Emory Nursing Magazine Summer 2020

SUMMER 2020

FACING A PANDEMIC Emory Nurses Survive, Thrive and Lead

INSIDE

BLAZING A TRAIL IN ETHIOPIA 10 SERVING IN HAITI 16 LEADING WITH HEART IN BOTSWANA 20

FEATURES 10

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Emory University is an equal opportunity/affirmative action employer fully committed to achieving a diverse workforce and complies with all federal and Georgia state laws, regulations, and executive orders regarding nondiscrimination and affirmative action.

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Emory University does not discriminate on the basis of race, age, color, religion, national origin or ancestry, gender, disability, veteran status, genetic information, sexual orientation, or gender identity or expression.

IN THIS ISSUE 16

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Facing a Pandemic.....2 Alumni, students thrive despite challenges

Leading in Ethiopia.....10 PhD candidate advocates for reform

Serving Haiti.....16 Haynes family continues decades of dedication

From Gabarone to Emory and Back.....20 Mabel Magowe honored with Sheth Award

Strengthening Research by Keeping it Local.....24 “Nurses have the best questions”

Cooking with Gas in Guatemala.....28 Air quality study makes progress

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PULSE 30

Dean, Nell Hodgson Woodruff School of Nursing

Linda A. McCauley 79MN Associate Dean and Chief Operating Officer

Jasmine G. Hoffman Director of Communications

J. Mike Moore Editor

Lane Holman Art Director

Laura Dengler Director of Photography

Kay Hinton Associate Director of Photography

Stephen Nowland Creative Director

Peta Westmaas

ALUMNI NEWS 34

SUMMER 2020

Editorial Contributors

Pam Auchmutey Debbie Carlisle Leslie Church Dana Goldman Kerry Ludlam Catherine Morrow Ema Perez Production Manager

Stuart Turner

FACING A PANDEMIC Emory Nurses Survive, Thrive and Lead

Executive Director, Communications & Marketing

Tionna Carthon Executive Director of Content

Jennifer Checkner Associate Vice President, Health Sciences Communications

Vince Dollard

INSIDE BLAZING A TRAIL IN ETHIOPIA 10 SERVING IN HAITI 16 LEADING WITH HEART IN BOTSWANA 20

Photo courtesy of Donté Flanagan

ON THE COVER | Donté Flanagan has answered the call.

Emory Nursing is published by the Nell Hodgson Woodruff School of Nursing (nursing.emory.edu), a component of the Woodruff Health Sciences Center of Emory University. ©2020.

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COVER STORY

Emory nurses take the lead in CHALLENGING TIMES

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or better or worse, everyone now has their own coronavirus story, no matter what our circumstances. Emory’s Nell Hodgson Woodson School of Nursing (NHWSN) has stories, too; through myriad perspectives. Read on to meet an alumnus doing life-

saving work in New Orleans; get to know some students through their stories of keeping their community together despite upheaval; and hear the latest from an Emory Healthcare nurse-leader who leads others in combatting deadly viruses.

Visit emorynursingmagazine.emory.edu for even more stories, including a look at how the School’s faculty, staff, and leadership came together to keep students safe, move classes and clinicals completely online, and ensure more than 130 students graduated on time in May.

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Breathing Room

By Roger Slavens

Donté Flanagan brings critical expertise to help coronavirus patients

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onté Flanagan 04Ox 06N MS DNP has one of the most difficult jobs on the front line of fighting COVID-19. As a certified registered nurse anesthetist (CRNA) based in hard-hit New Orleans, he’s been asked to cover emergency rooms and intensive care units to help in performing one critical task: Keep patients breathing.

“It feels like we’re in wartime here,” says Flanagan, who works at Touro Infirmary for LCMC Anesthesia. “My CRNA colleagues and I are stretching our scope of practice, going above and beyond our normal work in operating rooms. Since most elective surgeries and procedures have been postponed, we’re spending most of our time in ERs and ICUs, performing intubations, titrating sedation and paralytics, and administering mechanical ventilation.”

Intubation, in particular, is not only an unpleasant experience for patients, but also a tricky, specialized procedure.

“On paper, it seems like a straightforward, step-bystep technique, but in practice every case is different and presents unique challenges,” Flanagan says. “With some COVID-19 patients, we are seeing swollen or narrowing airways. Having the experience—and the visual expertise at recognizing the differences in anatomy by sight and feel—is critical in reducing the number of attempts. Extra attempts can further compromise or damage the airway.”

Flanagan estimates that he’s performed 10,000 intubations so far in his 10-year career as a nurse anesthetist, compared with a non-specialist who might have only performed 100.

“There is a different level of comfort and expertise that goes with it,” says Flanagan, who serves on Emory’s

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Nurses’ Alumni Association Board. “There’s a much greater chance at success if we are the first ones to attempt to manipulate the airway. That’s why we’ve been pulled in.”

All of the COVID-19 cases that reach this advanced stage have to be treated with great seriousness.

“We’re seeing patients coming in with pulmonary edema—fluid is building up in their lungs and they’re having a difficult time breathing,” he says. “Their tissues aren’t getting the oxygenation they need, and if we don’t intervene, eventually they go into acute respiratory distress or cardiac arrest.”

And Flanagan knows that even with successful intubation, COVID-19 remains a difficult foe to beat.

“When I intubate a patient struggling with the coronavirus, I do so knowing that in some cases I could be the last person they ever talk to,” Flanagan says.

COVER STORY “It feels like we’re in wartime here . . . my colleagues and I are stretching our scope of practice, going above and beyond our normal work.”

SUMMER 2020 |

Photo courtesy of Donté Flanagan

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“When I intubate a patient struggling with the coronavirus, I do so knowing that in some cases I could be the last person they ever talk to.”

Heavy Toll on Health Workers

Surviving the New Orleans Surge New Orleans’ hospitals saw a huge surge of cases in late March and early April, just weeks after hundreds of thousands of people enjoyed the city’s legendary Mardi Gras celebrations and traditional St. Patrick’s Day Parade despite the news that the coronavirus had reached the U.S. “I was screaming from the mountaintops about it, mainly because people just weren’t taking the risks seriously enough,” says Flanagan, who’s also worked as a CRNA in Atlanta and New York City. “I guess if you’re young and living in a big city, you feel like you’re immortal or immune and you don’t see the danger until you or someone you know gets sick. I knew the outbreak was going to happen—as did so many of my health care colleagues—but it didn’t matter. Like clockwork, the patients started arriving in droves.”

And although the health care industry predicted it, hospitals weren't fully prepared for the onslaught. “We were caught at first without the setup and the resources to fight the coronavirus,” Flanagan says. “At Touro, we had to convert two of our normal hospital units into isolation wards. And at one point our two main ICUs were completely filled with COVID-positive patients on ventilators. We even had a time where we couldn’t admit any more of them—we could only get them stabilized, intubated and on a ventilator, and then have to ship them to another hospital that had room.”

Over time, the city and its hospitals began to work more collaboratively and the outcomes improved, Flanagan says. “More units and floors in hospitals were turned into ICU units,” he says.

“We were able to borrow ventilators from pediatric wards and hospitals where they weren’t being used. We got better at using and reusing personal protective equipment (PPE).”

While the first surge of COVID-19 patients has slowed, Flanagan hopes they’ve learned enough to be prepared for future waves.

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Seeing so many patients in dire shape levies a heavy mental toll on Flanagan and his fellow front-line workers. “It’s difficult witnessing the outcomes, watching people suffer or even die alone since their families can’t visit them with the heightened restrictions in place,” he says.

Additional stress comes from being forced to work long shifts and the increased risk of becoming infected himself.

“Our shifts are very fluid, changing daily, and my days off are not necessarily guaranteed,” Flanagan says. “And when staff members test positive for the coronavirus and have to be quarantined, that pulls them out of the rotation and puts a heavier load on the rest of us. I don’t even look at my weekly schedule anymore—maybe just two days out at most—because it’s likely to change. This is a lot different from my pre-COVID job where most of my work was on a regular schedule and predictable, except for having occasionally to cover labor and delivery.”

Flanagan tries to maintain a positive attitude and remain in good spirits, but the daily grind of COVID-19 makes it difficult.

“I’m still coming in to work, still heeding the call to serve others in need, but there’s a sense of anxiety you can’t entirely escape,” he says. “We’re all wearing masks and gloves and maintaining our distance from each other as best we can.

However, we do so knowing we could get infected because of the tiniest slip we make in protecting ourselves. At the same time, the whole atmosphere has changed in the hospital—the isolation doesn’t just happen at home. We’re wearing our masks in the lounge unless we’re eating. It’s hard to hold a conversation when you’re geared up. It’s hard to stay connected.”

When Flanagan does get some time off, he has two rules: No discussing his work and no watching the news. He’d rather decompress and spend quality time at home with his fiancé.

“We’re getting to know each other even better by going through this together,” Flanagan says. “She’s been my solace.”

Still, Flanagan says, he had to tell his fiancé from the start that they both had to live as if they had tested positive for COVID-19 and were likely carriers—even if they exhibited no symptoms. That’s meant they’ve had to keep their exposure to the outside world as low as possible.

“I know it's the best way to treat it to avoid spreading the risk to others given the high risk I have for being infected,” he says. “It wouldn’t be fair.”

Alexis Perkins 20BSN

Kartis Connors 22ABSN

On a warm and sunny spring day, the president of Emory Nursing’s senior class, Alexis Perkins 20BSN, spread out her schoolwork and prepared to get to work in a new office—the backseat of her mom’s silver Toyota Camry, parked in her parents’ driveway. She opened the car windows, made sure her home’s wifi reached her laptop, and logged into class.

“It was really nice to get some fresh air and have a change of scenery,” Perkins says without sarcasm. A month before, she and her classmates had received notice that Emory’s campus was closing because of COVID-19 and Perkins had hurriedly packed her belongings, hauling them the 30 miles back to her childhood home in Loganville, Georgia. It was an unceremonious and abrupt ending to a college experience she had loved. “It was hard, a very emotional time period—our world was flipped upside down,” Perkins says.

Since then, Perkins, along with more than 130 other students, graduated on time. “I’ve heard a lot about how other schools treated their students during the pandemic, and I’m really glad I was at Emory when it happened. All our professors and administrators were so supportive with whatever we needed, even if it wasn’t related to class.

Professors made themselves available to us, whether it was staying later after Zoom meetings, or having office hours or being on their emails later than the usual time—even if we just felt like it was all too much and we needed someone to talk to, they were there for us. There was so much support to help us get through that time.”

Perkins is continuing to work PRN as a Patient Care Specialist for pediatric patients with blood disorders, cancer, and those requiring a bone marrow transplant at the Egleston Hospital campus of Childrens’ Healthcare of Atlanta (CHOA) in Atlanta. “As a health care provider, you see a lot of scary things,” she says. “But throughout nursing school, we’ve talked about how to protect ourselves, so for me I feel like I’ve trained for this and this is what my education has prepared me for.”

She hopes to start her planned residency with CHOA later this summer.

– Dana Goldman

Kartis Connors 22ABSN wishes she could be on the front lines. The former EMT was halfway into her first semester at the School of Nursing and had earned a nurse externship job at Emory Healthcare when COVID-19 shut down Emory’s campus and sent her back home to Florida. “I took a spring break trip, with one backpack and my laptop, and ended up staying for the whole summer,” she says.

Connors managed to stay motivated despite the abrupt changes that came with the pandemic. “The transition was hectic,” she says. “Everybody was very stressed. Focusing on time management, making sure I’m not missing assignments or Zoom classes was a challenging adjustment.”

Still, Connors counts her blessings, starting with Emory faculty. “The professors have done an amazing job. We were all very confused at first with everything going on. As soon as they had answers, they were communicating them to us. With exam and assignment changes, classmates in different time zones all over the world, and this entire transition to online classes—the professors have been very accommodating.”

She’s also grateful for classmates, and continues to keep up with them as they move into summer sessions.

“We’re very close and have group chats to make sure that everyone can stay on top of things. We’re holding each other accountable, and I couldn’t do it without them.”

Connors is excited to get back to Atlanta for fall classes, although the University has not determined how classes will be held.

Still, COVID-19 and the unusual start to her nursing education has not deterred Connors from her goal of becoming a nurse. “I like working with people and being there for them,” Connors says. “It’s why I chose this field.

You’re going to put yourself at risk in a lot of careers, but if you’re passionate about something it overweighs those risks. This is really scary but we’re learning so much from it.”

– DG

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Rachel Querido 21ABSN

Adam Bullock 20ABSN

Rachel Querido 21ABSN was enjoying starting over.

After seven years of serving in the military, the army captain was loving her first semester at Emory’s School of Nursing. “As a military officer I couldn’t necessarily be friends with everyone because of the rank structure,” she says. “But at Emory I’m equal to everyone and made friends quickly. I love it.”

In early March, ready to put down roots, she bought a house in Atlanta. Then COVID-19 hit home—literally.

In New York, Querido’s father became sick. “He had felt perfectly fine and then six hours later he got hit with fevers, chills, and severe body aches,” Querido explains. Her mother fell ill as well, with a milder form of the illness; happily, both parents have fully recovered and are back to their usual lives.

The past months since have been challenging, to say the least. Querido’s classes went online. Querido helped her sister evacuate back to the U.S. from New Zealand.

She began preparing to move to her newly purchased home. And, most importantly, Querido monitored her parents’ COVID symptoms from afar.

“It was tough not being there with my them,” Querido says. While her mother’s illness was limited to body aches and fatigue, her father spent weeks dealing with severe symptoms including difficulty breathing. “We kept measuring his oxygen levels and thankfully he never got to the point of needing a hospital,” Querido says.

One bright spot, she says, is that “my professors have been really supportive.” Professor Helen Baker [PhD MSc, FNP-BC], who teaches bioethics, has been hosting online gatherings so that the cohort can support one another.

And Querido is grateful for her schoolwork. “Studying is keeping me busy. I need to do well in school, and I have to pay attention to what I’m learning so that when the time comes to be able to practice, I know what I’m doing.”

Happily, Querido reunited with her dad when he came to Atlanta in May to help her with her new home. “I gave him the biggest hug—and can’t wait to see my mom, too” she says.

– DG

“I was really loving clinicals,” says Adam Bullock, remembering life before COVID-19. This spring, before the pandemic hit, Bullock was at Children’s Hospital of Atlanta for his pediatric rotation. “Going to the hospital was what I looked forward to every week. It’s always really fun to apply what I’m learning in real time.”

Now, Bullock’s life has narrowed considerably. His rotations became virtual simulations. In addition to clinicals, the School of Nursing’s summer immersion trips were also cancelled. Bullock had been looking forward to providing healthcare to farmworkers in Moultrie, Georgia. “I had to delete everything from my calendar,” he says.

One bright spot, however, is that the immersion cancellation made room for him to work Sundays at the Clarkston Community Health Center, just outside of Atlanta in Clarkston, Georgia. Bullock helps with logistics and some patient screening with questionnaires for COVID-19 testing.

Bullock is doing his best to practice self-care. “I cook more than I used to,” he says. “I’ve started baking some.

I take a lot of time away from the computer, especially on days I don’t have classes or upcoming deadlines. And I’m staying in touch with friends and trying to keep each other emotionally as normal as possible.”

It helps, Bullock says, to be so inspired by nurses working so hard. “I feel good about the people I go to school with and the program I’m in. Everyone is very much interested in what’s going on and isn’t scared to be a nurse. I’m so proud to be going into nursing when I see all the nurses and advanced practice students persevering through all of this and going to work and doing the job they signed up for,” he says. “The only thing I wish I could change right now is that I wish I could be helping. I wish I could be on the front lines with them.”

– DG

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COVER STORY

In this file photo taken before the 2020 pandemic, Vanairsdale pauses at the door of a patient room.

Back to the Front Lines

By Dana Goldman

Vanairsdale leads colleagues in adapting to a new normal

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e can never assume that our environment is clean,” says Emory nurse Sharon Vanairsdale 18DNP APRN. As program director for the Serious Communicable Diseases Unit at Emory University Hospital, if anyone is at the center of Emory’s COVID-19 response, it’s Vanairsdale.

For nurses and health care providers coming from other specialties, Vanairsdale says that the coronavirus pandemic is a crash-course in infection prevention and control. “We must be very intentional with our environment and movements.

We need situational awareness about every item we’re about to touch. We must sanitize surfaces before we put things down on them. We have to be very deliberate about how we put on gowns, masks, and gloves and how we take them off.”

Vanairsdale was on the front lines of Emory’s Ebola response in 2014. Now, Vanairsdale is working with colleagues across Emory Healthcare to share her expertise on best practices for treating infectious disease.

“We’re in response mode,” says Vanairsdale, who is also the founding director of education at the National Emerging Special Pathogen Training and Education Center. “Our focus is providing the best care possible for our patients,

whether they have COVID-19 or not, and my role is to help support the front-line staff so they can do what they need to care for our patients.” Her 12-hour-plus workdays include daily meetings with infection prevention managers and twice-daily incident command meetings. Vanairsdale also collaborates with Emory Healthcare colleagues to troubleshoot supply chain issues, operationalize social distance and masking guidelines, clarify how and what to communicate to staff, and strategize on how to ensure the health and wellbeing of patients without the coronavirus.

Vanairsdale has been pleased to see her colleagues adapting so quickly to the new normal. “It’s so cool to see staff, especially nurses, figuring out operating procedures that work for them. On some units, they've taped the floors to know where to walk and where not to walk. What we do in one location isn’t always translatable to another, so they’re thinking creatively and coming up with workflows that allow them to provide the best care possible.”

While her days are long, Vanairsdale says she is inspired by her colleagues and the larger community. “I have never been prouder to be a nurse. I hope everyone knows there are amazing individuals providing amazing patient care, with teams working behind the scenes to support them. It’s an incredible, yet challenging time to be in health care. It’s inspiring for sure.”

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Leading for CHANGE

By Kerry Ludlam

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ven over the phone, Lemlem Beza’s intensity comes through clearly.

She’s a student, a scientist, a leader, a mother—all at the same time—and you wonder how she manages it. Then, as the conversation progresses, you realize that heartbreak can be a powerful motivator—something Beza knows well.

“My elder sister bled to death after giving birth,” Beza says. “That moment made me decide that I was going to work in the medical field to help my family and my country.”

Beza was in eighth grade when her sister died. One of 17 siblings, she grew up in Fiche, a remote central Ethiopian village 120 kilometers from Addis Ababa, where she now lives.

Now a nurse clinician in the emergency department at Tikur Anbessa Specialized Hospital (TASH) in Addis Ababa, Beza also mentors and teaches postgraduate students at the bedside. She spends two days of the workweek performing her clinical duties and teaches one day a week. She reserves the remaining two days for her work in the Emory-Addis Ababa University (AAU) PhD in Nursing Program.

“I have a hectic and crowded schedule, but that is what it takes at this point,” she says.

Ethiopia's storied monument to the Lion of Judah stands a few blocks from TikurAnbessa Specialized Hospital in downtown Addis Ababa.

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ETHIOPIA sustainable partnership

Over a decade ago, Professor Lynn Sibley RN CNM PhD received a $5 million grant from the Bill and Melinda Gates Foundation to improve maternal and infant health in Ethiopia. At the same time, she was laying the groundwork for Emory-Ethiopia, a partnership that would bring Ethiopia its first nursing PhD program and launch an initiative to transform nursing practice in Ethiopia.

Since 2010, Emory nursing faculty and students have partnered with leaders, health workers, and community members in Ethiopia to implement and educate people on simple, low-cost solutions that can be used in any environment to improve maternal and infant health in Ethiopia. One example is Kangaroo Mother Care (KMC), which is the basic act of holding an infant in constant skin-to-skin contact during the first days of life. While it typically involves exclusive breastfeeding, any parent or guardian can provide KMC. “We have 35 years of science to show that KMC is effective in improving survival for low-birth-weight infants,” says Professor John Cranmer DNP MPH MSN ANP-BC, principal investigator for the KMC study. “It’s inexpensive and easy, but across the globe, it’s used with fewer than five percent of babies because people just don’t know about it. We’re working for it to become the standard of care for babies who need it.”

The partnerships and trust built between NHWSN faculty and staff and their local counterparts that started with Sibley’s work in Ethiopia have been fundamental in launching the broader Emory-Ethiopia Initiative. They have allowed for other projects to evolve, including the Emory-AAU PhD in Nursing Program and student-led regulatory changes to the nursing profession.

“The sustained partnership in Ethiopia is critical,” Cranmer says. “There is mutual trust and recognition of what each partner brings to the partnership to create meaningful discovery and science.”

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A hallway at Tikur Anbessa Specialized Hospital in Addis Ababa

Beza at hospital with Professor Philip Davis DNP MBA ANP-BC

the need

Health coverage is

inadequate, and

people are

suffering.

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Beza’s father, who had diabetes, passed away after an endocrine emergency. She believes he might have survived with adequate care.

“I grew up in a remote village where there is almost no health service,” Beza explains. “Health coverage is inadequate, and people are suffering. As an emergency professional, I have witnessed patients come to our emergency room with many complications, resulting in preventable deaths.”

Experiences like Beza’s are not uncommon in Ethiopia. Its health system struggles with maternal and infant mortality, a longer-living population with an increasing chronic disease burden, and infectious diseases, among others.

Adding to Ethiopia’s health care challenges is the lack of qualified medical professionals.

There is less than one medical professional per 1,000 people, far lower than the World Health Organization’s recommended minimum of 4.45 per 1,000. Most physicians work in private practice in larger cities. As for more remote regions, there are no physicians.

“In rural Ethiopia, nurses are critical to providing care, but there still aren’t enough of them,” explains Martha Rogers MD FAAP, director, Lillian Carter Center for Global Health & Social Responsibility and principal investigator of the African Health Workforce Project. “There are health extension workers, which are community-based health workers, but they are not a substitute for qualified nurses. Think about what can happen when there are no nurses to provide vaccines and engage in early child health care.”

ETHIOPIA

Beza and her extended family celebrate her mother’s birthday

Beza during her Emory visit last year.

the solution Lynn Sibley RN CNM PhD, a trusted colleague at both Emory and AAU with a history of work in Ethiopia, assembled a team in both Ethiopia and the United States to develop the Emory-AAU PhD in Nursing Program. One of Sibley’s research collaborators, Abebe Gebremariam MD, helped the group navigate AAU’s governance structure and make connections with key contacts in Ethiopia.

Gebremariam is now Emory’s in-country coordinator for Ethiopia.

With a focus on technology, the program offers a hybrid inperson and distance-learning curriculum. Students attend some courses at AAU and use tools like an interactive smart classroom to participate in NHWSN courses in real-time alongside NHWSN students. This use of high-tech teaching methods, combined with small class sizes, means students can connect and learn from each other despite the distance.

The Emory-AAU PhD course of studies relies heavily on mentorship, as well. “It is incredibly meaningful to mentor these students along the continuum from student to scientist,” says Rebecca Gary RN PhD FAHA FAAN, director of the Emory-AAU PhD in Nursing Program. “They’re very motivated, and mentors work with them on writing skills, dissertation development, and research methodology, among other things that will help them become nurse scientists and leaders.”

Beza, who is mentored by Gary, completed her intensive at Emory in the spring of 2019.

“My stay in Atlanta was wonderful because I could focus on my dissertation proposal work,” Beza says. “I collaborated with my advisor in person, spoke with her at length, and got her support and advice. I got to know many people that I can consult and work with in the future.” The intensive also provided opportunities for training in citation management, statistical software, and literature review. Of her time at Emory, Beza notes that it was hard work—but there was time to socialize, too.

“I had lots of fun and a great cultural exchange with my classmates and others,” Beza says.

The highlight?

“After a lot of work, I successfully defended my proposal,” Beza says.

Mentors work with students to make post-graduation plans, including post-doctoral fellowships or faculty opportunities. The hope is that these students will be a force for change—transforming the Ethiopian health system and increasing health coverage for all Ethiopians.

Currently, 11 students are enrolled, five have defended their proposals successfully, and one has graduated. That honor goes to Fekadu Aga, MSN, who graduated in 2019 and is now a Fogarty Global Health Post-Doctoral Fellow. Beza has also been awarded a Fogarty Global Health Post-Doctoral Fellowship with which she will examine community education interventions, risk reductions, and screenings for acute coronary syndrome.

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emory nursing in ethiopia Launched in 2015, the Emory-AAU PhD in Nursing Program is a collaboration between Emory School of Nursing and AAU. It is the first nursing PhD program in Ethiopia and the only one of its kind in Africa.

As part of the larger Emory-Ethiopia Initiative, the Emory-AAU PhD in Nursing Program has goals well beyond the education of individual nursing students. The program also aims to create a qualified, motivated workforce of nurse scientists, educators, and national nursing leaders in Ethiopia.

These trailblazers will sustain the program by becoming AAU leadership and faculty, while also working to bolster access to health coverage throughout Ethiopia.

The only woman from her family to have attended college, Beza will finish her PhD in late 2020, a crowning achievement after years of work. She earned her diploma in nursing from the Asella School of Nursing. Beza also has her bachelor of science degree in clinical nursing, her master’s of science in emergency medicine and critical care, as well as her nurse practitioner degree from AAU's School of Nursing and School of Medicine.

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ETHIOPIA lasting change While Beza is eager to complete her PhD, receiving her doctorate is only one step in her plan to change how health care is taught and delivered in Ethiopia. In addition to her studies and clinical work, she is also leading the charge to eliminate—or at least ease—many of the challenges nurses face in Ethiopia.

“Because there’s no standardization of the nursing curriculum, anyone can call themselves a nurse, or teach nursing,” Beza says. Additionally, physicians often decide what role nurses play in their practices or hospitals, so there is little consistency in different parts of the country.

“Currently, there is only one regulatory body for all medical professionals in Ethiopia, and it is very loose in scope and fragmented,” Beza says. “It’s important for nurses to have our own governing entity in place to both ensure quality of practice and delineate professional standards and day-to-day protections on the job.”

Fortunately, she’s not working alone. Beza has formed a task force of six, which includes a government leader from Ethiopia’s Ministry of Health, Linda A. McCauley PhD RN FAAN FAAOHN, dean and professor at Emory’s School of Nursing, and Rogers, to form a nursing regulatory body in Ethiopia and develop standards of care and practice. With the task force’s support, Beza is advocating for national reform, including the development of a national nursing council to set standards for training, licensure, and continuous professional education.

With the support of Rogers, Beza has leveraged connections to form a South-to-South collaboration between Ethiopia and Kenya, which already has a strong health workforce regulatory system in place.

“Lemlem developed the plan, and I just helped make the connections,” Rogers explains. “It is a smart strategy because it’s costeffective, any travel is just next door, and nurses in Ethiopia and Kenya are operating in a similar environment. They’re much more alike than different, and what worked for Kenya might very well work for Ethiopia in terms of putting a regulatory structure in place.”

Beza, along with the task force, visited Kenya in March 2020 to meet with regulatory boards, tour facilities, confer with Kenyan nurse leaders, and share ideas for how to implement regulatory practices in Ethiopia. Gary says that Beza’s work through the EmoryAAU PhD in Nursing Program gives her an advantage as she works to effect change.

“By virtue of having a PhD, she is prepared to sit at the table with other leaders and negotiate,” Gary says. “She has worked to elevate her own status so that she can make systemic change.”

For Beza, the Emory-AAU PhD in Nursing Program has uniquely prepared her for leading the task of transforming nursing and health coverage in Ethiopia.

“Having the chance to be part of Emory and see how nursing has its own scope of practice and regulatory body has shown me how I can change the system and do my part,” Beza says. “Having a PhD will lay the groundwork for making change. As I move forward in both my daily life and work, and in my collaboration with the task force, I’m empowered and confident.”

Having a PhD will

lay the groundwork for making .

change

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HAITI

Hope

By Pa m Au c h mute y

Photography by Kay Hinton

The island looked picture perfect from the air—a lush, green oasis surrounded by a turquoise sea.

But as the plane descended over Cap-Haitien, a port city on the north coast of Haiti, the ravages of lingering poverty and political strife were clear to see.

For Twilla Haynes, seated here, her work in Haiti long ago became a family affair.

All seven grandchildren, along with her son Rodney Haynes, his wife Elaina, and daughters Angela Haynes-Ferere and Hope Bussenius, travel to Haiti regularly to visit Hope Haven orphanage and provide health care at several mobile sites.

Photo by Kay Hinton

Editor’s note: This story was written and submitted in the days before the coronavirus pandemic began.

As the magazine goes to print, Doctors Without Borders (Médecins Sans Frontières) reports Haiti’s COVID-19 figures have spiked to more than 3,000 cases and 50 deaths. The nonprofit group says that due to a lack of testing, the count is likely much higher. Angela Haynes-Ferere reports that the Hope Haven children are all sheltering in place, with food being delivered to them. She adds “unfortunately, much of the community is being impacted and we continue to seek ways to lend support. Our March and June trips were impacted, but we are looking forward to returning.”

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HAITI

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llie Ankeny 19N JD MPH was aboard the plane that carried 11 Emory nursing students to Cap-Haitien for a two-week clinical practicum in population health last summer.

“I’ll never forget that moment,” says Ankeny, today one of the first graduates of Emory’s distance-based Accelerated BSN (DABSN) program. “When we landed, the contrast to our privileged lives could not have been more stark.”

A few days later, the DABSN students saw their first patients at a clinic set up outside an orphanage founded by their faculty leader, Twilla Haynes 80MN JD. “People walked for miles to get there and waited for hours to get care,” Ankeny says. “They had so many problems, and we could only treat the worst ones.”

At one point, Haynes asked Ankeny what she thought about Haiti so far. “There’s so much beauty and so much deprivation,” Ankeny told her. “I wasn’t prepared for how people live in such conditions.”

“Yes,” Haynes told her. “Haiti is a land of contrasts.”

Haynes had a similar reaction when she first traveled to the country in the 1980s. At the time, she worked for the Georgia Department of Public Health, overseeing three clinics she helped establish to serve carpet and other industry workers in North Georgia. Later, she established a clinic for underserved patients in a town near her home in rural Jackson County. She also worked with the homeless population in Atlanta and taught nursing students from across Georgia.

Haynes was drawn to serving and teaching others in North Carolina, where she grew up in the Lumbee Tribe. “I never felt that I was discriminated against,” she says. “But some of my Indian friends were not allowed to go to a county school. Knowing people who endured that made me more sensitive to the needs of families and communities.”

In 1984, Haynes accompanied Georgia nursing students on a service-learning trip to Haiti. The group helped local physicians and nurses treat hundreds of Haitians. For Haynes, the challenges—namely too few supplies and medications to treat people with typhoid fever, malaria, HIV, meningitis, and other illnesses—underscored a powerful need.

“I learned how simple it was to save lives,” she said, shortly after receiving the Emory Medal, the university’s highest alumni honor, in 2010. “We’re not talking about rocket science. It’s primary care, it’s learning about these diseases, working side by side with these strong practitioners.”

Since her first Haiti trip, Haynes has taught more than 1,500 nursing students from Emory and other Georgia schools, aided by her daughters, Angela Haynes-Ferere 91MPH 08N 09MN DNP and

Hope Bussenius 93MN DNP FPN-BC, both members of Emory’s nursing faculty. In 1993, they founded Eternal Hope in Haiti (EHIH), a nonprofit that provides basic health care and nutritional services to adults and children in and around Cap-Haitien.

Through EHIH, the Haynes family (wives, husbands, children, and grandchildren) and a host of repeat volunteers (including Emory nursing alumna Cheron Hardy 03MN, a nurse practitioner in Washington, D.C.) serve approximately 6,000 patients a year.

EHIH is self-sustaining, which Haynes attributes to divine intervention. Donations come in by word of mouth—from churches, businesses, friends, current and former nursing students, and volunteers who work for free and pay their own travel expenses to Haiti.

During a trip to Haiti in 1996, Haynes hurriedly wrote a personal check to lease a building to house two medically fragile babies under her care. In just 24 hours, Haynes had established Hope Haven, a home for orphaned and sick infants and children, as part of EHIH. “I didn’t know it, but when I returned home, someone had sent me a check for $200 more than the lease for the building,” Haynes says. “That’s how our work has been made possible.”

Hope Haven currently occupies two buildings, one for boys, the other for girls. The boys live in a building that housed a clinic run

“I learned how simple it was to save lives . . . it’s working side by side with these strong practitioners.”

– Twilla Haynes

by EHIH until an earthquake devastated much of Haiti in 2010.

The clinic was closed to free up space for children orphaned by the earthquake.

Every three months, Haynes returns to Haiti to visit Hope Haven and oversees the health care that EHIH provides at five mobile sites in and around Cap-Haitien. The clinics operate only when Haynes is there. The most remote site is a three-hour truck ride away.

“We see the same people we’ve been taking care of for 20 years,” says Haynes. “We decided early on that if we’re going to make an impact, we’ve got to stay with the same communities to see if we can measure outcomes.”

Measures have shown improvements in controlling conditions such as hypertension, diabetes, and HIV in adults and malnutrition in children.

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Three of the girls from Hope Haven.

Family matters On previous trips to Haiti, Bussenius and her Emory graduate nursing students have provided pediatric care. A few years ago, Haiti provided a testing ground for PediaBP, an app that she developed to help nurses assess hypertension in children more quickly and easily.

Bussenius was 14 when she first visited Haiti. Her son, a high school sophomore, and her daughter, who will begin her BSN studies at Emory this fall, have volunteered with the family most of their lives.

“All seven of my grandchildren are part of the work in Haiti,” says Haynes. “If you want to do grandma a favor, you’ve got to meet your family in Haiti.”

At the moment, the Haynes family includes 66 children and young adults at Hope Haven. The youngest is 6 months old; the oldest is 24. Because Hope Haven residents do not age out of the orphanage, support for each one continues when they become old enough to enter college or learn a trade. Thirteen students are now in college.

Three have finished college, the first of whom graduated from nursing school.

“Hope Haven is a little different from other orphanages,” says Haynes-Ferere, who has a grown son from Haiti. “We don’t adopt our kids out, and we don’t have a date when they need to leave. They age out as appropriate for them. They come back and have dinner together and go to church together. There’s still that sense of family.”

When Haynes founded Hope Haven, she didn’t envision helping her children transition to adulthood. Her priority was to keep sick 18 Emory Nursing

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babies and children alive and healthy. But she and the rest of the Haynes family now have a plan.

“The education piece is just as important or more so,” says Haynes, whom many Haitians call “Big Mom” in English and Creole.

“The children who are in college are really doing well. Now that the oldest child has graduated from nursing school and showed the others what is possible, the children have a different spirit now. They know if they do their part, we’re going to do ours.”

Hope Haven is growing up as well. Later this year, all of the children will live together in a new building, set on six acres donated to EHIH more than a decade ago.

“It’s a beautiful piece of land,” says Twilla. “It has every fruit tree that grows in Haiti. The engineer in charge of the building project says we can put 100 kids in the building. I told him, ‘Listen, we have enough!’ That’s the potential.”

HAITI

A view from the back of the truck during the three-hour ride to Hope Haven orphanage.

Nursing in a new light During her practicum in Haiti last summer, Allie Ankeny was determined to do her best. Her first day of clinic, held outside one of the orphanage buildings, was noisy, chaotic, and unbearably hot. At 5’8, she found it difficult to stoop over young pediatric patients while fumbling with an otoscope to look into their ears. She thought about lifting her patients up on a table until learning that it was reserved for use as a pharmacy. After taking another look at the long line of patients who had waited for hours, she knelt down to meet her patients at eye level.

“Suddenly it dawned on me that kneeling in the dirt was the least I could do,” says Ankeny, who is now COO and executive director of a large pediatric practice in northern Virginia. “If I could do one thing to make a difference, that’s what I was there to do.”

Ankeny tried not to feel overwhelmed by the experience. “I want to do so much and help everyone,” she told Haynes.

Her preceptor offered reassurance. “Allie, that kid you just helped, you made their life better,” Haynes told her.

“Remember, what you are doing matters to the person you are helping right now.”

Photo by Kay Hinton

“All seven of my grandchildren are part of the work in Haiti. If you want to do grandma a favor, you’ve got to meet your family in Haiti.”

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TO

BOTSWANA WITH LOVE

By Pa m Au c h mute y Photography by Kay Hinton

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BOTSWANA

Mabel Magowe

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mory is a long way from a third-grade classroom in Botswana, where a young Mabel Magowe told her teacher that she wanted to be a nurse. Several decades later, Magowe 08PhD

MSc BEd has gone far beyond her childhood goal, serving as a leader, researcher, and professor for generations of new nurses and midwives across Africa.

Now deputy dean of the health sciences faculty and senior lecturer and coordinator of HIV/AIDS education at the University of Botswana, Magowe was recently awarded the prestigious Sheth Distinguished International Alumni Award, presented by Emory’s Office of Global Strategy and Initiatives.

The annual award—established by Madhu and Jagdish Sheth, Charles H. Kellstadt Professor of Marketing at Goizueta Business School, nearly 20 years ago—recognizes alumni from other countries for outstanding contributions to humanity, art, science, or human welfare.

Magowe was honored earlier this year for her efforts to advance nursing practice, education, and workforce development in Botswana. She has practiced and taught midwifery; served on government policy task forces; developed family planning policies, procedure manuals, and midwifery curricula; created a national program to prevent mother-to-child HIV transmission; educated nurses in South Africa, Zimbabwe, and Tanzania; and collaborated on research in Africa and the United States.

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As a midwife who first taught at a district hospital in 1980, Magowe began to see the difficulties women faced in talking with their partners about safe sex to prevent HIV/ AIDS infection.

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The award ceremony brought Magowe back to Emory, where she also spoke to School of Nursing students as part of the Nursing Now speaker series, hosted by the Lillian Carter Center for Global Health and Social Responsibility. The Nursing Now campaign, sponsored by the World Health Organization (WHO) and the International Council of Nurses, seeks to raise the status of nurses and nurse-midwives worldwide.

“This is my home away from home,” Magowe told her audience, which included classmates and faculty with whom she studied as a PhD student beginning in 2003.

Throughout her career, she’s been blessed with strong role models, beginning with her mother, a widow who imbued her 10 children with a strong sense of responsibility, and her aunt and a family friend, both of whom were nurses. “These ladies were my best examples because they used to nurse in a business-like, graceful manner and knew exactly what they were doing,” Magowe said.

She began her nursing education at age 19 (her mother had to grant permission because she was so young) and subsequently learned to practice and teach midwifery, driven by a national need for clinicians and instructors in the specialty.

“I learned how to teach very early,” she says. She also learned how to care for pregnant women by listening and touching.

“I once attended an exchange program in the UK, where I accompanied a midwife,” Magowe adds. “She was querying whether a patient was a transverse lie (when a baby is in breech position) and wanted to confirm it with an ultrasound. I told her, ‘Look at the abdomen first. Just feel the head here—it’s transverse.’ The midwife got an ultrasound to confirm it. In my country, we use our hands. But technology is influencing how we practice nursing, and we have a long way to go to catch up.”

Botswana’s universal health care system relies heavily on nurses to provide essential services at various levels—from satellite clinics, health posts, and maternity clinics in villages and small communities to district and federal hospitals in larger towns and cities. As a midwife who first taught at a district hospital in 1980, Magowe began to see the difficulties women faced in talking with their partners about safe sex to prevent HIV/AIDS infection, a problem she would later study at Emory.

In fall 2001, Magowe traveled to Atlanta to attend the Lillian Carter Center’s first conference. Led by Marla Salmon, then dean of nursing, the conference brought 300 nursing leaders from more than 50 countries together to form partnerships that would strengthen the nursing workforce and health care system in their respective countries.

At the time, Magowe was president of the National Nurses Association of Botswana, one of the very leaders whom the conference targeted.

The meeting included a tour of the School of Nursing, where Magowe learned about its doctoral program for nursing scientists. “I went home and asked for a release from the University of Botswana to do a PhD,” Magowe remembers. She also obtained a Fulbright Fellowship to help support her doctoral studies, built around developing

BOTSWANA “Compassion is always important, even if it comes with sadness at times. That’s the key to nursing.”

a model for safe sex communication between women and their partners in Botswana. After five years of study, Magowe received her PhD in 2008.

“When I returned home, I could work independently,” Magowe says. “I didn’t have to rely on someone else to do basic research. I was on my own.”

Her body of research on HIV/AIDS prevention and improving women’s health has flourished, based on collaborations in Botswana and with partners like the Centers for Disease Control and Prevention (CDC) in the U.S. She remains an ardent member of the QUAD, a nickname coined by members of the African Health Profession Regulatory Collaborative for Nurses and Midwives (ARC). Established in 2012 by Emory’s Maureen Kelley PhD CNM FACNM, now emeritus professor, ARC has helped nursing leaders in 17 African countries strengthen regulation around sustainable nurse-initiated and nurse-managed HIV treatment. Although CDC support for ARC has ended, the QUADs continue to thrive on their own. The Botswana QUAD includes the president of the National Nurses Association, the registrar of the Nursing and Midwifery Council, the chief nursing officer, and Magowe, the adviser for research.

“ARC has been a pillar of strength in our countries,” says Magowe. “When we were working to define scope of practice in Botswana, we included family nurse practitioners, midwives, pediatrics nurses, and other nurses, so we called them the QUADplus. We extend the QUAD as needed to work on different aspects

of nursing practice and regulation. That is how we do things in Botswana. We no longer work in siloes.”

Like their colleagues around the world, the Botswana QUAD has embraced the International Year of the Nurse and Midwife, the 2020 campaign sponsored by the WHO. On May 12, the 200th anniversary of the birth of Florence Nightingale, Botswana nursing leaders unveiled their first-ever nurse and midwifery strategy. Among its goals: improving nursing education and research, strengthening regulation and collaboration, and building the nursing workforce.

The new strategy comes at a time when the African nation’s nursing workforce is growing. “There were years when we had a lot of migration of nurses to developed countries,” Magowe says. “Now there is in-migration of nurses working on projects in Botswana. They are applying for research positions funded by U-Penn, Harvard, and the University of Maryland. Many highly trained nurses are applying for those positions. And more and more nurses are working in private hospitals.”

Four decades ago, one of Magowe’s first hospital patients was an elderly woman, whom she fed, bathed, and sat with in a surgical ward. She felt a strong bond with her. When Magowe returned one morning, her patient’s bed was empty—she had died.

“That has stayed with me for a long time,” Magowe says gently.

“Compassion is always important, even if it comes with sadness at times. That’s the key to nursing.”

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OWNING THE RESEARCH

By Leslie Church

D

ar es-Salaam’s Muhimbili National Hospital, with 1,500 beds, is the largest public hospital in Tanzania.

To most people, that sounds like a lot of patients. But to a scientist, that sounds like a lot of data. The problem was, researchers would come from other institutions—often other countries—gather data, and then write a publication without much collaboration with hospital staff. “The hospital was incurring risk without the benefits,” says Sydney Spangler PhD MSN CNM, assistant clinical professor at the School of Nursing. “There is a lot of potential for exploitation around data,” she adds.

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That’s why becoming a renowned center for research— its own research—was one of the strategic goals Muhimbili Hospital set for itself in 2017, along with improving quality of both clinical services and business operations.

Spangler is part of a three-person team of Emory faculty, along with Jason Hockenberry PhD, associate professor at Rollins School of Public Health, and Brittany Murray MD, assistant professor at the School of Medicine, who joined forces with the hospital to support its mission. The Emory-Muhimbili Partnership for Health Administration Strengthening and Integration of Services (EMPHASIS) is a fiveyear initiative supported by Abbott Fund Tanzania.

Spangler has been helping the hospital take significant steps forward in the way it conducts research.

TANZANIA Connecting with resources in Atlanta Muhimbili’s new research department is partially modeled on Emory’s. During a month-long trip to Atlanta, staff met with their counterparts from the Office of Nursing Research to discuss grant applications, money allocation, and bioethical standards. It’s not the headline-grabbing part of research, but funding is the bottom line that drives the whole operation.

“This is about sustainability,” Spangler says. “Research brings money. Eventually, Muhimbili Hospital won’t have to rely on outside institutions if they don’t want to. They’ll get their own funding and do their own research.”

“Research goes hand-in-hand with clinical practice and guides the development of local treatment guidelines,” says Faraja Chiwanga, MD, head of the Teaching, Research, and Consultancy Unit at Muhimbili Hospital. “Having hospital staff as co-investigators ensures that they’re actively involved in research and hence increases their research capacity.”

To that end, a new rule was “RESEARCH ALLOWS NURSES TO GAIN SKILLS established: no outside THAT CAN IMPROVE PATIENT OUTCOMES AND researchers may conduct a study ADVANCE THEIR OWN at Muhimbili CAREERS. PLUS, THEY unless a hospital OFTEN HAVE THE BEST staff member is a QUESTIONS.” co-investigator.

What impact will this have on Muhimbili’s goal to become a renowned center for research in Africa and the world?

About 200 research projects are conducted at MNH every year. Having MNH staff as co-investigators ensures that the team is actively involved in research and hence increasing their research capacity After securing grants, steps two and three for building research capacity go hand-in-hand: establishing a means to collect continuous, accurate data; and having the expertise to know what to do with it.

Photo by Kay Hinton

Sydney Spangler

Photo courtesy of Sydney Spangler

Nurse midwives enter data on their iPads.

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“IT IS NOT THE EXPLICIT GOAL OF THIS RESEARCH PROGRAM TO HAVE A GRAND GLOBAL IMPACT,” SPANGLER SAYS. High-tech fix means better data

Photo courtesy of Sydney Spangler.

Nurse midwife Mariam Mlawa in the maternity ward’s supply room.

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One of the initiative's most tangible changes came in the form of an iPad. Previously, when a baby was born in Muhimbili Hospital, nurses would lug down a series of nine enormous binders from a shelf and document different bits of information from the birth in each one.

The baby’s birth weight, mother’s parity, and gravidity, C-section rates, and so on, were all reported to the Ministry of Health. The logbooks were cumbersome, and often plagued by missing data and unreadable handwriting. But inefficiency wasn’t the only problem.

“Here sat this enormous amount of data that could be used to improve clinical outcomes, but it was stuck in an outdated form of record-keeping,” says Spangler.

The iPads were a logical fix: the hospital’s occasionally unreliable internet was no problem since a SIM card could be used to maintain access to the cloud.

Birth indicators and demographic information were organized under REDCap, a research database that Emory uses, offered for free in developing countries.

Already, patterns have begun to emerge from the data.

It appeared that staff was underestimating blood loss from C-sections, for example. “So now they can say, if this is happening, are we under-treating blood loss?”

Spangler explains.

The REDCap model has spread to other areas of the hospital: newborn units, renal services, critical care. Even the hospital administrators have adopted it, surveying employees on job satisfaction and patients on their hospital stays.

TANZANIA “IT’S REALLY TO BENEFIT THE LOCAL COMMUNITY—THE STAFF AT MUHIMBILI HOSPITAL AND THE TANZANIANS THAT THEY SERVE. Nurses ask the best questions The final step in the EMPHASIS research initiative is a mentorship program where up to five Muhimbili employees will be paired with Emory faculty. The goal is for the Tanzanian investigators to conduct a two-year study and submit manuscripts for publication where they are the first author. Spangler is encouraging nurses and midwives to apply.

“Sometimes nurses get left out of these efforts,” Spangler explains. “Research allows nurses to gain skills that can improve patient outcomes and advance their own careers. Plus, they often have the best questions.”

While a PhD is usually a precursor to being a primary investigator on grants in the U.S., in other parts of the world like Tanzania, experience is more important than credentials. “They certainly don’t need a PhD to get funding,” Spangler says. “In developing countries, people aren’t always forced to go through the same systems we have here that might not work for them.”

After the mentorship program, the Muhimbili scientists will have the capacity to serve as co-investigators with academics from around the world, or with others at home in Tanzania.

“It is not the explicit goal of this research program to have a grand global impact,” Spangler says. “It’s really to benefit the local community—the staff at Muhimbili Hospital and the Tanzanians that they serve. The more people we have conducting their own research in their own communities all over the world, the better it is for everyone.”

THE MORE PEOPLE WE HAVE CONDUCTING THEIR OWN RESEARCH IN THEIR OWN COMMUNITIES ALL OVER THE WORLD, THE BETTER IT IS FOR EVERYONE.”

Photo courtesy of Sydney Spangler.

Mumbili National Hospital’s Strategic Leadership Team visited Emory for a month for meetings and training on the three major project objectives.

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BETTER AIR,

HEALTHIER

FAMILIES

By Leslie Church

While cooking your dinner over an open flame may sound nice for a camping trip, imagine having that fire permanently located inside your house; the throatchoking smoke, the stinging, watery eyes, the walls blackened with soot. And those are just the problems you can see.

Inside the body, smoke from a cooking fire wreaks havoc on the lungs and cardiovascular system. Those most affected are the ones doing the cooking—usually women—and the young children staying close to their mothers. Almost half of the world’s population cooks over solid fuels like wood, dung, and coal.

Pollutants from the smoke damage the body’s immune system response and more than double the chances of getting sick with a lung infection like pneumonia, the leading killer of young children in low-resource parts of the world.

Main photo: A new gas cookstove in a kitchen in Guatemala.

Inset: Lisa Thompson poses with some of the team in Guatemala.

Courtesy of Lisa Thompson.

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GUATEMALA What can be done?

Photo by Kay Hinton.

That’s a question Associate Professor Lisa Thompson RN FNP-BC MS PhD FAAN has been investigating for the past 20 years. Starting in rural Guatemala, she initially focused on chimney stoves. Her research currently looks at trial use of gas stoves in mountain communities.

“At first we thought that chimney stoves would stop the household air pollution problem,” says Thompson. “But we found that all that smoke just goes up and outside and creates pollution outdoors, where people also work and play.”

The HAPIN (Household Air Pollution Intervention Network) trial is looking at the effect of having a gas cookstove and free fuel for 18 months on 3,200 pregnant women and their babies in Rwanda, Peru, India, and Guatemala. The study, led by Professor Thomas Clasen from the Rollins School of Public Health, is the first randomized control trial of its kind.

Thompson and a team of 20 Guatemalan nurses developed a standardized assessment of the infants in the trial. In addition to surveillance for pneumonia, they are evaluating the effects of cleaner household air on birth weight, preterm birth, child development and growth. They’re also looking at cardiovascular outcomes in pregnant women and older adult women living in the homes.

“Respiratory problems are common here,” says Flor Esteban Jiménez, clinical supervisor for the field team of nurses. “I am sure the study will have a big impact on our communities since there are 400 families participating.”

Looking at behaviors and incentives Thompson, who co-leads the Guatemalan research site with investigators from Universidad del Valle de Guatemala, is the only nurse investigator on the trial.

“One of the strengths of being a nurse on this study is we think a lot about behavior,” Thompson says. “Before we implemented the gas stoves, we looked at how household decisions are made about cooking, and what barriers might exist.”

Thompson and her team ran exercises like a role-playing scenario where women pretended to ask their husbands for money to refill the gas tanks. They also did taste tests with local women on beans and porridge cooked over gas. They found the beans were softer and more evenly cooked, and the porridge was preferable because it didn’t have ash in it.

But the biggest incentives were time and convenience.

Traditional stove users spend hours each week chopping and gathering wood. With gas stoves, women can turn on the flame and have breakfast ready for their families in minutes.

“During our focus groups, one woman jokingly said, ‘I feel so lazy now. I get up at six in the morning instead of four,’” Thompson says.

Visible progress The HAPIN trial began in 2017 and will assess more than 7,000 participants over the course of five years. The final question is, what will happen when the families are no longer receiving the free gas? Thompson and her team hope that evidence on the health benefits of clean cooking will motivate government officials to subsidize the stoves and gas for low-income families. “It just takes one interested politician to put that on the agenda,” she says.

India and Peru have already begun gas stove programs that benefit low-income families, and Rwanda’s government appears open to the idea, according to Thompson. The Guatemalan government hasn’t made it a priority, yet. But Thompson is hopeful.

“I think we put a spark there,” she says. “Less than 20 years ago, in another region, our research project built over 500 chimney stoves. That created a groundswell and now most people there have a chimney stove. A whole industry has built up around them.”

In the meantime, the women participating in the study are seeing the short-term benefits of clean cooking.

“They’re breathing easier, their clothes don’t smell like smoke—people can feel very stigmatized by that,” Thompson says.

“And they’ve rebuilt their kitchens, painted the walls. Kitchens are no longer black from soot; progress is visible.”

Libny Monroy Alarcón believes some of the study’s health impacts will likely remain, even if the gas stoves are no longer used. Monroy Alarcón, a nurse sonographer who conducts ultrasounds on the infants and mothers, says “As part of the study, we educate participants on pneumonia and the importance of visiting health services to avoid complications. Now they'll be able to detect the signs and symptoms of pneumonia more easily.”

“One of the strengths of being a nurse on this study is we think a lot about behavior.”

— Lisa Thompson

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New master’s degree

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mory University’s Nell Hodgson Woodruff School of Nursing is launching a Master of Nursing degree program (MN) for students who hold a bachelor’s degree in another discipline and want to pursue a career in nursing. The MN degree offers a graduate curriculum to prepare a “population-ready graduate” with an emphasis on nursing leadership, evidence-based practice, and interprofessional education. Students will have clinical and simulated experiences in hospitals, ambulatory care settings, clinics, and other community health settings, which may be local, regional, and international. Students who graduate from this dynamic program will be prepared to sit for the National Council Licensure Examination (NCLEX) and will have advanced nursing knowledge that will accelerate their careers in health care. “The need for more RNs has never been greater,” said Linda McCauley, PhD, RN, FAAN, the dean of Emory’s School of Nursing.

“We are excited to offer the MN degree. This program will allow students to enter the workforce in 15 months with the knowledge and training to provide extraordinary patient care in a variety of clinical settings.”

The School of Nursing is currently accepting applications to the MN program. Applications for the new MN program will be accepted during the Fall, Spring, and Summer terms. To apply to this program, please visit nursing.emory.edu.

Faculty Spotlight | Associate Professor Jill Hamilton PhD RN FAAN

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r. Hamilton earned her BSN, MSN, and PhD in nursing from the University of North Carolina at Chapel Hill, a BS in Accounting from North Carolina Central University, and postdoctoral training in the nursing care of older adults at the Oregon Health & Science University. She previously held faculty positions at Johns Hopkins University and the University of North Carolina at Chapel Hill where she was tenured associate professor. Hamilton’s research interests include health disparities, social and cultural factors that influence health, and the coping strategies used among older African American cancer survivors and their families. She has developed measures of coping and spirituality and has conducted research to examine ways sociocultural factors influence how older African Americans use social support and spirituality.

Briefly, tell us about a research project you’re working on...

I am currently working on a compilation of stories that document the personal experiences of African Americans and ways that Black Sacred Music is used in response to current day struggles.

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What is one thing you hope your work can offer humanity by the end of your career?

I hope that my work will be recognized as making a significant contribution to the body of historical and cultural literature on the religious tradition of African Americans.

If you could go back in time and offer yourself some advice early in your career, what would you say?

Don’t seek permission to follow your passion.

What do you enjoy most about being at Emory Nursing?

I am permitted to engage in work that is meaningful to providing optimal health care of an underserved population. We take this for granted but not all our nursing colleagues have this freedom.

PULSE McCabe wins prestigious Emory Medal Currently the director of the Cancer Survivorship Program, the nation’s first survivorship initiative as well as the Ethics Committee Chair at New York's Memorial Sloan Kettering Cancer Center, Mary S. McCabe 72BSN has spent her career in oncology. She launched the program, developed Mary S. McCabe 72BSN a nurse-led patient care model, and led the efforts to make the program the largest in the nation. During her career, McCabe has been a pioneer in survivorship care following adult onset cancers. Her papers and protocols are read and studied around the world, and her research in health protocols has been a major influence on national health care policy.

The field of medicine was a natural choice for McCabe.

Her father was a physician, her mother was a nurse, and she married a doctor. When it was time for her husband’s residency, they chose Emory, not only for its excellence, but also because of its nursing school. Since she already had a four-year degree in biology, the administration set up a specific curriculum for her. “When I think about my affinity for Emory, I keep going back to the unique mentorship and focus on what were my needs and not just making me fit into the cookie cutter of what other students needed,” says McCabe.

About the Emory Medal

The Emory Medal is the highest university award given to alumni. It honors distinguished service to Emory or the Emory Alumni Association, service to the community, or outstanding professional achievement.

Meeting NeLL™ Data Science Symposium shows off analytics

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ozens of undergraduates came together for February’s Data Science Symposium to hear about the need for health scientists to integrate data analytics into their work. Hosted by Rose Hayes RN BSN MA, senior manager of Executive Communications, and Masato Yoshihara MPH, database engineer at the School of Nursing, the event gave attendees a glance at the future of healthcare and the innovations taking place at the nursing school.

The crowd got a sneak peek at the Center for Data Science’s flagship product: Project NeLL™. This revolutionary research tool makes big data accessible and easy to use for students and health scientists alike.

NeLL offers unprecedented access to 800+ million Emory Healthcare records, including nurse’s notes—a largely untapped and underappreciated source of bedside data.

After the NeLL demo, a multi-disciplinary panel of experts weighed in on data science in healthcare.

Health analyst Kathleen Adams PhD, informatician and data scientist Rishi Kamaleswaran PhD, and research manager Karen Lindsley RN MSN discussed how to promote diversity in the data sciences, the ways big data is influencing hiring and promotion practices today, and other topics submitted by students.

To learn more about Project NeLL, please visit bit.ly/2VSaWEq and follow the Center for Data Science at bit.ly/2TwAyFv. – Ema Perez

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Congratulations to Alexis Dunn

New Faculty Wonshik Chee

Congratulations to NHWSN Research Assistant Professor, Alexis Dunn, for being an honoree at this year’s Atlanta Black 40 Under 40 ceremony. Dunn earned her spot on this prestigious list through her outstanding work in research and community outreach.

PhD

Research Professor

Ethan Cicero PhD RN

Assistant Professor, Tenure Track

Ingrid Hopkins Duva PhD MN RN

Assistant Professor, Clinical Track

Nicholas Giordano PhD RN

Assistant Professor, Tenure Track

Eun-Ok Im PhD MPH RN CNS FAAN

Downes helps Fiji develop new degree

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lizabeth Downes served as a consultant to the School of Nursing, in the College of Medicine, Nursing & Health Science of Fiji National University to the review the current Post-Graduate Diploma in Nursing (Nurse Practitioner) curriculum and develop the new Masters of Science in Nursing degree. Downes had worked with the WHO in Fiji for 3 years previously to initiate the first NP program. The program is now led by former students who over the past 18 years have prepared over 100 FNPs for Fiji. In that time, the program expanded to other island nations including Tonga, Cook Islands, the Marshall Islands and Kiribati.

Fijian NPs teach through the use of Zoom technology and travel to the island nations to lead face-to-face courses and assessments. The transition to the MSN follows patterns common throughout the world where NP education starts with a diploma-level RN getting a certificate as a NP then the programs transition to a BSN + certificate and then BSN + MSN. Presently, the program has a primary care focus and, like many other countries. Fiji is looking to expand the roles for Advanced Practice Nurses into the hospital setting.

Professor, Senior Associate Dean for Research and Innovation

Shaquita Starks PhD APRN PMHNP FNP

Assistant Professor, Clinical Track

Beth Ann Swan PhD CRNP FAAN

Clinical Professor, Associate Dean and Vice President for Academic Practice Partnerships

JOIN THE CONVERSATION JO

Visit emry.link/interactSON to connect with Emory’s nursing community and learn the latest news via our social networking sites.

View Emory Nursing online @ Vi eemorynursingmagazine.emory.edu

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PULSE Emory nursing workforce report details shortage of nurses in Georgia Alexis Dunn CMM

Sara Edwards PhD MN MPH

Calli Cook DNP APNR FNP-C

Trisha Sheridan DNP WHNP-BC SANE-A CFN

Paula Tucker DNP FNP-BC ENP-C

New fellows in the American College of Nursing and Midwifery The American College of Nurse-Midwives (ACNM) has selected Alexis Dunn PhD CNM and Sara Edwards PhD MN MPH as Fellows. This designation allows them to expand their research of nurse-midwifery with the resources and platforms available to Fellows.

The ACNM is dedicated to honoring nurse-midwives and their efforts to improve the care of women, infants and families. To be accepted as a Fellow for the ACNM, nursing professionals have demonstrated consistent leadership and impactful contributions to the nurse-midwifery community and within an ACNM affiliate or related program. It is a Fellow’s responsibility to help further the ACNM mission by speaking, mentoring and advancing the midwifery profession.

New fellows of the American Association of Nurse Practitioners Nursing faculty Calli Cook DNP APRN FNP-C, Trisha Sheridan DNP WHNP-BC SANE-A CFN and Paula Tucker DNP FNP-BC ENP-C have been elected as Fellows in the American Association of Nurse Practitioners (AANP). The 2020 Fellowship in the American Association of Nurse Practitioners (FAANP) is an honor bestowed upon a group of leaders whose scholarly contributions have led to significant improvements to healthcare and the nurse practitioner role. The Academy is composed of more than 2,000 of the nation's most accomplished nurse leaders in education, management, practice, policy and research, and selection for fellowship is one of the highest professional honors in the field of nursing.

“This recognition places Cook, Sheridan, and Tucker among a global cohort of nurse practitioners making a positive impact on healthcare, dedicated to advancing the profession and developing our future leaders,” says Dean Linda McCauley PhD RN FAAN FAAOHN. “The exceptional contributions that these Fellows make to our profession and field exemplify the hours and hours of hard work that go into an acceptance.”

Established in 2000 to impact national and global health by engaging recognized nurse practitioners to lead new initiatives, the AANP inducts fewer than 100 fellows annually.

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eorgia has one of the lowest densities of registered nurses in the nation, according to a decadelong report recently published by the School of Nursing.

Led by Associate Professor Jeannie Cimiotti PhD RN, the 10-year longitudinal study details nurse demographic and employment characteristics. The study includes data from 2009-2018.

Estimates from the study suggest that Georgia has seen little growth in its registered nurse workforce, roughly 3% annually, over the past decade, despite a surge in the state’s population. While the report showed a larger increase of nurse practitioners, registered nurses provide most of the hands-on nursing care statewide.

A yearly increase of nurses aged 65 and older further complicates the shortage, as this cohort that soon retire, leaving vacancies.

“It is imperative that we understand the dynamics of Georgia’s nurse workforce to enhance future nurse workforce planning,” the authors said.

School of Nursing Dean and Professor Linda McCauley PhD RN is senior author on the report. Contributing authors include Vicki Hertzberg PhD, professor and director in the Center for Data Science; Yin Li PhD, assistant research professor; and Masato Yoshihara MPH, data analyst.

– Catherine Morrow

– J. Michael Moore

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CLASS NOTES 1980s The Alumni Board of the Nell Hodgson Woodruff School of Nursing presented NANCY AGEE 80MN with the Distinguished Nursing Achievement Award. This honor is presented to a NHWSN alumnus whose career has demonstrated continuous and exemplary contributions to the profession of nursing.

FEE PEE ANSHER 82N of Columbia, Maryland was awarded a 2019 NIH Clinical Center CEO Award in the Administration category in recognition of her tireless efforts as an exceptional leader and role model in representing “all that is good at NIH”. Ansher currently serves as the Neurology Clinic Coordinator at the Clinical Center at NIH. TANYA M. SUDIA ROBINSON 86MN 94PHD became dean of the College of Nursing at Augusta University in Augusta, Ga., on Jan. 1, 2020. She is an accomplished nursing leader with more than 30 years of experience in higher education, administration, nursing, and health care research. She was an instructor at Tuskegee University School of Nursing, spent 19 years teaching at Emory University School of Nursing, and seven years as a tenured professor at Mercer University’s Georgia Baptist School of Nursing before joining Baylor University as associate dean for research and scholarship at the Louise Herrington School of Nursing.

where she found her calling to care for patients with tuberculosis. She returned to the U.S. for graduate school and to work as a public health nurse in a TB and Refugee Health program before joining the RISE Tuberculosis Clinic. Hippchen was an Emory University School of Nursing Woodruff Scholar and was included in a slideshow during Emory’s Homecoming and Reunion Weekend in October 2019.

CORINNE BRAENDER OLIVER 02OX 04BSN 10MSN and Jeffrey Oliver II announce the birth of a daughter, Emilia Anne, on Nov. 16, 2019. They have another daughter named Isabella. Oliver, who serves on the Nurses Alumni Association Board for the Emory University School of Nursing, is a pediatric nurse practitioner at Children’s Healthcare of Atlanta.

JOANNE MCDOUGAL PATTERSON 04MSN, an assistant professor of health care informatics and nurse entrepreneur, recently opened Dr. Joanne Psychiatry, LLC (drjoannepsychiatry.com), a telepsychiatry practice specializing in reproductive mental health, children, and adolescent mental health. She treats patients in Maryland, Nevada and Georgia via telemedicine and plans to expand to other states and U.S. territories. Patterson is also the national volunteer director of the Stork’s Nest Prenatal Education and Incentive Program, which assists more than 6,500 underserved each year. She was also a 2018 March of Dimes Georgia Nurse of the Year finalist. In late May, she was a panelist on the March of Dimes’ Maternal Facebook Live webinar.

MINDI M. FRY 08BSN 09MSN is a nurse practitioner who specializes in cardiology at Virginia Cardiovascular Consultants in Fredericksburg, Va. She worked in Harrisburg, Pa., from 2010-2019 at the University of Pittsburgh Medical Center Pinnacle Health Cardiovascular Institute. Fry was an Emory University School of Nursing Woodruff Scholar and Woodruff Fellow and was included in a slideshow during Emory’s Homecoming and Reunion Weekend in October 2019.

1990s

2010s

MARY (MOLLY) K. JONES BACHTEL 99MSN received the American Association of Nurse Practitioners Advocate State Award for Excellence for the state of Georgia at the association’s national conference in June. This award is presented to a dedicated advocate in each state who has made significant contributions to the nurse practitioners field. Bachtel advocated to improve access to care and remove barriers to practice for Georgia’s APRNs at the capitol. SB 321 passed the GA Legislature this June and will remove the current restrictions on APRNs ordering radiological imaging. Georgia was the only state in the country imposing this restriction on APRNs. Bachtel also serves as the current APRN Director for the Georgia Nurses Association. She is a clinical assistant professor at the School of Nursing.

GABRIELLE L. BLOCH 16BSN is a registered nurse on the hematology-oncology and bone marrow transplant floor at St. Louis University Hospital. Bloch was an Emory University School of Nursing Woodruff Scholar and was included in a slideshow during Emory’s Homecoming and Reunion Weekend in October 2019.

2000s ANDY GISH 06N was given the Excellence in Nursing Award by the School of Nursing Alumni Board. This honor is presented to an alumnus who has demonstrated exceptional contributions to the profession of nursing in research, education, clinical practice, management and leadership in public health and community service.

ANNA HESS HIPPCHEN 00OX 02C 03BSN is a nurse practitioner at the Miriam Hospital RISE Tuberculosis Clinic in Providence, R.I. Hippchen pursued a career in emergency nursing and public health after graduating from Emory. She worked as an emergency department nurse at St. Joseph’s Hospital and volunteered with Mercy Corps. Later she served with Doctors without Borders in South Sudan, Uganda, Nepal, and Turkmenistan

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DENNIS FLORES, 12MSN was awarded the Recent Graduate Award by the School of Nursing’s Alumni Board. This award goes to a graduate from the past ten years who has contributed exceptional service to the Nurses’ Alumni Association, the School of Nursing, and to the profession of nursing.

2020s TIMOTHY R. MACCHI 20BSN was featured as the first fall 2019 ESNA Student Spotlight. As an undergrad student at George Washington University where he earned a bachelor’s degree in public health, Macchi volunteered for an ambulance company in the District of Columbia, serving at marches, marathons, and rallies. He also worked one year at an emergency medicine consulting group that dealt with telemedicine and disaster management, and one semester as a tech at George Washington Hospital Emergency Room. Macchi loves emergency medicine and disaster management and hopes to work in an intensive care unit after graduation from Emory.

KATHRYN K. MOORE 15BSN 20MSN, a Woodruff Fellow, gave birth to a healthy boy, Isaac Victor Moore, in June. Moore has also been selected for promotion to Major in the Georgia Army National Guard.

PULSE

To everyone rising to the calll in Atlanta, thank you.

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IN MEMORY

Jenna Hernan JENNA NICOLE HERNAN 19AMSN of Riverside, Calif., on Sept. 14, 2019. Hernan died two days after the vehicle she was driving was hit during a high-speed car chase.

She had moved to Riverside to join her fiancé, Holland Stewart 17L, and begin her nurse-midwifery career after graduating from Emory last May. Her sudden loss touched students, faculty, and staff throughout the School of Nursing.

“Jenna wanted to pursue a career in midwifery and family practice so that she could care for women who were marginalized and disadvantaged within the health care system,” says Alexis Dunn PhD CNM, Hernan’s faculty adviser. “She was passionate about health disparities and care of minority populations. Her interests stemmed from her experiences growing up in New York as well as her interpersonal relationships.”

Hernan grew up in the South Bronx, where in high school she organized a diverse group of 15 friends who called themselves the “CCs” (short for “cultural casserole”). Concerned that a new student would feel left out, Jenna invited her to join her volleyball team, and the CCs expanded to 16. “She was always concerned

about other people,” says her mother, Maria Hernan. “She wanted everyone to embrace and accept themselves.”

At Hunter College, Hernan majored in psychology and was accepted into the prestigious Thomas Hunter Honors Program. She also volunteered as an instructor with the Peer Health Exchange, which provided health education to students at underserved high schools. Her teaching experience, and a brief hospital stay for minor surgery, piqued her interest in women’s health. After graduating from Hunter, Hernan worked two years at Memorial Sloan Kettering Cancer Center before entering the family nurse practitioner/nurse-midwifery program at Emory.

She excelled as a student once again. When her midwifery clinicals proved especially challenging, her friends provided a morale boost, as she often did for them.

“Jenna had the best balance of anyone,” says Tara Noorani 18MSN. “She studied hard, but she made time for fun things. Maintaining that balance was a rare thing.”

“Fun things” included visits to Hernan’s favorite coffee shop and walking her dog, Kenley, a friendly 95-pound mutt, with Sarah Warsaw 18MSN and her 13-pound dog Molly.

The outings provided a respite to help Hernan complete the 20 deliveries required to qualify for licensing as a nurse-midwife. She graduated as planned in May 2019 and passed all her boards.

“Jenna loved Emory. It gave her the opportunity to come to Atlanta and meet such dear, beautiful people,” says her mother Maria. “I was so proud of her when she graduated.”

– Pam Auchmutey

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ALUMNI NEWS

IN MEMORY 1940s

FRANCES NICHOLS GARDNER 49BSN of Peachtree City, Ga., on Feb. 13, 2019. She practiced nursing in south Florida until the death of her husband, Eugene. In 1990, she moved to Tavares, Fla., to care for her mother and then later to Peachtree City. She is survived by two sons, a brother, and two sisters.

1950s

MONA SCARBOROUGH CLAYTON 52BSN of Augusta, Ga., on Dec. 22, 2019, at 88. Clayton had a long and fulfilling career as a psychiatric nurse for the Veteran’s Administration. She also had a beautiful voice and sang soprano with the St. Paul’s Choir and the Augusta Choral Society and was part of the team that launched Tuesday’s Music Live Concert Series in 1987. While studying at Emory, she met her former husband, Marcus M. Clayton Jr. 55C 56L 67PHD. And although they divorced, they lovingly raised four daughters together and maintained a close bond. Survivors include four children, nine grandchildren, and two sisters.

BARBRA RUCKER JONES 53BSN of Columbia, S.C., on Nov. 17, 2019. Jones worked as a surgical nurse at Orange Memorial Hospital in Orlando, Fla. After moving to Columbia, S.C. in 1962, she worked at Providence Hospital and taught health occupations and licensed practical nursing for the Richland County Schools. She loved spending time at their Edisto Beach vacation home, was active in the Ladies Golf Association at the Spring Valley Country Club, was a long-time member of the Saraband Dance Club, and belonged to two bridge clubs and two hand and foot clubs. She is survived by her husband of 67 years, C. Robert Jones Jr., three daughters, five grandchildren, and great-grandchildren.

JACQUELINE SAPP TILLER 53BSN 62MN of Lyons, Ga., on July 8, 2019, at 94. Prior to attending Emory, she earned a RN diploma from the Crawford W. Long School of Nursing. She served in World War II as a 2nd Lieutenant in the Army Nurse Corps. Tiller was a nursing professor at the College of Coastal Georgia and South Georgia College. She served as chair of the Division of Nursing at King Saud University in Riyadh, Saudi Arabia, for many years, and taught the Reach to Recovery Program for the American Cancer Society. Tiller is survived by two children, five grandchildren, and five great-grandchildren.

JOANN GAYLER KING 56BSN of Monmouth, Ore., on Dec. 18, 2019, at 85. King was employed as a registered nurse. Her first husband, John E. Grund, died on July, 8, 1978. She married David C. King on July 16, 1983 and they moved to Monmouth, Ore., in 1988. They were recognized for their volunteer contributions with the Monmouth-Independence Chamber of Commerce First Citizen

Award in 2003. King is survived by three children, three step-children, two brothers, 16 grandchildren, and five great-grandchildren.

CAROLINE SAUNDERS WALLACE 56BSN of Santa Rosa, Fla., on Sept. 29, 2019, at 94. Wallace studied nursing at Georgia Baptist School of Nursing, University of Maryland, Johns Hopkins University, Emory University, and the University of Michigan. Wallace taught nursing at Vanderbilt University, the University of Tennessee, and Gulf Coast Community College in Panama City, Fla. In 1970, she moved to Seagrove Beach, Fla., where she enjoyed painting, dogs, garden clubs, faceting and gemstones.

JOAN HARTLEY LEHNHERR 58BSN of Raleigh, N.C., on Jan. 31, 2019. Lehnherr was a registered nurse who retired from Arthritis Associates. She is survived by two daughters.

1960s

LAURA GEWECKE MALOOF 61BSN of Cumberland, Md., on June 14, 2019. Maloof started her nursing career as a circulating nurse at West Penn Hospital in Pittsburgh, Pa. She became a nursing instructor at Memorial Hospital School of Nursing in Cumberland before serving as a nursing instructor at Allegany College of Maryland.

She was active in her church as well as area clubs and service organizations such as GFWC Cumberland Women’s Civic Club, Women’s Sport Club, and Re Temple 118 Daughters of the Nile. Survivors include her husband, Donald Maloof, a daughter, and a sister.

JANET ADAMS MCPHERSON 63OX 66BSN of Marietta, Ga., on Dec. 9, 2019. After college, McPherson served as a Lieutenant in the U.S. Navy for four years. She then worked as a registered nurse on 5 West at Kennestone Hospital, retiring in 1995. She enjoyed traveling, painting, reading and working on genealogy. Most of all, she enjoyed her family. She and her husband, Pat McPherson, celebrated their 50th wedding anniversary in December 2018. She is survived by her husband, three children, five grandchildren, and a brother.

retired as a captain after 37 years in the U.S. Navy Nurse Corps in 2010. Grenfell was also a nurse consultant for 25 years with the law firm of Gordon and Rees in San Francisco. She earned a MBA degree in health services management from Golden Gate University. She and her son, Eric, shared a love of theatre performances and she volunteered for the Oregon Shakespeare Festival which took them to Ashland, Ore., where she moved in 2010 to work for Harry & David as a nurse manager before retiring. She enjoyed hiking and camping in Alaska, loved her animals, and volunteered for the Jackson County Animal Shelter. She is survived by her son, a brother, a nephew, and a great-niece and a great-nephew.

1980s

MARLOT WILSON WIGGINTON 82MN of Louisville, Ky., on Oct. 26, 2019, at 71. She worked as a registered nurse in critical care at Norton Hospital and Jewish Hospital, both in Louisville. She recently taught nursing at the University of Louisville and Spalding University, and was a member of numerous nursing societies and associations. Wigginton is survived by a brother, a niece, and a nephew.

MARGARET A. RILEY 86MN of Atlanta on July 29, 2019, after a battle with cancer. Riley began her nursing career at Beth Israel Deaconess Medical Center as a head nurse manager after completing a BSN degree at Saint Louis University in 1973. While completing her master of nursing degree at Emory, she was a nurse case manager at Hospice Atlanta. Riley was director of the Oncology Program at Saint Joseph’s Hospital until 2007, worked with the Oncology Palliative Care program at Grady Health System from 2007-2010, and then at the Atlanta VA Medical Center from 2011 until her retirement in 2018. She completed a Family Nurse Practitioner degree and palliative care certification followed by a Doctor of Nursing Practice in nursing palliative care at the University of Alabama at Birmingham. Survivors include two brothers, a sister, and many other extended family members.

1970s

PATRICIA L. MUAR 72MN of Tallahassee, Fla., on Oct. 9, 2019. Muar received a BS degree in nursing from Florida State University and a PhD degree from the University of Texas at Austin. She taught for many years at Tallahassee Community College. She and her late husband, John Buckley, were advocates for many causes that benefited their community and for the greater good of all. Survivors include a brother and his family.

NORMA JEANNE GRENFELL 73BSN of Seattle, Wash., on Nov. 19, 2019, at 68. After graduation, Grenfell was commissioned as an ensign in the U.S. Navy and proudly

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