Penn Nursing UPfront: Spring 2013

Page 1

spring 2013

W HY HE A LT H E Q U IT Y M ATTER S Toward Health Equity and Social Justice 4

Building Identity Through Diversity 12

The Reality of Simulation 14

Reaching Latinos With Puentes de Salud 19


London September 2013

Washington, D.C. October 2013

Philadelphia May 2014

Healthy C ities : Healthy Women “A woman multiplies the impact of an investment made in her future by extending benefits to the world around her, creating a better life for her family and building a stronger community.” From USAID “Why Invest in Women” More than half of the world’s population currently lives

Penn Nursing, Penn Alumni, and the Trustees’ Council

in cities, and the numbers are ever increasing. Women

of Penn Women have partnered to bring visibility to

and girls make up half of that urban population and

these issues. In Miami, New York City, and Los Angeles,

face unique challenges in living healthy lives in urban

the Healthy Cities: Healthy Women conference series

environments. They also have a unique and powerful

focused on understanding challenges and exploring

role in positively influencing the health of their

solutions for and with women and girls that promise to

children, families, and communities.

improve health for urban populations everywhere.

Join us for Healthy Cities: Healthy Women in London, Washington, D.C., and Philadelphia in 2013-14. For more information, visit Board of Overseers Dean Kehler, W’79, Chair Rosemarie Greco, Immediate Past Chair Nancy Adelson, Nu’78 Mark Baiada Phyllis W. Beck Carolyn Bennett, Nu’91 Carol Lefkowitz Boas, Nu’77 Cornelius Bond (emeritus) Lillian S. Brunner (emerita), HUP’40, Ed’45, HON’85 Gilbert F. Casellas, L’77 Eleanor L. Davis, Nu’82 Kim Dickstein, W’87 William Floyd Jr., C’67, WG’69 Seth Ginns, C’00 Terri Cox Glassen, Nu’91 (ex officio) Stephen J. Heyman, W’59 Daniel Hilferty

Ellen R. Kapito, Nu’79 Gail Kass Eunice King, Nu’71 Andrea Berry Laporte, Nu’69 Wendy Hurst Levine Patricia Martín, M’85 Barbara Nichols Melanie Nussdorf, CW’71 Vivian W. Piasecki (chair emerita) Krista Pinola, Nu’86 Marjorie O. Rendell, CW’69 Ralph F. Reynolds, W’84 Robert D. Roy, W’59 Sandy Samberg, Nu’94, GNu’95 Marie A. Savard, HUP’70, Nu’72, M’76 Martin J. Silverstein, GL’08 Patricia B. Silverstein, C’81 Susan Drossman Sokoloff, C’84 Carol Elizabeth Ware, Nu’73 Michael Wert

University of Pennsylvania School of Nursing Dean Afaf I. Meleis, PhD, DrPS (hon), FAAN, FRCN Director of Marketing and Communications Joy McIntyre Vice Dean of Institutional Advancement Wylie A. Thomas Editor Jennifer Baldino Bonett Online Editor Barbara McAleese Editorial Assistant Victoria Smith Contributors Liliana Castro, Justin Heinze, Katie Siegmann, Victoria Smith, and Nancy Tkacs Photography I. George Bilyk, Sarah Bloom, Josh Derek Photography, Karen Gowen, Melissa Hassey, Felice Macera, Laurie Beck Peterson, Andy Shelter, University of Mahidol Design Dale Parenti Design Printing Pearl Pressman Liberty Advisory Board Christina Costanzo Clark, Academic and Student Affairs; Janet Deatrick, Faculty; Patricia D’Antonio, Faculty; Carol Ladden, Admissions and Financial Aid; Yvonne Paterson, Faculty; Jennifer Pinto-Martin, Faculty; Wylie A. Thomas, Institutional Advancement; Lorraine Tulman, Faculty. Admissions 215.898.4271 | Institutional Advancement 215.898.4841 | Marketing and Communications 215.898.5074 | UPfront is a biannual publication of the University of Pennsylvania School of Nursing. The magazine chronicles the research and leadership of Penn Nursing faculty, students, and alumni.

Printed on Chorus Art Silk 80 lb. Text and 100 lb. Cover



contents care to change the world


Health as a Human Right A message from Dean Afaf I. Meleis


cover story 4

Toward Health Equity and Social Justice Penn Nursing research brings the health of marginalized and underserved populations into focus

d e pa rt m e n t s 10


Global Impact Giving Voice to Abused and Vulnerable Girls Student Voices Building Identity

14 Innovation

The Reality of Simulation

16 Leadership

Faculty Diversity Matters


How I Care to Change the World Martin Camacho, GNu’03, and Steven Cabrera, Nu’13, build bridges to Latino health at Puentes de Salud

22 The Lang Lecture


For inaugural Lang lecturer Dr. Terri Lipman, practice is core to her life’s work in pediatric diabetes and endocrine disorders


Penn Nursing Science in Action


Penn Nursing News


Alumni Connections


14 On the Cover: With her Penn Nursing colleagues, Dr. Lisa Lewis is committed to closing healthcare gaps. She conducts health research and consultations on hypertension at Mother Bethel African Methodist Episcopal Church in Philadelphia. See story on page 4. Editor’s Note: References to ethnicity, race, and other demographics are determined by the source.


Health as a Human Right In the early 1960s, I came from Egypt to the United States because it was the land of opportunity and because I thought it was also the land of equity. It quickly became clear that many inequities in access to healthcare existed. At the same time, I saw many opportunities to effect change. I knew change had to start with women. Taking care of women is taking care of the family, which is taking care of the community, which is taking care of society. In any dialogue about health equity and quality of life, there is global recognition of the centrality of women. In the United Nations’ Millennium Development Goals focused on eliminating poverty, enhancing education, and decreasing maternal and infant mortality rates, women and girls are at the center. The formation of UN Women and the appointment of Melanne Verveer as the first U.S. ambassador-at-large for global women’s issues are indications of the vital role healthy and educated women play. Ambassador Verveer wrote, “… we have indeed seen progress in protecting the human rights of women. … [But] there is no getting around the fact that progress is fragile in many places and barely measurable in others.” Dean Meleis blogs at

The International Council on Women’s Health Issues (ICOWHI) is dedicated to advancing the progress of women’s health globally. This past fall, leaders in healthcare, education, law, policy, and social research from 37 countries came together in Thailand for ICOWHI’s 19th International Congress on Women’s Health. Her Royal Highness Princess Bajrakitiyabha Mahidol of Thailand, an Ivy-League-educated lawyer dedicated to the causes of vulnerable and marginalized women, made the critical point to ICOWHI that we cannot think about women’s health without thinking about partnership.

you will see in this issue of UPfront, Penn Nursing’s leadership in health equity research is built on partnerships in our communities. On the following pages, you will find stellar examples of community-based participatory research conducted by Penn Nursing faculty. In this progressive research construct, our faculty works side by side with community members facing specific healthcare issues and inequities to design strategies for positive outcomes in health and well-being. Nursing research goes beyond the walls of the university to churches, schools, and community centers. This unique research focus is exemplified at its best by the global leadership of Dr. Loretta Sweet Jemmott, the van Ameringen Professor in Psychiatric Mental Health Nursing, and her colleagues in the Center for Health Equity Research, which she directs (page 9). The educational experience at Penn Nursing is preparing a new generation of nurses for a world that is ever more culturally diverse. Our dynamic student organizations, featured in Building Identity on page 12, promote cultural awareness, provide important supports, and enrich the collective voice of nurses. As you will see on page 6, cultural competence is woven throughout the curriculum and is part of nursing schools’ accreditation. Penn Nursing research on cultural competence calls for attention to knowledge, attitude, and skills in the curriculum, which we constantly review to ensure it reflects the populations our students will care for. Clinically, Penn Nursing reaches many culturally diverse populations. A highly successful example is Puentes de Salud (page 19), where alumnus Martin Camacho and senior Steven Cabrera are among the Penn nurses providing much-needed healthcare to Philadelphia’s Latino immigrants.

This is especially true of efforts to achieve health equity, a cornerstone of a truly just society. As

View “Why Focus on Women’s Health” (5:07)


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At the ICOWHI conference, (from left to right) Rajata Rajatanavin, MD, president of Mahidol University, Dean Afaf Meleis, and Siriorn Sindhu, DNSc, president of ICOWHI, spoke with Her Royal Highness Princess Bajrakitiyabha Mahidol of Thailand (far right) about her work on causes of concern for vulnerable and marginalized women.

And Dr. Terri Lipman, our inaugural Norma M. Lang lecturer (page 22), combines decades of research on diabetes with a community-based dance program to decrease obesity and maximize wellness in our West Philadelphia neighborhood where children and adults are predisposed to the disease. Much of our focus in nursing is rightly on marginalized populations who are highly vulnerable and unjustly underserved in society and in healthcare. Our faculty is making progress through partnerships and innovative research. As nurses, we deal with the whole patient –

everything in the life of an individual and her family. That places us in an optimal position to bring attention and science to improve the health and well-being of every individual and all populations.

Afaf I. Meleis, PhD, DrPS (hon), FAAN, FRCN; the Margaret Bond Simon Dean of Nursing; Counsel General Emerita, International Council on Women’s Health Issues; and International Council of Nurses Global Ambassador for the Girl Child


Toward Health Equity and Social Justice Penn Nursing research brings the health of marginalized and underserved populations into focus. As a nurse in a hospital on New York’s Upper East Side, Lisa M. Lewis, PhD, RN, found a distinct difference in health outcomes among her patients. From this neighborhood of disparate financial means, Dr. Lewis saw poor patients making recurring visits for acute, uncontrolled asthma, hypertension, and other chronic disorders. The more affluent patients remained healthy and did not need to return. “I didn’t have a name for what this was, but I knew what I saw,” said Dr. Lewis, now an assistant professor at Penn Nursing. “These individuals lived in the same two-mile radius, but their health outcomes were very different. I started asking, ‘What’s going on and how can we change it?’”

Dr. Lewis had encountered clear evidence of health disparities and, like many Penn Nursing faculty, has dedicated her career to evening the tipped scales of American healthcare. The Centers for Disease Control and Prevention defines health disparities as “differences in health outcomes between groups that reflect social inequalities.” Health disparities account for higher death rates, earlier disease onset, and greater severity of disease, stemming from differences in demographics such as race, age, and geography. In 2009, the Joint Center for Political and Economic Studies in Washington, D.C., noted that the economy loses nearly $400 billion annually because of health disparities.

Here and on facing page: Dr. Lisa Lewis conducts community-based hypertension research with congregants of Philadelphia’s historic Mother Bethel Church.


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View “High Blood Pressure and African-Americans” (1:21)

Long dedicated to closing healthcare gaps, Penn Nursing is commited to health equity and social justice as a central part of the School’s mission. More than half the faculty is focused on research in these areas, and Penn Nursing has the leading Center for Health Equity Research in the country. (See sidebar on page 9.) “Deeply embedded in our mission is to make societal impact, and deeply embedded in our society are health disparities that require the attention of nurses,” said Dean Afaf I. Meleis. “In a health equity and social justice model, everyone would have the same access to healthcare services, regardless of race, ethnicity, income, or any other difference. Attaining this critical element of fairness is part and parcel of our research, teaching, and practice.”

Confronting “The Silent Killer”

But why black people don’t seek out or adhere to treatment and why black patients don’t get proper treatment are two different things, explained Dr. Lewis. America’s history of slavery, racism, and discrimination, and the horrors of research misconduct using a rural black population in the Tuskegee syphilis experiment have deeply sown mistrust of the healthcare establishment among black Americans. In this shadow are other factors precluding black Americans from seeking or adhering to treatment, said Dr. Lewis. These include false health beliefs or poor knowledge about symptoms, disease, and the consequences that can occur without proper treatment; cultural beliefs; limited access to healthcare providers and long waits for clinic appointments; and key demographic factors, such as low-income status.

Hypertension brings the issue of health disparities into focus. It is a major public health problem for blacks who live in the United States, and the rate of prescribed medication adherence is significantly lower in blacks than in whites. Blacks in the U.S. are more likely to have high blood pressure than any other group, and they have striking co-morbidities largely because they do not adhere to their medication. Blacks with high blood pressure are at an 80 percent greater risk of stroke and a vast 420 percent greater risk of kidney disease compared with whites. “You have treatment available and a graveness of disease and common knowledge, even in the black community, about ‘the silent killer’ of hypertension, yet the poor outcomes continue,” said Dr. Lewis. To address this, Dr. Lewis created a churchbased hypertension intervention, funded by the Edna G. Kynett Memorial Foundation. For many Sundays before services, Dr. Lewis visited Mother Bethel African Methodist Episcopal Church in downtown Philadelphia to take congregants’ blood pressure and monitor their medication adherence. Over coffee and conversation in the meeting room of the historic church, congregants met with “Dr. Lisa” in a familiar, relaxed setting among their peers. “Community sites are key to moving toward health equity,” said Dr. Lewis. “Institutions like churches are comfortable mainstays in people’s lives, with trust among the leadership and the members. If Pastor said it’s okay to bring this program here or to go see Dr. Lewis to have your blood pressure checked, they’ll do it.”

The Pain of Health Disparities Another factor in poor outcomes among minority patients, said Salimah H. Meghani, GNu’00, GM’05, Gr’05, PhD, RN, MBE, FAAN, associate professor of nursing, is “implicit” or “unconscious” bias – when health providers unintentionally stereotype patients by race, gender, or other factors, affecting care and health outcomes. In Pain Medicine, Dr. Meghani synthesized 20 years of evidence on racial and ethnic disparities


Health Equity in the Curriculum The concept of “cultural competence” – behaviors, attitudes, and policies that are respectful, responsive, and effective in cross-cultural situations – is “one of the main ingredients in closing the disparities gap in healthcare,” reports the Office of Minority Health of the U.S. Department of Health and Human Services. At Penn Nursing, cultural competence flows into case studies, lectures, small-group discussions, and presentations beginning freshman year. A faculty task force, formed by Dean Afaf I. Meleis in 2004, developed a research-based “blueprint” for integration of cultural competence in the curriculum. Published in the Journal of Professional Nursing in 2008, the blueprint established educational objectives in cultural competence in knowledge, attitude, and skills. The authors wrote, “Globalization, immigration, the rapidly growing culturally diverse populations, and the changing ways of healthcare delivery have established the critical need for a curriculum

that incorporates culturally competent nursing throughout the educational process.” And the process is ongoing. “Cultural competence in the curriculum is a continuum, not a checklist,” said Ann Marie Walsh Brennan, PhD, RN, practice associate professor of nursing and coordinator for curricular implementation. “We constantly evolve our case studies to get students thinking about the bigger picture.” Missing from the picture was the inclusion of lesbian, gay, bisexual, transgender, and questioning (LGBTQ) health in the curriculum. Prompted by Penn Nursing students to consider this population, the task force reconvened. In a 2012 article in the Journal of Professional Nursing, Penn Nursing faculty called for “a life span perspective that addresses developmental needs and their impact on health concerns throughout the life course” for this population. LGBTQ health is part of Penn Nursing case studies, and the faculty curriculum committee

in the prescription of pain medications in the U.S. Findings showed that African-Americans experienced a significantly higher number and greater magnitude of pain treatment disparities than any racial or ethnic group in the analysis. “Provider, patient, and system-level factors may lead to clinical disparities,” explained Dr. Meghani. “Many healthcare providers believe African-Americans are more likely than whites to abuse prescription opioids, but research, including ours, consistently points otherwise.” On the patient’s side, “stigma consciousness” may result in more guarded clinical interactions between patients and providers. “Patients want to be agreeable,” said Dr. Meghani. “To negotiate pain treatment would mean, in their view, appearing to be difficult.” Among the inadvertent effects of unconscious bias are that minority patients often experience pain for many years before being seen by a pain specialist for treatment, possibly also because providers are more likely to underassess pain in minorities and less likely to refer them, reported Dr. Meghani. The recent Institute of Medicine Report, Relieving Pain in America, identified the fiscal burden of unrelieved pain as up to $635 billion a year.


UPfront | Spring 2013

continues to talk with students and faculty about further integration, which students in Nurses PUSH (Nurses at Penn Understanding Sexuality in Healthcare) consider essential. “As a student, I would love to see more from professors on ‘This is what you need to do,’ and move beyond ‘Let’s talk about our feelings on this,’” said Nurses PUSH President Jennifer Schockemoehl, Nu’13, GNu’15.

Including cultural competence in an entire curriculum and ensuring that it drives the content and the dialogues in every course and program is a work in progress, said Nancy C. Tkacs, Nu’75, GNu’77, GNC’05, GNu’06, PhD, RN, associate professor of nursing and

assistant dean for diversity and cultural affairs. “What does it mean to meet somebody where they are? It’s a continuously evolving area with room for improvement,” she said. “At the same time, our own identity isn’t separate from us as nurses. We are broadening the concept of ‘what is difference’ to the granular level of the individual – whether nurse or patient.”

“There is no question that pain treatment disparities matter,” said Dr. Meghani. “Unrelieved pain places tremendous burdens on patients, health systems, and society when the most effective pain care is not accessible, affordable, and delivered to those in need.”

Seen, But Not Heard This is particularly true for a population unable to speak for itself. Children face alarming health disparities, some in the name of the children’s own protection. Historically, a pivotal area of concern has been pharmaceutical testing and dosage for children. In her upcoming book on the topic, Associate Professor Cynthia A. Connolly, Nu’80, Gr’99, GNC’01, PhD, RN, PNP, FAAN, addresses an enduring “vexing and critically important clinical and policy problem.” Until 2002 legislation, up to 75 percent of drugs prescribed to children lacked safety and efficacy data. And even with new federal laws that have provided critical data for nurses, doctors, and pharmacists, developing safe and effective medications for children remains a scientific problem, said Dr. Connolly. Who should pay for their development is an economic and policy challenge, and safe medication decisions and administration for children is “a complicated ballet among nurses, doctors, and pharmacists,” she added.

View “Dr. Jennifer Pinto-Martin on Autism” (8:40)

It has never been easy, she said. The 1906 creation of the Food and Drug Administration itself is rooted in addressing the problem of “soothing syrups,” opium-laced products purported to reduce infant colic and other ills, which killed thousands of children. Despite efforts over the decades (including the Best Pharmaceuticals for Children Act and the Pediatric Research Equity Act, which passed respectively in 2002 and 2003), the FDA is a long way from its original charge to ensure that drugs for all Americans, including children, are safe and effective. “Children and their welfare have traditionally been used to justify both the extension and the rejection of state authority into family life,” said Dr. Connolly. “The issues embedded in discussions of children and pharmaceuticals involve considerations of what society ‘owes’ children in terms of health and social welfare services; evolving understandings of their place and protection in American society; grappling with how much control parents should have over their own children; and determinations of who should decide what interventions are in the best interest of the child.” In the expanding area of autism, the best interests of children often go unmet, said Jennifer A. Pinto-Martin, PhD, MPH. This is particularly true for early diagnosis, a critical factor in autism management. In a 2002 study, Dr. Pinto-Martin and colleagues demonstrated that African-American children in Philadelphia receive an autism diagnosis almost two years later than white children. “There’s no biological reason these kids should be diagnosed later,” said Dr. Pinto-Martin, who is the Viola MacInnes/Independence Professor of Nursing and chair of the Department of Biobehavioral Health Sciences. “The earlier a child receives a diagnosis, the better the

outcomes will be. This issue epitomizes the inequities in access to healthcare by low-income and minority groups.” Some of the disparity could stem from cultural differences, said autism expert Margaret C. Souders, Nu’81, GNu’96, Gr’08, PhD, CRNP, assistant professor of human genetics. “There may be cultural differences in parental perceptions of behavior,” she said. “Families respond to behavioral challenges and quirky manners in many different ways. Some families may not seek help from the healthcare system but rather reach out to extended family for ideas on how to handle their children.”

Above: Dr. Margaret Souders is part of the Penn Nursing partnership with Philadelphia’s Center for Autism. Below: Childhood deaths from falsely advertised “soothing syrups” led to the creation of the FDA.

And in schools and the offices of healthcare providers, unconscious bias may be labeling students of color as “oppositional” or “acting out,” extending the time to an accurate diagnosis. For girls with autism, who often present with more subtle symptoms, the time to diagnosis is often longer than for boys. Toward a solution, Drs. Pinto-Martin and Souders have formed a Penn Nursing partnership with Philadelphia’s Center for Autism, an evaluation and treatment site serving low-income and minority families. Nurses and nursing students enrolled in Penn Nursing’s autism certificate program rotate through the center to learn about screening, diagnosis, and relationship-based


treatment for autism. The students offer clinical support for co-occurring medical conditions, including insomnia, epilepsy, and asthma, in children and adolescents with autism.

• Services for mental and medical help are poorly coordinated due to fragmented communication among providers, negatively affecting patients’ physical health as well.

Autism opens the window on disparities in behavioral health, said Dr. Souders. Children with autism, severe maladaptive behaviors, and psychiatric disorders often do not receive comprehensive inpatient care because of insurance reimbursement issues; lack of inpatient centers that can meet the complex behavioral and sensory needs of autistic patients; and the dearth of healthcare providers sufficiently trained in autism. As a result, said Dr. Souders, families try to address their children’s complex behavioral and psychiatric needs on an outpatient basis in a fragmented system.

“These conditions are adverse to promoting health, and the consequences are dire,” said Dr. Hanrahan. “The population with serious mental illness dies 25 years earlier than the general population because they do not have adequate medical or psychiatric healthcare.”

“Children with autism turn into adults with autism,” she said. “Children with autism have complex behavioral health needs that should be addressed early, comprehensively, and across the life span.”

Falling Through the Cracks In U.S. society, mental illness accounts for some of the greatest burden of suffering and highest healthcare costs, said Nancy P. Hanrahan, Gr’04, PhD, RN, CS, FAAN, the Dr. Lenore H. Kurlowicz Term Associate Professor of Nursing. Schizophrenia and other serious mental health conditions bring grim prognoses, she said, as patients hear the message that they are not likely to live independently, be employed, or have an education. Yet research shows that people with a diagnosis of schizophrenia have hope for a normal life if they receive treatment early and build skills to adapt to their symptoms. “However,” said Dr. Hanrahan, “people with mental illness often fall through the cracks, with one in four not receiving needed care.” Inequities and unconscious bias affect healthcare access, she said. In particular: • Stigma about mental illness remains a powerful and common misperception. • Mental healthcare services are often not helpful to patients and families because of prolonged delays in obtaining them. • Many providers still think the prognosis is poor and may not be proactive about offering adequate and timely treatment.


UPfront | Spring 2013

But nurses are in a unique position to lead reform, said Dr. Hanrahan. “Many nurses are educated to understand mental and physical illness as integrated – and all nurses should be,” she said. “Nurses must provide health services with an understanding of the complex interplay between the mental and physical well-being of individuals within their support systems.” Dr. Hanrahan is leading research to test innovative models of care and clearly illustrate the needs of people with mental illness for healthcare providers and policymakers. Among her projects: • iVoice is a mobile app under development to obtain consumer feedback at points of service for quality-improvement efforts. • Simulated Urban Mental Health Organizations uses simulation- and agent-based models as a tool in healthcare decisions, policy-making, and resource allocation. • In Translating a Transitional Care Model for Individuals with Serious Mental Illness, an advanced practice psychiatric nurse follows a patient for 90 days after discharge from a psychiatric hospital. Most people remain acutely ill following hospitalization. Here, the nurse provides a rapid response to patients who need help for medical and psychiatric care. • In Videography of Recovery from a Mental Illness, patients with mental illness are documenting their experiences with video cameras to show how thinking toward recovery is important to achieving it. “We are aiming for creative ways to get the consumer’s voice into planning and policy,” said Dr. Hanrahan.

Culture Shift Penn Nursing faculty go beyond the U.S. borders to address health disparities. Among the faculty working on health equity and social justice around the world is William F. McCool, C’76, PhD, RN, CNM,

Term Associate Professor in Women’s Health and Nurse-Midwifery. Dr. McCool is among the 1 percent of male midwives in the U.S. While he said he has not encountered gender-based barriers in his career, he realizes he is among the privileged – a Caucasian man living and working in the U.S. Dr. McCool is acutely aware of this when he brings his midwifery expertise to impoverished areas of Haiti, Botswana, Guyana, and India. “You look around the world and in many places women are viewed as second-class citizens – or third- or fourth-class citizens – and those who care for them are not held in high regard either,” said Dr. McCool. He and his midwifery colleagues work to learn about midwifery education in various countries with the goals of improving women’s health and of encouraging educated midwives to stay in their home country rather than leave for foreign shores where midwifery may yield a better income. This is “vital work,” said Dr. McCool, and it is ongoing. “If you think of it as a revolution, it won’t happen. If you think of it as an evolution, that’s a more sustainable approach.” No matter the geography, addressing health inequities requires a serious culture shift, said Assistant Professor of Nursing Bridgette M. Brawner, GNu’05, Gr’09, PhD, APRN.

Seen here in India, Nurse-Midwifery faculty Drs. Diane Spatz and Wiliam McCool encourage educated midwives to practice in their home countries.

A nurse scientist, Dr. Brawner studied with faculty at the Penn Nursing Center for Health Equity Research in her graduate and postdoctoral work. Her area of expertise is sexual health promotion in disenfranchised populations including HIV prevention among adolescents facing mental illness and substance abuse. “The term ‘health inequity’ indicates that there are unfair, unavoidable differences in individuals’ health status and outcomes. In other words, the playing field is not level,” Dr. Brawner said. “Research demonstrates that most of these differences are rooted in inequities at political, economic, and educational levels, to name a few. “Moving toward health equity and social justice is not a small undertaking, but if we get paralyzed and don’t do anything, it will not get better,” she said. “People will not have an opportunity to be as healthy as they can be, and that is unacceptable. However, if we each chip away at something, taking our own small piece, we will make progress.”

Learn more: www.nursing.

Rolling the Boulder: The Center for Health Equity Research With innovative research methods that bring together an interdisciplinary research team and community members, the Center for Health Equity Research (CHER) at Penn Nursing is leading the charge to promote health and health equity, and to eradicate health disparities across the life span. Directed by Loretta Sweet Jemmott, GNu’82, GR’87, PhD, RN, FAAN, the van Ameringen Professor in Psychiatric Mental Health Nursing, CHER is an international leader in community-based participatory research. Working in the community and with members of the community – from schools to clinics to barbershops – CHER researchers design studies that put healthcare resources into the hands of underserved members of society.

View “Taking Science to the Street” (2:31)

“You take time to learn the code of the streets, to listen to the voices, to design studies that empower the community and that are sustainable after the researchers leave,” said Dr. Jemmott. Her program “Shape Up! Barbers Building Better Brothers” trains barbers to use a novel iPad application to discuss HIV prevention strategies with their clients. For community-based research like this to succeed, said Dr. Jemmott, “you build those relationships. You deal with communitylevel issues that have repercussions on our whole society.” Fitting “seamlessly” into the community is fundamental to CHER’s mission, said Professor Janet A. Deatrick, PhD, RN, FAAN, an associate director at CHER. “We work hard to be a transparent, positive force that people can trust.”

And trust does not come easily in the communities CHER has come to know. Ivy League credentials aren’t always the most welcome calling card, said Dr. Jemmott. “Racism, classism – they are embedded and so are the distrust and hard feelings that go with them,” she said. “It’s the rock in the river, but you don’t give up. You can’t overturn the boulder, but you can roll it slowly.”



G i v i n g Vo ice to Abuse d and Vul n era b le G irls In Los Angeles, Healthy Cities: Healthy Women focused on a vulnerable yet promising population. Drs. Robert Ross, above, and Anne Teitelman, below, at Healthy Cities: Healthy Women in Los Angeles

Anne M. Teitelman, PhD, FNP-BC, FAAN, FAANP, talks

candidly about sex and the city. Her research on adolescent girls provides evidence on the harsh realities of coming of age in urban America. Against a backdrop of neighborhood decay, unemployment, violence, and generations of poverty, urban adolescent girls ages 15 to 19 face the highest rates of sexually transmitted chlamydia and gonorrhea compared with all other ages among both males and females, and a future with HIV as a leading cause of death among young adult women in the United States. “Urban adolescent girls are growing up in environments where they have limited choices, limited opportunities, and compromised health and safety,” said Dr. Teitelman, the Patricia Bleznak Silverstein and Howard A. Silverstein Endowed Term Chair in Global Women’s Health and associate professor of nursing. She spoke about Invisible Walls: Women, Violence, and Safety in Los Angeles in November when Penn Nursing hosted the third conference in the Healthy Cities: Healthy Women series. The conferences address issues in urban living, such


UPfront | Spring 2013

as domestic violence, poverty, and lack of access to fresh food and safe transportation, that affect women’s health around the world. “For women and girls, health is power and power is health,” said Dean Afaf I. Meleis at the conference. “But in urban environments – including Los Angeles – poor, uninsured women fall into a medical poverty trap, compounded by insufficient transportation and sanitation, food insecurity, and violence.”

Meet Gina The cute boy had been chasing young Gina for a year. At age 13, she gave in and fell in love. He was 19. She wanted to use condoms during sex, but he told her she was “his girl” so they didn’t need protection. When he hit her, she believed it showed how much he liked her. When she had a baby at 14, she still wanted to be in a relationship with him. Then she learned she had gonorrhea and gave up on him. Now at age 24, Gina thinks what might help girls like her is a place for them to meet with trusted adults, because when she was young, she didn’t have anyone to talk to.

View “Collecting Their Stories” (3:23)

“Gina’s story echoes through our cities,” said Dr. Teitelman. The Centers for Disease Control and Prevention reports that 46 percent of high-school-aged girls have had sex, and in some urban areas, the rate is close to 60 percent. Rates of teen dating violence, likely underreported, she explained, are twice the national average among urban girls. And 12 percent of HIV infections in the U.S. can be traced directly back to partner violence. In her 2011 study of unwanted unprotected sex, Dr. Teitelman found that 56 percent of urban African-American adolescent girls reported that their partner did not use a condom the last time they had sex – often because of physical and sexual threats and abuse. “Adolescent girls often have less power in relationships so they are at a disadvantage in negotiations for safer sex,” said Dr. Teitelman. For Gina and girls like her, Dr. Teitelman started Stand Up Together, a theory-based HIV and partner abuse prevention intervention for urban adolescent girls. Funded by the National Institutes of Health, Stand Up Together presents strategies for healthy relationships in small, private groups of teen girls led by a trained adult facilitator. Over three Saturdays of discussion and interactive projects, participants in Stand Up Together “learn that healthy relationships involve trust and respect, understand the warning signs of an abusive relationship, and find supportive adults teaching groups of girls how to make their way,” said Dr. Teitelman. At Healthy Cities: Healthy Women, Dr. Teitelman connected with representatives of the Jenesse Center Inc., a domestic violence intervention program in Los Angeles. “Our mission very much intersects with Dr. Teitelman’s research,” said Karen Earl, executive director of the Jenesse Center. “The deep thought that Penn Nursing has put into reaching this population of underserved girls shows real out-of-the-box thinking.” Discussions to incorporate Stand Up Together into Jenesse’s work have begun.

The Urban Woman’s Burden While President Barack Obama has pledged national attention and UN Secretary-General Ban Ki-moon has vowed international efforts to improve the health of women and children, Dr. Meleis emphasized that “accessing a healthy life is an urban woman’s burden. Healthcare providers – especially nurses who are on the frontline of care – must advance a global agenda for women’s health.”

Bringing this point into sharp focus was Robert K. Ross, MD, C’76, M’80, G’92, president and CEO of The California Endowment, a private health foundation dedicated to affordable, quality healthcare for underserved communities and the health of all Californians. Formerly a clinician in impoverished communities, he was struck by a study on the effects of childhood trauma on adult health among Kaiser Permanante patients. “Chart after chart after chart,” he said, showed that adverse experiences in childhood (violence in the home, an incarcerated parent, abuse) correlated to adverse health conditions in adulthood (obesity, heart disease, and dozens of other indicators).

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The survey hit home for Dr. Ross. Formerly the commissioner of public health for Philadelphia, he knew that incarcerated women and women in drug and alcohol treatment programs were more likely to report having been abused as children. “This blows up the adage that ‘time heals all wounds,’” said Dr. Ross. “What implications does it have for how we think and rethink healthcare in this country?” From a powerful poem called Daddy Keeps, Dr. Ross drew raw, instructive lessons. A 17-year-old, Cheyenne, bared the pain of incest in verse: “Daddy keeps having fights with my body and daring me to tell Mommy, He covers my bruises with my T-shirts and the ones inside with pocket change, He keeps saying that it won’t happen if I just act my age… Daddy keeps saying that my private parts are not so to him. He says that it’s ok to touch cuz he helped to make ‘em.” The burning question, said Dr. Ross, is: “Do we have a healthcare system smart enough to pick this up – and not wait for a girl like Cheyenne to be an IV drug-injecting user who ends up in Graterford prison? That’s the challenge of the health system. We’re going to need voice, and we’re going to need advocacy, and we’re going to need to make some people feel uncomfortable with the lack of action on this.” Dr. Teitelman believes a path to action must involve girls. “When an adolescent girl is held back, that ripples through all of society,” she said. “But if she can safely navigate through adolescence, she will benefit and so will her family and community for generations to come.”



Building Identity Research illustrates the vital role of student organizations in supporting diversity. By Liliana Castro, MSEd‘13

One of the primary objectives of the Office of Student Services at the School of Nursing is how to best meet the needs of diverse student populations. As the graduate assistant in Student Services, I work with Penn Nursing’s 10 active student organizations. There, I see the value of student organizations, particularly to underrepresented students, in creating a supportive, engaged community that complements academic experiences. Research asserts that enhancing academic experiences through co-curricular opportunities enables students to gain leadership skills and explore a variety of interests. It also shows that involvement in student organizations helps all undergraduates acclimate to college life, a key element in student retention. Liliana Castro, MSEd‘13, is earning her master’s degree in higher education administration at Penn’s Graduate School of Education and is a graduate assistant in the Office of Student Services at Penn Nursing. This essay is based on her research paper “Exploring Diversity in the Office of Student Services.”

Students and faculty attended a Nurses PUSH workshop on care for transgender patients.

“Those who participate in learning communities, become actively involved in clubs and organizations on campus, and participate in purposeful campus activities are more likely than their disengaged peers to persist through the first year of college,” according to Student Engagement in Higher Education by Shaun R. Harper, PhD, of Penn’s Graduate School of Education, and colleagues. They also reported more specifically that “supportive environments and specialized, culturally appealing programs and activities can greatly aid in engaging firstyear racial/ethnic minority students.” Similarly, Nancy C. Tkacs, Nu’75, GNu’77, GNC’05, GNu’06, PhD, RN, assistant dean for diversity and cultural affairs, believes that in order to support an increasingly diverse student body (see chart),

the School of Nursing must continue to work on creating a more inclusive community that is welcoming and supportive, and promotes equal access. “Diverse groups of students have, over the years, come together to develop special interest student organizations to support diverse communities and to promote community engagement,” said Dr. Tkacs. “These groups and their faculty advisers plan activities and seminars open to students, faculty, and staff that enrich the whole school and our climate of inclusion.” In Underrepresented Students Benefit Most From ‘Engagement’ in The Chronicle of Higher Education, scholar George D. Kuh said that “the more engaged [students] become, the better their grades are, and they start catching up to students who started college with a higher level of achievement.” Organizations bolster students’ capability to do well both socially and academically, and organizations that meet students where they are can make an important difference in the key decision some face: whether to leave college or stay. “Penn is a large university. For some students, it becomes critical that they can carve out their own domain – a home where they are supported but also find their unique ability to make a difference. Our student organizations foster that inclusiveness and sense of purpose,” said Kathleen McCauley, Nu’74, GNu’77, GRN’90, GNC’96, PhD, RN, ACNS-BC, FAAN, FAHA, Class of 1965 25th Reunion Term Professor of Cardiovascular Nursing and associate dean for academic programs. “I can’t imagine our school without these groups. They are the best training ground for advocacy.” Each of the Penn Nursing student organizations (see sidebar) contributes to the School and nursing as a profession in its own way by spanning such key areas such as sexuality in healthcare for lesbian, gay, bisexual, and transgender people; global health; research; and minorities in nursing (including males, who make up 7 percent of nurses nationally and 11 percent of students at Penn Nursing). While each nursing student organization has its own distinct mission, all uphold the same


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Student Diversity Grows at Penn Nursing 8.3% 4.2% 3.1% 1.1% 22.9%

Asian African-American Latino American Indian Non-reporting/Other

20.0% 11.1% 8.9% 2.2% 12.2%

60.4% Caucasian

45.6% Caucasian

Undergraduate Class of 2012 inherent values of promoting cultural awareness in the healthcare community; creating a forum for discussion; providing social, academic, and professional support; collaborating in community service; and establishing a collective voice for nursing. The Asian Pacific American Nursing Student Association (APANSA) formed at Penn Nursing in 2011 to offer academic and social support to this growing student population. APANSA President Elizabeth Park, Nu’14, said that Asian Pacific American students at Penn Nursing “needed a cohesive community that united similar cultural identities.” Asian Pacific American students identify themselves in many ways, including Chinese, Korean, and Filipino, and sought a common ground where they all felt welcomed and supported. Ms. Park reported a stereotype in Asian Pacific American culture that nurses are “assistants to doctors.” She and some of her student colleagues have had to stand their ground with their families and Asian Pacific American friends “to prove that being a nurse is a worthy occupation.” At the same time, the group can support the need for Asian Pacific American healthcare providers who speak native languages, “look like their patients,” and have a cultural understanding of “where a patient is coming from,” said Ms. Park. Male students in nursing also face cultural hurdles. To address this, Christopher L. Coleman, PhD, MPH, APRN-BC, ACRN, FAAN, the Fagin Term Associate Professor of Nursing and MultiCultural Diversity, helped Penn Nursing students form the Male Association of Nursing at the University of Pennsylvania (MAN-UP) in 2006. The first student nursing organization of its kind, MAN-UP offers social connections and academic support. Student engagement begins as early as preview weekend – with MAN-UP T-shirts ready to wear – and ongoing mentorship throughout students’ Penn Nursing education.

Asian African-American Latino American Indian Non-reporting/Other

Undergraduate Class of 2016 “It’s both challenging and advantageous to be part of a community where men are traditionally a minority,” said Dr. Coleman. “We are really breaking ground here, bringing men into the profession and helping them feel engaged, but history is hard to change. It doesn’t happen in an instant.” In addition to holding meetings and social events, student organizations support and engage students by participating in scholarship, mentorship, film and speaker series, conferences, and community service. The Minorities in Nursing Organization is a way for students from underrepresented backgrounds to meet new people, share similar experiences, and learn about other cultures, said MNO President Jane Leung, Nu’15. The organization’s major annual event is the Red and White Ball, a formal night to raise funds for a local healthcare organization and raise awareness of MNO’s mission.

For more on Penn Nursing’s student organizations, go to students

Through this research and through my work experience so far, I have learned that, as higher education practitioners, we must meet our students where they are. Student engagement is most effective when we connect students who are passionate about similar interests and support them in building relationships and a sense of community.

Penn Nursing Student Organizations APANSA Asian Pacific American Nursing Student Association

DSO Doctoral Student Organization

GSO Graduate Student Organization

MAN-UP Male Association of Nursing at the University of Pennsylvania

MNO Minorities in Nursing Organization

NSFC Nursing Students for Choice

NSGH Nursing Students for Global Health

Nurses PUSH Nurses at Penn Understanding Sexuality in Healthcare

OSNR Organization for Student Nursing Research

SNAP Student Nurses at Penn



The Reality of Simulation In the new Helene Fuld Pavilion for Innovative Learning, technology makes learning an immersive experience. Call it unity of the theoretical and the practical. Based on contemporary research on the pivotal role of simulation in nursing education, the first floor of Fagin Hall has been strategically renovated as The Helene Fuld Pavilion for Innovative Learning. This pioneering educational center features high-tech simulation equipment to prepare students for real-life nursing experiences. The Fuld Pavilion expands Penn Nursing’s simulation space to 7,000 square feet with rooms and berths to accommodate multiple classes for small-group and individual learning.

“To deliver facts and lecture about care in a classroom and expect that the translation will just happen in clinical care is a thing of the past,” said Kathleen McCauley, Nu’74, GNu’77, GRN’90, GNC’96, PhD, RN, ACNS-BC, FAAN, FAHA, associate dean for academic programs. “Simulations offer challenging but safe opportunities to review and assess the effectiveness of our students’ developing skills, diagnostic instincts, and efficiency through hands-on learning.” Based on theory, research, and practice, the Fuld Pavilion’s simulation rooms reflect real-life care settings, including outpatient, hospital, and home care. Patient simulators include interactive mannequins, diverse in age, gender, and race, and the capability for behavioral, live-action, and high-fidelity simulations. “Technological advances and high-fidelity mannequins that faculty can control provide very realistic learning opportunities that ultimately protect patients,” said Dr. McCauley, who is the Class of 1965 25th Reunion Term Professor of


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Cardiovascular Nursing. “Our students go to their clinicals and into practice with experience in nursing care techniques. They are not managing feeding tubes or inserting IV catheters for the first time.” Further, sim-based case studies present particular opportunities to incorporate cultural competence into the curriculum. “We explore a diverse population of patients who will receive nursing care and include a wide range of ethnic backgrounds, religious preferences, and broadly defined family units,” said Simulation Director Angela Iorianni Cimbak, MSN, RN.

Long at the forefront of simulation education, Penn Nursing was the first nursing school to have the life-sized, interactive Sim-Man. In 2001, this technology became the centerpiece of the Mathias J. Brunner Laboratory and Nursing Simulation Center. With the Fuld Pavilion, Penn Nursing is a leader in the “state of the science,” said Mary Elizabeth Mancini, PhD, RN, ANEF, NE-BC, FAAN, FAHA,

professor and chair of the College of Nursing at The University of Texas at Arlington. As a visiting professor at Penn Nursing, Dr. Mancini is leading a sim task force to determine how best to leverage the new facilities throughout the curriculum and across undergraduate and graduate programs. “The plan is for simulation to be more than an event in the curriculum,” said Dr. Mancini, who is past president of the Society for Simulation in Healthcare. “It will be part and parcel of how education is delivered at Penn Nursing. Many people think of mannequins, but simulation is more than that, and here it is an immersive experience.” The Fuld Pavilion is outfitted with video systems to record students’ simulated patient encounters, maximizing opportunities for educational debriefing, evaluation, and reflection with faculty and fellow students.

Students report back that simulation gives them confidence. “These are realistic experiences that prepare us for clinicals and our professional nursing practice,” said Emily Redfield, Nu’15. Incorporating simulation across the curriculum “makes for deep learning,” said Dr. Mancini. Students practice common techniques and gain experience in rare, high-risk healthcare situations and in “soft skills,” such as teamwork, communication, and leadership. The possibilities of simulation in education, assessment, research, and health system integration, as outlined by the Society for Simulation in Healthcare, should be coupled with long-range goals for nurses and the nursing profession, said Dr. Mancini. There are opportunities for simulated experiences to: • Reduce medical errors through simulation of adverse events • Become a cost-effective means of continuing education for nurses and other healthcare providers • Be core to healthcare research and design, from optimizing the position of a resuscitation team and maximizing the arrangement of hospital head walls to identifying potential errors in care systems and developing new or refined devices • Develop games and other applications to promote health education, awareness, and treatment • Serve as a tool for more customized patient care through the 3D modeling of a tumor, injury, or usage of an individualized treatment device.

For more on Penn Nursing’s sim education, go to simlab

“The future for sim is endless, in academe and beyond,” said Dr. Mancini. “Penn Nursing is prepared for leadership in sim teaching methods and evaluation practices. It’s an exciting new specialty for nurses and an area for our profession to take the lead.”

“The students see the big picture,” said Deborah Becker, GNu’91, GNC’98, PhD, ANCP, BC, CCNS,

practice assistant professor of nursing and assistant dean for innovations in simulation. “By participating in hands-on case studies, they are learning to be critical thinkers and have the freedom to make mistakes. Afterward, they deconstruct their decision-making and work with a faculty member and peers to determine what they might do differently in the future.”



FAC U LT Y DIVE RS ITY MATTERS How Penn Nursing is becoming a model for the future of nursing education and science By Nancy C. Tkacs, PhD, RN

We aim for Penn Nursing to be a model of diversity among leading nursing schools. But this aspiration should be seen as a journey, not a destination.

Nancy C. Tkacs (pictured below) is associate professor of nursing and assistant dean for diversity and cultural affairs at Penn Nursing. She is former chair of the University Council Committee on Diversity and Equity.

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Before 2050, and within the practicing lifetime of the nurses who will graduate in 2020 and after, there will no longer be a “majority” race in the U.S. Asians, blacks, Latinos, whites, and racially mixed people will be much closer in numbers, and the greatest diversity will be seen in the youngest age groups. Advances in nursing and in healthcare require our profession to have comparable growth in diversity in order to be closer to the population we serve and care for, and to excel in our mission of teaching, research, and practice. Similarly, healthcare scholarship needs to address new areas of inquiry, particularly disparities in treatment and health outcomes. Asians, blacks, Latinos, people with disabilities, individuals with low educational attainment and socioeconomic status, and lesbian, gay, bisexual, and transgender people are at risk of receiving suboptimal or less access to care compared with those who are white, straight, middle- or high-income, and well-educated. Some of the most severe stratification in our society actually lies along socioeconomic lines, rather than racial differences. Research suggests that learning environments rich in diversity and different perspectives, as well as healthcare provider education about health disparities and unconscious bias, are effective at improving culturally competent care and reducing inequities in healthcare delivery. As part of a University-wide initiative to create a more diverse faculty and in keeping with our 2010 strategic plan, Penn Nursing developed a Plan for Faculty Eminence Through Diversity, with faculty on the Penn Nursing Advisory Taskforce for Diversity and Cultural Competence, members of the Dean’s Advisory Group, and Penn’s other health schools. Penn Nursing’s dedication to diversity is not new and grew from some of the most powerful voices in nursing, Dr. Vernice D. Ferguson, whose legacy we continue (see page 36), and Dr. Rosalyn J. Watts, whom we honor each year at the Diversity Scholars Graduation Celebration (see page 37).


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The plan builds on their efforts and broadly interprets faculty diversity as racial, ethnic, and cultural heritage; gender, gender identity, and sexual orientation; socioeconomic status; nation of origin; veteran status; disabilities; religious affiliation, beliefs, and observance; and scholarly discipline. The plan aims to: • Grow the faculty pipeline by increasing the enrollment, retention, and achievement of doctorally prepared nurses for careers as nurse educators • Recruit diverse faculty with a composition reflecting the pool of exceptional applicants nationally • Increase faculty retention and promotion • Create a robust climate of inclusion, where all feel welcome and supported, and have equal access to networks for mentoring and research. Nursing is still a very white, female profession. A pipeline for more diverse faculty within the profession exists, but remains small. With a grant from the Robert Wood Johnson Foundation, Assistant Professor J. Margo Brooks Carthon, Gr’08, PhD, RN, is conducting a survey of nursing pipeline programs nationally. The results of her study will inform policy and program development locally and nationally, and the development of additional Penn Nursing pipeline programs. Building the pipeline means building and maintaining relationships with students, new faculty, and peers. As my colleague Lisa M. Lewis, PhD, RN, an assistant professor at Penn Nursing said, “Although it is time- and labor-intensive, relationship-building should be as much of a priority as your next research project.” The racial and ethnic diversity of Penn Nursing faculty shows progress. In 2000, the minority standing faculty was at 4.3 percent. By 2009, that figure stood at 11.1 percent – a more than doubling of faculty who described themselves as something other than “white.” To date, there are 58 School of Nursing standing faculty, of

The Stereotype of “Women’s Work” Nursing faces a gender gap inverse to most other professions. According to the Robert Wood Johnson Foundation, the percentage of men who are registered nurses in the U.S. is 7 percent, and men account for just 5 percent of full-time nursing faculty teaching at baccalaureate or higher-level schools of nursing in the U.S.

Penn Nursing researcher Dr. Eun-Ok Im uses digital technology to address ethnic and gender health disparities.

whom 10 are of color with six (10.3 percent) identifying as black/African American and four (6.9 percent) as Asian. Compared with AACN data, the composition of the School of Nursing standing faculty closely reflects the national composition of students currently in doctoral programs who comprise our faculty pipeline. In 2010, the AACN reported this racial and ethnic breakdown of students enrolled in research-intensive doctoral programs in nursing nationally: 76.8 percent white; 11.9 percent black or African-American; 5.4 percent Asian, Native Hawaiian, or other Pacific Islander; 4.6 percent Hispanic or Latino; and 1.3 percent American Indian or Alaska Native. Penn Nursing reflects the national applicant pool in many respects.

Penn Nursing has six male faculty members, which is 10 percent of the standing faculty. But it’s more than numbers, said Christopher L. Coleman, PhD, MPH, APRN-BC, ACRN, FAAN, the Fagin Term Associate Professor of Nursing and Multi-Cultural Diversity. Showing the male face of nursing is important to recruiting future faculty. In 2006, he collaborated with students to form the Male Association of Nursing at the University of Pennsylvania (MAN-UP). The organization provides academic, social, and professional support for male students; offers a forum to address factors affecting male nurses and men interested in pursuing a nursing career; and focuses on men’s health promotion. (See story on page 12.) The organization’s efforts have been recognized by the American Assembly for Men in Nursing. Men who choose nursing still face consistent public stereotypes of “what a man should pursue as a profession and what a woman should pursue, both from society and even from their own families and friends,” said Dr. Coleman. “The reality is that nursing is a serious, important, vital profession. Men who choose nursing can take care of themselves and their families financially; teach, practice, and conduct research anywhere in the country; and be on a pathway to move up to leadership quickly.” Dr. Christopher L. Coleman formed MAN-UP to support male faculty and students in nursing.

Members of our faculty were born outside the U.S. in countries such as China, Egypt, Germany, Korea, and Pakistan; represent different religious faiths, including Jewish, Christian, and Muslim; and bring an array of disciplines including epidemiology, nutrition, physiology, neuroscience, and bioethics. Clearly important, too, is the diversity of scholarly research at Penn Nursing. Whether the research is historical, qualitative, biobehavioral, organizational, policy-related, community-based, or sociological, each facet enriches the community of scholars and the environment for our students. As my colleague Bridgette M. Brawner, GNu’05, Gr’09, PhD, APRN, an assistant professor at Penn Nursing, points out: “Norms need to be challenged. You do not have to just accept something because that is the way it has been. At other places, you stay in your lane. Here, we are challenged to think critically.”

Your thoughts and experiences on diversity in nursing and nursing education are welcome. How do you perceive or experience racial, ethnic, gender, and other barriers to advancement? Are there specific barriers that make achieving goals more challenging? How might the School of Nursing better understand and overcome those barriers to continue to grow in faculty and graduate student diversity? To share your comments, contact Dr. Nancy C. Tkacs, assistant dean for diversity and cultural affairs, at or 215.573.3045.


The question then is not whether the School of Nursing faculty is diverse: Indeed we are. Our progress is assisted by University programs in support of the faculty diversity action plans that augment the substantial commitment of resources made by Dean Afaf I. Meleis. In 2009, Dr. Brawner became the first University of Pennsylvania Distinguished Postdoctoral Fellow. We are seeking to appoint diverse visiting faculty, particularly from the Latino community, to help us evolve our scholarly expertise in the

needs of this rapidly growing segment of the U.S. population. We also have the potential to appoint a Presidential Term Professor who will increase the racial and ethnic diversity of our faculty and grow our ever-increasing pool of scholars studying health disparities. Our journey to become a model of diversity among leading nursing schools continues. It is a journey we take together and one that enriches us all as nurses, scientists, educators, and lifelong students of health and well-being.

Nurse Leaders in the Making Feeling a passion for global service or the desire to help underserved populations, nearly 60 Penn Nursing students are part of a Robert Wood Johnson Foundation program to increase diversity in nursing nationwide. These Penn Nursing students participate in the Robert Wood Johnson Foundation: New Careers in Nursing (NCIN) scholarship program. This national program between the Robert Wood Johnson Foundation and the American Association of Colleges of Nursing aims to expand enrollment of groups underrepresented in nursing or from economically disadvantaged backgrounds in accelerated degree programs in nursing, and increase diversity in the nursing workforce. “The overarching goal is to develop the future of nursing by focusing on leadership, mentorship, and professional development,” said Margaret J. Griffiths, MSN, RN, CNE, CDE, assistant dean for curricular initiatives and NCIN program director. “At the same time, we are building a more diverse workforce to meet the needs of an increasingly diverse, global population.” Penn Nursing is one of just 11 nursing schools nationally to have had scholars every year since the program’s inception in 2008. Each cohort of NCIN scholars, called a “cluster,” includes accelerated students (who have earned a degree in another field), each receiving $10,000 scholarships toward tuition and expenses. To date, 58 Penn Nursing students have received scholarships. Growing up, Crystal Saucedo, Nu’12, spent summers with her grandparents in her family’s native Mexico, igniting her passion for global experiences. At age 15, she overcame bone cancer, which led her toward nursing in 18

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pediatric oncology. Ms. Saucedo found that Penn was the only institution offering both pediatric oncology and study abroad to nursing students. “Plus,” she added, “Penn is No. 1 in just about everything it does.” She is studying in Honduras this spring. The NCIN experience creates not only awareness of racial and ethnic diversity, but of diverse paths in nursing. “Our cluster has students from China, Ghana, Cuba, and Argentina, and we’re all pursuing different avenues as nurses,” said Ms. Saucedo. “I can see what gets other students worked up and passionate.” For Antonette Shaw, GNu’13, that passion means working with underserved populations. Ms. Shaw considers NCIN “a foundational tool.” Through professional development seminars and research opportunities with leading faculty, the program “set this broad thinking in motion and opened my eyes to what the next steps could be” – health policy, law, a doctorate, any or all perhaps leading to

new clinics in Latin America and the Caribbean. “If I hadn’t had that help, I wouldn’t have been able to choose Penn,” said Ms. Shaw. “I haven’t had to stifle my educational opportunities based on finances.” With students like Ms. Shaw, the NCIN program supports the 2010 Institute of Medicine report, The Future of Nursing: Leading Change, Advancing Health which recommended increasing the proportion of nurses with a baccalaureate degree or higher, and increasing student diversity to create a workforce prepared to meet the demands of diverse populations across the life span. Brian Lin, Nu’13, believes it is important both

to work with an underserved population and to represent an underrepresented group in nursing. In his native Mandarin, there are many feminine identifications with the word “nurse.” In his family’s view, he should be a doctor. “It’s still a challenge getting their buy-in,” he said. “Through NCIN, it’s reassuring to see other students who are diverse. There’s a sense of camaraderie.” He has submatriculated into the adult gerontology primary care program. NCIN is yielding its intended success. Nationally, 96 percent of scholars have passed the National Council Licensure Examination; more than 50 percent have reported plans to pursue a master’s degree; and more than 40 percent have reported plans to pursue a doctorate. At Penn Nursing, all scholars have passed the licensure examination and about half have transitioned to graduate study.


Martin Camacho and Steven Cabrera Through Puentes de Salud – Bridges of Health – Penn nurses attend to the physical and mental well-being of Philadelphia’s Latinos. From the greeting at the front desk – Bienvenidos a Puentes de Salud – to the meeting with the enfermero practicante (nurse practitioner), this clinic is all about making the patient sentirse comodo (feel comfortable). Puentes de Salud is a one-of-a-kind, nurse-led clinic for the Latino population, just across the South Street Bridge from Penn Nursing. Established by University of Pennsylvania healthcare professionals in 2003, Puentes cares for Mexican immigrants – many undocumented workers without health insurance.

Steven Cabrera (left) and Martin Camacho consult with a patient.

It is an ever-growing mission, explained Martin Camacho, GNu’03, MSN, ACNP-BC, a lead health provider at Puentes and director of its nurse practitioner residency program. “Because of the precarious status of undocumented immigrants in this country,” he said, “they often approach healthcare providers with trepidation and are skeptical about whether to receive services at all.” With a bilingual Latino health team, Puentes provides treatment and wellness services ranging from diabetes care and an after-school reading program to dental exams and behavioral health consultations for approximately 100 patients during the clinic’s twice-weekly hours.


“Puentes is really who I am,” said Mr. Camacho, who was born in Puerto Rico. “Being able to give back to the Latino community has been so important to me. It has helped me maintain my native identity. Becoming Americanized is very subtle – you find yourself dressing differently, eating differently, not speaking in your native dialect as frequently. Through Puentes, [my native identity] has been rekindled, and it brings a different quality to my clinical practice.”

The Culture of an Office Visit “Hola, como esta?” Mr. Camacho greets his patient, a Mexican man in a black T-shirt and paint-flecked pants. A longtime patient at Puentes, he has returned for a follow-up visit to discuss his diverticulitis. Mr. Camacho took the lead in the visit, demonstrating physical assessment techniques to Penn Nursing student Steven Cabrera, Nu’13. The camaraderie with the patient is clear. They all converse in Spanish, and Mr. Camacho explains every step of the exam to his patient, looking him squarely in the eye and leaving time for questions. At the end of the visit, Mr. Camacho puts a firm grip on his patient’s shoulder, offers a strong handshake, and coaxes a laugh out of the quiet man with a joke. Even among Latino cultures, said Mr. Camacho, “it’s a delicate and careful process to understand another culture and history. I need to take into consideration other traditions and influences, and sometimes subtle differences in language.” He also considers health issues in the context of a patient’s customs and traditions to yield better outcomes. “You really have to dive into the culture to learn the flavors, to learn what healthcare really means to this population. Like most things, it takes time,” said Mr. Camacho. Being at Puentes “is like a homecoming,” said Mr. Cabrera. In striking serendipity, his family hails from the same Mexican town as many of his patients. Mr. Cabrera started as a volunteer at Puentes in his freshman year and has become the clinic co-coordinator. He plans to become a nurse practitioner and aspires to open a Puentesstyle clinic in Mexico. Much of what Mr. Cabrera learns comes from working with Mr. Camacho, who is a lecturer 20

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and clinical preceptor at Penn Nursing. He conducts research and serves as a peer reviewer for journals in advanced practice nursing, critical care, and emergency medicine. He received the Penn Alumni Association’s Recent Alumni Award for Clinical Excellence in 2007 and is a member of the Honor Society of Nursing. Before entering nursing, he was a U.S. Navy Corpsman with the Fleet Marine Force, Camp Lejeune, N.C. Both Mr. Camacho and Mr. Cabrera are proud of the impact of Puentes in the community and the influence of nursing at the clinic. Said Mr. Cabrera, “We are lending a nursing voice to a truly interprofessional group of healthcare providers with the common goal of delivering quality healthcare to a population in need.”

From Mexico to 9th Street The local Mexican population has a large presence in Philadelphia’s Italian Market section at 9th Street and Washington Avenue where the shopping and restaurant district yields employment. Since 2000, the U.S. census has found Latinos to be the largest minority group in the United States. Economic instability in Mexico and the U.S. demand for low-wage, unskilled labor have fueled the influx of Mexican immigrants. A high percentage of this population works in lowpaying jobs, lacking insurance and access to healthcare, and facing language and cultural barriers. These challenges make the behavioral health component at Puentes particularly important, said Mr. Camacho. “Coming to America takes a substantial physical and mental toll,” he explained. “These men and women are working all kinds of hours, often in physical labor. They are hearty and proud. But the stress and anxiety of the transition to a new country and what it took to get here is still fresh.” The Puentes team is alert for signs of depression. They are also attuned to this population’s rates of hypertension and diabetes, which can be attributed to fluctuations between American and Mexican diets. Some MexicanAmericans lean toward a diet high in saturated fats, cholesterol, and salt, with poor intake of fresh fruits, vegetables, and fiber, and those in a low socioeconomic status find easier access to less nutritious options, said Mr. Camacho.

The comprehensive wellness strategy at Puentes reflects the Social Determinants of Health outlined by the World Health Organization, which highlights “the profound impact that education, child development, literacy, social inequality, job security, physical and social environments, food security, discrimination, and access to services and social safety nets have on health outcomes.”

Puentes’ History Puentes began with a nurse. Margaret Harris directed Project Salud, launched in 1985 in Kennett Square, near the migrant farm worker community. As a volunteer there, Penn Medicine emergency room physician Steven C. Larson, MD, wanted to bring the nurse-managed practice model to the Latino community in Philadelphia. He teamed with Margaret M. Cotroneo, PhD, APRN, now associate professor emerita, to create a collaborative, interprofessional setting with providers “who have the right tools for the right job.” Said Dr. Larson: “The biggest frustration of healthcare is that various health professionals still haven’t learned to play well in the sandbox together. Puentes dismantles the ‘I’m the doctor, you’re the nurse’ model. We are a team. We are about true patient-centered care.” Shifting the axis of healthcare delivery to this model is a signature facet of Mr. Camacho’s role at Puentes. “We work hard to have an impact on healthcare delivery, not just provide it,” he said.

To accomplish this, educational opportunities for healthcare providers are a cornerstone of the program. Nursing students in their third and fourth years have the opportunity to work as triage supervisors. Nursing and medical students from Penn and neighboring universities are volunteers. From the start, Puentes intentionally decentralized the role of the physician, creating an interprofessional model in which promotoras (trained, volunteer “health promoters”), nurses, nurse practitioners, students, and physicians collaborate as equal partners to care for the community. “Puentes can be a voice for the community to get better quality healthcare, become better educated about their health, and advocate for their own well-being,” said Mr. Cabrera. At the end of a Puentes shift, he said he gets more than he gives. “It’s a place where I can apply what I’m learning in nursing school about leadership and advocacy,” he said. “It’s about being more than proficient, but rather seeking to serve above and beyond.”

What’s Next for Puentes As Puentes de Salud marks its 10th anniversary this year, the clinic will transition from being “the night-time clinic of the community” to a full-time community center and clinic. To learn more call 215.490.6700 or visit



Hitch Your Wagon to a Star For inaugural Lang lecturer Terri Lipman, GNu’83, GRN’91, PhD, CRNP, FAAN, practice is core to her life’s work in pediatric diabetes and endocrine disorders. In her talk Hitch Your Wagon to a Star: A Roadmap for Promoting the Health of Children with Endocrine Disorders, Dr. Lipman illustrated how her clinical practice at The Children’s Hospital of Philadelphia guides her world-renowned research at Penn Nursing. Many times throughout his life, my father said that to reach your goals you must hitch your wagon to a star. When I thought about my journey, my career, and this hectic life that some of us live, as researchers, teaching, maintaining a clinical practice, and having families, it was clear that it could never have been possible without all the stars that have guided my wagon. I accept this award on behalf of all those who consider practice core to what they do and who they are.

Roadmap for Diabetes I love the practice of diabetes and endocrinology because of the inherent education that is part of working with families. Diabetes is now the third most common chronic condition in children in the U.S. Diabetes is very labor-intensive and is really nurse-managed and family-managed. My research emanates from questions that come from my practice. In my early years, parents asked me about diabetes management and also were asking some unusual questions: “Are more very young children developing diabetes? Why is my son the only black child I know with diabetes?” I conducted my dissertation on the epidemiology of type 1 diabetes in children in Philadelphia, and that has been my life’s work. When we think about a roadmap for the health of children with diabetes and endocrine disorders, or a roadmap for the health of populations in general, the crucial first step is epidemiology. We must describe the population in order to determine the etiology of the disease and the effective interventions to prevent or decrease the development of new cases. 22

UPfront | Spring 2013

Drs. Lang (left) and Lipman at the inaugural lecture for the Norma M. Lang Distinguished Award for Scholarly Practice and Policy.

Epidemiology also guides the allocation of resources at the local, state, and national levels to direct policy. I have the privilege of leading the Philadelphia Pediatric Diabetes Registry, part of the World Health Organization’s Diabetes Mondiale project, and the only original registry still active. Twenty years of data show the incidence of type 1 diabetes in children in Philadelphia has significantly increased, particularly in very young children – the first data of its kind in the U.S. This is clinically significant: The highest rate of mortality and morbidity in children with diabetes at diagnosis is in children under age 5. The symptoms can be insidious, and often primary care providers don’t consider the diagnosis of diabetes for very young children.

Important Measures In addition to diabetes, I have always been interested in linear growth assessment. Growth failure can be the first sign of a serious illness, including celiac disease, hypothyroidism, a brain tumor, renal disease. … One of my mentors said that the differential diagnosis for growth failure

View “Dance, Dance, Dance” (5:11)

is Nelson Textbook of Pediatrics. A leading endocrinologist considered growth the “single most important indicator in the health of a child” but recognized that the heights measured in the average outpatient encounter are “useless” for clinical purposes, let alone research, because children are so frequently mismeasured. When you think about the cost of healthcare, and all the money spent on invasive and noninvasive procedures, it turns out that a growth chart for a child provides the most important information. It is not only that children are mismeasured, it’s that healthcare providers don’t pay adequate attention to growth. In an intervention through the Pediatric Endocrinology Nursing Society, we increased the accuracy of linear measurement in primary care practices in eight U.S. cities and educated more than 500 U.S. nurses in growth, growth disorders, measuring procedures, and psychosocial issues related to stature. My most recent area of research is racial disparities in children with endocrine disorders, a crucial aspect in promoting the health of children. Health equity is where we all need to move. The Affordable Care Act is certainly looking at the importance of health equity – investing in prevention and wellness, giving individuals and families more control over their own care.

Community Partnerships Data show that black children with diabetes have a mortality rate nine times greater than white children, and have worse outcomes and poorer diabetes control. Focus groups from The Children’s Hospital of Philadelphia demonstrated racial differences in the goals, priorities, and perceptions of parents of children with diabetes. If we are ever going to decrease racial disparities, it will not be by clinicians and researchers sitting around a table, trying to “figure it out.” We have to listen to the voices of our patients and their parents. In the type 1 Diabetes Exchange – a collaborative study among 38 U.S. pediatric sites with more than 14,000 children – we showed that white children are significantly more likely than black and Hispanic children to be treated with insulin pump therapy. Many hypothesize that disparities are not due to race, but to socioeconomic status. We controlled for income and parental education. Yet among all families where the parents had master’s degrees, white children were more likely to be treated with insulin pumps.

The first step is to identify inequity. Truly, until we describe it, we can’t deal with it. Until we recognize that these disparities exist, until we describe the population from an epidemiologic perspective, we cannot even hope to intervene. And how do we intervene? We have to understand the community. Since 2005, thanks to funding from Penn’s Netter Center for Community Partnerships, my students have taught in West Philadelphia on topics related to obesity, diabetes, and growth, and partnered with Sayre High School to screen children for type 2 diabetes risk factors. We screened almost 300 children, and a third were at risk for type 2 diabetes. To develop an intervention, I asked families: “What activity is fun and easily accessible, and you can do it at home for free?” We came up with dance. More than 100 community members, ranging in age from 5 to 73, attended our Dance for Health nights. They loved it. The true test of a community intervention is sustainability. At Sayre, the dance nights are still going strong. We will return in the spring to collect more data, with an aim to get more funding to keep this project going. So we will be back! This project brings together my passions in diabetes, clinical practice, research, and children’s health, and makes me grateful once again that I hitched my wagon to such stars throughout my career. When I think about them, I am eternally grateful. To paraphrase Ralph Waldo Emerson: “When you hitch your wagon to a star, your path becomes infinite and the universe is yours.” The Norma M. Lang Distinguished Award for Scholarly Practice and Policy honors the professor and dean emerita of the School of Nursing for her celebrated contributions to health policy and practice. Established in 2012, the award will be given annually to a Penn Nursing faculty member or a graduate of the School’s doctoral program who has made a distinguished contribution to nursing through scholarly practice.


SCIENCE IN ACTION Standardizing Military Pain Management An Army pain management task force developed a new integrated pain rating instrument – the Defense and Veterans Pain Rating Scale (DVPRS). It introduces a consistent way to measure pain across transitions of care in military and Veterans Health Administration settings. Rosemary C. Polomano, HUP’74, Nu’76, GNu’79, PhD, RN, FAAN, associate

professor of pain practice, collaborated with task force leaders Col. Chester C. Buckenmaier III, MD, director of the Defense and Veterans Center for Integrative Pain Polomano Management; Col. Kevin T. Galloway, BSN, MHA, of the Office of the Army Surgeon General; and Rollin M. Gallagher, MD, MPH, of the Philadelphia VA Medical Center, to conduct initial psychometric testing of the DVPRS in 350 inpatient and outpatient active duty or retired military service members at the former Walter Reed Army Medical Center in Washington, D.C.

identify risk for pain-related issues, and providing a minimum set of patient-reported outcomes for communication and documentation across transitions of care,” said Dr. Polomano and colleagues in Pain Management. The proposed general adoption of the DVPRS by the Department of Defense and the Veterans Health Administration could mean standardization of “pain questions” through integrated electronic health records, said Dr. Polomano. A uniform minimum pain data set would allow comparisons and outcomes tracking not possible with existing clinical pain assessment practices.

“This scale has important implications for standardizing pain assessment practices throughout military and veteran healthcare settings – improving screening practices to

Courtesy of

Secondhand Smoke Linked to Children’s Behavior Problems New Penn Nursing research suggests that secondhand smoke, or environmental tobacco smoke (ETS), may be just as harmful to child health as active maternal smoking during pregnancy.



UPfront | Spring 2013

In one of the first studies of its kind, researchers examined data from 646 motherchild pairs in China, where more than 70 percent of men smoke, and concluded

that 25 percent of children of whose mothers were exposed to smoke exhibited behavior problems, compared with 16 percent of children of unexposed mothers. Children of passivesmoking mothers also demonstrated poorer performance on tests of speech and language skills, intelligence, and behavioral outcomes, wrote Jianghong Liu, PhD, RN, FAAN, associate professor at Penn Nursing, in NeuroToxicology. “Such findings could inform public health efforts to reduce public smoking and underscore the need for including ETS avoidance as a potential component of prenatal care among pregnant women,” said Dr. Liu.

Nursing Workloads Multiply Likelihood of Death Among Black Patients over White Patients Older black patients are three times more likely than older white patients to suffer poorer outcomes after surgery, including death, when cared for by nurses with higher workloads. A large-scale Penn Nursing study showed higher nurse workloads negatively affected older surgical patients generally and that the rate was more significant in older black individuals. When the patient-to-nurse ratio increased above 5:1, the odds of patient death increased by 3 percent per additional patient among whites and by 10 percent per additional patient among blacks. Assistant Professor of Nursing J. Margo Brooks Carthon, Gr’08, PhD, RN, and Penn Nursing colleagues studied more than 548,000 patients ages 65 and older undergoing general, orthopedic, or vascular surgery in 599 U.S. hospitals. The data, reported in the Journal of the American Geriatrics Society, suggest that the

probability of death for black patients is equal to that of white patients when the patient-to-nurse ratio is low to average (considered up to 5:1), and greater in hospitals where nurses had heavier workloads.

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“Hospitalized surgical patients sometimes experience periods of instability in vital functions, and the quality of nursing care they receive has a significant effect on their recovery and well-being,” said Dr. Carthon. “Better staffed hospitals are better prepared to meet the more complex needs of older patients, particularly minorities with higher rates of co-existing conditions.” Carthon View “Risk Factors for African-Americans” (1:35)

Clinicians and Parents: Working Together During Invasive Procedures


Parents present during a child’s more invasive procedures report higher levels of comfort, more procedural understanding, and less emotional distress, and clinicians reported parent presence did not affect their technical performance, therapeutic decision-making, or ability to teach. The study, conducted over four years at Boston Children’s Hospital in the cardiovascular and critical care programs, used multiphase surveys of clinician perceptions and practice from the perspectives of clinicians and parents experiencing the same procedure. “Clinicians reported parents to be calmer and less distraught. Across phases, clinicians reported that the parents’ need for information and support were met,” wrote Martha A.Q. Curley, PhD, RN, FAAN, the Ellen and Robert Kapito Professor in Nursing Science, in Pediatrics. “Regardless of whether parents were present, most clinicians would, under future similar circumstances, provide parents with the option to remain.”

Parent presence during invasive procedures and resuscitation, still controversial, draws most concern from the medical community. The nature of procedures and resuscitation had clinicians concerned that parents could interrupt their technical performance or decision-making. But data indicated that interference on the part of parents occurs only 2 percent of the time. “The intervention facilitated a cultural shift in the clinical practice of providing parental support during their children’s invasive procedures and resuscitation,” said Dr. Curley.

The research utilized high-realism simulations with pediatric mannequins and professional actors as parents.


PENN NURSING NEWS LIFE Pathway to Excellence Living Independently For Elders (LIFE) has been granted a Pathway to Excellence designation through the American Nurses Credentialing Center. The Pathway to Excellence program recognizes healthcare organizations for positive practice environments where nurses excel and where they must meet 12 practice standards. They are: that nurses control the practice of nursing; a safe and healthy work environment; systems to address patient care and practice concerns; orientation preparing new nurses for the work environment; a chief nursing officer who is qualified and participates in all levels of the organization; professional development; equitable compensation; that nurses are recognized for achievements; encouragement of a balanced lifestyle; value of collaborative relationships; competent, accountable nurse managers; and a quality program informed by evidence-based practice. LIFE, founded in 1998, has served more than 600 Philadelphia seniors. The program provides preventive, primary, acute, and long-term care services so that qualified older individuals may live in their own homes and communities as long as possible. LIFE is both a health plan and a healthcare provider.

LIFE provides preventive, primary, acute, and long-term care services so that qualified older individuals may live in their own homes and communities as long as possible.

View “Penn Nursing Helps Elders at LIFE” (2:24)

Learning Through Coursera As part of Penn’s new partnership with the online cyber education platform Coursera, Sarah H. Kagan, PhD, RN, FAAN, of Penn Nursing will lead the six-week summer course Growing Old Around the Globe: An Introduction to Psychological and Social Gerontology. Coursera is a web portal intended to make interactive online courses from top universities available for free to millions of people around the globe. Penn and other major universities are partnering with Coursera in the company’s effort to distribute math, engineering, and science courses, and a selection of courses in the humanities and social sciences, to interested students everywhere.


“Aging inevitably affects all of us as we advance in years and as our parents and friends grow old,” said Dr. Kagan, the Lucy Walker Honorary Term Professor of Gerontological Nursing. “Coursera, as a large-scale education platform, is an excellent venue to analyze how individuals, families, communities, and societies navigate in an aging world. By sharing their experiences and perspectives, students will create a global community to discuss aging and the science of gerontology in action.” To sign up for the course, go to The Penn Nursing team working on Coursera is making a gerontology course available for free to millions of people around the globe.


UPfront | Spring 2013

Health Sciences Leaders as Visiting Professors This academic year, three major figures in nursing, technology, and women’s and gender issues are visiting professors at Penn Nursing. Kathleen A. Dracup, DNSc, RN, FAAN, dean emerita of the school of nursing at the University of California, San Francisco, shares her vast experience in scholarly and interprofessional initiatives. Her professional career spans four decades of leadership in nursing and cardiovascular nursing science. One of the first nurses to study heart failure, she is internationally recognized for her research in the care of patients with heart disease and its effects on spouses and other family members. Dr. Dracup designed interventions such as CPR training for family members of high-risk patients and co-chaired the development of clinical practice guidelines for heart failure for the Agency for Health Care Policy and Research. The recipient of many honors, she was the only nurse and woman to receive the Eugene Braunwald Academic Mentorship Award from the American Heart Association, and she is a member of the Institute of Medicine. Mary Elizabeth Mancini, PhD, RN, ANEF, NE-BC, FAAN, FAHA, brings her significant expertise in

simulation education to The Helene Fuld Pavilion for Innovative Learning. She is professor, associate dean, and chair for undergraduate nursing programs at the University of Texas at Arlington College of Nursing. She holds the Baylor Health Care System Professorship for Healthcare Research. Prior to joining academe, Dr. Mancini was senior vice president for nursing administration and chief nursing officer at Parkland Health & Hospital System. Susan M. Reverby, PhD, is a scholar on women’s and gender issues as they relate to health

policy. She is the Marion Butler McLean Professor in the History of Ideas, professor of women’s and gender studies at Wellesley College, and an historian of American women, medicine, public health, and nursing. Her research on an immoral government medical study in Guatemala between 1946 and 1948, in which doctors gave men and women the syphilis infection, led to a U.S. government response from the secretaries of the Departments of State and Health and Human Services and an apology from President Obama to President Colom of Guatemala.




CCNE Invites Comments Regarding Reaccreditation The University of Pennsylvania School of Nursing is pursuing reaccreditation by the Commission on Collegiate Nursing Education, the accrediting body of the American Association of Colleges of Nursing. The commission invites constituents to submit written comments

concerning the BSN and MSN academic programs. Comments are held in confidence by CCNE. During its review of the program, the evaluation team considers thirdparty comments, if any, that relate to the accreditation standards.

Signed comments may be submitted to Elena Mityushina (emityushina@aacn.nche. edu), Accreditation Coordinator, Commission on Collegiate Nursing Education, 1 Dupont Circle, N.W., Suite 530, Washington, D.C. 20036. The deadline for submission of signed comments is August 1, 2013.


PENN NURSING NEWS $4.63M Grant to Dr. Paterson for PENN-PORT Yvonne Paterson, PhD, associate dean for research, has been awarded a $4.63 million grant to continue her fellowship program to enhance researchoriented teaching, promote collaborations, and encourage minority students to enter graduate school and increase participation in biomedical research in the academic setting. The program has been running for five years. The program, University of Pennsylvania Postdoctoral Opportunities in Research and Training (PENN-PORT), funds 15 fellows who currently teach in local colleges and universities that have a significant minority enrollment. PENN-PORT combines postdoctoral research training with mentored teaching experience at a minority-focused institution. Paterson

Penn’s Center for Public Health Initiatives Jennifer A. Pinto-Martin, PhD, MPH, the Viola MacInnes/Independence Professor

of Nursing and chair of the Department of Biobehavioral Health Sciences, has been named executive director of Penn’s Center for Public Health Initiatives for a five-year term. She has served as interim executive director since October. CPHI promotes interdisciplinary research, education, and practice in public health, and houses Penn’s multidisciplinary, interschool master’s in public health program, which Dr. Pinto-Martin has directed since CPHI’s founding in 2007. Dr. Pinto-Martin has a secondary appointment in the department of biostatistics and epidemiology in the Perelman School of Medicine. She is also a senior scholar in the Center for Clinical Epidemiology and Biostatistics, a senior fellow of the Leonard Davis Institute of Health Economics, and director of the Center for Autism and Developmental Disabilities Research and Epidemiology.


Dr. Whelan as Association President Jean C. Whelan, PhD, RN, has been named president of the American Association for the History of Nursing. Founded in 1978, the American Association for the History of Nursing is an organization that advances historical scholarship in nursing and healthcare, and promotes the development of nurse historians. Dr. Whelan is assistant director for the Barbara Bates Center for the Study of the History of Nursing. Her research focuses on the historical development of the U.S. nursing workforce and the policy involved in maintaining adequate nurse services.


Coming Soon: New Doctoral Student Journal Edited by Penn Nursing doctoral students Maxim Topaz, Gr’14, Justine S. Sefcik, Gr‘14, and editor-elect Paule V. Joseph, Gr‘15, the inaugural Journal of Nursing Doctoral Student Scholarship, will include four articles authored by Penn Nursing PhD students and editorials reflecting on the academic life of PhDs. The journal, due out this spring, will be posted on 28

UPfront | Spring 2013

ALUMNI CONNECTIONS Laura Bush, former first lady and an advocate of health and education initiatives for women and children, will be the Penn Nursing Commencement speaker on May 13. For tickets (required) or more information, email graduation@nursing. by April 1.

Penn Nursing Alumni Board Updates Bylaws

In fall 2012, the Nominations Committee reviewed and updated the Penn Nursing Alumni bylaws. The board approved the updates in January. The bylaws can be found at Get Involved: Join a Nursing Alumni Committee

Are you interested in giving back to Penn Nursing with your time and skills? Consider joining a committee to focus on alumni awards, events, or student-alumni connections. Participation is open to all alumni on an annual basis and can be filled by alumni from around the country and the globe, participating remotely. These are non-elected positions, and committee members work with Alumni Board members to further alumni involvement and interaction. For more information, see or email Ellen McCabe, Nu’88, GNu’91, at

Want to Know More?

Contact Penn Nursing’s Office of Institutional Advancement Monica Salvia Associate Director of Alumni and Donor Relations 215.898.9773 Email: Web: Penn Nursing Alumni Board Leadership

President Terri Cox Glassen, Nu’91 Glendale, Calif. Past President Naomi H. Higuchi, Nu’86, GNu’92 Cherry Hill, N.J. Vice President for Student and School Support Ashley Zampini, Nu’07, GNu’10 Levittown, Pa. Secretary Brian Bixby, GNu’97 Philadelphia

S U P P OR T in g stu dents For more information on how you can support Penn Nursing students, contact Desirée Carr at 215.898.4841 or, or make a gift with the enclosed envelope.

Working in a clinic in Guatemala was instrumental in Antonette Shaw’s decision to pursue a career in nursing. “Helping families felt so great, and the light bulb came on as to what would help me combine education and clinical skills into my dream career,” she said. “But since I was about to go back to the U.S. with just pennies in my pockets, I needed help to follow my dream. Penn Nursing gave me that opportunity.” With scholarship support, Antonette can pursue her goals and

care to change the world.

Antonette Shaw, Nu’11, GNu’13, is pursuing her master’s degree in nursing.


From the Penn Nursing Alumni Board President In my first few months as president, I learned so much more about the global scope and impact of our alumni. While our roles may vary from corporate to university to clinical settings, Penn Nursing graduates around the world demonstrate the same commitment to social justice and patient advocacy. As nurses, we value an individual’s right to reach her or his full health potential. Through innovative research, practice, and the creation of policy, we work to address social and structural injustices that lead to health disparities. Promoting equal opportunity for healthcare access and quality of care across the globe remains a central priority of the School. This past fall, I had the honor of serving on the planning committee for the Healthy Cities: Healthy Women conference in Los Angeles, part of a series of events intended to foster discussions about re-envisioning our communities to make them safer and healthier for women and their families. (See page 10.) This tremendous event was just another testament to the dedication that Penn Nursing and the University show toward advancing health equity. This experience also demonstrates further evidence of Penn Nursing’s commitment to providing lifelong education and networking opportunities for alumni. As a result of this conference, I was able to build new relationships with so many fellow alumni, parents, and supporters in the Los Angeles area and beyond. These partnerships and the incredible knowledge I gained from our wonderful panelists will continue to serve me throughout my life and support my own mission to improve global healthcare. I look forward to sharing what I learned with my Alumni Board colleagues and continuing this discourse on global health issues with you, our fellow alumni. Alumni engagement and support plays as crucial a role in the growth of current Penn Nursing students, initiatives, and research as the School’s outstanding leadership. Our contributions help ensure the ongoing success of Penn Nursing’s education, practice, and the advancement of its scholars. I’d like to hear about how you or fellow alumni work to promote health equity locally, regionally, nationally, or globally. I encourage you to suggest new ways the School and our alumni can care to change the world. Please contact me at Go Quakers! Terri Cox Glassen, Nu’91 President, Penn Nursing Alumni Board


UPfront | Spring 2013

From the HUP Nursing Alumni Association President Much has changed for nursing education at Penn since the inception of the HUP Nursing School, but today’s Penn Nursing graduates remain guided by the same principles that came to define HUP nurses. Driven by a sense of social responsibility and a desire to care for each and every patient, HUP graduates have traveled the world, served in military conflicts, and influenced the advancement of healthcare on a global scale. Penn Nursing’s scholars continue to embody this legacy, advocating for social change and improved patient care around the world. During my time as president of the HUP Nursing Alumni Association, I have been proud to witness and share in Penn Nursing’s mission to increase programs, research partnerships, and international collaborations to advance nursing practice and policy here and abroad. The HUP Nursing Alumni Association is thrilled to play a role in these efforts, pay tribute to the nursing pioneers who paved the School’s path, and help blaze new trails in nursing science and education. As I write my final letter as president, I want to thank all who have made my tenure so productive and rewarding. Several people must be named because of their outstanding and long-term dedication. Betty Irwin, HUP’50, has single-handedly organized our archives and artifacts. Isabella Harrison, HUP’49, our treasurer, continues to keep our finances in order. Julia Davis, HUP’73, our secretary, newsletter editor, and “regular girl Friday,” gives continuous support to all members of the board. I am excited for Cleo Libonati, HUP’68, Nu’72, to take on the role of president later this spring. All newly elected board members will be installed at our luncheon and annual membership meeting, which will be held on April 27. Looking forward, the board and committee chairs will be planning the next reunion, to take place in 2016. I encourage HUP and Penn Nursing graduates to remain involved with our alumni associations so we can keep our history alive. To all of my fellow HUP alumni, colleagues, and friends at Penn Nursing, thank you for your continued support and guidance over these past few years. It has been an honor to represent our School and work with you to further nursing education and care across the globe. Sincerely, Candace Stiklorius, HUP‘66, Nu’71, GNu’83 President, HUP Nursing Alumni Association


C LA S S NO T E S 1950s Shirley Sears Chater, HUP’53, Nu’56, HON’97,

former U.S. Commissioner of the Social Security Administration, stepped down from her position as the national advisory committee chair of the Robert Wood Johnson Foundation’s Executive Nurse Fellows program in September. She was the first person to hold this post. Named a “Living Legend” by the American Academy of Nursing in 2000, Dr. Chater continues to receive accolades for her work and influence on nursing practice, policy, and education. She served as a member of the honorary committee for Penn Nursing’s Healthy Cities: Healthy Women conference in Los Angeles in November. (See page 10.) Esther H. Jaeger Staley, Nu’57, recently

moved to Phoenix from the Navajo and Hopi reservations, where she had worked in public health nursing since 1960. Prior to her move, she lived with her husband, Robert, at Immanuel Mission, an isolated mission on the Navajo Reservation where her husband served as principal of the mission school.

1970s Debra Koniak-Griffin, GNu’74, received the 2012 Pathfinder Award from the Friends of the National Institute of Nursing Research. The award recognizes a nurse researcher whose work advances a better understanding of human health and healthcare. She has focused much of her research on combating health disparities among young parents from ethnic and racial minorities. Dr. Koniak-Griffin established and directs the Center for Vulnerable Populations Research, the first federally funded Nursing Center of Excellence at the UCLA School of Nursing. Her work has been lauded in the healthcare community for providing vital theory-based interventions for adolescents at risk for sexually transmitted diseases, unplanned pregnancies, and teen parenthood. The U.S. Department of Health and Human Services has selected three of her programs as evidence-based models.


UPfront | Spring 2013

Donna Martsolf, GNu’75, has been named a fellow of the American Academy of Nursing. Dr. Martsolf has directed mobile health clinics in Haiti for more than 30 years. In 2003, she earned a Fulbright Award to research and lecture there while working with local agencies to develop the nation’s first BSN program. Her work has helped Haiti earn nearly $2.5 million in grants awarded by the United States Agency for International Development to help construct a nursing campus. She is professor and associate dean for research and translation at the University of Cincinnati College of Nursing. Donna L. Torrisi, GNu’76, has been named a

fellow of the American Academy of Nursing. She is network executive director of the Family Practice and Counseling Network. Her research is on the nurse-managed model and on integrating behavioral health and primary care. She is a founding member and the first chair of the National Nursing Centers Consortium. She co-wrote the book Community and Nurse-Managed Health Centers: Getting Them Started and Keeping Them Going. Kathy Stoddart-Drucker, GNu’79, works as

school nurse at the Convent of the Sacred Heart School, an independent girls’ school in New York City. She lives with her husband, Joe, in Pelham Manor, N.Y., and she is interested in mentoring a Penn Nursing student considering school nursing.

1980s Elizabeth Scannell-Desch, GNu’80, joins

Adelphia University Hudson Valley Center as nursing coordinator for graduate and undergraduate students. A retired colonel of the U.S. Air Force Nurse Corps, she served as command nurse executive for the entire Air Force Reserve Headquarters at the Pentagon, where she was senior nurse adviser to the Reserve Commanding General. She recently obtained a certificate from Rutgers University College of Nursing in post-master’s nursing education.

Filomela “Phyllis” Marshall, GNu’82, of Lafayette Hill, Pa., has been named dean of the W. Cary Edwards School of Nursing at Thomas Edison State College. She had served as associate dean of the school since 2010, leading the development of nursing informatics study in the MSN program and launching the school’s accelerated seconddegree BSN program. Formerly, she was a tenured professor and chair of the MSN program at Holy Family University in Philadelphia. Deanna Gray-Miceli, GNu’83, has been

named a fellow of the American Academy of Nursing. Her research led to the development of a clinical algorithm to address the underlying factors leading to falls among elderly patients in nursing homes. This unique evidence-based study of fall prevention resulted in a 30 percent fall reduction rate in pilot health services using the tool. An assistant professor at Rutgers University College of Nursing-Newark, she is recognized as the lead consultant for statewide fall prevention initiatives. Amy Wishner, GNu’84, directs the immunization education program at the Pennsylvania chapter of the American Academy of Pediatrics. She has posted her artwork at Derryl Block, GNu’85, Gr’91, has been named dean of the College of Health and Human Sciences at Northern Illinois University. Since 2009, she has been chair of the professional program in nursing and director of BSN-LINC, an online RN-to-BSN program at the University of Wisconsin-Green Bay. She joined UW-GB in 2001 as an associate professor and, from 2009 to 2011, served as interim dean of the College of Professional and Graduate Studies. Mary Anne Peters, GNu’85, has been named

president of the Pennsylvania Higher Education Nursing Schools Association. Previously, she was chair and professor of nursing at Eastern University. In 1999, she was given a Lindback Award for distinguished teaching.

Mary Elizabeth Cooley, GNu’86, GNC’92, Gr’98, has been named a fellow of the

American Academy of Nursing. As an assistant professor at the University of Massachusetts-Boston and a nurse scientist at the Dana-Farber Cancer Institute, Dr. Cooley has specialized in lung cancer care for most of her career. She has served on interdisciplinary committees such as the American College of Chest Physicians Evidence-Based Guidelines for the Diagnosis and Management of Lung Cancer, and is the recipient of several honors and awards. Amy J. Levi, GNu’86, Gr’00, has been named the first Albers Endowed Professor of Midwifery at the University of New Mexico College of Nursing.

1990s Elizabeth Burgess-Dowdell, Gr’93, professor of pediatric

nursing at Villanova University, has been named a fellow of the American Academy of Nursing. A pioneer in the study of electronic aggression, her interdisciplinary research has led to more complete profiles of high-risk youth, taking into account the relationship between physical, sexual, emotional, and technological factors in their lives. Matthew D. McHugh, GNC’94, GNu’98, Gr’04 has

been named a fellow of the American Academy of Nursing. An assistant professor at Penn Nursing, Dr. McHugh conducts multidisciplinary research on the effects of policy and law on nursing practice and health outcomes. He also directs Penn’s coordinated dual-degree program in nursing and healthcare management.

Christopher Friese, Nu’97, GNu’01, Gr’05,

has been named a fellow of the American Academy of Nursing. An assistant professor at the University of Michigan, he has been lauded for his investigation into hazardous drug exposure in the understudied ambulatory oncology setting and has implemented his research findings into oncology nursing practice. He has held leadership positions in the American Society of Clinical Oncology and the National Quality Forum. In 2008, Dr. Friese was the first nurse scientist to receive a K99/ R00 Pathway to Independence Award from the National Institutes of Health. Melina Begun, Nu’99, earned a master’s

degree in nursing administration from Western Governors University in October. She is pleased to have collaborated with Monica Salvia, associate director of alumni and donor relations at Penn Nursing, for her capstone project “Determining the Effects of a Mentoring Program on Undergraduate Nursing Students.”

Nicki Ahles-Moses, GNu’07, welcomes a daughter, Emma. She joins big brother Michael. The family recently purchased a new house in the suburbs of St. Paul, Minn. Wendy Miner, Nu’07, GNu’10, is an acute care nurse practitioner with Univita, which provides home healthcare management for the elderly and underserved. She also works as a critical care nurse at Pennsylvania Hospital. Her experiences internationally and domestically have focused her interests on the relationship between global health and the environment.

2010s Caitlin Dougherty, Nu’10, GNu’11, has worked as a nurse in Fiji and now is a family nurse practitioner with Home Visit Doctors. She continues to follow her passion of working in community health and lowresource settings in the north and northwest communities of Philadelphia.

2000s JoAnne Reifsnyder, Gr’03, has been appointed chief nursing officer of Genesis HealthCare. Formerly coordinator and co-developer of a palliative care minor at Penn Nursing, Dr. Reifsnyder completed a postdoctoral fellowship in psychosocial oncology here. She holds a PhD in nursing from the University of Maryland, an MSN from Thomas Jefferson University, and a BSN from Holy Family College.

To submit an Alumni Note or an In Memoriam listing, please send your notice and photos to Submissions will be edited for space and style considerations.

Anthony Shamoun, GNu’06, C’06, has been named chief clinical nurse specialist and neuroscience clinical nurse specialist at American University of Beirut Medical Center. Mr. Shamoun is happy to announce his marriage to Cynthia, a nurse specializing in multiple sclerosis.


I n M em oriam 1930s Helen Morningstar Sunday, HUP’33, of

Frederick, Pa. Mrs. Sunday supervised the maternity ward at York Hospital in York, Pa., for 20 years. While working there, she graduated from Elizabethtown College and received a master’s degree from the University of Maryland. In 1967, she joined the nursing faculty at the State University of New York in Plattsburgh. She is survived by her husband, Robert Sanderson, her daughter, Susanne, and many loving family members.

1940s Emily Radue Blenderman, ED’42, of

Bridgewater, N.J., worked as an assistant supervisor for 10 years with the Philadelphia Visiting Nurse Association, and became the first school nurse for the Barrington, N.J., school system, a position she held until her retirement. She then volunteered with the Red Cross and The Children’s Hospital of Philadelphia. Phyllis Patterson, HUP ’47, of Harrisburg, Pa., was the head surgical nurse at the Hospital of the University of Pennsylvania and, while working with renowned HUP surgeon Dr. I.S. Ravdin, participated in the first televised surgical procedure. She spent her free time gardening, sewing, traveling, and visiting family. Mrs. Patterson led many fundraising efforts for the Polyclinic Hospital Auxiliary, where she served as president for two years. She was a member of Grace United Methodist Church in Harrisburg and the Pennsylvania Medical Society Alliance, and an avid curler at the Hershey Country Club. She is survived by her husband of 56 years, Lewis; two sons, two daughters and 12 grandchildren; and many family members and friends. Virginia Lang, CW’49, of Hollidaysburg, Pa.,

worked at West Penn Hospital from 1949 to 1951, teaching nursing arts; was assistant director of nursing at Southside Hospital from 1951 to 1953; was director of nurses at Delaware Valley Medical Center in 1980; and worked at Passavant Hospital in Pittsburgh as director of the School of Practical Nurses, retiring in 1983 after 30 years in nursing.


UPfront | Spring 2013

Marion Bernadette Yost Ray, HUP’49, of

Chestertown, Md., enjoyed a long career working in a wide range of nursing settings. She ended her career working in hospice, putting into practice her strong patient advocacy beliefs. She loved to garden, spend time with her family, and volunteer with PTA, local libraries, and the YMCA. She is survived by her husband, Ronald, her sister, Nanette Fluck, five children, and four grandchildren.

1950s Kathryn Porter Clark, HUP’50, Nu’50, GEd’56, of

Honeybrook, Pa., and her husband, Donald Gould Clark, passed away on the same day, holding each other’s hands. Both lived at Tel Hai Retirement Community. Mrs. Clark worked as a nursing instructor in obstetrics at Lankenau Hospital for most of her career, and later became a school nurse in the Marple Newtown School District until her retirement. She and her husband spent 34 years in Broomall before moving to Coatesville. They remained active members of their church and treasured their roles as grandparents and great-grandparents. Catherine A. Quinn, HUP’53, NU’68, of

Philadelphia, worked as an emergency room nurse at the Hospital of the University of Pennsylvania until her retirement. Violet A. Breckbill, NU’54, GED’61, of

Vero Beach, Fla., received her doctorate from Case Western Reserve University and became director of nursing at Montgomery Hospital in Norristown. She served on the faculties of Case Western Reserve University, the University of Cleveland, and Penn Nursing. She retired as dean of nursing at Binghamton University in New York. She was a member of the Church of God in Vero Beach, Fla., and of the University Women’s Association. She is survived by her son, Robert, and three sisters.

Bernadine Delores MacNeal, HUP’55, of

Huntingdon Valley, Pa., practiced nursing for more than 40 years, retiring as a nurse with the School District of Philadelphia. She was committed to charity work, including cooking meals for Aid for Friends. She was skilled at sewing and cooking, an avid reader, and a devoted wife and mother. She is survived by her brother, Julius, five children, three grandchildren, and many nieces, nephews, cousins, and friends. Jean E. Fedder Breiner, HUP’56, of

Timmonium, Md. had a nursing career that spanned almost three decades, including work at Lutheran Hospital in Catonsville, Md.; the Greater Baltimore Medical Center in Towson, Md.; and school nursing for the Baltimore County school system. She was nurse and counselor to students, neighbors, and injured people she met on backpacking trips. Diagnosed with acute myeloid leukemia in September 2009, she fought bravely through two experimental clinical trials of chemotherapy, multiple bone marrow procedures, and countless hospital stays. Jean is survived by her husband of 56 years, Robert, daughters, Nancy and June, and son, Robert. Libby Barnshaw, NU’59, of Springfield, Mass., worked as a registered nurse at Graduate Hospital in Philadelphia and Porter Hospital in Denver. She then specialized in problem pregnancy counseling, becoming director of the Voluntary Action Center in Billings, Mont., and serving on the Youth Home Board there and in Colorado Springs, Colo. She later obtained her master’s degree in mathematics, taught high school math, and helped her husband in his private practice. Her favorite pastimes included golfing, traveling, and knitting. Mrs. Barnshaw died after a seven-year battle with frontal temporal lobe dementia. She is survived by her husband, Douglas, two children, four grandchildren, and her brother.

1960s Dorothy S. Gallos, Nu’60,

of Egg Harbor Township, N.J., worked as a kindergarten teacher for the Cherry Hill School District for more than 30 years. She was a veteran of the U.S. Air Force who served as a flight nurse evacuating wounded soldiers. Mrs. Gallos was an active member of St. John Lutheran Church in Ocean City, the Red Hat Society Scarlets Violets Group, and the Order of the Eastern Star for more than 50 years. She is survived by her daughter, Gerri L. Black, and her stepchildren, Deborah Begley and Scott Gallos. Elva J. Tate, Nu’64, GNu’76, of Philadelphia,

worked as a registered nurse for many years at Einstein Hospital, taught pediatrics, and was involved with the American and Pennsylvania Nurses associations. She is survived by many nieces and nephews. Margaret J. Franck, Nu’68, GNu’80, of Ardmore, Pa.,

was a nursing teacher and administrator for much of her life. She also worked as an account manager at McKesson Corp. in Mount Laurel, N.J., demonstrating medical software to health professionals around the world. She held several offices throughout the years for the alumni association of the Presbyterian School of Nursing, most recently as president. She is survived by her husband, Richard G. Bickel.

1970s Nancy Cox, Nu’71, GNu’74, of

Philadelphia, was a longtime leader in the West Philadelphia community. Mrs. Cox helped establish the University City Arts League and the University City Swim Club. She worked as a registered nurse at Pennsylvania Hospital for several years, where she met her future husband, Dr. James Cox. In 1963, the couple founded the swim club, notable as one

of the earliest racially integrated clubs in the country. They traveled to almost every continent in the world. Mrs. Cox is survived by her husband, two sons, two daughters, and nine grandchildren. Vivian Gedaly-Duff, Nu’73,

of Portland, Ore., was a well-known nurse educator, writer, and researcher. Dr. Gedaly-Duff was devoted to family healthcare nursing. In her career, she worked as a pediatric staff nurse; served as a faculty clinician and consultant at Doernbecher Children’s Hospital in Portland and at The Children’s Hospital of Philadelphia; and was training coordinator of nursing for the Oregon Institute on Disability and Development at Oregon Health and Science University. Following her lifelong passion for teaching, she taught undergraduate and graduate courses at University of California, San Francisco and the University of Portland, then joined the faculty at Oregon Health and Science University School of Nursing, where she stayed until her retirement 29 years later. She is survived by her husband, Robert. Judith A. Coffman, Nu’78, GNu’83, of Ocoee, Fla., was a retired neonatal nurse and college nursing professor. An active Democrat, she served for many years as secretary of the Orange County of Florida Democrats and secretary for County Watch. She is survived by her sister, Lois Miller, and brother, Kenneth Coffman, and many nieces and nephews. Nancy Mattera Gaunt, GNu’79, of Deltona,

Fla., was an employee at the Hospital of the University of Pennsylvania and more recently at Halifax Hospital. She is survived by her husband, David, her son, David, and her daughter, Melissa.

1980s Joan Ulmer Bretschneider, GNu’80, of

Philadelphia, began her career as a school nurse at Holy Cross High School in Absecon, N.J., where she had attended. For 18 years, she was a nursing administrator at Jefferson Hospital, in charge of all departments relating to women and children. She retired as the director of education and lifelong learning at the Hospital of the University of Pennsylvania. Throughout her career, she was a champion for women and breastfeeding, especially among low-income mothers, and a longtime board member of the Maternity Care Coalition. After retirement, she led leadership training for nurses in Botswana. She is survived by husband Bud, children Martin and Pilar, sister Eileen Wertz, and five grandchildren. Harriett W. Ferguson, GNu’81, of Churchville, Pa., dedicated her career to clinical practice and education. An associate professor in nursing at Temple University, she received the Lindback Award for distinguished teaching in 1989, with the distinction of being the first nursing professor to receive this award at Temple. In 1999, she was elected to Temple University’s first teaching academy. One of the greatest joys in her life was spending time with her family, especially at their mountain home in Sullivan County. She is survived by her husband, daughters, sister, grandchildren, and nephews. Joan Jackson, GNu’81, of Atlanta, worked as a nurse and a school nurse practitioner. She is survived by her husband, Harry, and daughter, Mary.

2010s Arya Singh, of Allentown, Pa., was a junior at Penn Nursing. Remembered as “a light in so many lives,” Ms. Singh lived in Rodin College House and was a member of PennHype, a hip-hop fusion dance troupe. The University and her family held a candlelight vigil in her honor on February 13, 2013.


Vernice D. Ferguson One of Diversity’s First Voices Considered by colleagues to be “the consummate nurse,” Vernice D. Ferguson, former member of the Penn Nursing Board of Overseers and the School’s first director of diversity and cultural affairs, died on December 8, 2012, at age 84. Ms. Ferguson was a senior fellow at Penn Nursing, hold­ing the Fagin Fami­ly Term Chair in Cul­tural Diversity from 1993 to 1997. In addi­tion to serving on the Penn Nursing Board of Overseers from 2000 to 2007, she was a frequent visitor to Penn Nursing, where she mentored faculty and students, gave lectures, and was the speaker at its 1991 commencement ceremony. Born in Fayetteville, N.C., Ms. Ferguson received her BS and nursing certif­icate from New York University and Bellev­ue Nursing Center in 1950. She earned a mas­ter’s degree from Columbia University Teach­ers College in 1957. From early on, Ms. Ferguson pursued a tireless career of public service. She had been a sci­ence teacher in the Baltimore school system and then head nurse of the neoplastic metabol­ic research unit at Montefiore Hospital in Bal­timore. From 1972 to 1980, she served as chief of the nursing department at the National Institutes of Health Clinical Center. She then be­came assistant chief medical director for nurs­ing programs and director of nursing service at the U.S. Department of Veterans Affairs in Wash­ington, D.C., from 1980 to 1992. Ms. Ferguson’s teaching appointments also includ­ed the University of Wisconsin at Madison, the University of Illinois, Georgetown University, and the University of Maryland.

She held leadership positions in numer­ous nursing service organizations, including the American Academy of Nursing, Sigma Theta Tau International, and the International Society of Nurses in Cancer Care. Her honors and awards were many, including eight honorary doctor­al degrees, the R. Louise McManus Medal for Distinguished Service to Nursing, the National League for Nursing’s Jean MacVicar Outstand­ing Nurse Executive Award, and the American Nurses Association’s prestigious Mary Mahoney Award. She was designated as a “Living Legend” by the American Academy of Nursing. Ms. Ferguson was an honorary fellow of the Royal Col­lege of Nursing in the United Kingdom, the second American nurse so honored. In 2008, she was the first nurse to be awarded the Freddie Lifetime Achievement Award. Previous honorees include Bill and Melinda Gates and Christopher Reeve. Most recently, she served on the Quality Care Committee of the Bon Secours Health System, the Independence Foundation’s Adviso­ry Committee on Nurse-Managed Primary Healthcare, and the Robert Wood Johnson Foundation Ex­ecutive Nurse Fellows Advisory Committee. She was also immediate past chair of the NOVA Foundation of the Nurses Organization of Veterans Affairs. “In all of her roles, Vernice was the consummate nurse and colleague, and the voice and conscience for inclusion of diversity in every aspect of the nursing mission,” said Dean Afaf I. Meleis. “She challenged us to envision and create a world that was more ethical and that valued diversity in all its forms. She was behind many of our initiatives in diversity that made Penn Nursing a model for the University.” Ms. Ferguson is survived by her sister, Vel­ma O. Ferguson, and six nieces and nephews.


UPfront | Spring 2013


Events Calendar Spring–Fall 2013

Alumni Weekend and Commencement – May 10-13, 2013

Spring 2013

For more information or to register, call 215.746.8812 or visit

Continuing Nursing Education Courses See for schedule

Friday, May 10

March 20, 12-1:30pm, Room 435, Fagin Hall


Bates Center Seminar “Nursing Leadership and Legacy: Reflections on Dr. Ildaura Murillo-Rohde” with Dr. Barbara L. Brush March 27, 12-1:30pm, Room 2019, Fagin Hall

Bates Center Seminar “Resistance and Religion: Healthcare in Uganda, 1970-1980” with Madeline Reckart April 1, 9am-12:30pm, Room 213, Fagin Hall

Center for Global Women’s Health Colloquium “Family Health: Crossing Borders and Communities” with Dr. Catherine (Kit) Chesla April 4, 3-5pm, Ann L. Roy Auditorium, Fagin Hall

Claire M. Fagin Distinguished Researcher Lecture and Award with 2013 honoree Dr. Martha Curley April 5-6

Preview weekend for future Penn Nursing students

Celebrating Excellence: Faculty and Alumni Awards Ann L. Roy Auditorium, Claire M. Fagin Hall Reception follows. 5:30-9pm

Third Annual West Philadelphia Wellness Day at LIFE, co-hosted by Philadelphia Councilwoman Jannie L. Blackwell; Penn Nursing’s Healthy in Philadelphia and LIFE; the magnet nursing programs of Penn Presbyterian Medical Center; the University of Pennsylvania Health System; and Penn’s Office of Government and Community Affairs. To learn more, contact Becky Snyder Phillips, MSN, RN, at 215.898.4998 or April 10, 12-1:30pm, Room 2019, Fagin Hall

Bates Center Seminar “Working Mothers: How the Consumer Thermometer Created a New Medical Laborer” with Deanna Day April 15-19

Nursing Spirit Week April 24, 12-1:30pm, Room 2019, Fagin Hall

Bates Center Seminar “The China Gadabouts: Nursing with the China Convoy, 1941-1951” with Dr. Susan Armstrong-Reid May 10-13, Alumni Weekend and Commencement October 3, 3:30-5pm, Ann L. Roy Auditorium, Fagin Hall

Dean’s State of the School of Nursing Address October 15, 3-5pm, Fagin Hall

Norma M. Lang Distinguished Award for Scholarly Practice and Policy November 9

Penn Nursing in the Parade Between 38th Street Bridge and Hamilton Village (formerly “Superblock”) All Nursing alumni are invited to march with Dean Meleis, the Nursing alumni board presidents, and fellow alumni. Help us uphold our tradition as the most vocal and upbeat group in the parade!

Healthcare Administration and Leadership Programs Reunion Claire M. Fagin Hall


Healthcare Administration and Leadership program alumni and students are invited to join current and past program faculty for a poster session, recruiter tables, networking opportunities, guest lecturer, and reception. Special registration rate if you stay the weekend.

All nursing alumni (undergraduate, graduate, HUP, and School of Education nursing majors) are invited to a picnic lunch and networking with fellow alumni, graduating seniors, faculty, and Dean Meleis. President Amy Gutmann will stop by to make remarks. Register for the Nursing tent when signing up.

Saturday, May 11

April 6



Penn Nursing Legacy Breakfast 4th Floor, Claire M. Fagin Hall Dean Afaf I. Meleis invites Penn Nursing “legacy” alumni (Class of 1963 and earlier and all HUP alumni) for an intimate breakfast and conversation in the Dean’s suite. Breakfast followed by optional tours of Fagin Hall. Seating is limited, so register early. Legacy breakfast check-in begins at 8:15am. 9:30-10am

Nursing Continental Breakfast and General Registration Carol Elizabeth Ware Lobby, Claire M. Fagin Hall Meet Penn Nursing Alumni Board President Terri Cox Glassen, Nu’91. 10-11:20am

Visit Penn Nursing’s New Simulation Laboratories Helene Fuld Pavilion for Innovative Learning, 1st Floor, Claire M. Fagin Hall Penn Nursing faculty and staff will lead tours and interactive demonstrations of the cutting-edge simulation technology in the new Helene Fuld Pavilion for Innovative Learning. Advance registration required.

Penn Nursing at the Picnic Tent at 34th and Walnut Streets


Rosalyn J. Watts Diversity Scholars Graduation Celebration Carol Elizabeth Ware Lobby, Claire M. Fagin Hall Alumni are invited to applaud the graduation of Penn Nursing’s Diversity Scholars from undergraduate and graduate programs, and celebrate with the students and their families.

Sunday, May 12 12pm

Sigma Theta Tau Induction Ceremony and Luncheon Ann L. Roy Auditorium, Claire M. Fagin Hall To register email Dr. Deborah Becker at

Monday, May 13 3-5pm

Penn Nursing Commencement with speaker Laura Bush, former first lady of the United States Kimmel Center For tickets (required) or more information, email by April 1.

Homecoming Weekend Featuring special programming and the Penn v. Princeton football game For more information, go to and click on Events.


Non-Profit Org. U.S. Postage P A I D Permit #2563 Phila., PA

Claire M. Fagin Hall 418 Curie Boulevard Philadelphia, PA 19104-4217

Simulatio n Inn ovati on

For more on Penn Nursing’s sim education, go to

The unity of the theoretical and the practical at Penn traces back to Benjamin Franklin’s original aim for the University. His intentions have taken new shape in The Helene Fuld Pavilion for Innovative Learning at Penn Nursing. This pioneering educational center features high-tech simulation, with realistic outpatient, hospital, and home care settings, and high-fidelity, interactive mannequins, all designed to prepare students for real-life nursing experiences. Healthcare simulation has great reach and potential – from reducing medical errors to continuing education to customizing patient care – for nursing at all levels.

To learn more about sim education at Penn Nursing, see page 14.