Spring/Summer 2022 Duke Nursing Magazine

DUKE NURSING

SPRING/SUMMER 2022 Volume 18 No. 1

a publication of Duke University School of Nursing

NURSE-LED INTERVENTIONS THAT ARE CHANGING HEALTH CARE TODAY

Health

Professions

2021

At Duke, we’re committed to shaping a workforce that reflects the communities we serve.

Diverse representation within our clinical and

®

educational setting builds better connections between

Top Colleges for Diversity

health care providers and patients, and influences

Duke University School of

outcomes for real people, families, and communities.

Nursing received the 2021 Health Professions Higher Education Excellence in Diversity (HEED) Award from “INSIGHT Into Diversity” magazine for its commitment to a diverse and inclusive environment.

the quality and impact of research and health care

Duke is a place that deeply values diversity and inclusion, which helps us teach, research, and conduct clinical practice aligned with our commitment to health equity.

Dean’s Welcome

I

t is a dynamic time of significant transformation in the nursing profession and in the field of health care. The current care context and delivery systems, including nursing practice, are being shaped by large-scale issues and social determinants of health, such as infectious disease pandemics, widening socioeconomic inequality, climate changes, political divisions, community violence, migration, structural racism, and technology, to name a few. As our health care systems encounter and respond to these transformative changes, the scientific, clinical expertise and leadership of nurses will be required. In the pages of this magazine, you will see project examples of how the Duke University School of Nursing (DUSON) is addressing the most pressing contemporary and future health and social challenges we collectively face.

There are exciting opportunities ahead for the DUSON community to prepare future generations of nurse scientists, clinical experts, and leaders empowered to make tangible impacts on achieving health equity throughout our transformed systems of health care domestically and across the globe.

Nurse leadership in the coming decade will require nurses trained in rigorous scientific methods, excellence in clinical care delivery, seasoned nurse educators, and expertise in policymaking at state, federal, and global levels. To meet these needs, DUSON is: • Addressing the social determinants of health with novel, multi-level health interventions that mitigate the precise mechanisms by which social determinants of health influence real people, families, and communities; • Designing, evaluating, and disseminating nurse-led models of health care designed to reimagine health care delivery with greater attention to prevention, overall wellness, disease management, use of technology in health care delivery, and locational preferences of individuals and groups; • Developing, growing, and supporting a diverse and inclusive nursing workforce to ensure the United States and the world at large have well-trained public health and health care delivery professionals to prevent and respond to global pandemics and the ongoing health challenges facing our planet; and • Effectively communicating the value of the health care services nurses deliver, the impact of those services on health outcomes, and the opportunities for rethinking current health care payment models to allow for greater alignment with nurse-delivered services.

In this issue of Duke Nursing magazine, I invite you to read more about DUSON’s signature initiatives and our vision for the role of nurses in the transforming landscape of health care. Now is the time for nursing! And now is the time for DUSON! Sincerely,

Vincent Guilamo-Ramos, MSN’17, PhD, MPH, LCSW, RN, ANP-BC, PMHNP-BC, FAAN

Dean, Duke University School of Nursing Vice Chancellor, Nursing Affairs, Duke University

MATTHEW SEPTIMUS

Nurse-Community-Family Partnership Program team member Diego Guaman, left, meets with a family in their home to discuss COVID-19 and health care through a project led by the Center for Latino Adolescent and Family Health.

Leading in Nurse-Designed Models of Community health nurse Miguel Ángel Pérez Mendez and community health worker Lori Pasqualino visit the home of José and Rosalind as part of the Nurse-Community-Family Partnership.

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COVER PHOTO: Miguel Ángel Pérez Mendez prepares to visit a family home as part of the

Nurse-Community-Family Partnership led by the Center for Latino Adolescent and Family Health.

Sections Education & Advocacy

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Student Spotlight

8

News Briefs

9

Nurse-Led Models of Care

14

New Faculty & Promotions

24

Alumni Connections

26

Class Notes

28

In Memoriam

31

Centering Care in the Home 16 Community Partnerships to Reduce Health Disparities 19 Empowering Family Caregivers 22

FACULTY CONVENE, DISCUSS PATHS TO HEALTH EQUITY In a day-long retreat, the Faculty Governance Association organized a discussion around the promise of health equity.

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Health Care

7 Artificial Intelligence

VOLUME 18 ISSUE NUMBER 1

Health Equity Scholar

EDITOR

Michael Cary is retooling

Katie Bowler Young

health care’s future.

MANAGING EDITOR

LaWanda McCreary CONTRIBUTING EDITOR

Stephanie Turner

PHOTO AND VIDEO EDITOR

Andrew Buchanan ART DIRECTOR

Sarah Chesnutt

All photos and corresponding online videos were obtained in accordance with COVID-19 protocols.

FOLLOW US ONLINE:

DukeU_Nursing

DukeUniversitySchoolofNursing

@DukeU_Nursingschl school/duke-university-school-of-nursing

Paths to Health

The Faculty Governance Association (FGA) engaged in a day-long retreat in January 2022 to discuss paths to help achieve the promise of health equity—and ways to translate recommendations from “The Future of Nursing 2020-2030” report into opportunities at the School of Nursing. Graphic recorder Rio Holaday added an artistic element to the discussion by facilitating dialogue while concurrently illustrating and revising a visual that reflected ideas faculty generated during the retreat. The work is an important input for strategic planning underway at DUSON. Based in California, Holaday is a graphic practitioner with a background in public health.

She is also a Culture of Health Leader with the Robert Wood Johnson Foundation.

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DUKE UNIVERSITY SCHOOL OF NURSING

Equity

a visual discussion guides the plan

Rio Holaday, graphic recorder, facilitator, and visual coach, is a Culture of Health Leader with the Robert Wood Johnson Foundation.

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Education and Advocacy

Johnson and Adcock Recognized for Accomplishments with AANP State Award for Excellence

By Stephanie Turner

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wo Duke University School of Nursingaffiliated nurse practitioners (NPs) have received the 2022 American Association of Nurse Practitioners (AANP)’s State Award for Excellence for North Ragan Johnson Gale Adcock Carolina—a reflection of their dedication to the field of advanced practice nursing. AANP has awarded Ragan Johnson, DNP, FNP-BC, CNE, associate professor, the NP Award for her health equity work, and Rep. Gale Adcock, consulting associate and former School of Nursing Board of Visitors member, the Advocate Award for her leadership as a member of the North Carolina House of Representatives and advocacy leadership.

Johnson and Adcock develop and disseminate nurse-led models of health care to reduce health disparities and strengthen nurse leadership in policy making. “[Nurses] are the key to reaching health equity,” Johnson says. “As the most trusted profession, we can bridge the gap of medical distrust for communities most impacted by health disparities just with our patient-first mindset to care. We are using our voices to impact health policy at the local, state, and national level. We understand what the systematic barriers are that need to be removed, and we have the answers for designing the system to replace the one that is not working.”

Ragan Johnson, NP Award “I am extremely honored to receive an award of this magnitude. To have been recognized by my peers in this way means so much to me,” says Ragan Johnson.

Anne L. Derouin, DNP’10, RN, MSN’00, CPNP, FAANP, assistant dean, Master of Science in Nursing (MSN) Program, and professor, nominated Johnson due to her efforts as the program’s chair, including leading the process to introduce diversity, equity, inclusion, and belonging statements to the syllabi. These statements have been implemented throughout the school and proved crucial in creating the Leading to Equitable Access to Health Professions (LEAHP) Program, a mentorship opportunity offered through the Office of Diversity, Equity and Inclusion. The program welcomed its first cohort in June 2021, when the Health Equity Academy and the MSN Program partnered with North Carolina Central University (NCCU) to present a weeklong summer immersion program to five BSN students from NCCU and North Carolina A&T State University. Johnson’s output has garnered

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national attention, resulting in requests for consultation on how the framework can be implemented at other schools of nursing.

A mentor at Tennessee State University encouraged Johnson to pursue the NP profession; Johnson went on to earn a MS in nursing and a DNP with a public health concentration from The University of Tennessee Health Science Center. Johnson focuses on improving health equity and caring for patients from underserved communities through practice, advocacy, and research. Her focus on health care reform for the Black community stems from her family’s experiences.

“My great-grandfather was refused care in the South and was left without full use of one of his arms,” she says. “I knew I would do something to change who patients see when they need health care and how that care was delivered.”

Johnson serves as the co-investigator for The HEEAT Research Lab, led by Schenita D. Randolph, PhD, MPH, RN, CNE, associate professor. Comprising an interdisciplinary team of researchers, clinicians, entrepreneurs, and community members, the lab operates two programs designed to reduce health inequities in the Black community around HIV and sexual health.

“My passion is to reach health equity and eliminate HIV, particularly in the Black community,” Johnson says.

Gale Adcock, Advocate Award Gale Adcock, a family NP of 35 years, is the first and only advanced practice registered nurse (APRN) to serve in the state legislature. She was nominated for advocacy efforts during her four terms in the NC House of Representatives where she holds the position as deputy Democratic leader. Especially notable are her efforts to pass APRN full practice authority, known as the SAVE Act, of which she is a primary sponsor. The SAVE Act would eliminate the state’s requirement for physician supervision of NPs and modernize the regulation of all APRN practice.

“Advocacy by NPs is truly advocacy for patients,” Adcock says.

“Often, NPs provide care for individuals and communities who have no voice in the policy arena. We must speak for them, as well as for ourselves, if we want to see legislation and regulations that serve people in the ways they deserve.”

During Adcock’s career, she has served as the chief health officer for global software company SAS for 26 years, president of the North Carolina Nurses Association, chair of the North Carolina Center for Nursing and was a two-term member of the North Carolina Board of Nursing. She received her BSN from East Carolina University and her MSN and FNP from the University of North Carolina at Chapel Hill.

As a public health nurse in the early 1980s, Adcock observed the autonomy, influence, and partnership with patients that NPs have and it motivated her to advance her career by becoming an NP. “NPs have an unparalleled skillset that makes us effective leaders and problem solvers in all settings,” she says. “To broaden our influence and impact, NPs must think beyond traditional leadership roles in health care settings. More NPs need to hold elected and appointed offices at all levels of government.

“As health care providers who care for people in their totality—as individuals who are also part of families and communities—NPs are well-prepared and well-positioned to use data and tell stories that illustrate the changes needed in health care access, delivery and outcomes,” says Adcock.

MICHAEL CARY

RETOOLING HEALTH CARE’S FUTURE AS AI HEALTH EQUITY SCHOLAR

By Adam Halbur, with contributions from Duke AI Health

D

uke Artificial Intelligence (AI) Health recently launched its inaugural AI Health Equity Scholar Program, with a goal of developing, evaluating, and implementing ethical and equitable data science and AI-enabled tools—both here at Duke and as part of a broader impact Duke has in shaping the future of health care.

Michael P. Cary Jr., PhD, RN, Elizabeth C. Clipp Term Chair of Nursing, is Duke Health’s first AI Health Equity Scholar, helping to deepen Cary’s connections with Duke University faculty, staff, and postdoctoral scholars as the university and health system consider AI of the future at Duke and beyond. Cary will build guidelines Michael Cary to ensure fairness, transparency, and bias reduction in algorithmic models that advance health equity across Duke Health.

“Machine learning algorithms, computational-based predictive models, are providing increasingly sophisticated AI-enabled decision support and population-level monitoring,” says Cary, “and it should encode principles of ethics and equity to ensure that models benefit all patients.” Cary underscores that biased algorithms can create unfair outcomes, such as privileging one group over another, exacerbating racial and gender inequity in health care.

A Unique Set of Skills Cary has a unique set of skills and experience in gerontological nursing, population health, health disparities, and machine learning algorithms applied in health care, which positions him to contribute to key programs within Duke AI Health, such as the Algorithm-Based Clinical Decision Support Oversight Committee, an executive-level oversight team that provides governance of algorithmic models deployed across Duke.

Cary’s research leverages complex biomedical and healthcare datasets and innovative data science approaches to identify risk factors that contribute to functional decline and rehospitalization among older adults, primarily belonging to minoritized racial and ethnic groups.

Building on previous work funded by Duke Clinical and Translational Scientific Institute (CTSI), Cary is focused on making meaningful contributions by identifying health care algorithms and algorithm-informed decision tools that exacerbate or perpetuate racial, ethnic, and

gender health disparities. He is currently in the fourth stage of his own research, which looks to develop and implement automated risk prediction tools that employ social determinants of health data collected at the point of care to guide data-driven discharge decision-making in inpatient rehabilitation facilities.

“This automated risk prediction tool will develop best-practice alerts embedded in the electronic health record to guide referrals at discharge,” explains Cary. “The idea is to reduce rehospitalization among older adults.”

Preparing the Next Generation of Nurses As one of the few PhD-prepared nurses trained as a health service researcher and an applied data scientist, Cary provides nursing students and clinicians opportunities to develop highly valued skills by promoting their ability to extract meaningful clinical insights from real-world data.

He is faculty lead for health data science at DUSON and partners with the Duke School of Nursing Center for Nursing Research to build the institutional infrastructure needed to develop educational/training programs and support scholarly collaborations, build innovative programs of health data science education, and increase the number of faculty and students engaged in research and collaborative work.

Since joining the school in 2012, Cary has advanced principles of diversity, equity, and inclusion in research, service, and education/ mentorship. In 2015, he was one of 28 scholars invited by the NIH Chief Officer of Scientific Workforce Diversity to present his research at the inaugural Future Research Leaders Conference. He later chaired the School of Nursing racial justice task force focused on faculty retention and promotion and identified key levers to advance racial equity in faculty hiring and retention and more recently, strengthen the leadership pipeline for diverse future nurses in professional organizations. As an educator, to improve next-generation nurses’ recognition of the social determinants of health, Cary creates innovative case studies focused on health inequities among minoritized and historically marginalized groups and simulated learning environments using evidence-based tools. He also mentors budding scholars and helps them write and publish papers on topics relating to the social determinants of health, cultural humility, and health equity.

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Student Spotlight

Irene Abella, DNP Student, Named 2021-22 University Scholar A Duke nurse committed to Filipino nurse advocacy

D

octor of Nursing Practice student Irene Abella read her acceptance letter to the University Scholar program several times before she believed the news that she was selected as Duke University School of Nursing’s 2021-22 University Scholar.

“I received an email a day before I was expecting the result to be out,” Abella explains. “My heart almost stopped after I read the email.”

But recognition for her nursing expertise isn’t new to Abella. While working at the Al Qurayyat General Hospital in Saudi Arabia, she was nominated as Best ICU nurse. The Duke Friends of Nursing recognized her with an Excellence in Critical Care Nursing award in 2014.

Abella has spent 29 years in nursing and Irene Abella is a nurse practitioner at the Duke Sleep Disorders Center. She has been a Duke Health employee for 13 years and earned her Master of Science in Nursing (MSN) from Duke in 2015.

“I was blessed to have learned from expert professors who share the Duke passion for excellence,” she says.

The Philippines, Abella’s home country, is the largest producer of nurses worldwide. Since her parents wanted her to have access to a breadth of opportunities, they encouraged her to be a nurse.

“Compassion is a virtue innate in the Filipino culture,” Abella says.

“We take pride in being able to lovingly care for the sick.”

Before her family immigrated to the U.S., in 2006, Abella held several different roles in the Philippines including community health

Abella decided to pursue her DNP to further

PRIOR UNIVERSITY SCHOLARS • Pamila “Pami” Ellis, DNP, 2020 • Rose Feinberg, ABSN, 2019 • Kristin Whitley, MSN, 2018 • Kathryn Starr, ABSN, 2017 • Asma Agad, Nurse Anesthesia-DNP, 2016

her education and learn how to effectively

• Sarah Free, ABSN, 2015

collaborate more with health care stakeholders,

• César Avíles, DNP, 2014

such as fellow nurses and community members.

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grassroots organizer, social research assistant, nurse educator and professional exams reviewer. Once in the U.S., she began as a staff nurse in a long-term care facility before joining the Duke Neurology ICU team.

In addition to her MSN, Abella earned a master’s degree in health services management from the University of the Philippines Baguio and a BSN from Saint Louis University Philippines.

She decided to pursue her DNP to further her education and learn how to effectively collaborate more with health care stakeholders, such as fellow nurses and community members.

Through the University Scholar program, she looks forward to meeting other scholars and gaining knowledge to apply toward her own career and advocacy for other Filipinx nurses, such as her new FRIEND (Filipinx Reformative International Education for Nursing Development) Initiative. Abella created this initiative to better attend to the educational and professional development needs of current and future Filipinx nurse leaders while providing them with ways to network with each other. DN

DUKE UNIVERSITY SCHOOL OF NURSING

• Daniel Lacambacal, ABSN, 2013

News Briefs // News Brie

Center Focused on Latino Adolescent and Family Health Launches ‘NO FEARS’ The Center for Latino Adolescent and Family Health (CLAFH), led

by Dean Vincent Guilamo-Ramos, launched at Duke in September 2021. One of its successful initiatives is “NO FEARS, or Nurturing Ourselves: Family Education and Activities to Reduce Stigma,” a program that provides youth living with HIV and their families with guidance on how to support stigma reduction and promote youths’ life opportunities and their development into healthy and fulfilled adults. The program features an animated film series and other resources designed to connect with youth.

When CLAFH launched in 2021, it was designed to meaningfully engage the Latino community to identify, understand, and collaboratively address the underlying drivers of health and social inequities.

The Center strengthens the role of families in supporting adolescent and young adult health and life opportunities, and it develops and evaluates innovative, nurse-driven models of health care delivery that improve access to prevention and treatment services in underserved communities—driving real-world impact, locally and nationally.

View and share the series at https://duke.is/peq65

EXTERNAL MEASURES FOR SUCCESS 2022 U.S. News & World Report Best Online Graduate Nursing School Rankings #5 Overall #1 NP-Family #1 Nursing Administration #1 Nursing Education #2 for Veterans

2022 U.S. News & World Report Best Bachelor’s of Science in Nursing (BSN) Program #2 Overall

2023 U.S. News & World Report Best Graduate Nursing School rankings

#2 Overall

#1 NP-Adult-Gerontology Primary Care #1 NP-Family #1 Nursing Administration #1 NP-Psychiatric/Mental Health Across the Life Span #1 DNP Executive Leadership Specialty #2 NP-Adult Gerontology Acute Care #2 Doctor of Nursing Practice (DNP) program

2021 National Institutes of Health (NIH)-Funded Research #5 in funding #6 overall for individual training awards $8.4+ million in annual funds SPRING/SUMMER 2022

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News Briefs // News Briefs // News Briefs // News B Simmons Inducted into Inaugural Class of AANA Fellows Virginia (Chris) Simmons, DNP’11, CRNA, CHSE-A, FAANA, FAAN, program director and associate professor, was inducted as a Fellow of the American Association of Nurse Anesthesiology (FAANA).

Simmons, an AANA member since 2002, has demonstrated an exceptional level of expertise, service, and commitment to transforming the nurse anesthesia profession, which she does in part as program director of and faculty for the School’s Doctor of Nursing Practice-Nurse Anesthesia (DNP-NA) Program. Simmons prepares future nurse anesthetists for the current landscape and future of the field through keeping Duke’s program up-to-date and sharing her insightful expertise with the students.

Duke School of Nursing Recognized as Best School for Men in Nursing

Olivia Myszewski and Brian Oh

Rear Admiral (Ret) Sylvia Trent-Adams, PhD, RN, FAAN, FNAP, delivered the distinguished 2022 Harriet Cook Carter Lecture.

Trent-Adams is executive vice president and chief strategy officer at the University of North Texas Health Science Center at Fort Worth, former leader of the U.S. Public Health Service, and the first female nurse to serve as U.S. surgeon general. She delivered “The New Normal: Preparedness for Better Health — Where Do We Go from Here?” At right: Trent-Adams with Dean Ramos and Duke Health Chancellor Eugene Washington.

VIEW LECTURE

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The Duke University School of Nursing has received the American Association for Men in Nursing (AAMN)’s 2021 Best Schools for Men in Nursing Award for its dedication to creating an inclusive environment for all students, faculty, and staff. This is the seventh year the School received the Best Schools for Men in Nursing Award. On October 21, ABSN students Brian Oh and Olivia Myszewski, co-presidents of the Duke University Chapter of AAMN (DAAMN), officially accepted the award on behalf of the School during the 46th annual AAMN conference.

Briefs // News Briefs // News Briefs // News Briefs // Carter, Alumni Selected as 2021 American Academy of Nursing Fellows Brigit M. Carter, PhD, MSN, RN, CCRN, associate dean for diversity, equity and inclusion and professor, has been inducted into the 2021 class of the American Academy of Nursing Fellows (FAANs). She joins 224 other distinguished leaders from throughout the world, including alumni Edwin Aroke, MSN’11, and Susan Haynes Little, DNP’17, consulting associate.

FAANs are leaders transforming the country’s health system by enhancing the quality of health and nursing; reducing health disparities and inequalities; promoting healthy aging and human development across the life continuum; shaping healthy behaviors and environments; integrating mental and physical health; and strengthening the nursing and health delivery systems.

New Dean’s Lecture Series Addresses Pressing Health, Social Challenges The Building Upon Excellence Dean’s Lecture Series launched in the 2021-22 academic year, bringing experts, innovators, educators, and leaders in the nursing and health care professions to Duke. This lecture series is designed to create opportunities to engage in national and global conversations about how to leverage nurses to address pressing health and social challenges. Presentations have focused on social determinants of health; nursing workforce; improving health care access, outcomes and health equity; nursing education; nurses in public health disaster preparedness; and payment models and nurses as agents of change.

Speakers have included: •V incent Guilamo-Ramos, MSN’17, PhD, MPH, LCSW, RN, ANP-BC, PMHNP-BC, FAAN, dean, Duke School of Nursing, and vice chancellor of nursing affairs,

Duke University, discussing social determinants of health, examining historic large-scale health and socially transformative events that have elevated the profile of nurses in safeguarding the health and well-being of the country.

• Kody H. Kinsley, North Carolina Secretary of Health and Human Services, providing an update on the status and outlook of the COVID-19 pandemic, its impact on health care providers as well as insight into the department’s strategic priorities.

• Peter I. Buerhaus, PhD, RN, FAAN, a nurse and health care economist, discussing strengths that the nursing workforce developed prior to the pandemic, the pandemic’s immediate economic impacts on the nursing workforce, and the post-pandemic challenges facing nurses and nurse educators in his April 2022 presentation.

The Building Upon Excellence Dean’s Lecture Series has an exciting lineup for the 2022-23 academic year, including: Margarita Alegria, PhD, chief of the Disparities Research Unit at the Massachusetts General Hospital and The Mongan Institute, and a professor in the Departments LINK TO THE VIDEO

of Medicine and Psychiatry at Harvard Medical School; Regina S. Cunningham, PhD, RN, AOCN,

FAAN, chief executive officer, Hospital of the University of Pennsylvania, and adjunct professor of nursing, University of Pennsylvania School of Nursing; and Congresswoman Lauren Underwood, U.S. representative from Illinois’s 14th Congressional district.

Derouin, Alumni Among Great 100 Nurses Brigit M. Carter

Several faculty and alumni received The North Carolina Great 100 Nurses Award for 2021: Anne L. Derouin, DNP’10, RN, MSN’00, CPNP, FAANP, assistant dean, Master of Science in Nursing (MSN) Program, and professor; Priscilla Ramseur, DNP’16, MSN’95, certificate 2008, chief nursing officer of Duke Raleigh Hospital; and Nancy (Shell) Eisenson, MSN’96, certificate 1997.

Edwin Aroke

Susan Haynes Little Anne Derouin and Valerie Howard, vice dean for academic affairs

Nominations are scored based on how the nominee promotes and advances the profession of nursing in their practice setting and/ or community; demonstrates integrity, honesty, and accountability; displays commitment to patients, families, and colleagues; demonstrates caring and assists others to grow and develop; radiates energy and enthusiasm; and contributes to overall outcomes in their practice setting.

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News Briefs // News Briefs // News Briefs // News B DUSON in Spotlight on World AIDS Day 2021

Researchers Receive Duke REACH Equity Research Awards

For World AIDS Day 2021, school leaders were in the national spotlight. Vincent Guilamo-Ramos, MSN’17, PhD, MPH, LCSW, RN, ANP-BC, PMHNP-BC, FAAN, dean, Duke School of Nursing, and vice chancellor for nursing affairs, Duke University, participated in a panel discussion and was invited to an event at the White House for its commemoration and unveiling

Harold Phillips, MRP, director of the White House Office of National AIDS Policy, delivered the keynote presentation for “The Role of Nursing in Ending the HIV Epidemic: A Call to Action.” The event highlighted 40 years of indispensable contributions of nurses to fighting HIV in the U.S. and globally and new directions for leveraging nurses and nursing schools in support of reinforced national efforts to end the HIV epidemic by 2030.

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of the National HIV/AIDS Strategy 2022-2025 and Plan to End the HIV epidemic by 2030 in the U.S. and Territories. Michael V. Relf, PhD, RN, ACNS-BC, AACRN, ANEF, CNE, FAAN, associate dean for global and community health affairs and associate professor, participated in a Nasdaq closing bell ringing ceremony, which was also broadcast to Times Square.

Tolu Oyesanya, PhD, RN, associate professor, Stephanie Ibemere, PhD, RN, assistant professor, and Michelle Franklin, PhD’20, were among the 2021 recipients of the Duke Center for Research to Advance Healthcare Equity (REACH Equity) Research Education and Training Subcore Awards. The 2021-2022 Research Education and Training Subcore Awards were granted to projects that focus on the Center’s theme to develop and test interventions that reduce racial and ethnic disparities in health by improving the quality of patient-centered care in the clinical encounter. Oyesanya’s award is being used to address the needs and preferences of Spanishspeaking patients with traumatic brain injuries and their families by linguistically and culturally adapting an existing transitional care intervention to be suitable for Spanish-speaking participants and to build the capacity to enroll Spanish-speaking participants.

Through her project, Ibemere is investigating barriers and facilitators of patient satisfaction with the outpatient sickle cell care experience while examining the limitations of current patient satisfaction tools.

Briefs // News Briefs // News

Investing in Ourselves and Our Future: School Launches 5-Year Strategic Plan The decade ahead will demand a more diversified and equipped nursing workforce that is prepared to provide evidence-based care across physical and digital modalities; promote health and well-being within communities; and address the systemic inequities that have fueled wide and persistent health disparities. Leading nursing institutions will need to advance nurse-driven adaptations in education and practice to meet future workforce and industry needs.

As Duke School of Nursing approaches the school’s centennial in 2031, it needs a data-informed strategic plan based on a bold vision and

actionable objectives that builds on the school’s legacy of excellence to equip and empower the nursing workforce of the future. To that end, the School has engaged Slalom, a global consulting firm focused on strategy, technology, and transformation, to help facilitate strategic planning.

Since January 2022, the DUSON community has been providing input through a series of ongoing workshops, interviews, listening sessions, and a survey. The input will inform a five-year strategic plan that builds on DUSON’s credibility and innovation to drive measurable impact for our students, faculty, staff, partners, and community.

Center for Nursing Research to Release Podcast Bound to Break Barriers in Health Care Research

Listen Now!

The Duke University School of Nursing Center for Nursing Research is releasing the School’s first podcast, “Breaking Research Barriers.” This innovative podcast is designed to advance health equity at each stage of research and through the implementation and translation of science into practice and health care delivery.

Made possible by a $20,000 Faculty Seed Grant from the Duke Office of Faculty Advancement, the podcast features health experts and researchers within the Duke Community and across the field of nursing, including peers from the National Institutes of Health and schools of nursing around the world. Featured guests share thoughts about racial and social justice ideas and practices.

The 35- to 60-minute episodes address topics such as closing the health equity gap, cultural intelligence, colorblind racism and white hegemony, data equity, causes

of health inequities, partnering with stakeholders, inclusion in research, community partnerships, and more.

The podcast is produced by co-PIs John Myers, PhD, MSPH, faculty, and Christin Daniels, assistant dean, research development, in partnership with co-investigators an organizing team that includes Allison Lewinski, PhD’17, MPH, RN, assistant professor, Hanzhang Xu, PhD’18, RN, assistant professor, Stephanie Ibemere, PhD, RN, assistant professor, Jessalyn Byrd, clinical research coordinator, and Yazmin Spearman, research assistant.

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MATTHEW SEPTIMUS

From community centers and clinics to schools, hospitals, and homes,

By Margot Lester and Stephanie Turner

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every day around the world, millions of nurses show up to lead, care, educate, research, and innovate. In just the U.S. alone, nurses comprise more than four million in the health care workforce. In addition to their span of reach, nurses bring clinical, scientific, and relational expertise to care—and have been deemed the most trusted profession for 20 consecutive years. All of these factors, plus this period of tremendous social change, put nurses in position to drive changes that transform health care and reduce health inequities.“Across the Duke University School of Nursing, there are compelling and innovative models in which nurses are designing health care interventions and solutions that meet today’s greatest health challenges,” says Vincent Guilamo-Ramos,

Duke’s Nurse-Led Models of Health Care Transform Delivery and Reduce Health Inequities Duke Carries Out Model Through Innovative Programs MSN’17, PhD, MPH, LCSW, RN, ANP-BC, PMHNP-BC, FAAN, dean, Duke School of Nursing, vice chancellor of nursing affairs, Duke University, and director, Center for Latino Adolescent and Family Health, home to the Nurse-Community-Family Partnership Program.

“These programs and projects are designed to reduce health inequity and create opportunities for students to learn about community health and policy across health systems and delivery models.”

Three projects at Duke School of Nursing that are led by nurses and are creating efficacious, scalable, and sustainable models of care include: • A n HIV prevention program implemented as a hair salon-based intervention. The program turns to salons and barbershops —often a safe space for intimate conversations—to help raise HIV prevention awareness and uptake of PreP or other HIV prevention services among Black women in the U.S. South.

• A nurse-community-family partnership to mitigate the spread of COVID-19 in households, initiated as a randomized control trial in socioeconomically disadvantaged communities in the South Bronx.

A nurse and community health worker team regularly meets with families in their homes to discuss COVID-19 prevention and help to reduce household transmission and COVID-related morbidity and mortality.

• A project supporting caregivers of an aging U.S. population, providing support, training, education, and technological tools to caregivers. Studies from this work have helped influence changes in the health system, leading to better home care, lower hospital readmissions, and greater patient satisfaction.

“These projects and other nurse-led models of care at Duke are helping to set a new standard for health care delivery,” says Ramos. “Our models work and often lead to improved health outcomes that are difficult to achieve with more traditional approaches to health care delivery.”

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While much of the U.S. focused on the work of nurses delivering expert care to COVID patients at New York’s over-stretched hospitals in the earliest stages of the pandemic, a cadre of nurses in the city were working outside the care setting to battle community transmission. The novel coronavirus was disproportionately impacting communities of color, especially Latino and African American populations in the South Bronx. A seldom recognized fact is that secondary attack rates, or chances of passing the virus to another individual, are much greater within households as compared to community spread. “While the guidance from the city, the state, and the country was, ‘stay home,’ for families in communities with high rates of coronavirus, there was a potential higher risk of getting COVID from an infected member of your own home,” Ramos says. “Many people in these neighborhoods are essential workers living in multi-generational settings and were unable to afford to isolate.”

Ramos and nurse and epidemiologist Holly Hagan serve jointly as principal investigators on the project; Hagan also has appointments in the Departments of Social Behavioral Sciences and Epidemiology at NYU School of Global Public Health. Together, they developed a

Centering Family Care in the Home

From left to right: Family members Rosalind and José meet with Nurse-Community-Family Partnership team members Vincent Guilamo-Ramos, Lori Pasqualino, and Marco Thimm-Kaiser.

plan modeled on their prior community health interventions: develop COVID guidance for families and send nurses and community health workers into homes to review family plans and deliver care.

The goals of Ramos and Hagan’s nurse-led initiative were straightforward: reduce the risk of getting and spreading COVID-19 at home and prevent people from seeking care at the city’s overwhelmed ERs when they could, instead, obtain necessary care at home and through alternative paths identified through the project. To achieve those goals,

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Ramos and Hagan designed a model program to reduce household transmission involving nurses, community health workers who are also members of the community, and local families themselves. The elements of the program were developed for and by the community and focus on those living in public housing and apartments with families of multiple generations, many of whom have co-occurring health issues independent of COVID-19. The Nurse-CommunityFamily Partnership study is part of the NIH’s Rapid Acceleration of Diagnostics in Underserved Communities initiative. A randomized controlled trial, it evaluates the efficacy of the model to increase COVID-19 testing, vaccination, and mitigation behaviors (such as mask-wearing, social distancing, and handwashing) for families in socioeconomically disadvantaged communities.

Family-Centered, Reality-Based Care and Services Nurses and community health workers were trained to

work with families to develop a personalized family plan to reduce risk, identify exposure, and keep members of the family out of the ER and hospitals. The approach meets community members’ needs from prevention and testing to diagnosis and treatment with: • E ducation & Information. Plain-language educational resources outline exposure risks and the signs and symptoms of COVID. Nurses share this information, provide answers and guidance, and help family members develop a plan to limit transmission within the household. The program also runs a hotline families can call when they suspect an exposure or have questions.

• T ests, Supplies, & Vaccines. Nurses coordinate free, regular at-home testing for every family member and provide rapid point-of-care testing for people with symptoms or a significant exposure. The program furnishes free PPE and thermometers, and—in collaboration with the New York City Department of Health—offers vaccination to every eligible person at home with two doses and a booster.

• I mmediate Intervention. When somebody tests positive, the nurses help the family enact their personalized plan to reduce the chances of COVID transmission to other members of the household. They monitor every single family member for seven days after a positive infection to make sure that other people aren’t getting sick too.

• E motional Support & Chronic Care. The teams also helped families cope with psychological distress from watching Delta and then Omicron affect their communities. People living with chronic illness were also unable or afraid to access regular care.

The team provided health education and reinforced existing chronic disease care management treatment plans.

Building a Path to Better Outcomes Because the Nurse-Community-Family Partnership (NCFP) puts families at the center of care, it enables nurses to create plans tailored to each household’s specific circumstances, tackling social determinants of health that often contribute to worse health outcomes, including:

Elena F. is among families participating in the NurseCommunity-Family Partnership project.

•H ealth Care Access. Family members didn’t have to miss work, arrange transportation or pay for childcare to access testing services because nurses came to the home.

•E conomic Stability. In-home care plus free vaccines, PPE, and other items removed economic barriers to care and didn’t create a financial burden for families.

•C ommunity Context. Since the program was created with people of the community, recommendations were realistic and actionable, which increases engagement and adoption.

The NCFP also provides a trusted resource for people who, Ramos says, “may be feeling a lot of mistrust in health and public health institutions that have been inconsistent in communicating about COVID. Families are wondering, what does this new variant mean, what about the new oral anti-viral? People are relieved to have a nurse who shows up at their door and explains it to them.”

The program is a model for future nurse-led community health initiatives. “We developed relationships with the family members,

“ Focusing on families in their homes represents an important public health strategy that has largely been omitted in the national response to COVID mitigation.”

—DEAN VINCENT GUILAMO-RAMOS

which enabled us to engage each member of the household in the collective goal of keeping themselves and their overall families safe.

Focusing on families in their homes represents an important public health strategy that has largely been omitted in the national response to COVID mitigation,” Ramos says. “Nurses go to the homes, put on their PPE, and work directly with the families. Importantly, we kept people from going to the hospital who didn’t need to go, avoiding more of a surge on our overburdened health care system. That’s the power of nurse-led models of care.”

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Into the Community: Addressing Health Disparities through Equity, Engagement, Advocacy & Trust Access to quality care is one of several social determinants

of health that impacts people’s ability to stay healthy. Americans of color have lived this experience for generations. Research demonstrates multiple influencing factors. According to the Agency for Healthcare Research and Quality’s 2019 National Healthcare Quality and Disparities Report, “racial and ethnic minorities … often face more barriers to care and receive poorer quality of care when they can get it.

The growing evidence base shows that patients of different racial and ethnic groups experience quality of care inequitably and disparately.”

This inequitable situation persists despite years of research, policy, and programming to close the gap by using the traditional health care infrastructure. Nurse researchers at Duke are transforming community health in ways that contribute to meaningful progress in reducing health disparities.

Associate Professor Schenita Randolph, PhD, MPH, RN, observes that it is essential to identify additional environments in which it’s possible to advance community health because of the comfort that people have with a particular place.

“We need to find ways to make sure all people have access to accurate health information and access to care to get their health needs met,” Randolph says.

For example, Randolph leads an HIV prevention program that connects with community members through venues they frequently visit — beauty salons and barbershops. This health intervention turns to salons and barbershops, often a safe space for intimate conversations, to help raise HIV awareness among Black women in the U.S. South. Collaborators for this program include Associate Professor Ragan Johnson, DNP, FNP-BC, CNE, and two beauty salon owners and stylists, Tamica Campbell Hughes and Corinna Dunn.

Data from AIDSVu shows why awareness and prevention are so important: • Most women who contract HIV do so from heterosexual contact (81.7 percent).

• In the southern region of the U.S., the rate of Black females diagnosed with HIV is 14.3 times that of White females.

Activating Community Members Randolph launched The HEEAT Lab, addressing Health

disparities through Equity, Engagement, Advocacy, and Trust, in 2020. Its research is informed by Randolph’s experience as a public health nurse specializing in sexual health, where she saw firsthand ANDREW BUCHANAN

Akili Hester, owner of two Durham barbershops and community partner with The TALK, receives a haircut from fellow barber Demetrius Brockington.

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Deploying Local Influencers HIV prevention and care represents the largest disparities,

according to the Agency for Healthcare Research and Quality report.i For example, Black women constitute 12.9 percent of the U.S. population yet represent 60 percent of new HIV cases among women, and more Black people die from HIV than from any other group.

There are multiple contributors for these disparities, so addressing them is complicated. One contributor that warrants attention is that research shows that Black women experience discrimination by health care providers in the clinical encounter. This, in turn, prompts many women to lose interest in interacting with the health care system.ii Another contributing factor is the underutilization of new drugs that dramatically reduce the risk of contracting HIV. For example, PrEP (pre-exposure prophylaxis) is a daily pill proven to be ninety-nine percent effective at preventing transmission to HIV-negative people, according to the Centers for Disease Control and Prevention. Though readily available, less than one percent of women eligible for the medication are taking it. The barriers for this are many and well documented. Many women perceive their risk to be low and do not see themselves in the marketing of PrEP, as most of the drug’s marketing is directed to men who have sex with men. Once women learn about PrEP, they are open to considering it as a good option for them, says Randolph.

That’s why Randolph’s lab is rolling out Using PrEP and Doing It for Ourselves (UPDOs), a salon-based intervention to raise awareness of PrEP. “UPDOs was developed with the community, with other Black women, for the community,” Randolph says. “That’s really important.”

Salons have been venues for health promotion for many years. But unlike programs that use the stylist as an interventionist, UPDOs leverages the salon to reach social networks of women who may be eligible for PrEP

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or know other women who would benefit from PrEP. “The salon is the place most people come to get service – but, most of all, talk,” says Tamica Hughes, UPDOs partner and owner and stylist of Kotur Hair Salon in Greensboro, North Carolina.

“People feel safe to talk and share anything with their stylist and barber, and we are able to impact the community with the knowledge we share about PrEP – information that can save their lives.”

UPDOs provides information and training for salon staff, which carries CEU credits. This encourages owners and managers to participate because continuing education is required for licensure renewal. “Getting CEU credit hours and learning information to help our clients is the best part,” UPDOs research team, from left Hughes says. “It is a win-win to right: Ragan Johnson, Tamica Campbell Hughes, Schenita for everyone.”

Randolph, Allison Johnson, Cori Dunn, The trial program will measure and Crystal Taylor. the approach’s ability to improve awareness, knowledge, and uptake of PrEP among Black women living in the U.S. South.

“Black women are influencers in their communities. We are gatekeepers,” Randolph says. “If we can bring information on PrEP and other health issues to Black women, they can share it with others. We’re building on the community’s strengths.”

ANDREW BUCHANAN

ANDREW BUCHANAN

the shortcomings of traditional health promotion and care delivery models. To counter that, the Lab is investigating how use of community members can Akili Hester get vital information and care to people who may not trust or rely on traditional health systems or who have limited access to care.

“Engaging the community to help us develop programs allows us to hear their lived experiences and to understand what will work and what will not work in a real-world setting. We want our efforts to be impactful and sustainable,” she says.

Activating influential members of the community as health advocates increases trust in the information, encourages people to engage with the health system, and can improve overall wellness. The Lab is launching two projects that take health promotion to trusted, accessible people and places in the community.

Engaging Black Fathers Moms carry a lot of the responsibility for talking to teen

family members about sex and health, but dads can be very influential as well. Most health care providers and health promotion programs focus on mothers, missing an opportunity to engage fathers to further influence decisions and behaviors.

Prior research has shown that many fathers don’t have these conversations because they’re not sure how. They may lack experience of talking to their own fathers or father figures about sexuality, and they don’t know what’s appropriate to discuss with their sons, or when.

“A lot of us have not been raised like that,” says Akili Hester, partner and owner of the Hayti and Black Wall Street barbershops in Durham.

“We were latchkey kids, raised mostly by TV ... so it isn’t like we had this information given to us. But who doesn’t want their child to be

safe? Who doesn’t want to have information and resources to give their child to protect them? Who doesn’t want to be able to figure out a way to have those tough conversations with their sons?”

Initially, the HEEAT Lab developed The Talk to engage men in discussing sexual health with their kids. They produced an online curriculum for dads that includes father-to-father podcasts, videos, and other educational content. The research trial was designed with members of the Black community, specifically for Black fathers.

“The Talk is a great way to get the ball rolling in getting this information and the resources to the community,” Hester says. “We speak the same language. The face that’s helping you is just like yours. And we give it to you in a way that can be relatable.”

Two major events expanded the program’s reach. In response to the COVID-19 outbreak, which disproportionately impacted (and still impacts) Black families, the Lab created materials and had online community conversations to talk about COVID safety and prevention.

LINK TO THE VIDEO

“With the racial unrest in this country, we shifted our focus to also look at The Talk in terms of addressing experiences with racism,” Randolph says. The team partnered with WE ARE, a nonprofit that delivers anti-racism training for children, families, and educators, to develop strategies for conversations with adolescents about racism and health.

After further reflection and conversations with WE ARE, expanding The Talk made sense. “Racism wasn’t directly a part of our research,” Randolph says. “But if we’re true to addressing health disparities and inequities in our community, we have to do more than talk about it as a contributing factor. We have to take action.”

Nurses are in a unique position to influence prevention and care delivery.

“We’re often more aware of the patient’s lived experiences. We understand social determinants of health, and we know how to take a holistic approach to the care that we give, which gives us a total view of patient and family care,” Randolph says.

“ We were latchkey kids, raised mostly by TV ... so it isn’t like we had this information given to us. But who doesn’t want their child to be safe? Who doesn’t want to have information and resources to give their child to protect them?”

—AKILI HESTER, BARBERSHOP OWNER SPRING/SUMMER 2022

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Improving Outcomes & Empowering Family Caregiver Family and friends play a vital role in patients’ ability to

transition successfully from the hospital to home. In fact, most adults get help after discharge from these informal, unpaid caregivers – few of whom are fully prepared for the caregiving role. The lack of training and support can produce poor outcomes for patients and caregivers alike.

Elder patients and their caregivers are particularly vulnerable to complicated recoveries because of physiologic aging consequences and comorbidities. And their physical function frequently declines after discharge, which may limit their ability to live independently.

These factors lead to preventable utilization of health care services or

readmissions: One in five older adults is readmitted to the hospital within 30 days of their discharge, and the readmission rate increases to about 31 percent for those who are medically vulnerable and frail.

There’s also evidence that, without support and training, caregivers are burdened, stressed, anxious, and depressed. They often have concerns about responsibilities for providing care in the home.

They may already be short on time, potentially juggling caring for their children or managing their own careers, health issues, and other commitments.

“Research suggests that caregiver support programs result in better outcomes for patients and their family caregivers,” says Cristina Hendrix, DNS, GNP-BC, FNP, FAAN, associate professor and director of the Duke Elder Family/Caregiver Training (DEFT) Center, which develops, implements, and evaluates an innovative and scalable model for teaching, training, and supporting caregivers who assist and care for patients at home following a hospital discharge.

“It has always been the responsibility of nurses to prepare caregivers for home discharge but in the past two decades, nothing has really changed about how we do it despite the increasing role of caregivers at home,” says Hendrix.

Integrating Family Caregivers into Post-Discharge Care Despite the positive results, many hospitals and health

systems are stretched too thin to deliver formal training programs.

Hendrix developed a model that provides caregiver support and training in a way that health systems and hospitals can integrate within their hospital workflow by their own workforce. She believes that this is key for the caregiver program to be adapted and sustained.

The Duke Elder Family/Caregiver Training (DEFT) Center at Duke School of Nursing is a bridge between admission and discharge and primary care follow-up or acute/post-acute care. The Duke Endowment provided funding to develop and implement the nurse-led initiative.

The program removes the most significant barrier to helping family caregivers: identifying them. In many cases, the primary caregiver isn’t the next of kin or listed as the emergency contact in the medical record.

DEFT built a caregiver consult order that resides in the medical record, which allows the inpatient team to identify the primary caregiver and their contact information. The DEFT team then contacts the caregiver and conducts an assessment to uncover special needs, concerns, and support before training is scheduled.

In the sessions, DEFT facilitators review factors of a successful discharge. They also teach critical skills like giving shots and injections,

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providing wound care, cleaning of central lines, and understanding body mechanics. Trainings were delivered in person and in a group Cristina Hendrix setting until COVID-19 hit, forcing implemented at scale, can have an important impact on readmissions, the program to move online. This improving value-based care efforts and quality ratings. created an opportunity to deliver the Hendrix notes that caregivers are in a diverse range of circumstances, content on demand at the caregivers’ sometimes having short-term responsibilities and other times needing to convenience. adjust to supporting a loved one for the long-term.

“This meant we could offer “Each caregiver has different needs,” says Chelsea Landon, who training to more people without Chelsea Landon enrolled in the online program when her mother was hospitalized with any time constraints,” says Doreen COVID after visiting from out of town. “I was very lucky with my Matters, DEFT’s program director. “Now we’re expanding to a mobile mother. She recovered very quickly. But while she was in the hospital, application that will allow us to push notifications and reminders and in that initial period of bringing her home, is where I really needed to caregivers, while helping us track the users’ progress through the the support.” curriculum.”

Landon observes that it’s often hard for people to ask for help, so.

After training is completed and the patient is discharged, DEFT having somebody from DEFT think to call just to check in and ask what team members follow up with caregivers to reinforce training, answer they could do to help made a huge difference to Landon for her situation. questions, and connect caregivers to community-based resources.

The DEFT staff provided recommendations on what Landon could “Caregivers of older adults – a spouse or sibling – not only need skills, release from her responsibility and helped her see steps she could take to but they also need support,” Matters says. “Discharge to home after a resolve certain obstacles or matters she was facing. “The staff was able to complex hospital stay is daunting. We coach caregivers to ask questions read me and dial in on how they could help,” Landon says before discharge, so they can prepare for the ‘what ifs.’”

Caregivers continue to rate the DEFT training sessions very highly and Addressing Health Inequity are satisfied with the knowledge and support they received. Discharge planning and preparation are key components of Hospital Consumer & Social Determinants of Health Assessment of Healthcare Providers and Systems scores. Customer DEFT can also be an important element in a hospital or health experience and satisfaction are important elements of reimbursement system’s efforts to improve equity and mitigate negative social models, including the Medicare STARS ratings, which reflect how well determinants of health (SDOH). plans and providers perform across a section of quality measures.

DEFT’s focus on the home environment and the family caregiver’s “Changes in medications, functional status, nutrition, and mobility: situation makes it possible to factor in SDOH and deliver training and these all increase an older adult’s vulnerability for adverse events post support to mitigate impacts. discharge,” says Matters. “It’s important that caregivers are prepared “Patients who lack access to resources rely more on their family and serve as advocates for their loved ones, and have the confidence caregivers for support and for their needs at home,” Hendrix says. “A and skills to navigate the complexities of any health system. Nurses tailored program, offered online and via an app, allows us to assist patients are integral to helping older adults and their caregivers optimize their and caregivers who are often underserved and under-represented.” health and prevent readmission.”

Getting Results Hendrix believes that caregivers will continue to have important roles in health care as the U.S. population gets older and lives longer.

As Hendrix and her team evaluate the online program, A program like DEFT complements patient DEFT’s pilot study gets results. DEFT demonstrates that implementing LEARN care and positions nurses to train and support a caregiver training and support program in an academic medical center is MORE ABOUT caregivers, thus improving the quality of care possible. Readmissions in the elderly have decreased by almost 50-percent DEFT during the pilot. This underscores how a program like DEFT, when that patients get at home.

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NEW FACULTY

Interviews by LaWanda McCreary Photos by Andrew Buchanan

Stephanie Ibemere, PhD, RN

Jamie Lord, DNP, MSN, RNC, PMHNP

ASSISTANT PROFESSOR

ASSOCIATE PROFESSOR

BS in natural sciences, BA in Spanish, and MSN, Xavier University

BA in education, BS in nursing, University of North Carolina at Chapel Hill

PhD, University of Cincinnati

MSN in nursing education, University of North Carolina at Greensboro

Postdoctoral Fellowship, Duke School of Nursing

Master of Psychiatric Mental Health - Nurse Practitioner, University of Virginia

What brought you to Duke?

The opportunity to contribute to, work with, and learn from Dr. Paula Tanabe and the Sickle Cell Disease research team brought me to Duke. I was hired to work with Dr. Tanabe following my PhD studies as a postdoc on her randomized control trial, COMPARE-VOE. While in my tenure as a postdoc, an opportunity to apply for a faculty position became available and I put my hat in the ring for consideration. It’s an honor to have my work thus far recognized by the school and to now be on faculty with so many esteemed colleagues.

Tell us about the focus of your work.

I am currently working in sub-Saharan Africa, focused on improving the quality of care that sickle cell warriors receive through capacity-building techniques (e.g. nurse champion model) to improve a provider’s ability to manage sickle cell disease. In the U.S., my research program is focused on understanding how we can improve the outpatient sickle cell care experience by better understanding patient satisfaction, leveraging technology, and engaging advanced practice providers as a means of expanding access to high quality care.

What important advice did you receive as a student?

A phrase that remains with me and I must often remind myself of is “trust the process.” I received this advice in the first year of my journey to PhD. This phrase helps me think about the entirety of my journey as just that—a journey rather than the destination. It is a reminder that growing in your knowledge comes with growing pains and amazing victories, all of which are part and parcel of the journey.

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DNP, Western Carolina University

Tell us about your clinical, academic, or research interest and why you are passionate about this topic.

I love bringing the different facets of the mental health world into the classroom to prepare the students to work in a variety of settings. The PMHNP degree covers the lifespan in every setting. Each setting requires a different approach and specific nuances to best meet the needs of the clients. We continue to shape the program to reflect the plethora of clinical aspects by implementing a variety of simulations, clinical processing groups, clinical opportunities, and course work. It is so rewarding to watch the students enter the program and grow into phenomenal providers to meet the needs of the mental health clients.

Who has influenced you the most in life?

My belated mother was an amazing woman who was the most influential person in my life. She taught me to always be loving and kind, especially to those in need. No one was left out when she was present, as she would go to the person and make a connection to make them feel welcome.

My siblings and I were raised to participate in her volunteering efforts at young ages—with Meals on Wheels, assisting at a local children’s home, helping with food and clothes drives, and other activities that impacted my life in ways I did not understand until I was older. Her passion to help others with her sense of calm, positivity, and always seeing the good in others provided me the basis of my philosophy in life.

What is your favorite part of your work at Duke?

I love the energy from the students, staff, and faculty at Duke. There is a strong current of excellence in education driven from a desire to learn and teach from everyone. I was most impressed by the motivation of the students in the classroom and clinical arenas.

PROMOTIONS

Sean Convoy

Staci Reynolds

PROMOTED TO ASSOCIATE PROFESSOR TRACK II

PROMOTED TO ASSOCIATE PROFESSOR TRACK II

Margaret Bush

Ragan Johnson

PROMOTED TO PROFESSOR TRACK II

PROMOTED TO ASSOCIATE PROFESSOR TRACK II

Blanca Iris Padilla

Brandon Knettel

PROMOTED TO ASSOCIATE PROFESSOR TRACK II

APPOINTED AS ASSISTANT PROFESSOR TRACK I

Desi Newberry, DNP’12, NNP-BC INSTRUCTOR BSN, Michigan State University MSN/NNP, University of North Carolina at Chapel Hill DNP, Duke University School of Nursing

Tell us about your clinical, academic, or research interest and why you are passionate about this topic.

My research background involves non-invasive monitoring of neonates in the neonatal intensive care unit, including the utilization of placental blood for admission labs and transcutaneous bilirubin monitoring.

What do you want the public to know about your research? Why is this important?

I am currently focused on diversity of NNP faculty and students, as more diverse faculty has the potential to increase diverse nursing student recruitment and retention, increase cultural competence, and decrease implicit bias—and could potentially expand diversity in the nursing workforce, resulting in improved outcomes for neonates in the NICU. What is your favorite part of your work at Duke?

The best part about working at Duke is the intra- and interprofessional collaboration opportunities. These opportunities allow me to give my students the best learning experiences.

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DUSON Alumni and Friends Serve Their Communities

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hen their communities need help, alumni and friends of Duke University School of Nursing step up, whether that means providing direct nursing care or supporting other individuals or organizations providing care. “The word that comes to mind is service,” says Ellen Donaldson, BSN’81. “As nurses, we provide such an amazing service to patients and their families and our colleagues in the health professions. Lots of times people who have that service mindset can go on to provide service to the communities in which they live.”

Ellen Donaldson and Dave Cable, founders of the Davidson Community Foundation.

Supporting Community Nonprofits

by Creating a Foundation Donaldson worked for three years as an ICU nurse at Duke before moving north and transitioning to a corporate career, first in the pharmaceutical industry and then in medical communication. She sold her medical communication company in 2005 and a few years later, decided to make some changes. She wanted to be closer to her elderly parents in North Carolina, and she wanted to get involved in a local community. “I wanted to give back because I’ve been so blessed,” she says.

“I ended up retiring from corporate life and moving down to Davidson and starting a whole new life.”

She got involved right away, joining numerous local boards and committees, including the Town of Davidson Planning Board. The more she learned about the town’s needs and resources, the more she believed that the town needed a community foundation. That’s why she and a friend, Dave Cable, founded the Davidson Community Foundation, a donor-advised fund under the umbrella of the Foundation for the Carolinas.

The Davidson Community Foundation raises money and awards grants to local nonprofits that serve clients in need of support. “Our idea is to not get a piece of the existing pie, but rather to dramatically grow the pie

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through our leadership and engagement,” she says. “We help assess the need and galvanize the community around addressing those needs.”

She and Cable spent months interviewing community members, both philanthropists and those in need of philanthropy, before launching the foundation in April of 2020. Because of the timing, the initial three rounds of grants addressed the economic needs of families affected by the pandemic. The foundation raised $350,000 and, by giving grants to nonprofits, helped 230 families, totaling a little more than 750 individuals. “None of the people we helped got evicted and none of the people had to default on their mortgage and everybody had food on the table and kept the utilities on,” she says. The foundation also helped keep some local nonprofits afloat.

Now the foundation is pivoting to focus on affordable housing. In particular, the foundation is working to support “naturally occurring affordable housing” in the historically African American West Davidson community. Many are seniors and own their homes, but may not have the resources to make safety renovations and upgrades, such as getting the electrical wiring up to code. The foundation also plans to help increase the availability of affordable rental housing in Davidson, a college town of 15,000 that is one of the wealthiest towns in North Carolina. “We want to help provide affordable housing so the police officers and fire fighters and teachers and nurses who serve us valiantly every day can afford to live in this college town,” Donaldson says.

Volunteering During Disasters As a nurse, Steven Powell, MSN’19, likes helping people recover from illness or injury. He also likes helping communities recover from disaster. As a nurse and clinical advisor for Client Success at Elemeno Health, he does both.

Powell works with the VA’s Disaster Emergency Medical Personnel System (DEMPS), and in that role, he periodically responds to calls to travel to other communities and help out in the aftermath of a disaster, such as an earthquake, hurricane, or COVID-19 spike.

“DEMPS has been one of the most rewarding experiences in my nursing career,” he says. In the past couple of years, he’s been deployed to Puerto Rico, New Orleans, Dallas, and Little Rock. In each deployment, he spent two weeks working daily 12-hour shifts in a local VA. “Every one of those missions, I’ve been very grateful for the opportunity to be a part of recovery and be a part of relief,” he says, “but my most recent deployment to New Orleans was like a homecoming for me because, of all the cities I’ve lived in, New Orleans was the first city that I got to pick.”

Steven Powell

By Mary Russell Roberson

Christy Bell

Providing Free Health Care to the Uninsured Christy Bell, the father of DUSON alumna Liz Bell, BSN’08, MSN’12, has retired from his career in health insurance and health care administration. But he is still working hard to improve health care delivery, particularly to those most in need.

A member of the DUSON Board of Visitors since 2009, Bell moved to Southport, North Carolina, about 10 years ago. Soon after arriving, the priest at his new Steven Powell, center, with Donald M. Remy, Deputy Secretary of the U.S. Department of Veterans Affairs, at left, and Fernando Rivera, church asked him to serve on the Director/Chief Executive Officer of the Southeast Louisiana Veterans Health Care System Fernando Rivera, at right. board of the New Hope Clinic.

The New Hope Clinic, founded Powell, who is Peruvian-American, grew up all around the world, in 1998, offers free medical, dental, and pharmaceutical care five days a including stints in Qatar, Malaysia, Russia, and Argentina. As a high week to low-income and uninsured residents of Brunswick County. “It’s remarkable,” Bell says. “They have over 150 volunteers, including a dozen school student, he decided he wanted to attend college in New Orleans each of doctors, nurses, pharmacists, and dentists.” New Hope Clinic is in part because the city was recovering from Hurricane Katrina and he located in Southport, with a satellite clinic in Shallotte. Today, Bell serves wanted to contribute to that process. He’s drawn to disaster response as the chair of the board and helps with tasks including supporting the because of a desire to serve. His grandfather, who passed away last executive director, carrying out strategic planning, recruiting volunteers, year, served in the military. “The interactions I had with him really and raising funds. “Of the funds raised, 94% goes directly to medical care; inspired me to want to continue that act of service,” he says. Powell, we have about 6% overhead,” he says. “People know when they are making a a self-described people person, says his well-traveled childhood and donation it’s going directly to patient care.” multicultural heritage help him relate to patients in VA hospitals, Bell says the clinic, which is supported in part by The Duke Endowment who come from a wide variety of backgrounds and often have served and Duke Health, has made a huge difference in the lives of people who overseas in areas near where he’s lived. And his experience in the VA live in Brunswick County. Not only has the clinic improved the health helps him relate to patients in different communities during DEMPS of its patients, but it’s also helped reduce the number of ER visits by deployments. “As nurses we interact with many different patients on a uninsured patients who had no primary care doctor. “I’m very enthusiastic regular basis,” he says, “and that experience translates into being able about the clinic in part because I’ve seen and heard patient stories and the difference it makes in patients’ lives,” he says. “When you see that, it’s hard to best serve those in different communities who are going through not to be enthusiastic.” trauma and [to meet] their individual recovery needs.”

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CLASS NOTES NANCY MUNN SHORT, BSN’76, is the editor of Milstead’s Health Policy and Politics: A Guide for Nurses, 7th ed., published by Jones & Bartlett Learning in August 2021. The name honors the founding editor of this textbook that is sold in 22 countries.

Nancy Munn Short

Mary Ann Peter

1960s

1970s

MARY ANN PETER, BSN’62, MSN’65, began swimming again in 2015 and entered her first masters swimming meet in July 2021, the Masters Swimming National Championships in Greensboro, NC. She finished first in the 50-yard, 100-yard, and 200-yard backstroke and the 50-yard breaststroke.

She has been a potter since retirement.

She lives in Hillsborough, NC.

CONNIE BOSSONS BISHOP, BSN’75, DNP’12, is currently teaching part time at Chamberlain University in the MSN program and in the informatics program at DUSON. She also served as Elector Teller for NCNA 2021 convention. She’s a proud emeritus member of DUSON’s Nursing Alumni Council (NAC). “I love being part of the NAC because I get to stay connected and learn about new initiatives,” she says.

BRENDA HEMPHILL STONE, BSN’66, was interviewed about her experiences as a Navy nurse during the Vietnam War by the Veterans History Project of the Library of Congress American Folklife Center. The project was created by the United States Congress to collect and preserve the firsthand remembrances of U.S. wartime veterans.

DEBORAH WILLIAMSON, BSN’72, retired and moved to Durham in May 2021 with her husband Dave Garr to be closer to their daughter, Rebecca, and grandchildren, ages two and four.

Rebecca works with the Margolis Center for Health Policy at Duke University and her husband is VP for Development for Northwood Ravin. Their son, Joshua, lives in Washington, DC, and works at Georgetown Medical Center.

1980s ALLANA HARPER MINNICK, BSN’83, retired in May after 38 years at WakeMed. She spent the last 36 years

KATHRYN BULS CARPENTER, BSN’78, is the senior vice president for the new system, CommonSpirit Health, which formed from the merger of Catholic Health Initiatives (CHI) and Dignity Health, to form the largest nonprofit health system in the country.

Alanna Harper Minnick

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DUKE UNIVERSITY SCHOOL OF NURSING

in the NICU as a staff nurse, preceptor, supervisor, and neonatal transport nurse.

ANNE WALTERS, BSN’83, is the director of the Camden County Department of Health & Human Services in Camden County, New Jersey.

She assists with COVID testing, vaccinations, and education.

2000s KELLY THOMPSON-BRAZILL, MSN ’02, DNP ’16, was promoted to associate professor at Georgetown. She was also appointed as a panelist for the Society of Critical Care Medicine’s ICU Design Guidelines Panel, which is writing the 2024 ICU Design Guidelines.

BURTON SHELTON, MSN’04, completed a DNP in 2021 from UNC-Greensboro School of Nursing.

2010s EDWIN AROKE, MSN’11, received several awards this year including the 2021 Mary Hanna Memorial Journalism Award from the American Association of PeriAnesthesia Nurses and the 2021 Researcher of the Year Award from AANA Foundation.

Since the establishment of the AANA awards, Aroke is the second CRNA to be recognized for excellence in research and teaching (after receiving the 2020 AANA Didactic Faculty of the Year Award). He was also selected for Induction as 2021 Fellow of the American Academy of Nursing.

AMANDA DAVIS, MSN’14, graduated from Vanderbilt University in June 2021 with a PhD in Nursing Science. In August 2021, she began working as a clinical assistant professor and traditional BSN coordinator at Mercer University.

Amanda Davis

CARLIE FELION, MSN’13, POSTMASTERS PMHNP CERTIFICATE ‘20, is living in Scottsdale, Arizona, and working full time at the Mayo Clinic providing care to medically-complex patients with Crohn’s disease, ulcerative colitis, and other gastrointestinal problems. She is also in her second year of the PhD in Nursing program in the Precision Science track, focusing on psychoneuroimmunology as it applies to immune-mediated gastrointestinal diseases. She received the prestigious University Fellows Award and is a member of the Arizona Area Health Education Scholars Program.

SUSAN HAYNES LITTLE, DNP’17, is the chief public health nursing officer for the NC DHHS. She received the North Carolina Nurses Association 2020 Health Systems Nurse of the Year award and was inducted as a Fellow of the AAN in October. She published three articles about the public health nursing specialty in peer-reviewed journals in 2021 and continues to serve DUSON as a consulting associate and member of the D-CHIPP and Academic Program Advisory Boards.

CARSON MCCAFFERTY, ABSN’13, is currently the clinical director of Eye 35 ASC and a surveyor for the American Association for Accreditation of Ambulatory Surgery Facilities (AAAASF). McCafferty was recently selected to sit in the standards committee for AAAASF.

Carson McCafferty

Susan Haynes Little

CAROLINE FRANKS MAHONEY, ABSN’16, and her husband, Carter, welcomed a son, Evan Richard Mahoney, on August 24, 2021. They live in Charlotte, NC, with their golden retriever, Magnolia.

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CLASS NOTES

2020s DWAYNE BELL, MSN’20, transitioned from critical care nurse to Nurse Practitioner Intensivist during the pandemic.

CLAIR SECKNER DILLEY, ABSN’20, was diagnosed with osteosarcoma in 2020. After 65 inpatient hospital days, 25 blood transfusions, and many other complications, she received the news in August 2021 that scans are clear and she is in remission. She has been volunteering with the Virginia Medical Reserve Corps to get the community vaccinated and with the American Red Cross seeking blood donations.

Gabriela Mota-George

GABRIELA MOTA-GEORGE, MSN’20, earned the Post-Graduate Fellowship in Oncology Nursing Program at The University of Texas MD Anderson Cancer Center. Throughout the 12-month fellowship, she will train to serve as a future clinical expert in a complex oncology care setting.

Dwayne Bell

Clair Seckner Dilley and Andrew Dilley

Support Our Students Today Your support of the School of Nursing Annual Fund enables us to prepare the next generation of nurses to become leaders in their field—nurses who provide the highest quality of care to patients, reduce health inequities, and improve health outcomes for real people, families, and communities.

To learn about ways to give, please contact: Sarah Blumig, sarah.blumig@duke.edu Or call the Office of Development and Alumni Affairs, 919-684-8862 To make your gift online, visit gifts.duke.edu/nursing

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DUKE UNIVERSITY SCHOOL OF NURSING

GIVE HERE

IN MEMORIAM

1940

School Awards Posthumous Degree to Carol Darwin

Dorothy Bigos, N’44

The Duke University Office of

Jean Bundy Scott, N’47

the Provost approved a request from Duke University School of

1950

Nursing to award a posthumous

Pauline Walters, N’51

Doctorate of Nursing Practice

Mildred Teague Evans, N’52

in honor of DNP student Carol

Margaret H. Christy, N‘53

Darwin at the Spring 2022

Edith Moore Nichols, N’55

Hooding and Graduation

Virginia Neelon, N’57

Ceremony. Darwin, 34, beloved

1960

friend, died suddenly at home

wife, mother, daughter, and

Sandra Walsh, BSN’60

on December 21, 2021.

Margaret C. (Peggy) Wilbor, BSN’61

Darwin joined Duke in 2017 to

Joyce Lee Hayman, BSN’67 Robin Graham Wellman, BSN’67 Lesley-Ann Carpenter Grilli, BSN’64 Patricia St. Georges, BSN’62

Carol Darwin with her son, Carter, at the 2018 Hooding and Graduation Ceremony.

pursue an Adult-Gerontology Nurse Practitioner—Acute Care

post-graduate certificate and subsequently began pursuing her DNP. She served as a dual-certified adult-gerontology primary care and acute care nurse practitioner at Louisville Emergency Medical

1970

Associates, in Louisville, Kentucky.

Patricia F. Prather, BSN’71

Darwin was an extraordinary nurse and nursing leader. She served as

Diane Melahn, BSN’75

1980

president-elect of the Kentucky Association of Nurse Practitioners and Nurse Midwives and as APRN council member of the Kentucky Board of Nursing, a position to which the state governor appointed her.

Karen T. Goggin, BSN’83

In recognition of service to community, state, and country, she was

2010

of the Kentucky Colonels—the highest honor bestowed by the State

Marcia Zuzul, DNP’13

2020 Tabitha Thompson, MSN’20

appointed by Kentucky Gov. Andy Beshear to the Honorable Order of Kentucky. Additionally, she received the American Association of Nurse Practitioners’ Advocate State Award for Excellence for the State of Kentucky.

Darwin’s mother, Laura Pollock, received the degree on behalf of her late daughter. Additional family members in attendance include Carol’s husband, Robert; children, Carter and Luna; and father, Dr. Samuel Pollock, a 1976 graduate of Duke Trinity College of Arts and Sciences.

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Duke University School of Nursing

Duke University School of Nursing

BOARD OF VISITORS

NURSING ALUMNI COUNCIL

JULY 1, 2021-JUNE 30, 2022

Bimal R. Shah, MD ‘01, MBA ’01 CHAIR

Guy C. Arnall, Jr., BA ’85 Amy E. Bell, DNP ’17 Michele Chulick, BSN ’77 Lynn K. Erdman Joanne L. Mazurki, BA ’74 Bettye M. Musham, N ’54 Maria Del Pilar Rocha-Goldberg Ruth C. Scharf, BSN ’80 Carolyn Scott Pamela M. Sutton-Wallace, MA ’94 Orit R. Szulik James E. Vanek, Jr., BS ’01

Emeritus Members Christy W. Bell Charles C. McIlvaine, BA ’87 Brett. T. Williams, BS ’81 Sheppard W. Zinovoy

JULY 1, 2021-JUNE 30, 2022

Officers Andrew R. Benson, MSN ’09 PRESIDENT

M. Christine Fulgencio, MSN ’99 VICE PRESIDENT

Luisa Soler-Greene, DNP ’14, MSN ’13 SECRETARY

Members Phylis Christian Alford, BSN ’75 Dwayne E. Bell, MSN ’20 Sandra A. Davis, BSN ’82 Ellen G. Donaldson, BSN ’81 Kathleen V. Gallagher, BSN ’75 Christine A. Long, BSN ’70 Heather B. Paradis, MSN ’95 Meghna Patel, ABSN ’14 Steven D. Powell, MSN ’19 Marcelle P. Scheyer, MSN ’16 Melisa A. Wilson, DNP ’20 K. Becky Zagor, BSN ’80

Emeritus Members Sally Ann Addison, BSN ’60 Sandra S. Averitt, BSN ’67 Connie B. Bishop, DNP ’12, BSN ’75 Laurel J. Chadwick, BSN ED ’53 Nancy S. Coll, N ’68 Nancy J. Davenport, MSN ’69, BSN ’67 Susan M. Glover, BSN ’70 Constance C. Kendall, BSN ’84 Carole A. Klove, BSN ’80 Virginia B. Lang, BSN ’67 Aliki H. Martin, DNP ’13 Marilyn R. McIlvaine, BSN ’58 Barbara Nims, BSN ’71 Christine Pearson, BSN ’84 Susan J. Rainey, BSN ’70 Martha C. Romney, BSN ’77 Ruth C. Scharf, BSN ’80 E. Dorsey Smith-Seed, BSN ’60 Judith Snyderman, RN Joan M. Stanley, BSN ’71 Martha S. Urbaniak, BSN ’67 Marianne T. Williams, BSN ’81 Barbara D. Yowell, BSN ’62

Alumni Reunion More than 80 alumni returned to campus to reunite and reconnect with classmates from their days at Duke. Held in conjunction with Duke University’s Reunions Weekend, alumni whose class years ended in 2 or 7 were able to experience an ABSN class and honor the Class of 1967 who were inducted into the School’s Half Century Society. Alumni from the Classes of 1970 and 1971 also returned to celebrate their 50th Reunion in-person, following two years of virtual events during the pandemic.

Gayle Bridtes Harris, BSN’72 (left) and Pamela Jones Reis, BSN’77 (right)

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DUKE UNIVERSITY SCHOOL OF NURSING

Judith Miller, BSN’71, Joan Stanley, BSN’71, and Carolyn Sexton, BSN’71

Nursing Alumni Council members left to right: Kathy Gallagher, BSN’75, Marianne Tango Williams, BSN’81, and NAC President Andy Benson, MSN’09

Become a Nurse Leader.

Earn Your MSN or DNP at Duke — While Continuing Your Career at Home Duke’s distance-based MSN and DNP degrees take your career to the next level. Graduates of our programs are nurse leaders, working to improve systems of care, patient outcomes, quality, and safety.

We advance nursing science on issues of global importance and foster the scholarly practice of nursing, helping nurses advance their careers.

Learn More! nursing.duke.edu/request-information SPRING/SUMMER 2022

33

Duke Nursing Magazine DUMC 3322 307 Trent Drive Durham, NC 27710

2022-2023 SPEAKERS Margarita Alegria, PhD, chief of the Disparities Research Unit, Massachusetts General Hospital and The Mongan Institute; professor, Departments of Medicine and Psychiatry, Harvard Medical School.

Regina S. Cunningham, PhD, RN, AOCN, FAAN, chief executive officer, Hospital of the University of Pennsylvania; adjunct professor of nursing, University of Pennsylvania School of Nursing.

Lauren Hilgers, journalist covering health care for The New York Times, The Guardian, and other publications worldwide.

Congresswoman Lauren Underwood, U.S. House of Representatives, Illinois-14th Congressional District.

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