses Association through 2016, was named one of Modern Healthcare’s “Top 25 Women in Healthcare” for 2015. The sixth biennial list, which honors highly accomplished female healthcare executives, received nearly 200 nominations.

RESILIENT NURSES, a radio

Darden and School of Nursing leaders met June 1, 2015, to solidify a formal agreement on the new Leadership Partners in Healthcare Management Program.

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VA’s Darden School of Business Executive Education program and School of Nursing have established the Leadership Partners in Healthcare Management Program, an initiative that gives nurse and physician managers opportunities to build leadership skills together, with an interprofessional focus. After the deal was inked in June between Dean DORRIE FONTAINE of the School of Nursing and ROBERT F. BRUNER, now the former dean of the Darden School, the first cohort of students begins in January 2016.

The School of Nursing’s core Aging Research Team: Joel G. Anderson, Ishan Williams, and Karen Rose

documentary series supported by UVA’s Compassionate Care Initiative, has aired on more than 100 National Public Radio stations countrywide. Listen to the first two segments—“Facing Challenge and Change” and “How Nurses Regain Their Center”—at www.humanmedia.org/nurses, or check your local NPR station for air dates.

The School was awarded membership in the

NATIONAL HARTFORD CENTERS OF GERONTOLOGICAL NURSING EXCELLENCE , the nation’s premier

organization committed to the health of older adults, in recognition of UVA’s established and growing commitment to gerontological nursing. The affiliation will further faculty development, research, and leadership in gerontology and fortify UVA’s role in discussions about policies affecting older adults as well as the work of the School’s recently established Aging Research Team, which annually provides a Naomi Rhodes Sims Scholar Award in Aging Research to a PhD nursing student interested in the specialty. Projects currently under way include the link between urinary incontinence and nighttime agitation, vascular dementia risk among African-Americans, a psychosocial analysis of blogs by caregivers of family members with dementia, nutritional concerns of caregivers for persons living with dementia, and a novel tool designed to assess the quality of life for both AfricanAmerican and Latino caregivers and their loved ones with dementia.

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Worth NOTING

Pamela Kulbok speaks to attendees of the Public Health Nurses for a Healthy Virginia Summit.

THE PUBLIC HEALTH NURSES FOR A HEALTHY VIRGINIA SUMMIT, held at the School

in June, rallied more than 40 nurse managers, educators, faculty members, and students from across the Commonwealth to discuss top priorities for the state’s public health activities. Attendees included the Virginia Department of Health’s director of public health nursing, Joanne Wakeham, and summit organizers PAMELA KULBOK, the Theresa A. Thomas Professor of Nursing; DORIS GLICK, UVA nursing professor emerita; and James Madison University nursing professor Maria Gilson deValpine.

M cLEOD HALL’s five-floor transformation is

now complete after a six-year process and the installation of more than 25 miles of electrical wire, 7.5 miles of conduit, and 3,000 pieces of drywall—yielding state-ofthe-art classrooms and two resilience rooms for group and individual meditation, yoga, and Tai Chi practices.

School of Nursing Dean DORRIE FONTAINE was inducted into the Raven Society, UVA’s oldest and most prestigious honor society, last April.

This past summer, SUSAN KOOLS—the School’s Madge M. Jones Professor of Nursing and director of inclusion, diversity, and excellence—launched an analysis of the Clinical Nurse Leader (CNL) program curriculum, with an eye toward offering more diversity and inclusive course content.

The analysis, which entails a systematic review of course syllabi, is just one action being taken as part of the Dean’s Initiative on Inclusion, Diversity, and Excellence Achievement (IDEA), launched this academic year after being introduced to

After 15 years, a new medical clinic in San Sebastián, El Salvador, has finally opened its doors, thanks to fundraising from UVA’s Nursing Students Without Borders and the Charlottesville-based Building Goodness Foundation.

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School faculty and staff last spring. Kools, assisted by second-year BSN student ASIA WRIGHT, is beginning with the CNL program, but ultimately plans to expand the analysis to every program. “Exposure to content and clinical experiences that best reflect the myriad people we serve makes us better nurses and is a concrete strategy to reduce health disparities and promote health equity,” Kools says. Wright is eager to participate because, as she says, “As future nurses, we will all come in contact with patients from all backgrounds, and as a student it is important to be prepared to care for all populations.” Better integration of diverse perspectives and materials will promote nursing excellence, adds CNL program coordinator EMMA MITCHELL (MSN ’08, PhD ’11): “CNLs act as change agents in their settings, and so are poised to influence others on the healthcare team.

Having a strong background in cultural humility helps prepare them to be strong patient advocates.”

Nurses and Disasters—a new book by ARLENE KEELING ( B SN ’ 7 4 , M SN ’ 8 7 , PhD ’92), the Centennial Distinguished Professor of Nursing; and BARBRA MANN WALL, the newly named Thomas A. Saunders III Professor of Nursing—“describes and analyzes the collaborative nursing response to a variety of historic and recent global disasters that occurred between 1908 and 2012.”

STUDEN

IN FOC US

Mia Carhart (BSN ’95, DNP ’16)

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Going As Far As She Can in Her Nursing Education

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iev “Mia” Carhart remembers her first encounter with nursing like this: she was five years old, living in a Cambodian refugee camp after fleeing the despotic regime of the Khmer Rouge. The American Red Cross, which had set up tent shelters on a hillside for the 20,000 refugees in the border country of Thailand, was her family’s only source of medical care.

“That really stuck in my mind,” she says, “and from early on, I always had an interest in medicine and healthcare.”

By 1979, Carhart and her family had endured difficult conditions in three refugee camps when they were finally able to flee to the United States, where they settled in Richmond, Va. Always a strong student, she received her BSN from UVA in 1995, meeting her husband, Lowell Carhart (Darden ’95), along the way.

Fast-forward 20 years, and today, she’s a lieutenant colonel and nurse practitioner in the US Air Force. With two master’s degrees under her belt (in management and women’s health), Carhart has had six military assignments (in Maryland, Japan, Germany, Virginia, Colorado, and Hawaii— in that order), picked up multiple accolades, and had three children. She has worked the clinical spectrum, from medical-surgical and emergency room to labor and delivery, even caring for critically ill patients in transit in the Pacific theater.

Now, she says, she’s back “home”—at her alma mater—“going as far as I can with my nursing education.”

“You would think with all my experience, there’s not much else to learn, but there is— and UVA’s DNP program is really pulling it all together for me,” Carhart says. “I always had an interest in returning to UVA … the professors have the guidance and knowledge to really support us and make us successful.”

Besides the faculty, Carhart lauds the rich interaction with her DNP classmates, who, like her, bring an immense diversity of experience and interests.

Attending on an Air Force scholarship while on active duty, Carhart’s scholarly research project focuses on why the HPV (human papillomavirus) vaccination rate among adolescent females is so much lower in Virginia—the only state that mandates the vaccine—than it is nationally (28 vs.

38 percent). With a countrywide goal of 80 percent by 2020, she is working with

She’s already chosen to give back, too.

Carhart supports the School through giving and recently served on her class’s 20-year reunion gift committee.

“Where I am now is because of the School of Nursing.”

—Mia Carhart

three nursing school professors to learn “the barriers and facilitators to improving the HPV rate” in Virginia and, ultimately, to influence stakeholders to help make progress.

It’s work that informed her practicum last year at UVA’s Teen Health Center, as well as her plans to pursue nursing research long term—including an exploration of HPV vaccination rates in the military. After attending the Tri-Service Nursing Research Program Grant Camp this past July, and with skills sharpened by her DNP courses, she has her eye out for more military-specific nursing research opportunities.

And even if her life’s path has been paved with achievements, her perspective remains grounded in her humbler beginnings.

“My family and I could’ve been dead if our church hadn’t sponsored us,” she says, with emotion. “The United States gave us a home, and where I am now is because of the School of Nursing. I’ve been very fortunate.”

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N U R S I N G I N N O V A T I O N

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BY CHRISTINE PHELAN KUETER

t’s the bird’s-eye view of nursing. Nursing from 10,000 feet. Or nursing’s Google Earth.

Liza Wayland calls it the “big eye opener.”

For Wayland’s final Cells to Society class project last fall, she and fellow third-year students Josh Moore, Kate Ferner, and Katie Carrancho followed the strict dietary guidelines that patients diagnosed with coronary artery disease (CAD) receive. For two weeks, the group planned, budgeted, went grocery shopping, cooked, and ate together. While Moore whittled fat, ate more vegetables, and instituted strict portion control, Carrancho went vegan—no meat, no eggs, no dairy. Wayland and Ferner shot video diaries of the two, and kept food logs, receipts, and cost charts. Their final assignment—which included a four-minute video and a children’s pop-up book, complete with an evil queen and an intrepid hero—was pithily titled Aorta Eat Right.

Adherence, the students found, was tough. It was also complicated, time-consuming, and much more expensive than the usual, carbohydrate-heavy student diet. The project gave the undergraduates a real appreciation of the difficulties CAD patients face, along with an empathy the students were able to tap when seeing their first patients in clinicals last spring.

“You go to the hospital and people say, ‘You need to eat healthfully,’ but it’s so much harder” than those issuing the mandate realize, explains Wayland, of Richmond.

If nursing school has always been something of a creative endeavor, lately, UVA’s has upped its game.

Taking classrooms from “sage on the stage” to “guide on the side”

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These days, roundtable discussions and role-playing with standardized patients are the rule rather than the exception. Ditto for field trips, film screenings, streamed lectures, and in-class problem solving. A year after the painstaking overhaul of the undergraduate curriculum, there’s more room for UVA nursing students to engage with their full imaginations and to digest knowledge, skills, perspective, and strategies as they become caregivers energized by challenge.

“For nursing professors, knowledge that sticks is best,” says School of Nursing Dean Dorrie K. Fontaine, “and how we get there—through assignments that students love and remember, interprofessional exercises that bring students together to imagine and role play, and professors who make concepts come alive— has everything to do with the quality of the nurses we’re cultivating.”

Students seem to agree.

“Nurses, although we have to be technically sound, also have to get very creative with how to approach patients,” says Moore, who grew up in Richlands, Va. “No day as a nurse is going to be the same as any another day, so it’s important that we have those kinds of creative activities that get us ready for something new, because every single day we’re going to have to get creative about explaining things to our patient. If you can learn how to present information in a creative, memorable way, one that actually is fun to learn, that is interesting—that makes you say, ‘Wow, I didn’t know that’—it sticks with you.

“When you get creative, it’s more interactive too,” Moore continues. “It’s not just one person giving and one receiving; it’s a mutual understanding that one group is relating to another. And it works.”

And that, of course, is precisely the point.

Mr. Jefferson himself would certainly concur.

C R E A T I V I T Y

H O W

W E

T E A C H

There’s a lot of nursing school that I wasn’t expecting … there are a lot of assignments where we have opportunity to do things in creative ways, a lot more discussion-based classes, a lot of group projects as well. It’s all really good experience, especially in leadership and teamwork skills.”

—Jackie Bae, third-year BSN student from Herndon, Va., who sketches to learn

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NURSING CREATIVITY: INNOVATION IN HOW WE TEACH

Learning through videography: In her pathophysiology class, assistant professor Donna Schminkey had students actively engage course material by creating videos about topics such as scleroderma (left screenshot) and tuberculosis (middle).

Likewise, in Cells to Society (cotaught by Linda Eastham and Karen Rose), nursing student Katie Carrancho (pictured in the screenshot at right) and three classmates kept Survivor-spoofed video diaries while spending two weeks on a vegan diet—an option given to patients with coronary artery disease.

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Old Path, New Way iven healthcare’s ever-shifting terrain and nursing’s expanding role in it, course content in nursing school has always been in near-constant flux. But until 2013, a formal BSN overhaul hadn’t taken place at UVA in more than a decade. The review process, which began in 2010, included a thoughtful reordering of existing courses—exposing students to leadership, ethics, and resilience topics during their first clinical experience, for instance—as well as an expansion of key scientific elements—such as Chemistry for Health Sciences—beforehand. New and revised courses debuted over the past three fall semesters.

“For us, it wasn’t just about cleaning house as much as rearranging it,” explains Karen Rose (PhD ’06), who directs the PhD program and served on the BSN curriculum review committee. “We already have topquality raw materials in our students and faculty. With the new curriculum, we’re using them to their best, most powerful effect.”

The new curriculum didn’t tack on more requirements so much as it amplified the emphasis on inculcating key competencies like communication, collaboration, resilience, and compassion. So although much of what’s covered in traditional nursing classes remains—including anatomy, microbiology, maternal and child health, and Foundations of Nursing Care— faculty members like assistant professor Donna Schminkey (BSN ’88, PhD ’14) have student groups engage and present material to their peers in new and different ways, rather than solely relying on lectures and readings. In her pathophysiology class, for example, students rapped, performed skits, wrote poems and songs, and made videos to explain topics ranging from scleroderma to sprained ankles to sepsis during a semester peppered with other collaborative, creative assignments. The strategy not only made learning fun and memorable but also pulled students off the sidelines and into front-and-center roles in the uptake of skills and knowledge.

“We can’t prepare students for every eventuality they’ll face in nursing,” acknowledges Schminkey, “but we can up their participation in learning by putting the onus on them to really understand the material,

VIRGINIA NURSING LEGACY | nursing.virginia.edu

practice it, be creative with it, and work out the bumps and scrapes along the way together with their peers.

And they’ve taken up the challenge beautifully.”

Teamwork and compassion skills saturate assistant professor Anita Thompson-Heisterman’s (BSN ’84, MSN ’90) reimagined Foundations of Nursing Care class, too, where lessons sometimes come in the form of metaphors—the telephone game, for instance, in which a medical-jargon-laden patient-charting message is whispered around the room and gets invariably misconstrued by the time it reaches the last person.

Thompson-Heisterman also takes her students to UVA’s Morven Farm for a daylong mindfulness workshop to learn and practice meditation and deep breathing skills, relaxation techniques, active listening, and purposeful pauses.

Other times, Thompson-Heisterman leans on contemporary films and mainstream books to stir class discussion. The movies Crash (2004) and Josie’s Story (2009), for instance, sparked lively conversations about trauma, bias, medical errors, and the American healthcare system. Films contextualize and contemporize issues in ways textbooks and reading can’t, ThompsonHeisterman says—and their value isn’t lost on students.

“If you hand a student an article, the brain isn’t as stimulated as it would be doing something creative,” says Jackie Bae, a third-year BSN student. “Sure, you could read and spit the information back out, but it’s not something that really gets taken in. So, yes, nursing is still about facts—you have to give a patient this drug at this time to get this effect—but if you want a little kid to take his medicine, you have to get creative. It’s what this kind of learning is about.”

In With the New: Passivity Not Permitted n addition to revamping old courses, the School developed new ones to give students a bird’s-eye view of disease, treatment, and the swirl of associated social issues and challenges many patients face. Both the new semesterlong Cells to Society course (taken in the fall of undergraduates’ second year, just prior to clinicals) and the new REAL courses (taken in the second, third, and fourth years) aim to prepare students for the

NURSING CREATIVITY: INNOVATION IN HOW WE TEACH

Creative people find solutions; every patient is unique, and the more creative skills a student has, the easier it will be for them to solve problems. We’re also working in earnest on students’ communication, how they work with other members of their teams, and how well they articulate their opinion. Just to get a great idea isn’t enough; you have to present it, know your sources of information, be a team player.” —Associate Professor Rebecca Harmon

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NURSING CREATIVITY: INNOVATION IN HOW WE TEACH

Below: Students take an active part in courses with Dr. Christine Connelly (left), whose teaching emphasizes collaboration and creative delivery of the core sciences.

enormous perspective they’ll need—not only in caring for patients but also in working with colleagues and managing their own mental and physical well-being.

REAL courses, as the acronym implies, meld research, ethics, advocacy, and leadership topics so “those subjects aren’t just things that PhD nurses think and talk about,” says associate professor Mary Gibson (BSN ’75, MSN ’86). Gibson, who cotaught REAL with assistant professor Pamela DeGuzman (BSN ’96, MSN ’00, PhD ’12) and instructor Michael Swanberg, invites speakers to discuss library use and literature reviews as well as resilience and emotional intelligence. She also has convened a Jeopardy-like gameshow on American Psychological Association style to sharpen students’ knowledge of writing rules.

Gibson also ensures students are exposed to the history of their profession so they get a much-needed perspective. Last year, she took students to the historic Exchange Hotel (in nearby Gordonsville, Va.), where some 70,000 Civil War soldiers were treated and which is now home to the Civil War Medical Museum.

Understanding how it was, Gibson says, enables a fuller understanding of why things are. “We as teachers need to develop activities and strategies to tap students’ creative and innovative thinking,” explains Gibson.

“Just like Civil War caregivers improvised care using available resources like horsehair, our future nurses will have to do more with less. We want to get their attention and engage their brains to recognize more than just facts and formulas. They need on-the-ground critical thinking and clinical reasoning skills to meet the challenges of today’s healthcare.

“That’s why creative ways work,” she adds.

“They grab.”

Above: In Mary Gibson’s REAL course last year, students spent several weekends visiting the historic Exchange Hotel in Gordonsville, Va.—home to hundreds of artifacts related to nursing and medicine in the Civil War. Students wrote research essays chronicling the use of items like syphilis glasses (due to photosensitivity brought on by treatment involving mercury) and horsehair sutures, which were boiled (and unwittingly sterilized in the years prior to full-scale acceptance of germ theory) to make them more pliable, especially for closing amputation wounds.

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NURSING CREATIVITY: INNOVATION IN HOW WE TEACH

Showing, Not Telling xperiential learning is often a profound driver of long-term retention. From the time rookie nurses practiced starting IVs on one another and giving injections using oranges, hands-on approaches to teaching have proven effective—with nearly endless opportunities for student nurses to learn the ropes of the profession.

This tactic is exactly what prompts nursing professor Valentina Brashers to use breath mints each semester to make a point about patient prescriptions. Brashers uses bottles of Tic Tacs, which nursing and medical students take according to instructions before reconvening to discuss their difficulties and observations.

“In our world, medication adherence is a sizable issue,” explains Brashers, noting that poor medication adherence costs about $100 billion in the United States each year, according to the Journal of the American Medical Association. The hands-on exercise helps students “develop an appreciation of how difficult it can be to be a patient, too.”

The same ethos drives the lessons in assistant nursing professor Edie Barbero’s gerontology classes.

Over Thanksgiving break last year, students in one class “disabled” themselves to mimic some of the complexities of growing older. They wore mittens while attempting buttons and zippers, taped their knuckles to simulate arthritis, and smeared petroleum jelly on plastic-wrapped spectacles to imitate macular degeneration. Experiences like these, says Barbero, “drive the messages deeper.”

“There have always been pieces of creativity in nursing,” Barbero adds, “so while the talk was always there, today, we’re living it better.”

This is certainly the case with associate professor Rebecca Harmon (PhD ’03), whose teaching innovations have shown measurable improvement in students’ learning.

Four years ago, at the urging of her graduate assistant at the time, Robin Hills (DNP ’14), Harmon decided to “flip” her undergraduate Psychiatric-Mental Health Nursing course. A flipped classroom means students familiarize themselves with concepts through reading before coming to class, so they arrive ready to apply what they learned, often in groups. They spend class time practicing key concepts, asking questions, and discussing answers with peers; meanwhile, professors circulate as coaches, providing feedback, rather than simply lecturing.

It’s a method Harmon continues to use today. And although departing from a lecture format was a “leap of faith, and a bit scary” for Harmon, the data she and Hills collected over eight semesters was striking. Of 347 undergraduate students, those in the flipped class scored more than 10 percent (and nearly 100 points) higher on the psychiatric-mental health portion of a practice NCLEX exam, and reported they studied more at home compared with those in the traditional course. The majority of “flipped” students also reported enjoying the collaborative projects and feeling better prepared for tests and in-class engagement with their peers. Harmon’s and Hills’ findings on the effectiveness of a flipped classroom will be published in the Archives of Psychiatric Nursing.

“Many of us nurse educators teach as we were taught, and think of ourselves as gatekeepers of knowledge as we evaluate, synthes i z e, org an i z e, and deliver large amounts of material to relatively passive students,”

Dr. Valentina Brashers, professor of nursing, sorts Tic Tacs by color; places them into three orange prescription bottles with different names, schedules, and instructions; and has her students take the “pills” over a week to drive home challenges related to medication adherence.

Fall 2015 | VIRGINIA NURSING LEGACY

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NURSING CREATIVITY: INNOVATION IN HOW WE TEACH

Third-year BSN student Josh Moore gets hands-on experience practicing his clinical skills.

says Harmon. “But there are certain competencies that we want students to have that the didactic lecture techniques don’t deliver.” Flipping the class and taking a team-based learning approach “requires active participation by all members, [and] allows them to apply communication, team-building, [and] research findings,” Harmon adds. “I’ve been very impressed.”

The Road to Remembering any lessons in nursing—like what it’s like to follow dietary guidelines after a heart disease diagnosis—are easy to conceptualize but difficult to impart. And in a culture in which students constantly receive complex information in entertaining, bite-sized chunks across a dazzling array of technologies, it’s even more critical that the lessons of their discipline are heard, received, and, most importantly, remembered.

That’s precisely what compelled Karen Rose and assistant professor Linda Eastham (MSN ’82, NP ’87) as they developed the course Cells to Society.

For years, Cells to Society was a two- to three-day School of Medicine course that immediately preceded the annual White Coat Ceremony. But last fall, the class—now a semester long—debuted as a central component of the revamped undergraduate nursing curriculum. Using a single chronic illness (CAD) as a vehicle, the seminar looks at the physiology of a disease before examining everything else that touches (and often contributes to) it—the social determinants of health (e.g., environmental factors, dietary issues, people’s jobs, and what’s available at the local grocery store and at what cost).

“We found ourselves talking about the differences in somebody’s life who’s, say, from a coal-mining town in West Virginia versus someone who lives in an affluent 14

VIRGINIA NURSING LEGACY | nursing.virginia.edu

area of Northern Virginia, where Whole Foods is the rule, not the exception,” explains Eastham. “This is a way for students to try to step into the patients’ shoes.”

It’s not the only way. Eastham and Rose brought two former heart attack and surgery patients to class to tell students about their experiences. They organized panelists that included pharmacists, palliative care doctors, nurse practitioners, telehealth experts, and dieticians. The students watched and discussed films like Escape Fire (2012), picked apart the Affordable Care Act, explored the meaning of terms like “patientcentered care,” and talked extensively about the intimate relationships between health and a person’s geography, money, and education.

Through it all, students dug deep, asked questions, and, ultimately, put boots to the ground. They compared food and prices at downtown Charlottesville bodega Reid’s Market with those of Walmart or Kroger— which would require car travel. Students considered generic versus brand-name prescription costs and figured out how to get medications filled using only public transportation. For their culminating projects, they assembled into groups, picked a single learning objective, and delivered a product—such as a paper, presentation, or video.

Even in its infancy, the new Cells class leaves an indelible mark. “Now when I approach a patient, I will think about Cells to Society,” says third-year BSN student Josh Moore. “My nursing professors, they’re doing something right, because there is even at this point in my career a lot I can already do, have the confidence to do, techniques that’re staying with me, keeping me engaged, and focused on being the best nurse that I can be.

“They’re teaching us,” Moore adds, “and we’re learning. And the passion just flows out of them.”

In Their Own Words Reprinted here are two of the four winning entries in the UVA School of Nursing’s 13th annual student writing contest held last spring. Sponsored by the Compassionate Care Initiative, the contest offers students the ability to share their experiences with one another and the world through reflective writing. Each winner received a check and a small gift, thanks to the School’s annual fund and the generosity of its alumni, along with guidance in getting their work published in a nursing journal.

The First Death*

By Melissa Beth C. Behl (CNL ’15)

F

or the first time, I was present as one of my patients died. I had been working in intensive care all year, and many of the people I’d cared for were dead now. But this patient died with my hand on his forehead. I was with him and saw the monitor the minute his heart quit, its rate dropping from 130 beats a minute to 90, 70, 40, 30, asystole. It was peaceful. He had a do-not-resuscitate order, and the family was expecting it. As far as dying in an intensive care unit goes, it was a good death.

Within the first days of nursing school, we students began to draw lines between our personal and clinical selves. In physical assessment class, we learned the term “professional hands.” You have to put on your professional hands when you examine a patient. No trembling, no insecure fingers. You need your hands to say: I am competent, you are safe.

We tried out our professional hands on each other. Our group of 30-plus—all but three women and most comfortable with bodies as just bodies—paired off and stripped down to shorts and bras, then palpated livers, percussed abdomens, looked deep into ears and eyes, felt necks and shoulders and chests and armpits for lymph nodes, moved breasts aside to place a stethoscope on the apex of the heart. I am proud of my professional hands.

Marry intimacy to utility, and I’m in my comfort zone. If you’re watching a movie with me and I take hold of your wrist, please be cool. I’m just curious about your heart rate.

I put my professional hands on this man’s forehead, and he died. Then I turned off the monitors, removed the wires, brought in some chairs, and pulled a clean white sheet up to his chest. His family sat with him. They soon left. I pulled out his IVs, bandaged the many holes we’d made in him, and put a tag on his big toe. I rolled him, surprised by his warmth, left to right to situate him in a body bag. I used my professional hands to zip the bag from his feet to his shoulders. I looked at his face a long second. I’m not sure which hands pulled the zipper closed.

The Walls of Your Room Are Jaundiced

By Callie Bateman (BSN ’16) The walls of your room are jaundiced.

A couple weeks ago I leaned against them and laughed because you tied glowsticks to the ceiling fan, videotaped them spinning around until the colors faded.

You looked ridiculous staring up at them like that, with your mouth hanging open.

This morning I went to the hospital and stood over the yellowed body of my newborn patient while his chest stuttered and after a few minutes, I watched it stop.

That night you ask me if I saw the light leave his eyes, as if he had lamps beneath his pupils or maybe glowsticks because light leaves in all kinds of ways but it doesn’t look like that.

It looks like a spinning ceiling fan.

It looks yellow.

Bateman has wanted to be a nurse since volunteering at a hospital in Connecticut during high school. She wrote this poem after working in the neonatal intensive care unit.

Hailing from Alexandria, Va., Behl transitioned into nursing after earning an undergraduate degree in Spanish and working with rural migrant populations in Virginia. *Ran on April 22, 2015, in the Washington Post under the title “Putting on ‘Professional Hands’” Fall 2015 | VIRGINIA NURSING LEGACY

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Resiliency at the School of Nursing is more than simply bouncing back from isolated instances of adversity. It’s about the ability to be one’s best self in the ongoing challenges of being a nurse, physician, or other clinician. It means thriving— embodying a sense of wellness, connectedness, joy, and meaning—within the

THE IMPORTANCE OF RESILIENCY

everyday work environment.

22% CRITICAL CARE NURSES WHO ARE HIGHLY RESILIENT 1

74% NURSES WHO CITED THE EFFECTS OF STRESS AND OVERWORK AS A TOP CONCERN2

RESILIENCY …

34%

Reduces burnout and workplace stress

Fosters compassion, connectedness, and communication among nurses, their colleagues, and patients

Helps nurses cope more effectively with moral distress and professional incivility

Improves the quality of care, including reducing medical errors

ANNUAL COST PER HEALTHCARE INSTITUTION DUE TO NURSING TURNOVER

Boosts nurses’ own health and sense of well-being, which makes them positive role models of self-care and healthy lifestyles

(REPLACING ONE NURSE WHO LEAVES HIS/HER EMPLOYMENT COSTS TWICE ONE NURSE’S YEARLY SALARY) 4

RNS WORKING IN HOSPITALS WHO EXPERIENCE BURNOUT3

$15M

226

NURSING STUDENTS attended Compassionate Care Initiative resiliency retreats at Morven Farm in 2014–15

400,000

DEATHS PER YEAR CAUSED BY MEDICAL ERRORS IN THE USA5

Saves healthcare costs associated with high turnover and sick-day rates, overuse of unnecessary or unwanted tests and treatments, and medical errors

Mindful Clinical Encounters: W-O-R-T-H a Lot and Pay Dividends

By Susan Bauer-Wu, Director, Compassionate Care Initiative Wash your hands with awareness, feel the warm water, and watch the soap lather and rinse away.

Open the door, notice the experience of walking into the room, and observe the patient and family as you enter.

Remember you are caring for a person who has a full life, who is much more than a disease or a procedure.

Take a couple of slow, full breaths and tune in to how you feel before saying or doing anything.

Handle the patient’s (and family’s) concerns with calm, clarity, and heartful presence.

1

16

MINUTES to clear your mind or relax your body with resiliency-building exercises, such as yoga or other physical exercise, meditation, and reflective writing

Defined by Mealer et al. (2012) as being “significantly associated with a lower prevalence of posttraumatic stress disorder, symptoms of anxiety or depression, and burnout syndrome.” 2 2011 survey, American Nurses Association 3 McHugh et al. (2011) (four-state study) 4 Steven Hunt, Success Factors Inc., 2009 report 5 Lown Institute

VIRGINIA NURSING LEGACY | nursing.virginia.edu

United around Compassionate Care

F

rom undergraduate to PhD students, compassion is a vital thread woven into every nurse’s education at the University of Virginia, and considered a nonnegotiable ingredient in patient care—not just the cherry on top. And although it’s often missing in today’s addled, stress-filled healthcare environments, when present, compassion is a brilliant and powerful force.

It’s also a force that can stir generosity and ignite collaboration.

Such was the case with Greene County, Va., resident Mel Haney, who derived immense comfort from the exceptional palliative care his wife, Muriel, received before she passed away in 2012. The kindness and dignity with which they were treated as a family made such an impression on Mr. Haney that he was inspired to make a gift to the School of Nursing, with the aim of ensuring that instruction in compassion would be an integral and growing part of clinical care.

And thus, the Melton D. and Muriel Haney Interprofessional Conference on Compassionate Care at the End of Life was born, formalizing a young but already robust partnership among the School’s Compassionate Care Initiative, the UVA School of Medicine’s Center for Biomedical Ethics and Humanities, Martha Jefferson Hospital, and Hospice of the Piedmont.

“Compassionate care at the end of life makes such a difference, not only for the patient, but for the family,” says Haney. “This conference is my way of giving back, to educate the whole clinical team involved in palliative care and hospice, and inspire nursing and medical students to improve quality of life for patients and families.”

First held in November 2013, the second conference took place in April 2015 in McLeod Hall, with sessions on everything from breaking bad news to helping children

grieve, and from the ways different racial and cultural groups deal with end-of-life issues to the comfort therapy animals offer the dying and their loved ones. Cumulatively, the events have drawn hundreds of health professionals to the School.

“This conference is a wonderful coming together of the community—different organizations and professions—all committed to education and compassionate care at the last phase of life,” says conference coorganizer Susan Bauer-Wu, the Tussi and John Kluge Professor of Contemplative End-of-Life Care and director of the Compassionate Care Initiative. “Mr. Haney’s generous gift allows us to continue this unprecedented collaborative event in perpetuity, having a positive ripple effect for many years to come.”

Fall 2015 | VIRGINIA NURSING LEGACY

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NURSING RESEARCH

Nursing research affects prevention measures, practice, and policy—at the individual and institutional levels and throughout the nation’s healthcare system. University of Virginia nurses are leading the way in research that directly impacts patient care today and in the future.

Can At-Home HPV Tests Save Lives?

Study aims to see if at-home HPV tests might reduce rural Virginia’s cervical cancer rates

F

irst came at-home pregnancy tests.

Today, there are mail-in tests for HIV, genetics, and determining paternity.

Even sexually transmitted diseases, diabetes, and thyroid dysfunction can be screened from the privacy of one’s own home.

But privacy isn’t always the chief concern of those who turn to at-home diagnostics. In some cases, a lack of access to clinics, doctors, or nurse practitioners is the reason people— particularly residents of rural areas—go without screening. It’s why, says School of Nursing assistant professor Emma Mitchell, rates of cervical cancer—a disease easily detected through a routine Pap test—is roughly 22 percent to 33 percent higher in Southwest Virginia than elsewhere in the Commonwealth.

“Cervical cancer is really a cancer of disparities,” explains Mitchell, who received $40,000 from UVA Cancer Center and the National Cancer Institute for a study on athome HPV (human papillomavirus) tests, work she is doing with the help of Cancer Center outreach coordinator Nila Saliba and Mountain Empire Older Citizens Inc. care coordination director Judy Miller. “In Virginia, women who live in poor, rural areas have vastly different health outcomes than women just hours away in more affluent and urban areas. Our ultimate goal with this study is to help women get tested for specific strains of HPV, which can help us assess risk for developing cervical cancer quickly and easily in the comfort of their own homes—and if they need follow-up care, to help them understand it’s imperative not to wait.”

Current screening guidelines recommend Pap tests—which involve a trip to a 18

VIRGINIA NURSING LEGACY | nursing.virginia.edu

medical doctor or nurse practitioner’s office, where cervical cells are collected and the sample sent to a lab that can detect abnormal cells under a microscope (cytology)—every three years for women ages 21–29. Screening with cytology and HPV DNA testing (called cotesting) are recommended every five years for women ages 30–65. Between 50 million and 60 million Pap tests are done each year in the United States, about 3.5 million of which require follow-up.

But many women don’t get these tests at all, often due to a dearth of providers. In Southwest Virginia, for example, women are 5 percent to 16 percent less likely to have had a Pap test over the past three years than women elsewhere in the state. In these cases, the at-home test may offer a real solution.

The self-collection test involves inserting a pliable collection brush into the vagina (much like a tampon), turning the handle five times, and then extracting it. The kit comes with a screw-top test tube in which

the specimen is sealed. Patients then use an enclosed mail-in box to send the test to a lab, where the specimen is analyzed for the presence of HPV DNA, just as it would be after an inoffice cotesting screening. Science has already supported that clinical collection and self-collection have comparable sensitivity and specificity.

Mitchell began studying use of the at-home tests this past summer. She received feedback from the Cancer Center Without Walls Community Advisory Board before meeting with a group of lay navigators employed by health departments in Virginia Health Districts 1 and 2 to get feedback about the test’s acceptability and feasibility in the region. With help from UVA students Christy Garcia and Heather Lothamer, she also mapped area providers and access to care information throughout Southwest Virginia. Beginning this fall, Mitchell plans to recruit participants—both lay navigators and women in rural Virginia—who will try the at-home test in the study’s third phase.

Mitchell’s goal is to enroll 100 women in the self-collection program. Based on previous research, she expects about 80 percent to complete the test and 10 percent to 13 percent to screen positive for HPV. Those eligible for the trial must live in Southwest Virginia, be aged 30–64, not be pregnant, not have had a hysterectomy or pelvic radiation, and not have had (or remember having) a Pap test in the preceding four years.

“Cervical cancer quickly caught can be treatable,” says Mitchell. “It’s when it’s not detected that it becomes so deadly. We’re hoping this test will help make it less so.”

IMPACT | Nursing Research

BEFORE AND AFTER

Summer Research Interns Dig Deep

T

hey arrived knowing next to nothing about literature reviews, databases, EPIC (computerized charting system), Excel, and PowerPoint, but by summer’s end, the School of Nursing’s latest crop of undergraduate summer research interns emerged with a boatload of research know-how. During their eight-week journey alongside faculty researchers, interns tackled everything from perceptions about the HPV (human papillomavirus) vaccine to analyses of the links among stress, geography, and cancer.

Chosen from dozens of applicants, the School’s 10 summer 2015 interns worked 40-hour weeks in some of UVA’s few paid summer research internships, part of a

partnership assembled by the Office for Nursing Research, Dean Dorrie Fontaine, and the UVA provost’s office. Mentored individually by faculty researchers and collectively by Linda Bullock, associate dean for research; and Beth Hundt, a PhD nursing student, the interns developed number crunching, spreadsheet, poster, and presentation skills as well as softer skills like office etiquette and attire. The group also convened over lunch each week to hear from speakers, who lent broader perspectives on research and the RN profession.

Shyonna Jones (BSN ’17)—who is “deadset on becoming a NICU [neonatal intensive care] nurse”—helped associate professor

Randy Jones (BSN ’00, MSN ’02, PhD ’05) with his racial disparities work. Whetting her appetite for behind-the-scenes analysis and patient interaction, the internship allowed Ms. Jones to become literate in complex cancer lingo while assisting with recruitment of study subjects and data mining in UVA Medical Center’s EPIC files.

“Research is so vast and extensive,” says Ms. Jones, of San Pedro, Calif., “and to me, too, it was also important to be able to get to interact with patients, because I didn’t just want to be sitting behind a desk.”

Meanwhile, Emily Sun (BSN ’18), of Fairfax Station, Va., worked with assistant professors Emma Mitchell (MSN ’08, PhD ’11)

Summer intern Emily Sun helped assistant professor Emma Mitchell advance her research on the HPV vaccine in Virginia.

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IMPACT | Nursing Research

“We have to be able to bounce back from all the things that we see as nurses, and this summer’s really made me see that,” says Evie Stinger (BSN ’17), of Lovettsville, Va., who interned this past summer with Susan Bauer-Wu, the Tussi and John Kluge Endowed Professor in Contemplative End-of-Life Care and director of the Compassionate Care Initiative. and Jessica Keim-Malpass (CNL ’08, PhD ’11) on a social media analysis of the HPV vaccine and hypoplastic left heart syndrome (a serious condition in which a left ventricle is missing, causing circulation and blood oxygen problems). Sun labels the experience fun and eye opening: “Going into this, I had no idea how important, profound, and detailed nursing research can be,” she says.

“And now, we are all literature review and spreadsheet experts!”

Other interns, like Erika Fernandez (BSN ’17), cultivated patience and compassion as they interacted with study subjects who were occasionally unreliable.

“At times, it could be frustrating,” confesses Fernandez, who worked with Bullock on a study assessing phone versus in-person support on the health outcomes of 125 pregnant teenagers and adolescent parents and their babies. Fernandez’s role entailed conducting phone interviews in

Anatomy of the BSN Class of 2019 832 BSN applicants for 73 spots 10% growth in BSN applicants from last year (754 applicants in 2014); two-year growth of

19% (699 applicants in 2013)

2:1 in- to out-of-state student ratio 93% ranked in the top 10% of their high school graduating class 20

VIRGINIA NURSING LEGACY | nursing.virginia.edu

English and Spanish. “The girls would say they’d call, and then they wouldn’t,” Fernandez explains. “It really made me step back and think about their lives, the fact that they’re teen girls, and that they’re working full time and are new parents. They have a lot going on.”

Nurturing that kind of insight and empathy is precisely the point, says Bullock.

THE

NURSING ALUMNI ASSOCIATION

FROM THE PRESIDENT

D

uring my first year as president of the School of Nursing Alumni Association, I’ve had the pleasure of meeting a number of current students and alumni from various programs within the School of Nursing. Attending the Pinning and Hooding ceremonies on graduation weekend was a meaningful experience that helped remind me why we all chose the nursing profession. Reunions weekend validated those decisions when I realized the collective accomplishments and contributions of our alumni regionally, nationally, and even internationally.

We are all members of an amazing group of more than 11,000 UVA nursing alumni—each making a difference in our own way.

At the request of the UVA Alumni Association Young Alumni Council, we recently asked a group of nursing alumni to share their best advice and words of encouragement for our incoming students. The response was so great that we would like to extend that opportunity to all interested alumni. If you would like to pass along some words of wisdom to the Nursing Class of 2019, please send your comments to nursing-alumni@virginia. edu. Thank you!

As we approach 2016, one of the Alumni Council’s top priorities will be the Nursing Alumni Association’s centennial. We look forward to recognizing the association’s 100 years of service and support to the School of Nursing and its alumni. We hope to see you at one of our events in the coming year.

Best regards,

Judy Etheridge Bilicki (BSN ’81) Alexandria, Virginia

2015 Faculty Award Winners T he Nursing Alumni Association recognizes three faculty leaders annually for their contributions to the School and the nursing profession.

Distinguished Professor Award Kathryn Laughon (BSN ’98, MSN ’99) Associate Professor of Nursing

SONAA to Celebrate 100 Years In 2016, the School of Nursing Alumni Association (SONAA) will celebrate 100 years of service and support to the School and its alumni. Help us celebrate! Here are three ways you can take part: n Send us your photos: What photo best captures your experience at the School of Nursing? n Send us your memories: What is your favorite memory at the School of Nursing? E-mail it to us or share it on our Facebook page (University of Virginia School of Nursing). n Come to an event: See the calendar of events on the back cover and keep an eye out for your invitation. n Send your advice: What is your best piece of advice for current students and new graduates?

Send any or all of the above to nursing-alumni@virginia.edu or to the UVA School of Nursing, Alumni and Development Office, P.O. Box 801015, Charlottesville, VA 22908. We can scan and return original photos to you.

Excellence in Teaching Award Rebecca Harmon (PhD ’03) Associate Professor of Nursing

Faculty Leadership Award Randy Jones (BSN ’00, MSN ’02, PhD ’05) Associate Professor of Nursing BSN Program Director Fall 2015 | VIRGINIA NURSING LEGACY

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NURSING ALUMNI ASSOCIATION

Recognizing Extraordinary Alumni Each year, the School of Nursing Alumni Association honors individual alumni for their contributions and service to the nursing profession. If you would like to nominate an outstanding alumna/alumnus for next year’s awards, please contact the Alumni and Development Office at nursing-alumni@virginia.edu or (434) 924-0138. Nominations are due March 15, 2016. A description of the awards is available at www.nursing.virginia.edu/alumni/resources.

Distinguished Alumni Award Nancy Howell Agee (BSN ’79) President and CEO Carilion Clinic Roanoke, Va. Nancy Agee has spent her more-than-30-year career with the Carilion Clinic. Carilion (formerly known as the Carilion Health System) is an integrated, nonprofit healthcare organization serving more than one million people in western Virginia. Today, the clinic includes a comprehensive network of seven hospitals, primary and specialty practices, and complementary services.

Agee joined Carilion immediately after graduating with honors from the UVA School of Nursing in 1979. She served in various management roles before becoming a vice president in 1996. In 2001, she was named executive vice president and chief operating officer. Ten years later, she was appointed to her present roles, chief executive officer and president. Under her guidance, Carilion has undergone a reorganization that has made it the patient-centered clinic it is today.

In her spare time, Agee nourishes her twin passions of healthcare and higher education through service to numerous organizations.

She currently serves on the prominent American Hospital Association Board of Trustees. A past chair of the Virginia Hospital and Healthcare Association, she has also served on The Joint Commission’s Board of Commissioners, Radford University’s Board of Visitors, and the leadership bodies of many other healthcare, business, and community organizations.

Agee also holds a master’s degree from Emory University. She and her husband, Steve, have one son, Zach.

Nursing Alumni Network in Richmond, Reston, and Charlottesville

T

he School of Nursing hosted three networking receptions for alumni in the spring of 2015. Dean Dorrie Fontaine joined nursing alumni attending Black Alumni Weekend (April 11), and Associate Dean Ken White (ACNP ’13) met alumni in Richmond (March 19) and Reston (April 17).

22

VIRGINIA NURSING LEGACY | nursing.virginia.edu

Decade Award Elizabeth Bradshaw Mikula (BSN ’05) Regulatory Compliance Coordinator, Quality Department Henrico Doctors’ Hospital (HCA Virginia network hospital) Richmond, Va.

NURSING ALUMNI ASSOCIATION

REUNIONS 2016 Reunite with your classmates and celebrate the 100-year anniversary of the School of Nursing Alumni Association!

35-, 40-, 45-, 50-, 55-, AND 60-YEAR REUNION CLASSES AND THE THOMAS JEFFERSON SOCIETY Classes of 1981, 1976, 1971, 1966, 1961, and 1956 Celebrating Reunions June 2–5, 2016 Nursing Building Tours: McKim Hall, McLeod Hall, Claude Moore Nursing Education Building Friday, June 3 2:30 p.m.–4 p.m.

Meet in the McLeod Hall lobby at 2:30 p.m. Faculty and students will lead tours.

50-Year Reunion and Thomas Jefferson Society Luncheon Saturday, June 4 Noon–1:30 p.m.

Newcomb Hall Ballroom Nursing Alumni Reception Saturday, June 4 4 p.m.–6 p.m.

Pavilion IX Garden, West Lawn

5-, 10-, 15-, 20-, 25-, AND 30-YEAR REUNION CLASSES Classes of 2011, 2006, 2001, 1996, 1991, and 1986 Celebrating Reunions June 9–12, 2016 Nursing Building Tours Saturday, June 11 9 a.m.–10:15 a.m.

Meet in the McLeod Hall lobby at 9 a.m.

Faculty and students will lead tours.

Nursing Alumni Reception Saturday, June 11 4 p.m.–6 p.m.

Pavilion IX Garden, West Lawn

For information on nursing alumni events, contact the Alumni and Development Office at (434) 924-0138. To register for your reunion weekend, contact the UVA Alumni Association at (434) 243-9000 or visit www.virginiareunions.com.

Do you have photographs, letters, or other memorabilia from your time as a UVA School of Nursing student or from the early days of your nursing career? Consider donating these items to the Eleanor Crowder Bjoring Center for Nursing Historical Inquiry to add to your reunion experience and to help preserve nursing history.

Contact the center’s staff at nurs-hxc@virginia.edu or (434) 924-0083.

Fall 2015 | VIRGINIA NURSING LEGACY

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Class Notes Six members of the UVA School of Nursing community presented posters at the 25th Annual Conference of the Virginia Council of Nurse Practitioners (VCNP) in Roanoke, VA, in March 2015: Dawn W. Bourne (BSN ’04, MSN ’10, DNP ’16) presented “Implementing a Transitional Care Clinic in Family Medicine”; Jolene Carlton (MSN ’16) presented “Neonatal Nurse Practitioners Effectively Managing Neonatal Pain”; and UVA nurse practitioner Reagan Thompson (BSN ’03, MSN ’06, DNP ’13), former faculty member Audrey Snyder (BSN ’89, MSN ’91, ACNP ’98, PhD ’07), associate professor of emergency medicine David R. Burt, and associate professor of nursing emerita Doris Greiner presented “Risk Screening for Cardiovascular Disease and Diabetes in Latino Migrant Farmworkers: A Role for the Community Health Worker.”

SHARE your good news and accomplishments with your UVA nursing classmates! Submit class notes to nursing-alumni@virginia.edu.

1960s

Members of the BSN Class of 1960 took their annual beach trip to the Outer Banks of North Carolina in May 2015 as they have been doing for the last decade. The class started the annual trip as a way to reconnect and raise support for the Margaret G. Tyson Innovative Teaching Endowment Fund (the class’s 50-year reunion gift, honoring the nursing school’s first dean). A member of the class writes, “Getting old together is much more fun than apart!”

1970s

Betty Dunning (BSN ’74, DNP ’15) accepted a job at Virginia Heart in Falls Church, VA, after completing her DNP in May 2015.

1990s

Marisa Kozlowski Phillips (BSN ’99) and husband John welcomed a son, Shane Anthony Phillips, on May 21, 2015.

1980s

Kathy Chappell (BSN ’88) was selected to be inducted as a fellow in the American Academy of Nursing.

The induction ceremony is set to take place at the organization’s annual policy conference on October 17, 2015, in Washington, DC. Kathy is the vice president of accreditation and research at the American Nurses Credentialing Center.

2000s

Beth Gordon (BSN ’00), Emily Gunn (BSN ’84), Ellen Trovillion (BSN ’77), Bridget Whitson (BSN ’70), and Wendy Wolf (BSN ’78) gathered in St. Louis, MO, on April 13, 2015, for dinner and stories on the occasion of Thomas Jefferson’s birthday.

This group got together every year for ’Hoos Coming to Dinner and decided to continue to meet for this special occasion. The restaurant even gave them cake in honor of Mr. Jefferson’s birthday!

Katie Berschback Cooper (BSN ’00) started Recovery Room Nashville LLC in April 2014, the only concierge rehydration service in the Nashville, TN, region. Nurses provide intravenous rehydration in the comfort of a client’s hotel room or home and also can administer medication for headache, sore muscles, or nausea as well as vitamin boosters like B12 injections in a spalike atmosphere (www.RecoveryRoomNashville.com).

Katie also works as a CRNA at Vanderbilt University Medical Center in a freestanding ambulatory surgery center specializing in orthopedic surgery. Katie lives with her husband and three children in Franklin, TN.

2015 Nursing Graduates 75% of BSN and CNL graduates received a job offer prior to graduation 91% were employed within 3 months of graduation 56% of CNL graduates (20 of 36) and 31% of BSN graduates (36 of 117) took a job at UVA Medical Center 81% growth from 2014 to 2015 in BSN or CNL graduates who took a job at UVA Medical Center (31 in 2014 vs. 56 in 2015)

CLASS NOTES

Amanda Caroline Faircloth (BSN ’00) recently completed two doctoral degrees through Virginia Commonwealth University (VCU), a DNAP (in 2011) and PhD (2014).

Amanda currently works as a CRNA at VCU Medical Center and is an adjunct faculty member in the VCU Department of Nurse Anesthesia.

In August, Martha Schneider (RN-BSN ’04, MSN ’08, DNP ’13) and her husband, Dave Schneider (RN-BSN ’09), relocated to Florida, where she is now the director of Magnet nursing at the University of Florida in Gainesville. Martha previously was the director of critical care at Rockingham Memorial Hospital in Harrisonburg, VA. She currently serves as vice president of the Nursing Alumni Council.

Nursing school assistant professor Jessica Keim-Malpass (CNL ’08, PhD ’11) and her husband, Charles, welcomed a son, Howard Charles “Huck” Malpass IV, on Father’s Day 2015.

Brooke Giles Bailey (BSN ’09) welcomed a son, Heath Walker Bailey, on April 18, 2015. Brooke is an FNP at Central Virginia Health Services.

2010s

Laura Manley (BSN ’11, MSN ’15) married Nathan Bryan on June 20, 2015, in Rixeyville, VA. The couple resides in Arlington, VA, near where Laura works as a nurse practitioner at MedStar Washington Hospital Center on the inpatient end-stage heart failure service.

medical ICU at UVA Medical Center and is pursuing her DNP. Steve recently finished his residency at UVA and joined University Physicians–Orange.

Annabel Rose (BSN ’11) began a two-year nurse anesthesia master’s degree program this past summer at the University of Pennsylvania. She has been an ICU nurse at the Children’s Hospital of Philadelphia for the last four years.

Monika Criman (BSN ’13) accepted a job in the Cardiothoracic Surgical ICU at Allegheny General Hospital in Pittsburgh, PA. Ashley Allen (MSN ’15) will be running the New York City Marathon on November 1, 2015, to benefit the nonprofit Every Mother Counts, which promotes maternal health worldwide.

She planned to travel to Haiti in September.

Katelyn Overstreet (BSN ’11) married Steven Rybicki on August 8, 2015. The couple will continue to reside in Charlottesville. Katelyn works in the

Margaret G. Tyson Innovative Teaching Awards The Margaret G. Tyson Innovative Teaching Awards, funded by members of the Class of 1960 in honor of their 50-year reunion, support projects or course development activities that result in excellent, innovative, or cost-effective teaching methods.

2015–16 RECIPIENTS Piloting a Medical Spanish Course in the School of Nursing Randy Jones (BSN ’00, MSN ’02, PhD ’05) Associate Professor of Nursing Teaching the Next Generation of Lifesavers (CPR in Schools) Vickie Southall Assistant Professor of Nursing

Phyllis H. Steger (DIPLO ’38) Charlottesville, VA May 3, 2015

Agnes Washington Hougas (DIPLO ’47) Amarillo, TX May 29, 2015

Elizabeth S. Miller (DIPLO ’65) Harrisonburg, VA June 13, 2015

Mereka S. Martin (BSN ’85) Fredericksburg, VA April 15, 2015

Georgellen Eaton Lieman (DIPLO ’40) San Antonio, TX April 2, 2015

Myrtle J. Downer (DIPLO ’53) Henrico, VA July 25, 2015

Ann Lamont Patrick (BSN ’65) Williamsburg, VA April 5, 2015

Patricia N. Stewart (BSN ’90) Charlottesville, VA June 7, 2015

Laura Fern Hensley Mims (DIPLO ’43) Oakton, VA March 25, 2015

Elizabeth S. Walters (DIPLO ’55) Mechanicsburg, PA June 23, 2012

Mary J. Howell (BSN ’70) Oklahoma City, OK February 27, 2015

Victoria Jeanne Sheahan (BSN ’92) Maitland, FL June 22, 2015

Mary Jane B. Kite (DIPLO ’45) Fern Park, FL March 27, 2015

Mildred J. Fitzgerald (DIPLO ’59) Charlottesville, VA August 18, 2015

Leslie H. Crosby (BSN ’73) Tucson, AZ May 22, 2015

Mary Lynne Dessert (BSN ’93) Ocala, FL May 8, 2015

Mary Lynn J. Richards (DIPLO ’45) Huffman, TX April 20, 2015

Nancy G. Pittman (DIPLO ’59) Gainesville, VA May 8, 2015

Susan C. Dedrickson (BSN ’79) Baltimore, MD June 13, 2015

Jennifer J. Tickle (BSN ’98) Edgewater, MD January 29, 2015

Josephine V. Parkinson (DIPLO ’46) White Oak, PA May 13, 2015

Barbara Pleasants Quarles (DIPLO ’59) New Bern, NC August 3, 2015

Susan L. Dunn (MSN ’80) Sarasota, FL April 26, 2015 Fall 2015 | VIRGINIA NURSING LEGACY

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FY 2015 ANNUAL REPORT These charts and graphs provide a snapshot of fiscal year 2015, which ran from July 1, 2014, to June 30, 2015.

Thank you to all who support the School of Nursing!

$16 million

$15.8 million

Revenues

Expenditures

Endowment Through new gifts and investments, the School of Nursing endowment reached $54.99 million in fiscal year 2015. These funds represent permanent support for the School.

FY 2015 TOTAL:

Nearly

$3.7M

in new gifts and commitments

7-YEAR TOTAL (FY 2009–15):

MILLIONS OF DOLLARS

$30.3M

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in new gifts and commitments since Dean Fontaine took the helm

VIRGINIA NURSING LEGACY | nursing.virginia.edu

NURSING ANNUAL FUND Thank you! The School of Nursing is grateful to the

more than 1,500 individuals, families, and organizations that made philanthropic contributions to the School in fiscal year 2015. A consistent influx of annual support means more students graduate with lower debt loads; we’re able to employ the best possible nursing faculty to teach and perform consequential research; and more patients are served, comforted, and healed every year. Each gift is meaningful and important to the life and future of our School.

Nursing Annual Fund FY 2011–15 Generous donors to the Nursing Annual Fund gave

HUNDRED THOUSANDS OF DOLLARS

nearly $428,000 in fiscal year 2015. This total represents the fourth consecutive year of Annual Fund growth and an almost 30 percent increase over Annual Fund giving five years ago.

Fall 2015 | VIRGINIA NURSING LEGACY

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A

MNI IN ACTION

Dawn M. Jones (BSN ’89)

LU

At the Intersection of Nursing and Law After graduating from the UVA School of Nursing, Dawn Jones accumulated 14 years’ experience in critical care nursing before starting her second career as a lawyer.

Formerly a senior attorney at King & Spalding and associate general counsel for Grady Health System in Atlanta, Ga., she established her own firm in 2014, in which she combines her love of nursing, medicine, and science with the practice of law. She stays connected to UVA and the School of Nursing by attending reunions, Black Alumni Weekends, and Atlanta-area alumni events, as well as supporting the School and University financially.

On her early career: “I always wanted to be a nurse. By the time I graduated from UVA, I’d set a five-year plan for completing my clinical nurse specialist (CNS) master’s degree.

I took my first graduate course at UVA, then transferred to Georgetown to continue my studies while working full time in the

university hospital’s medical ICU. After finishing my master’s degree, I moved to Atlanta and became a night-shift nurse at Grady Memorial Hospital’s trauma center, where I cared for patients with postoperative complications and people involved in motor vehicle accidents, gunshot wounds, stab wounds, and suicide attempts. I was also a part-time nurse at an Emory University medical ICU. I worked at Grady full time while completing my law degree.”

On her transition to law: “Dorrie [Fontaine] led the Critical Care CNS graduate program when I was at Georgetown, and she always had us thinking outside the box.

In one class, she invited some folks from the Department of Health and Human Services (DHHS) to speak to us. Before that, I’d always looked at improvements in patient care from the bedside viewpoint, but that class gave me new perspectives on how a nurse could impact patient care and outcomes in other ways, on a national scale.

Years later, I was reminded of that class as I watched worrisome hospital staffing and budget cuts—not only threatening my own job security but, more importantly, negatively impacting the quality of care. Yet my concerns, voiced to the administration orally and in writing, seemed to have little effect. I decided to become a lawyer to help patients countrywide from a broader platform. Initially, I thought I would work for DHHS, but in law school my interest in government law waned while my interest in litigation practice grew.”

On her solo practice: “I started my own firm because I wanted more control over the types of cases and work I took on and, having spent my entire

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VIRGINIA NURSING LEGACY | nursing.virginia.edu

legal career doing defense work, I wanted to get courtroom trial experience and the opportunity to work on the plaintiff ’s side. In my practice, I assist lawyers with legal research and writing, expert witness identification and development, and review and analysis of medical records for potential claims or defenses. After an extremely successful first year, I’m expanding to take on personal injury and medical malpractice cases. My biggest challenge is knowing when to stop working, because business is booming!”

On the School of Nursing’s impact: “The most important lesson the UVA School of Nursing taught me is to care—whatever the context. Nursing is part of who I am, not just what I did, and it’s been pivotal to the legal work I’ve done and continue to do. Each of my former legal employers hired me specifically because of my nursing experience. And that experience has served me well in the practice of law. I’m able to interpret medical records, and analyze claims or defenses, in a way nonnurses and nondoctors can’t. More recently, my nursing background has led to unexpected relationships, clients, and connections that prove a nursing and law degree is a uniquely valuable combination. There’s quite a bit of synergy between the two professions, especially in my torts litigation practice.

I’m thankful I was a nurse first, because it made me the lawyer I am today. And I’m a better lawyer because I was a nurse.”

Advice to new graduates/current students: “Take nothing for granted, including those things you may think of as ‘little.’

Everything you do is impactful. Today, I miss the opportunities to connect with patients and their families through the everyday ‘chores’ I used to have at the bedside. Those little things matter. On top of all the learning, don’t ever forget it’s a human being in front of you—someone with needs like yours.”

Virginia Moments TEACHING NURSING, THEN AND NOW By the mid-1900s, nursing instructors used life-size dolls to demonstrate how to diaper, feed, and bathe infants. This group of UVA nursing students watches the demonstration, most likely held in the playroom on the pediatric ward of UVA Medical Center, in 1954.

Today, the School’s 9,200-square-foot Mary Morton Parsons Clinical Simulation Learning Center is home to eight “high-fidelity” patients, including several baby mannequins that cry, hiccup, run fevers, and exhibit digestive problems and heart issues only detectable by stethoscope.

PHOTOS COURTESY OF THE ELEANOR CROWDER BJORING CENTER FOR NURSING HISTORICAL INQUIRY AND DAN ADDISON, UVA PHOTOGRAPHER.

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CALENDAR OF EVENTS OCTOBER 2015

DECEMBER

APRIL

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Homecomings: Alumni Brunch (Pavilion IX)

2

16

20

Nursing History Forum: Generalized Nursing: The Solution to the Difficulty of Public Health Work? presented by Jaime Lapeyre, lecturer, University of Toronto, and 2015 Brodie Fellow

Admissions: RN to BSN Program Information Session

18

End of fall semester examinations

20

Admissions: PhD and MSN–DNP Programs Information Session

23–25 UVA Family Weekend: School of Nursing activities include recognition and White Coat ceremonies, Sigma Theta Tau induction ceremony, and screening of The American Nurse 28

JANUARY 2016 20

FEBRUARY 6

Alumni Council winter meeting

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Southern Nursing Research Society Conference: Alumni Reception (Colonial Williamsburg Lodge, Williamsburg, VA)

Zula Mae Baber Bice Memorial Lecture

by Marcus Engel: “The Other End of the Stethoscope”

31–Nov. 1 Empowering Those Who Care for Others: Innate Compassion Training weekend retreat with John Makransky (register by Oct. 16 at www.compassion.nursing.virginia.edu/events/)

NOVEMBER 4

Admissions: RN to BSN Program Information Session

10

Nursing History Forum: The Evolution of School Nursing panel presentation

11–14 Train-the-Trainer Interprofessional Faculty Development Program (Center for ASPIRE, School of Nursing, School of Medicine) 25–29 Thanksgiving break

Spring 2016 semester begins

MARCH 5–13 Spring break 11

Virginia Council of Nurse Practitioners Conference: Alumni Reception (The Homestead, Hot Springs, VA)

Alumni Council spring meeting

TBD Catherine Strader McGehee Memorial Lecture

MAY 5

Northern Virginia/Washington, D.C., Alumni Reception (location TBD)

13

End of spring semester examinations

21

School of Nursing Pinning and Hooding ceremonies

22

Final Exercises/School of Nursing ceremonies

JUNE 2–5

Reunions weekend: Classes of 1956, 1961, 1966, 1971, 1976, and 1981 (35- through 60-year reunion celebrations) and Thomas Jefferson Society

9–12 Reunions weekend: Classes of 1986, 1991, 1996, 2001, 2006, and 2011 (5- through 30-year reunion celebrations)

11–12 Agnes Dillon Randolph International Nursing History Conference 2016 Randolph Award recipient and keynote speaker: Anne Z. Cockerham, associate dean of midwifery and women’s health at Frontier Nursing University (address: “Mary Breckinridge: Steady in the Saddle; Leadership and the Frontier Nursing Service”) 18–19 Advisory Board spring meeting (including emeritus board members)

For more information and a full listing of School of Nursing events, visit www.nursing.virginia.edu/calendar.

NURSING CREATIVITY, page 8