Emory Nursing Magazine - Fall 2021 by EmoryWeb

FALL 2021

A Matter of

COMMUNITY, CONNECTION & TRUST SPELMAN AND EMORY PARTNER TO EMPOWER A NURSING WORKFORCE THAT MIRRORS AN INCREASINGLY DIVERSE PATIENT POPULATION.

INSIDE: SOCIAL DETERMINANTS 12 RACE, HEALTH & HISTORY 18 AWARDS & ACHIEVEMENTS 22

DEAN’S LETTER Hello to all of you,

Leading the School of Nursing is one of the greatest blessings in my life. Teaching and mentoring the next generation of caregivers, innovators, researchers, and innovative leaders comes with rewards and challenges my colleagues and I take very seriously. There are many paths to success and problems to address. Photo by Emory Photo Video

Linda McCauley PhD, RN, FAAN, FAAOHN

In this issue you will read about a deep and meaningful partnership between the Nell Hodgson Woodruff School of Nursing and Spelman College—a historically Black liberal arts college for women in Atlanta. Our institutions recognize the growing need for nurses and the importance of a more diverse health care workforce. We created a joint degree offering, bringing together Emory nurse education and Spelman’s long history of success in the areas of science, technology, engineering, and math. For the past seven years, the School of Nursing has welcomed Spelman graduates into one of our programs to complete a degree in nursing. All have successfully passed their NCLEX on the first try. And most stayed in the Atlanta area. Our role goes beyond education and well into securing the future of nursing by understanding its challenges and bringing more care and advocacy to a growing and diverse population. The personal journeys profiled in this issue represent just a few examples of how the world of nursing continues to evolve and the importance of community—in education and practice. Efforts such as these strengthen the nursing industry by increasing diversity and making training available to more aspiring health care workers. It also supports the work of HBCUs long noted for developing exceptional leaders, including Vice President Kamala Harris. I’m very proud of these students and excited to see what their future holds. Our partnership with Spelman is just beginning, and I’m eager to share more success stories and promote additional ways the school moves forward by innovating in all areas of teaching, research, and policy, and developing new tools and procedures to advance health care. To complement this issue’s cover story, you’ll find details about integrating more materials and teaching on social determinants of health into the School of Nursing’s curriculum. When finished, every class offered at the school will contain elements of society, culture, environment, and policy that affect patients, particularly those experiencing health inequities. At most graduation and award ceremonies I leave our students with a message of encouragement and a reminder their call is more than their chosen job functions. Whether in research, administration, education, or at the bedside, nurses have a duty to be the advocate for those in need. These are just some of the ways we’re preparing them for that most important job. Enjoy the issue, Linda McCauley 79MN, PhD, RN, FAAN, FAAOHN Professor and Dean Nell Hodgson Woodruff School of Nursing

FEATURES

IN THIS ISSUE

FALL 2 02 1

A Matter of Community, Connection & Trust.....2

How Emory is working with Spelman College to create a more diverse nursing workforce.

Determinant Determination.....12

Understanding social disparities is key to updated nursing curriculum.

A Powerful Research Tool.....16

Project NeLL helps students leverage Big Data to solve problems.

Reducing Risks of Maternal Mortality.....17

Nursing professor works to improve childbirth outcomes.

At the Intersection of Race, Health & History.....18

Examining the legacy and life's work of Professor Kylie Smith.

PULSE 22

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 Managing Editor

Roger Slavens Art Director

Laura Dengler Director of Photography

Kay Hinton

Director of Digital Media

Stephen Nowland Creative Director

Photography Disclaimer: COVID-19 protocols appropriate to each setting and time were followed in taking the photographs that appear in this magazine. 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.

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.

Peta Westmaas

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Editorial Contributors

Pam Auchmutey Debbie Carlisle Kristin Baird Rattini Maddie Speece Copy Editor

Stacey Jones Production Manager

Stuart Turner

Executive Director, Communications & Marketing

Tionna Carthon

Executive Director of Content

Jennifer Checkner

Photo by Bita Honarver

Associate Vice President, Health Sciences Communications

ON THE COVER | Jordan Murphy earned dual degrees from Spelman College and Emory's School of Nursing.

Nikki Bartholomew Troxclair

COVER STORY

By Kelley Freund Photography by Kay Hinton | Illustration by Egle Plytnikaite

Rosiland Gregory-Bass

Jodian Grant

Jordan Murphy

A Matter of

COMMUNITY, CONNECTION & TRUST A growing partnership between Emory’s School of Nursing and Spelman College helps create a top-educated and diverse nursing workforce to serve an increasingly diverse patient population—in Atlanta and beyond.

A Photography Disclaimer: COVID-19 protocols appropriate to each setting and time were followed in taking the photographs that appear in this magazine.

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s our world changes, it’s becoming ever more necessary to develop a health care workforce that mirrors the patient population, and Emory University's Nell Hodgson Woodruff School of Nursing has figured out a unique way to do just that: a joint degree program with Atlanta metro area neighbor Spelman College, the nation’s top HBCU (historically Black colleges and universities). The partnership between Emory and Spelman College is a natural fit. Emory’s

School of Nursing has been a longtime leader in nursing education, consistently earning top-five spots in US News and World Report rankings. Likewise, Spelman College, the nation’s oldest institution of higher education for Black women, is known for its strong STEM curriculum and has been ranked the No. 1 HBCU by US News and World Report 14 years in a row, and is one of the country’s top institutions for sending Black women to medical school.

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COVER STORY

At a Glance

A WIN-WIN RELATIONSHIP The relationship between the two schools began in 2014, with the creation of a dual-degree program designed to graduate more minority nurses into the field. Students earn their bachelor of arts degree from Spelman College, then transfer their fourth year to Emory to complete a two-year curriculum and receive a bachelor of science in nursing. But administrators soon discovered many students wanted to complete all four – Rosiland Gregory-Bass, years at Spelman, Spelman faculty member thanks to the unique opportunities and experiences an HBCU provides. So Emory created more options for Spelman students to earn their nursing degrees—and at a quick pace. Today, most of the students complete their undergraduate degrees in full before enrolling in one of Emory’s accelerated programs such as a bachelor of science in nursing or one of the master's programs at the school, says Jasmine Hoffman, associate dean for enrollment and communications at Emory’s School of Nursing. Rosiland Gregory-Bass currently serves as director of the Health Careers Program and associate professor in the Department of Environmental and Health Sciences at Spelman. She helped launch the partnership with Emory back in 2014, and, as a Spelman graduate herself, understands the importance of having that full HBCU experience. “For many students at Spelman, this is a time where they not only have this depth of content acquisition from an academic standpoint, but there’s also a personal development that occurs,” she says. “It’s an experience that allows them to flourish devoid of any societal challenges associated with racism or other discriminatory experiences. And this is where we find individuals coming into their own.”

“THIS IS A TIME WHERE STUDENTS NOT ONLY HAVE THIS DEPTH OF CONTENT ACQUISITION FROM AN ACADEMIC STANDPOINT, BUT THERE’S ALSO A PERSONAL DEVELOPMENT THAT OCCURS.”

THE SPELMAN-EMORY DUAL-DEGREE PARTNERSHIP Creates a path for graduates of Spelman College—the nation’s oldest HBCU dedicated to serving Black women—to earn a nursing degree from Emory. Known for its strong STEM curriculum, Spelman has been ranked the No. 1 HBCU by US News and World Report for 14 years in a row and is one of the country’s top institutions for sending Black women into advanced health care and medical programs. Creation of the nursing dual-degree between Spelman and Emory began in 2014. How it works: Students first complete a bachelor’s of arts degree at Spelman and then transfer in their fourth year to complete their bachelor’s of nursing degree in two years from Emory. 100 percent of Spelman graduates who have completed their degree in nursing from Emory have passed their NCLEX exams and are now either in graduate school or working full time. Most graduates of the Spelman-Emory dual-degree program have stayed in the Atlanta area.

Rosiland Gregory-Bass, director of the Health Careers Program at Spelman College

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COVER STORY CONFIDENCE + NURSING EXPERTISE That’s exactly the way recent Emory graduate Jodian Grant 21N describes her time at Spelman. Grant and her family moved to the United States from Jamaica when she was 16, and as an immigrant and first-generation college student, she was unsure how she would fare in Emory’s nursing program. “But HBCUs like Spelman really prepare Black women to go out into the world and be leaders,” Grant says. “I appreciate that now as a graduate. I see how much that experience developed me not only academically but personally. I’m more confident now. I’ve come out a different person.” Grant says she decided to continue her education at Emory because she knew the program would provide the clinical time and simulation labs she needed to enter the workforce as competent as possible. Emory’s reputation as a top nursing school is well-known among Spelman graduates, and, as Bass points out, if a student is already having a great experience in Atlanta, the relationship between the two schools offers a seamless transition to continue that by enrolling in a nursing program just across town. That was the case for Kiara Hill 18N, whose extra high school credits led her to graduate a year early from Spelman. While she was attracted to Emory’s high-ranking nursing program, Hill also wanted to stick around Atlanta to be close to friends who were still attending Spelman. After completing Emory’s accelerated bachelor of nursing degree, she now lives in Los Angeles, where she works as a psychiatric nurse. Hill often helps with her hospital’s admissions and feels the nursing skills she learned at Emory, such as assessing patients, has led to her success. So has the program’s emphasis on critical thinking. “This is my first nursing job, but I know the right questions to ask to get more information,” Hill says. “I don’t have to call in my supervisor constantly because I can think through a situation and figure it out.”

“PATIENTS WANT TO FEEL CONNECTED, AND THEY WANT TO FEEL LIKE THEY CAN TRUST THEIR HEALTH CARE PROVIDERS. DIVERSITY HELPS YOU BE MORE RELATABLE. BECAUSE I’M AN IMMIGRANT, I CAN RELATE TO FELLOW IMMIGRANTS AND THEREFORE THOSE PATIENTS MIGHT BE MORE WILLING TO PARTICIPATE IN THEIR PLAN OF CARE.” – Jodian Grant, recent nursing graduate

Jodian Grant, recent nursing graduate

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COVER STORY SERVING ATLANTA AND BEYOND Of the 12 Spelman graduates who have come through Emory’s School of Nursing since 2014, all have passed their NCLEX exams and are now either in graduate school or working full time—and the majority have stayed in the Atlanta area. Jordan Murphy 15N 18G 20PhD is one such alumna. A native of Durham, N.C., Murphy graduated from Spelman with a degree in biology. She chose to continue her education at Emory because of its reputation as one of the top institutions for preparing nurses and nurse scientists and went on to earn her bachelor’s, master’s, and PhD from the school. Today, Murphy works as a pediatric nurse practitioner and director of operations at Atlanta’s Community Advanced Practice Nurses Clinic, a free health care clinic that serves homeless or uninsured families. “I love the population I work with, and because we have satellite locations, I’m always interacting with different groups of people,” Murphy says. “I feel so connected to the community. I’ve spent the last 13 years working and volunteering throughout Atlanta, and I’m committed to continuing what I’ve begun here.” Other Spelman-Emory graduates have found positions with Children’s Healthcare of Atlanta, Piedmont Healthcare and the Atlanta VA Medical Center. “Many of these students are not from Atlanta, but they fall in love with the city and decide this is where they want to help support the health care workforce,” Hoffman says. “That’s really powerful.” It’s powerful because the Atlanta metro area has some major health and health care disparities to overcome. The city has the widest gap in breast cancer mortality rates between African American women and white women of any United States city, as well as the nation’s highest death rate for Black men with prostate cancer. A 2015 study conducted by researchers at Virginia Commonwealth University found – Jordan Murphy a 12-year difference in average lifespan in the neighborhoods of Fulton County, with predominantly Black areas faring worse. These neighborhoods often lack access to critical resources such as quality medical care, and because housing and food are top priorities for lowincome families, there’s little to no money to spend on preventive care.

“BECAUSE WE HAVE SATELLITE LOCATIONS, I’M ALWAYS INTERACTING WITH DIFFERENT GROUPS OF PEOPLE. I FEEL SO CONNECTED TO THE COMMUNITY. I’VE SPENT THE LAST 13 YEARS WORKING AND VOLUNTEERING THROUGHOUT ATLANTA, AND I’M COMMITTED TO CONTINUING WHAT I’VE BEGUN HERE.”

Jordan Murphy, pediatric nurse practitioner

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COVER STORY ADDRESSING DIVERSITY AND DISPARITIES

“WE PLAN TO CONTINUE TO PROMOTE INITIATIVES THAT ARE AIMED AT CREATING DIVERSITY IN THE HEALTH CARE WORKFORCE. THAT IS A REAL PRIORITY FOR THE SCHOOL OF NURSING AND FOR EMORY AS A WHOLE.” – Jasmine Hoffman

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Of course, the rest of the nation isn’t immune to these disparities, which don’t exist solely within the context of race and ethnicity. Sexual orientation or identity, religion, citizenship status, and disability also contribute to a person’s ability to achieve good health. Creating a more diverse nursing workforce that is ready to address the cultural needs of patient populations can help eliminate some of those disparities. Research has shown that when nurses understand and relate to the culture and history of a patient’s community, they are able to provide more customized treatment, and patients feel more comfortable and confident in the care they are receiving. “Patients want to feel connected, and they want to feel like they can trust their health care providers,” Grant says. “Diversity helps you be more relatable. Because I’m an immigrant, I can relate to fellow immigrants and therefore those patients might be more willing to participate in their plan of care.” That trust can have a major impact on the prevention, diagnosis, and treatment of various diseases and conditions in our society, especially those that disproportionately affect African-American populations, such as heart disease and diabetes. “I have great uncles and grandparents who don’t want to go to the doctor’s office, and I think that’s the case for a lot of Black people,” Hill says. “No one looks like them there, and therefore they can’t trust anyone. I think the more Black people we can get in the health care workforce, the more it alleviates that problem. People would be more inclined to get help and those disease rates wouldn’t be as high.” But creating a diverse nursing workforce begins with the institutions providing nursing education and how

much they strive to reflect the culture they want to see out in the world. Emory University has an Office of Diversity, Equity, and Inclusion (DEI), and last summer the School of Nursing created its own DEI office in an effort to create a strong culture that embraces and promotes those values. According to the office’s assistant dean, Lisa Muirhead, one of the focuses of the new office is to provide awareness and education about DEI topics, and the office’s website provides access to a variety of articles, podcasts, books, and professional development courses for the School of Nursing community. Another focus is to enhance the nursing school’s curriculum by weaving concepts of diversity, cultural sensitivity, and social action throughout each program of study. A third goal is to create benchmarks for the recruitment of faculty, students, and staff from underrepresented communities. “There’s a richness that diversity brings,” Muirhead says. “In order to improve the quality of our education here at Emory, it’s essential to bring together people with diverse backgrounds, life experiences, and perspectives. I believe the School of Nursing can be a catalyst for innovation and advancing education through diversity.” The School of Nursing’s partnership with Spelman College certainly plays a role in that. But Hoffman says it’s only the beginning. Emory is working to establish a similar joint-degree program with Morehouse College, a men’s HBCU also based in the Atlanta metro area. “We plan to continue to promote initiatives that are aimed at creating diversity in the health care workforce,” Hoffman says. “That is a real priority for the School of Nursing and for Emory as a whole.” FAL L 2021 |

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FEATURE

DETERMINANT DETERMINATION By Pam Auchmutey Photography by Kay Hinton illustration by DAN BEJAR

Disparities in the distribution of wealth, power, and resources shape the conditions into which we are born, live, work, and play—often driving adverse health outcomes and risks. Thanks to professor Jill Hamilton and her peers, understanding these social determinants and how they impact patients have become an integral part of the School of Nursing’s curriculum.

ill Hamilton has never been one to turn down an opportunity to transform how nursing students and nurses care for patients. So when Dean Linda McCauley asked the associate professor to lead an initiative to integrate the social determinants of health (SDOH) into each and every class at the Nell Hodgson Woodruff School of Nursing, Hamilton said yes. She well knew the importance of the task at hand. For a number of years, the World Health Organization (WHO), the Centers for Disease Control and Prevention (CDC), the Association of American Colleges of Nursing (AACN), and other agencies have called for addressing the SDOH to reduce health inequities among minority, ethnic, LGBTQ, and rural populations. Hamilton’s own research has centered on health disparities among African Americans, including the social determinants that influence coping with a cancer diagnosis. When talking with students and faculty about the SDOH, Hamilton points to a definition from the US Department of Health and Human Services report Healthy People 2030. It describes social determinants as “conditions in the environments in which people are born, live, work, play, worship, and age that affect a wide range of health, functioning, and quality of life outcomes and risks.” Hamilton witnessed these conditions long before “social determinants of health” became part of

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health nomenclature. She grew up in a small, rural African American community in western North Carolina, where she first practiced nursing in 1982. “Everyone knew then that people of color didn’t get the same quality of care,” she remembers. “When I was in nursing school [at the University of North Carolina at Chapel Hill], the thinking was that if we educated more health professionals who are members of those populations, it would help alleviate the problem. We also needed to place more of them in rural settings. Both helped address the problem to some extent. But in spite of these efforts, we still have health disparities among people of color and in rural areas.” Hamilton has a vision for how to do better. “It’s not about certain populations trying to alleviate the problem,” she says. “It’s up to each and every one of us in the nursing profession to alleviate health disparities. People are suffering and dying because we haven’t figured out how to address the social determinants of health.” The place to begin, AACN and Emory leaders agree, is in the nursing curriculum. “We want to move away from a place where the social determinants of health are taught in certain courses and not in others,” Hamilton says. “We know that’s important because our nursing accreditation boards have said so. Above all, it’s important that we fully embrace it, so that we provide the best care to our patient populations.”

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Photo by Kay Hinton

FEATURE

It’s up to each and every one of us in the nursing profession to alleviate health disparities. People are suffering and dying because we haven’t figured out how to address the social determinants of health. –Jill Hamilton, associate professor of Nursing Jill Hamilton

POWERFUL CONVERSATIONS

Associate Clinical Professor Hope Bussenius 93MSN has included the SDOH in her courses for years. At the start of the health assessment course she coordinates, undergraduate students complete a self-evaluation to gauge their cultural awareness and their ability to assess different communities and populations. “It leads to some powerful conversations with students,” says Bussenius, who has served vulnerable populations in Atlanta, Haiti, and North Carolina, where she grew up in the Lumbee Tribe. “It’s important that they learn how to gather subjective components from different populations of patients—their family history, their symptoms, their chief complaint—and how those components are threaded through their health history. We orient students early on to conduct those interviews through a cultural evaluation lens.” Culture is part of the curricular framework Hamilton developed for the School of Nursing. The framework rests on four SDOH pillars: social, cultural, environmental, and policy. She considered other frameworks used in medicine and public health, but they gave her pause. “I’m not saying those frameworks are wrong,” says Hamilton. “But it was clear to me that nursing needed something more pragmatic and comprehensive—something that could guide us in the way we approach social determinants among the diverse populations that we serve. Nurses are in hospitals, in clinics, in communities, in schools. We needed a framework that’s useful, regardless of the setting or population.” 14 Emory Nursing

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WOVEN INTO THE CURRICULUM

Faculty are rolling out the SDOH in phases. In fall 2020, they wove them into their course objectives for students in the MN+MSN program. This spring, students in the InEmory program began learning about them, followed by students entering the Distance Accelerated BSN program this summer. This fall, the SDOH will span the entire curriculum, including courses for DNP and PhD students. “We know this is a huge undertaking, and it’s a lot to ask faculty to incorporate these concepts into their objectives and their teaching strategies,” says Hamilton. “We are going to emphasize one pillar each semester, so that faculty and students don’t feel overwhelmed.” DNP student Priya Schaffner 18N 19MSN is helping Hamilton’s faculty team bring the SDOH to life across the curriculum. Schaffner remembers how it used to be as an Emory BSN and MSN student only a couple of years ago. “Generally, the exposure to the SDOH was in course readings or a PowerPoint slide,” she says. “It was introduced, but it didn’t go the next step into how these determinants play a role in health. Dr. Hamilton wants to push students to think, ‘how can I address them?’” Schaffner is reviewing course assignments with an eye toward incorporating SDOH concepts in meaningful ways. For one course, she has recommended turning a conflict outcome journal assignment into an SDOH clinical reflection. “For example, if transportation is an issue for a patient and poses a conflict in making an appointment, what are

some community resources that could address this determinant of health,” says Schaffner. “That’s the next step—what can I as a student do to address the problem?” She came to that very realization as a student in the family nurse practitioner program. She was completing a clinical rotation at Mercy Care, which serves homeless and other vulnerable patients in Atlanta. “It was the first clinical setting where the work I was doing was interwoven with the work being done to address the social determinants of health. Everything— social work, behavioral health, primary care—was done simultaneously as a team.” “As nurses—depending on what setting you’re in—we have the means, the skills, the leverage to make important changes in patients’ lives,” Schaffner adds. “The model is patient-centered care, which is very much at the heart of the nursing model. It all really hit home for me at Mercy Care.”

SHIFT IN PERCEPTION

Once the curriculum changes at the School of Nursing firmly take hold, Hamilton expects to see a shift in how faculty and students perceive the SDOH. Rather than seeing them as detriments to health, could some be seen as strengths? Are there specific determinants that can improve a patient’s health? In her studies of how African Americans cope with cancer, Hamilton has observed how the cultural factors of spirituality and religious songs help ease their depression and anxiety. Those studies inform her discussions with students about the African American population, which continues to have the highest rates of cancer illness and deaths. She encourages students to consider

how to address the SDOH that contribute to these morbidity and mortality rates. Does the patient have social support at church or in the community? What are their spiritual beliefs? Does their home and family environment increase or alleviate their stress? Are there policies at their hospital, doctor’s office, or in the community that contribute to their anxiety? By raising similar questions throughout the nursing curriculum, faculty will broaden and deepen how students care for patients and populations as nurses. “Students will begin to think more about the factors that contribute to a patient’s illness and recovery,” says Hamilton. “It’s never one thing that causes a patient to become ill. It’s multiple factors. The social determinants of health are not independent of each other. They are tied together like a piece of woven cloth.” Bussenius has taken Hamilton’s initiative to heart by focusing more on the application of the SDOH in her teaching. Recently, she helped run a health equity simulation that Assistant Clinical Professor Quyen Phan developed for undergraduate students in her population health course. During the simulation, students play different roles in a scenario that illustrates the difficulties a hospital patient and family encounter in navigating a bewildering health care system. The scenario is based on the courses Bussenius and Phan have taught for years. “It’s going to take all of us to continue moving forward,” says Bussenius. “We now have a structure for defining the social determinants of health that gives it more meat and potatoes, I would say. Now we can move forward and all be on the same page.” FAL L 2021 |

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FEATURE

A Powerful Research Tool School of Nursing students are leveraging Project NeLL to incorporate health disparities research into their capstone and dissertation projects. By Pam Auchmutey

mory nursing students and faculty have a powerful new research tool to strengthen their ability to solve problems in patient care. The Nurse’s Electronic Learning Library, or Project NeLL, is a robust and user-friendly platform created by data scientists at the School of Nursing. Piloted by 10 nursing students in 2019–2020, Project NeLL provides a webbased suite of apps for teaching, learning, and practicing data science. It is the flagship project of the Innovation Hub in the new Emory Nursing Learning Center, which will occupy four floors of newly renovated office space in Decatur by next year. Students at all levels are now using NeLL to capture data for capstone and dissertation topics that span care settings, geographies, different conditions, and patient populations. Given the school’s curriculum-wide emphasis on the social determinants of health (SDOH), specifically eliminating health disparities, NeLL has become an invaluable tool for investigating the multitude of factors driving differences in care. Currently, Project NeLL includes data from across Georgia and the Emory Healthcare Network, providing access to 2.7 billion de-identified health records and representing more than 1.2 million patients.

The database includes visit information, medications, procedures, orders, lab results and non-lab measures, a multitude of standard values from nurses notes, and much more. No matter its size, NeLL is as an easyto-use portal that nurses across the country will eventually be able to use. The portal includes several web-based apps: a big data depository, a big data dictionary, self-directed learning modules for students and nurses, and curricular bundles for faculty. Self-directed learning and teaching apps, including an online course, will be available soon. “Project NeLL is unique as a data source because it is nursing centered,” says Rose Hayes, the nursing school’s director of engagement. “It’s very rare to see a database that’s inclusive of so many conditions and specialties. We purposely made NeLL easy to use so that nurses of every level leverage it as a tool for health system leadership and health care transformation.” The School of Nursing and the American Nurses Informatics Association conducted focus group testing of NeLL in March. The NeLL team is now accepting inquiries about beta testing and is in the process of establishing test sites across Georgia and and beyond.

To subscribe, beta test, or partner to help Project NeLL grow, contact ProjectNell@emory.edu.

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Alexis Dunn Amore, assistant research professor of nursing

Reducing Risks of Maternal Mortality The School of Nursing’s Alexis Dunn Amore is building a web platform and mining Big Data to help mothers—especially Black mothers—and their infants survive childbirth. By Pam Auchmutey

or nurse-midwife Alexis Dunn Amore 09MSN 17PhD, the social determinants of health (SODH) are ingrained in her soul. She encounters these factors when caring for pregnant Black women. She studies a variety of physiologic and social risk factors that increase the population’s disproportionately high rate of maternal mortality. Additionally, she explores these factors more intimately in a community support group for new moms and in classes with Emory nursing students. Amore, an assistant research professor, is currently working on a project with Dean Linda McCauley 79MN to develop a web-based platform to address maternal mortality risk. It’s being developed as a user-friendly resource to help new mothers and their infants stay healthy. The project is supported with funding from the Woodruff Health Sciences Center at Emory. “When a mom and her baby are discharged home, we instruct them to call their provider if they develop X,Y,Z symptoms,” says Amore, who practices at the Atlanta Birth Center. “If a new mom is sitting at home, and her chest starts to hurt and she’s just had a baby, this platform would allow her to go to our website and click through their symptoms. It would give them the option of following up with their provider and generate a PDF to take with them. We’re creating this platform to provide them with more accessible resources.” Amore is also using Project NeLL, the School of Nursing’s new data science platform, to collect and analyze information

on the SDOH. Working with researchers from Rollins School of Public Health, she is incorporating data into the tool utilizing information available from analyses of state birth records and discharge data for Georgia mothers. The team is also mining the US Census Bureau’s American Community Survey to gather SDOH data on women who live in certain parts of Georgia. Amore will use this information to look at health risks based on where women live. In yet another analysis, Amore will examine specific SDOH factors such as transportation. Her research dovetails with Professor Jill Hamilton’s initiative to incorporate the SDOH throughout the School of Nursing curriculum. During a recent guest lecture to nursing students, Amore spoke about the high rates of preeclampsia, preterm birth, and maternal mortality among Black women. Georgia’s maternal death rate is the highest in the country. Black women in the state are twice as likely to die after giving birth than white women. As she told students, “I don’t want you to leave class thinking it’s about the color of someone’s skin. I want you to understand the social factors around it.” Such discussions can make students feel uncomfortable, Amore admits. “It’s important for them to examine the lens where they’re coming from to better understand the social factors that affect people who don’t look like them. You have to take the conversation inward and then take the conversation outward to help the patients you are caring for.” FAL L 2021 |

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THE LIFE'S WORK OF PROFESSOR KYLIE SMITH

Professor Kylie Smith’s research on history and nursing’s role in society has been attracting international attention— and acclaim—for years.

Photo by Stephen Noland

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Kylie Smith

TO LEARN MORE ABOUT SMITH’S BOOK, VISIT nursing.emory.edu/talkingtherapy.

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She’s recently been focusing more of her efforts on exploring racial equity and social justice in her work as the Andrew W. Mellon Faculty Fellow for Nursing and the Humanities. This role at Emory is truly interdisciplinary, and Smith strives to build collaborations and bridge gaps between the School of Nursing, the Center for Ethics, the Center for Human Health, and Emory College of Arts and Sciences. This past year, Smith taught a new class that examined the intersection of race, health, and US history, guiding Emory College students in studies of the historical and structural factors that have led to racial disparities within the American health care system. The course’s challenging topics included racism as a public health crisis and gender, reproduction, and eugenics. “I love being interdisciplinary. It’s really satisfying to see the value of the humanities for nursing, and to know that the work we do in this space will improve our understanding of current health problems,” Smith says. “I love being able to work with nursing students as well as history ones, and I love seeing the way that history and critical theory can have a real impact on nursing education, on the types of practitioners we produce, and on the research they undertake.” While this class was the first of its kind, Smith is no stranger to analyzing the crossover between race, history, and the health care system. She teaches multiple courses throughout the university, ranging from the history of race within health care to nursing theory and philosophy. She’s currently working on a new book, Jim Crow in the Asylum: Psychiatry and Civil Rights in the American South. The book looks at the impact of the Civil Rights Act on racist practices in psychiatric hospitals in Georgia, Alabama, and Mississippi, comparing the reactions of these state governments to the mandate to integrate. In doing so, her work will reveal the horrific

conditions that existed for African Americans in state asylums and make links between past practices and current disparities in mental health. The US National Library of Medicine awarded Smith a $150,000 Grant for Scholarly Works in Biomedicine and Health to complete research for the book. “What an exciting opportunity this grant provides Dr. Smith as well as the School of Nursing to further examine and learn from this important topic and time in history,” says Nursing School Dean Linda McCauley. Smith hopes her work as a teacher and researcher leaves a lasting impact. “I really hope that by the time I am ready to shuffle off this mortal coil, people will have realized that health disparities and injustice are a direct consequence of racist and discriminatory policies of the past,” she says. “To be able to address them, we must really face that history. I want us to stop blaming individuals for problems that are caused by policies and ideologies that we are think are finished but are really so deeply embedded in the social fabric that they are almost invisible.” Her previous book, Talking Therapy: Knowledge and Power in American Psychiatric Nursing, was named the 2020 American Journal of Nursing Book of the Year for History and Public Policy. The book also received the 2020 Lavinia L. Dock Award from the American Association for the History of Nursing. In the book, Smith examines the history of psychiatric nursing, drawing many comparisons to the Netflix episodic thriller Ratched, which follows the life of the fictional Nurse Ratched before she appears in the classic novel and film One Flew Over the Cuckoo’s Nest.

"I LOVE SEEING THE WAY THAT HISTORY AND CRITICAL THEORY CAN HAVE A REAL IMPACT ON NURSING EDUCATION, ON THE TYPES OF PRACTITIONERS WE PRODUCE, AND ON THE RESEARCH THEY UNDERTAKE.”

—Kylie Smith

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PULSE New Helene Fuld Health Trust Gift Supports Nursing Master’s Students

generous philanthropic partner who helped transform the Nell Hodgson Woodruff School of Nursing two decades ago made a recent significant gift to help master's students prepare for nursing service. The Helene Fuld Health Trust made a $600,000 gift commitment that will provide tuition support to students in the Master of Nursing (MN) program. The gift establishes the permanently endowed Helene Fuld Health Trust Scholarship, and income from the endowment will enable the School of Nursing to award annual scholarships to students pursuing MN degrees. Because endowed funds take time to become available, the gift also provides immediate scholarship funds, and four current students received awards of $10,000 each for the 2021–2022 academic year. “The Helene Fuld Health Trust supports our mission to make a nursing education possible, and we are grateful,” says Linda A. McCauley, dean of the Nursing School. Helene Fuld (1858–1923) was a health care advocate and educator whose children created a foundation in her memory to help those suffering from illness. The Helene Fuld Health Trust is the nation's largest private funder devoted exclusively to nursing education and students. Its $5 million gift in 2002 was the largest gift in the School of Nursing’s history. The Helene Fuld Health Trust also gave $6.5 million to the school in 2013. “The Fuld Foundation partnership has been integral for our progress from regional leadership to a national leadership in nursing education,” says Jasmine G. Hoffman, associate dean for enrollment and communications, noting that the School of Nursing is ranked No. 5 nationally for master’s programs by US News & World Report. “The funding helps us attract and retain the best students regardless of socioeconomic disparities.” Emory’s accelerated BSN/MSN program allows students with a bachelor’s degree to earn a BSN in just fifteen months and an MSN in two-and-a-half years. Fuld Service Learning Fellows are accelerated MN+MSN students who have a special commitment to social responsibility within professional nursing. The meaningful results of this major donor’s funding include signature programs. Palliative Care Fellows are part of the School of Nursing’s innovative program to develop nurse leaders who influence palliative care, an area of health care that is rapidly growing as more Americans are facing life-threatening and chronic illnesses. The Center for Nursing Excellence in Palliative Care teaches nursing students to implement palliative care principles across Emory Healthcare. Settings include Emory University Hospital, Children’s Healthcare of Atlanta, and the Atlanta VA Medical Center. The Helene Fuld Health Trust funding provides for general nursing scholarships as well, McCauley says. In 2020, the School of Nursing had distributed more than 1,500 need- and merit-based scholarships to almost 900 students. 22 Emory Nursing

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Nursing Professors Receive NIH Grants

Using Yoga to Treat PTSD: Professor Finds Positive Results in Research

Matthie Receives Grant for Work Studying Sickle Cell Disease

hree members of the School of Nursing’s faculty recently were awarded funding for their efforts to improve human quality of life in very different ways, ranging from improving air quality to developing better health communication tools and processes. These Emory nursing awardees are: Lisa Thompson, PhD, RN, FNP-BC, MS, FAAN, associate professor, who received a grant totaling $2,667,915 over five years from NIH. The grant goes toward implementing community working groups in Guatemala to improve air quality by reducing household plastic waste burning, reducing human health effects, and improving health-related quality of life in women of reproductive age. Jessica Wells, PhD, RN, WHNPBC, assistant professor, who was awarded a grant totaling $1,954,690 over five years from NIH to promote HPV vaccination among HIV-positive adults and pursue novel approaches to addressing a serious and preventable public health problem. As people with HIV are aging, comorbidities are emerging, and Wells will tailor and implement evidence-based, multilevel programs at HIV clinics to promote HPV vaccinations and improve cancer outcomes. Rasheeta Chandler, PhD, RN, FNP-BC, FAANP, FAAN, assistant professor, who received $744,264 over three years from NIH to develop a mobile app to optimize HIV prevention and sexual and reproductive health communication among Black women in the Southern US. Black women have the second highest rate of all new HIV infections in the US, and Chandler and a multidisciplinary research team will work to refine and test the in-the-kNOW app designed to help Black women at risk.

rsula Kelly, PhD, APRN, ANPBC, PMHNP-BC, and others provided interim results earlier this year after assessing the effectiveness of Trauma Center Trauma-Sensitive Yoga (TCTSY) for post-traumatic stress disorder (PTSD) among female veterans related to military sexual trauma (MST). Ursula Kelly According to Kelly, this is the first randomized study comparing yoga with cognitive processing therapy, a long-standing, traditional treatment for PTSD. Initial findings can be found in the Journal of Alternative and Complementary Medicine: Paradigm, Practice, and Policy Advancing Integrative Health. Kelly, an associate professor at the School of Nursing, has research and clinical expertise on the impact interpersonal violence plays on a woman’s mental and physical health. She works as principal investigator of the study, funded by the Veterans Administration. Participants in the study focus on the physiological condition of the body—in Hatha-style yoga—and relay themes of establishing safety, individual choice, being in the present moment, and taking effective action. Kelly will present findings and recommendations to the Independent Review Commission that President Joe Biden established to review how the Department of Defense is handling military sexual trauma.

he National Institute of Nursing Research of the National Institutes of Health has awarded an R21 Exploratory/Developmental Research Grant to Nadine Matthie, PhD, RN, CNL, assistant professor of nursing. Her grant proposal, “HomeBased Self-Management Nadine Matthie of Chronic Pain in Adults with Sickle Cell Disease: Applying a Biopsychosocial and Technological Approach,” received funding for a clinical trial to improve self-management of chronic pain from sickle cell disease (SCD). The grant gives Matthie and the School of Nursing the opportunity to examine and learn from this important topic. Matthie's research indicates a high occurrence of chronic pain in adults with SCD. Moreover, Black adults with SCD often encounter challenges in obtaining comprehensive care for chronic pain that includes behavioral pain management strategies. As an alternative approach to using opioids, Matthie will apply virtual reality (VR) as an evidence-based and nonpharmacological treatment option that addresses chronic pain management without decreasing the quality of life of affected individuals. This award will allow Matthie to use AppliedVR's EaseVRx system as a behavioral pain management strategy to determine the feasibility for self-management of chronic pain among sixty Black young adults, ages 18–40, with SCD. Taking place in the home, Matthie’s study will help assess the preliminary efficacy of EaseVRx on pain and pain-related outcomes and how the system can be tailored for a target audience of primarily Black patients. FAL L 2021 |

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PULSE Clevenger Appointed to Georgia Board of Health Care Workforce

arolyn C. Clevenger, DNP, RN, GNP-BC, AGPCNP-BC, FAANP, FGSA, FAAN and associate dean for transformative clinical practice, has been appointed by Georgia Governor Brian Kemp to serve on the Georgia Board of Health Care Workforce (GBHCW), along with fourteen Carolyn Clevenger other health care industry experts. The group consists of practicing physicians and health system executives across disciplines who identify the health care workforce needs of Georgia communities. The board advises on community development and oversees support and development of medical education programs in medically underserved areas. Members meet quarterly to provide specific recommenda-

tions to the Georgia Department of Community Health. Clevenger is a nationally recognized educational leader in advanced practice nursing, geriatrics, and gerontology. She is a fellow of the American Association of Nurse Practitioners (AANP), the Gerontological Society of America, and the American Academy of Nursing. She is a contributor to the AANP Certification Board for the Adult/Gerontology Primary Care Nurse Practitioner exam and publishes on the advanced practice nurse workforce and nurse-led models of care. Her work in implementing an integrated clinical model that provides primary care to people living with dementia has resulted in more than eight publications, ongoing consultations, and testimonies to governmental oversight bodies. “As a nurse practitioner who delivers primary care for older adults, I am delighted to work alongside the board’s group of experts to measure and improve the pipeline of advanced practice nurses for Georgians of all ages,” said Clevenger. Clevenger earned her BSN from West Virginia University, her MSN from Emory University, and her DNP from Medical College of Georgia (Augusta University). She completed a postdoctoral fellowship at the Department of Veterans Affairs.

Faculty Honored with Prestigious University Awards Every year, two faculty members are recognized at commencement for their work in the classroom. The 2021 winners continue a long tradition of excellence at the School of Nursing and show devotion to the school’s stated values.

Rowena Elliott

McCauley Elected to National Academy of Medicine’s Governing Council

inda A. McCauley, RN, PhD, FAAN, FAAOHN and dean of the Nell Hodgson Woodruff School of Nursing, has been elected by the National Academy of Medicine (NAM) membership to serve on the academy’s Governing Council. McCauley will serve alongside four other NAM members for a three-year term, effective July 1, 2021, through June 30, 2024. “As a member of the NaLinda McCauley tional Academy of Medicine, I am honored to serve my peers through this governing council,” says McCauley. “The academy’s work providing independent and authoritative advice is an important role in assuring a healthy future for people around

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the world, and I am looking forward to continuing this impactful work in the next three years.” The National Academy of Medicine is one of three academies that make up the National Academies of Sciences, Engineering, and Medicine of the United States. As private, nonprofit institutions, the National Academies provide objective advice on matters of science, technology, and health. With members elected for their outstanding achievements, NAM acts as an independent, evidence-based scientific adviser on critical issues of health nationally and globally. McCauley’s tenure on other governing bodies such as the EPA’s Children’s Health Protection Advisory Committee (CHPAC) and fellowship within prestigious academies such as the American Academy of Nursing (AAN) and the American Academy of Occupational Health Nurses (AAOHN) has earned her recognition across the country. The National Academy of Medicine hosts many programs, including expert guidance on health policies, leadership programs, a human gene editing initiative, and a network of organizations committed to reversing trends of clinical burnout. Along with her Governing Council peers, McCauley will serve more than 2,000 NAM members.

Phyllis Wright

The 2021 Emory Williams Distinguished Undergraduate Teaching Award is presented to faculty members in each of Emory’s four undergraduate programs. The award, which recognizes a record of excellence in undergraduate teaching, was established by Emory Williams, a 1932 Emory College alumnus and longtime trustee. The 2021 recipient from the School of Nursing is Rowena Elliott, FAAN, associate clinical professor of nursing. The Provost’s Distinguished Teaching Award for Excellence in Graduate and Professional Education recognizes outstanding scholars who excel as teachers within formal and informal educational settings. One faculty member in each of the seven graduate and professional schools is given the award in recognition of the important role of exceptional teaching in graduate and professional education. The 2021 recipient from the School of Nursing is Phyllis Wright, FAAN, assistant clinical professor of nursing.

For more on these and other awards received by faculty, staff, and students, visit: nursing.emory.edu/awards

Emory Associate Dean Earns Outstanding Nurse Scientist Award

Eun-Ok Im

he Council of Advancement of Nursing Science (CANS) has selected Eun-Ok Im, PhD, MPH, RN, CNS, FAAN, as the recipient of the 2020 Outstanding Nurse Scientist Award. Im currently serves as dean of research and innovation for Emory School of Nursing and was honored at the virtual CANS 2020 State of the Science Congress on Nursing Research,

September 17–18, 2020. This prestigious award acknowledges a member of CANS whose sustained research has had significant impact on nursing and health care knowledge development, with recognizable benefits for nursing practice. Im showcases her leadership capacity and research dissemination through her work in the field of global cross-cultural women’s health research, which addresses gender and ethnic differences in the health experiences of midlife women. Im’s most outstanding contribution to nursing is a research program that adopts emerging technologies to eliminate gender and ethnic disparities by tracking and studying the experiences of underrepresented women. With more than 370 papers, abstracts, and chapters and more than 320 international and national multidisciplinary presentations, she has obtained in excess of $17.5 million in research funding to continue advancing health equity across genders as well as ethnicities. Alongside her research, Im’s dedication to teaching and mentoring a new generation of scholars is reflected in her efforts to individually mentor more than sixty doctoral and postdoctoral students, ninety undergraduate students, and seventy research assistants. She has been a tenured faculty member at four research-intensive universities and appointed to named chairs at three of these prior to coming to Emory. The Council for the Advancement of Nursing Science is an initiative of the American Academy of Nursing (AAN) to help share, translate, and disseminate nursing science while nationally and internationally supporting the development, conduct, and utilization of nursing science. Its commitment to promote better health care serves as a voice for facilitating and recognizing lifelong nursing science career development.

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ALUMNI NEWS

Gift Expands Reach of Integrated Memory Care Center

recent $3.1 million gift from an anonymous donor will support a new initiative to allow the nursemanaged Integrated Memory Care Clinic (IMCC) to expand to continue serving patients living with dementia and residing in senior living communities, such as assisted living. “We want to continue to provide support and care for our patients and their care partners, so that they may maintain their health while in assisted living,” says IMCC Director Carolyn Clevenger, RN, DNP, AGPCNP-BC, GNP-BC, FAANP. “By providing optimal primary care as well as dementia care, we help families avoid unnecessary inpatient hospitalizations and receive late-stage and end-of-life care that matches their preferences. This gift reinforces that our work values partnering with patients and families to maintain dignity and optimize their quality of life.”

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The IMCC is the first clinic in the nation to fully integrate primary care for people living with dementia and is the first nurse-led primary-care medical home at Emory Healthcare. The IMCC was established as a partnership between the Nell Hodgson Woodruff School of Nursing and the Emory Brain Health Center. This anonymous gift allows the IMCC to further innovate in community care—the term for seeing patients who are in assisted living or personal care homes. This gift, like the previous $2 million in gifts initially funding the IMCC in 2015, recognizes the School of Nursing’s success in creating new ways to provide innovative patient care, says Dean Linda McCauley. “The IMCC’s nurse-managed model of care for patients with Alzheimer's and different types of dementia is critically important to them and their caregivers and families,” McCauley says. “When families

have a beloved family member diagnosed with a cognitive disease and prepare to go through the downward spiral with that patient, the IMCC and this anonymous donor recognize the critically important role that nurses play.” “We are all about following the patient, with their family, wherever they are in their journey,” Clevenger says. “We treat their families as part of our team, and we come up with a plan together. When a patient has had to move to assisted living, the family often has to make the difficult choice: to leave the relationship with the IMCC or to join the senior community’s domiciliary program, which is often more convenient. The decision to switch care providers means losing our years-long relationship with the family. This anonymous gift means families living with dementia won’t have to make this difficult choice and can remain with the IMCC." IMCC community care is slated to begin later this year after the IMCC formalizes agreements with senior living communities. The continuation of IMCC care means each patient can count on a nurse-led team to identify and manage symptoms of dementia, to prevent and treat co-existing health conditions, and to support families in order to optimize the quality of life. Each patient and care partner has 24/7 access to on-call IMCC nurse practitioners. The new program also incorporates additional team members in occupational therapy to engage and support the patient every week. “Families look for access to someone who understands, through the lens of dementia, what they and their loved one are going through,” Clevenger says. “They want access to simple solutions in one practice, not the complicated usual system of care that sends them to various practices and specialists. When they need to get us, they pick up the phone and call us, and they get us.”

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Navy Rear Admiral Trent-Adams Gives 2021 Ada Fort Lecture

he School of Nursing was honored to welcome Rear Admiral Sylvia Trent-Adams as the keynote speaker at the 2021 Ada Fort Lecture. The event Sylvia Trent-Adams is held each year honoring the life and legacy of Dean Ada Fort. She established the lecture to provide students an opportunity to learn from impactful scholars in various health care fields. Fort served as dean for 25 years, advancing nursing practice education and administration at both the state and national levels.

Trent-Adams served as Interim Surgeon General of the United States, topping off a long and decorated career with the US Public Health Service. She now serves as senior vice president and chief strategy officer at the University of North Texas Health Sciences Center. She was awarded the Public Health Service Meritorious Service Medal for her work during the Ebola outbreak in West Africa and in 2017 received the Red Cross Florence Nightingale Metal, the highest international distinction in the nursing profession. In her remarks, Trent-Adams noted many disparities and inequities related to social determinants of health. She highlighted how access to health care during the COVID-19 pandemic shed light on racial disparities and

systematic problems. “Nurses can be the innovators in creating the value proposition for improved equity and outcomes in health and health care,” she said. Three additional panelists continued the discussion. Breanna Lathrop, chief operating officer and chief operating officer and nurse practitioner at Good Samaritan Health Center in Atlanta, presented on health disparities in Atlanta and her vision for health equity. Gina Papa, clinic administrator at Clarkston Community Health Center, shared stories about the problems impoverished patients have in gaining access to health care and insurance. Tawanda Austin, MSN, RN, chief nursing officer at Emory University Hospital Midtown discussed the impact social determinants of health have in hospitals.

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