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a publication of the University of Tennessee at Chattanooga School of Nursing
SPIKIN’ IT
Volleyball and Nursing and 4.0 GPA
Nursing and theatre students train together Celebrating Mary Lambert
UTC.EDU/NURSING School of Nursing
contents
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22 in every issue 3 Letter from the Director 4 Announcements 23 Alumni Notes
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8 COVER STORY | Spikin’ It 12 A New World Awakens 14 Lifelong Learner 16 Enlightening and Frightening 19 Movin' on Up 20 Playing the Part 22 BSN to DNP
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"We have been on the front line, swabbing noses, giving more injections than we ever thought possible and serving as contact tracers for the campus."
Christine Benz Smith, Ph.D., APRN, FNP-BC Director, School of Nursing Chief Health Affairs Officer
director Christine Benz Smith
graphic designer Meghan Phillips
editor Gina Stafford
photographer Angela Foster
writers Shawn Ryan Chuck Wasserstrom
videographer Michael Andrews Jacob Cagle
creative director Stephen Rumbaugh
contact Chris-Smith@utc.edu
UTC is a comprehensive, community-engaged campus of the University of Tennessee System. UTC is an EEO/AA/Titles VI & IX/ Section 504/ADA/ADEA institution. E040950-001-22
letter from the director
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t is hard to believe we have lived in a pandemic for almost two years and have weathered remarkable challenges. Some have lost loved ones and friends because of COVID-19. Some have experienced this disease firsthand, being isolated from family and friends. Others have been fortunate to “escape” infection all together. Our faculty has never experienced anything like this, so we are learning with our students. We have been on the front line, swabbing noses, giving more injections than we ever thought possible and serving as contact tracers for the campus. The continued presence of COVID has taken its toll on physical and mental health for many. We have tried to ensure that faculty, staff and students understand the need for recharging and downtime. We were able to take off the Labor Day weekend and fall break this year and realized what a gift each of those three-day vacations are. There are still great things happening. We are venturing into virtual reality with our nurse anesthesia students. The Virtual Dementia Tour is now offered in our undergraduate and graduate programs. The Nurse Practitioner Program has a new home in Davenport Hall with a suite for standardized patients which is dedicated to Dr. Richard Krause through a generous gift from Dr. Rebecca Corey. Our curriculum is changing from top to bottom. We enrolled our last master’s classes and are transitioning to the doctor of nursing practice. The Nurse Anesthesia concentration will enroll its first cohort in January 2022, and the Nurse Practitioner program will follow in August. The bachelor of science in nursing program will roll out a new curriculum in January 2023. We are all working toward incorporating the new Essentials from the American Association of Colleges of Nursing, which were adopted in March. Thank you for taking the time to read this edition of On+Call. There are great things happening in the School of Nursing. Please come by and see what’s going on in the Metro Building.
announcements
FACULTY AWARDS
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For his exceptional leadership, JASON PETER was chosen by School of Nursing faculty as this year’s recipient 2020-21 Outstanding Faculty Award. When our students were asked to support the Hamilton County Health Department’s vaccination efforts in spring 2021, it was difficult to find a way to support the request because it required that faculty always accompany them. He volunteered to take groups of students on his own time, making a tremendous impact on the number of people who could be vaccinated. The Outstanding Service/Outreach Award was given to KRISTI WICK for her work to make sure the elderly received the services they needed during the pandemic. In spring 2020, as COVID-19 began to race through the United States, she took the reins to make sure the elderly were receiving the services they needed. She created a philanthropic drive, collecting donations for older adults who were isolated in their homes due to virus-related quarantine. Puzzles, coloring books, decks of cards, books and games were donated to the drive and passed on to the adults. She also collected such items as adult diapers and Ensure nutritional drinks. TESSA MULLINAX BAKER and CHRISTI DENTON are the new Mary B. Jackson Professors for 2021-23. Jackson came to the University of Tennessee at Chattanooga and created the School of Nursing.
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BROOKE EPPERSON is the new H. Clay Evans Johnson Professor for 2021-24. Johnson is the former chair of the Board of the UC Foundation and president of the Hamilton County Memorial Hospital Association. Through the Bess Taylor Cofer Professional Health Care Student Advocacy Fund, LATISHA TONEY received money to attend conferences, obtain training and other professional development to enhance her skills for educating students in a health care profession. GARY WARD was named the Outstanding Graduate Student for the Nurse Anesthesia program.
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NATALIE HALL, a senior in the doctor of nursing practice program, received the Outstanding DNP Student Award. 1 2 3 4
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Jason Peter Kristi Wick Tessa Mullinax Baker Christi Denton
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Brooke Epperson Latisha Toney Gary Ward Natalie Hall
WEDDING Madison Collier '21 BSN married Jake Sanders on June 12, 2021. School of Nursing students and faculty celebrated the marriage.
WATCH ONLINE: utc.edu/WhiteCoat2021 2021 WHITE COAT CEREMONY Nursing students receive their white coats as they enter their clinicals.
HOMETOWN HEROES In September 2021, Chris Smith, Yasmine Key and Dawn Ford were honored as Hometown Heroes for their work to manage COVID-19 at UTC. Smith is the director of the School of Nursing, while Key is the director of University Health Services, and Ford is a member of the faculty in the Master of Public Health program and chief epidemiologist for UTC.
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Studying the advantages of single-use tape by Shawn Ryan STUDIES HAVE indicated that multiuse tape found in most operating rooms is a carrier of infection-causing pathogens, some as deadly as Methicillin-resistant staphylococcus aureus, or MRSA. But no studies have been published that examine whether single-use tape can reduce the number of healthcareassociated infections. School of Nursing faculty Laura Tyndall, assistant program coordinator-nurse anesthesia concentration, and Rachel Nall, clinical assistant professor, are changing that. In what appears to be a first-ofits-kind study, they're conducting research to determine whether single-
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use tape is a safer choice to reduce surgical-site infections in the 30 days after an operation. Specifically, they're examining whether single-use tape is a better choice for nurse anesthetists when securing endotracheal tubes. Now taking place at Erlanger Hospital, the study is in the data-gathering phase, which is expected to be finished by January 2022. Submission of the data to the American Association of Nurse Anesthetists Journal will most likely be March or April 2022 with publication of the research depending on the journal's editorial calendar, Tyndall says. "To our knowledge, this is an innovative approach and first study of its kind that utilizes the many research
Image of MRSA bacteria under microscope. Photo credit: U.S. Centers for Disease Control and Prevention
recommendations that suggest utilizing singleuse taping systems," Tyndall and Nall say in the study's proposal. "The significance of this study addresses the potential to change one of the last areas of multi-use anesthesia practice (taping) that could be potentially contributing to a portion of the 440,000 (healthcare-associated infections) in hospitals on an annual basis. Through this study, we plan to create a justification for the movement toward single-use taping systems to protect patients and to maintain an anesthetist's reputation as a source of help, comfort, and trust among patients. "The taping system chosen for utilization in this study meets the parameters of several previous studies for a hygienic taping system: The tape is in a single, disposable package; its design is intended to prevent migration of the endotracheal tube; and the tape has easy-tofollow directions that require minimal education to the anesthesia provider," the proposal says.
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SPIKIN’ IT Volleyball, nursing and a 4.0 GPA by Chuck Wasserstrom
Athletics and nursing school typically do not mix. College coaches are wary of studentathletes pursuing a degree that necessitates the amount of time and dedication required in nursing school. A rigorous schedule of clinicals and simulations is unchangeable. Adding on a collegiate sport makes it a nearly impossible task. Don't tell that to Megan Kaufman, though. She not only survived as a volleyball-playing nursing school student, she thrived in that atmosphere. Kaufman will be receiving a Bachelor of Science in Nursing from the University of Tennessee at Chattanooga School of Nursing in December 2021, carrying a 4.0 GPA into her final semester. A defensive specialist for the Mocs volleyball team, she finished her on-court career with 1,400 digs, the seventh-highest total in the program’s history.
"My college experience has definitely been unique," she says. "It's like two different worlds. You have two separate lives as you go about your day. "The last two years of my didactic courses have all been with the same core group of people. Then, when I was playing volleyball, I had my 14 to 16 teammates. I would put on nursing Megan in that setting and then I would put on student-athlete Megan in the gym, just balancing the stress that comes with nursing school and the expectations that I had set for myself in volleyball." A native of Cincinnati, Ohio, Kaufman knew UTC would be the right fit after visiting Chattanooga as a high school junior. She remembers the Mocs' volleyball coach, Travis Filar, tell her, "If you want to go into nursing, we're going to make it work."
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"And then, as an athlete, to have the professors behind me just shows how they support their students and how they truly want to see you find success," Kaufman says. "It was such a privilege to be able to do both. It was hard, but I never once questioned what I was doing." Nursing students and faculty know the rigors of that program, but to be a Division I athlete, you need to hone your craft year-round. Being a student-athlete means practices, weightlifting, conditioning and the actual events. Not to mention out-of-town travel. "From a nursing perspective, you know you have commitments, but from the athlete perspective, it was a whole other job. That’s how I had to treat it, like I was going to work," Kaufman says.
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"Honestly, it was strictly business for me in the fact that I knew that nursing was going to take away some of the time that I had in the gym because of conflicts and accommodations that needed to be made around me. But when I was in there, I was all in, and it was anywhere from three to four hours a day, on top of our clinical schedule and nursing classes and such." Nursing is a noble profession, and nurses talk about not being in it for the awards and accolades, the opposite of athletics. But Kaufman had the opportunity to experience the glory of being a true student-athlete this summer when she was selected to the College Sports Information Directors of America 2020-21 Academic All-America® Division I Volleyball Second Team.
Opposite top: Kaufman plays her final collegiate match against Georgia State in Maclellan Gymnasium, helping UTC to earn a 3-2 victory. During the game, Megan picked up her 1,400th career dig—the seventh student-athlete in program history to ever reach 1400 digs. Opposite bottom: Kaufman during a matchup between UTC and Manhattan in 2019. Above and middle: Kaufman practices patient care during lab.
"It was such a privilege to be able to do both. It was hard, but I never once questioned what I was doing." –Megan Kaufman "To be recognized for something like that was very humbling. Recognitions are great, but it really doesn’t give light to all the work that went behind it," she says. "I had so many professors in the School of Nursing that wanted to see me succeed and helped me navigate this crazy schedule, and all the coaches and teachers and advisors that worked to help me find success. "The award has so little to do with me. I put in a lot of work, but I truly believe that I would not have been able to study nursing—let alone achieve what I have—had I not had the army of people supporting me." Kaufman says she never felt sorry for herself for having too much on her plate. The time management and dedication skills learned at UTC
will pay big dividends when she takes them into the nursing profession. "I never once questioned my motives and the why behind what I do," Kaufman says. "My parents have always said, 'Find your why and use that every single day, even when things get hard.' My 'why' with nursing is very clear: It's the type of nurse that I want to become and the people that I can impact. And then my 'why' with volleyball was to be the best on the court that I can be, the best leader, the best motivator for my teammates. "My experience here was very different than most, but I’ll always be able to say that I played four years of college volleyball and graduated with a BSN. I’m proud of how far I’ve come."
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A New World Awakens in Anesthesia by Shawn Ryan
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ric Jones has worn a virtual reality headset to immerse himself in the simulated world of building solar systems. "That was cool. Super cool," he says. But he'd never worn a virtual headset as a nurse anesthetist student in the University of Tennessee at Chattanooga School of Nursing. It was cool, too, but working in a virtual operating room brought everything down to earth. "It was more realistic and functional. It certainly felt like a good way to get more familiar with the room and the equipment," says Jones, a registered nurse who is in training to be certified as a nurse anesthetist. Produced by Prodigy Anesthesia in Huntsville, Alabama, the Simvana Anesthesia virtual reality training simulator can lead students step-by-step through an operation, from opening the operating room door to checking the anesthesizing machine's operations before and during surgery, to dealing with emergency situations if necessary. "You are just immersed. I did it, too. You feel like you're in another place, but you have to be," says Rachel Nall, a clinical assistant professor in the School of Nursing and a certified registered nurse anesthetist who works at Erlanger Hospital. The School of Nursing has a simulation lab with mannequins and hands-on equipment for training nurse anesthetists, but when the lab is booked up, the virtual program can be used to practice certain procedures, Nall says. With COVID taking away the ability to be in actual hospitals for some hands-on clinical experience, the Simvana machine also can make up some of that experience, she says. "Last year, our students weren't able to get in the actual ORs for our clinical hours because the hospital was so locked down," she says. "To have something like this virtual reality experience, where they could
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see everything as much as they could in the hospital, it's responsive in that way. It's a more COVID-friendly approach." The UTC School of Nursing is one of two—the University of Alabama at Birmingham is the other—helping Prodigy refine the Simvana simulator before it goes into full commercial production, says Peter Stallo, president of Prodigy Anesthesia. "When you're developing something you're so familiar with it, you don't recognize the problems that other people would have. Being able to see students go through it, figure out what issues they had that we never anticipated, allowed us to go back and reiterate several components of the design, and we're doing that now. It's been a tremendous help getting the feedback from the students and the faculty," says Stallo, who worked as a nurse anesthetist in Birmingham for 10 years prior to developing the Simvana simulator. Working with Prodigy as it perfects the simulator is a win-win, Nall says. As the company learns, so do the students. "Whenever Prodigy has a new simulation, and they want to try it out, we're going to have the technology here. So the students can use that," she says. Knowing the ins and outs of the anesthesia instruments is a major category on the national certification
exam, and the simulator provides those lessons, too. For instance, in a real operating room, the anesthetist performs a machine check before the procedure to make sure everything is working correctly. The simulator will tell a student whether an instrument is working properly and also has pop-up boxes that give detailed information about the instrument, how it works, what it does and more, Nall says. "There's a very educational component to that," she explains. The simulator will be ready for students when spring semester begins in January and available during the School of Nursing's regular business hours, another plus for students, Nall says. "Students today want to engage in structured and non-structured environments. So to have the ability to say, 'Hey, we're going to be here from nine to five,' then come and do it in their time and pace. That's really how the students seem to prefer to learn. So I feel like it's very responsive to them and their learning needs." Peter Stallo, president of Prodigy Anesthesia, top, teaches Laura Tyndall, assistant program director of the nurse anesthesia program within the School of Nursing, middle, and UTC nursing students, bottom left and right, how to use the Simvana Anesthesia virtual reality training simulator.
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LIFELONG LEARNER Nursing grad Mary Lambert has followed a path in public health by Shawn Ryan
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he nurse, dressed in her bright, white uniform, often stood in the doorway of the clinic in Brainerd High School, watching the students walk by as they went from class to class. Mary Lambert was fascinated by her. The way she looked. The way she would answer any question Lambert asked. The way she was just there. "She was phenomenal. I would just make up excuses, not to go to the clinic, but to walk by there and hope she was at the door," says Lambert, who graduated from the University of Tennessee at Chattanooga School of Nursing in 1978, the school's second graduating class. The nurse at Brainerd wasn't the only reason Lambert chose nursing and public health as a career, but she was a building block. With a UTC nursing degree in hand, Lambert spent the next 34 years in healthcare, working for, among others, Erlanger Hospital, the Hamilton County Health Department, the U.S. Veteran's Administration, the Centers for Disease Control and the Federal Drug Administration.
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She was in her office in Washington, D.C., when the 757 hit the Pentagon on 9/11, killing a total of 189. "It's the biggest, blackest column of smoke I have ever seen, that I ever want to see," she says. Lambert retired in 2012 and returned to Chattanooga, although she remained involved in local health organizations and local issues. With her experience ability to work on a team, in April she was chosen by Mayor Tim Kelly to be director of Community Health, a newly created position on his senior staff. Lambert says she was silent for a moment when she received the phone call—out of the blue—asking her to take the position. "I had to pause, but I couldn't say, 'No.' I retired from active-duty service, but I did not retire from service," she says. Patti Childers, project coordinator for the Hamilton County Family Justice Center, has known Lambert worked with her on several public health projects, both governmental and strictly volunteer.
"She is like a sponge, her wealth of knowledge is amazing, her level of care and concern," Childers says. "Dr. Lambert has the ability to see the larger picture, to see how things can affect the community at large." A LIFE IN NURSING A native of Chattanooga, Lambert grew up as Mary Dawson in East Chattanooga, the fourth of five children. "They call that 'next to the baby,'" she explains. She attended Orchard Knob Elementary and Junior High, graduated from Brainerd High in 1970 and enrolled in the University of Tennessee Knoxville. Halfway through nursing school, she got married and moved to Virginia. "I was following the husband," she says. She returned to Chattanooga with her young son in 1975, enrolled in UTC and earned her Bachelor of Science in Nursing in 1978. The lessons she learned at UTC—both in classroom and beyond— have been invaluable in her life, she says. "The value of knowing the community. The value of public health and increased awareness. The value of knowledge, of being a lifelong learner," she says. "That was the UTC faculty in my head. You can't think that you've arrived and you know it all, and you don't need to learn anything else." In the years after UTC, she went on to earn a master's degree in nursing from Emory University in Atlanta and a doctorate in nursing practice from Vanderbilt University. She spent time as a nurse with Erlanger and the Hamilton County Health Department. She moved to a hospital in Grenada, Mississippi. From there she took jobs in Memphis at the Veterans Administration Medical Center then at International Paper. Born into a family that strongly believed in military service, she joined the U.S. Army Reserves in 1979, and was stationed at Fort Jackson in South Carolina during the First Gulf War in 1992, vaccinating soldiers before they went to the Middle East. "Some of my team were vaccinating people on the tarmac as they were loading them on planes," she says. Her resume is packed with health service. Advanced practice nurse, taking care of migrant and seasonal farm workers in primary care clinics for the U.S. Public Health Service Commissioned Corps. A member of the review team for new drug applications at the FDA. Branch chief for the CDC's national immunization program. As director for its Office of Military Liaison and Veterans Affairs in the Department of Health and Human Services in Washington, D.C., she was the emissary between the department, the
Department of Defense and the Department of Veterans Affairs. "You'd be surprised at the connections that have to be sorted out or set up between those big federal departments," she says. "They're all in. They're all huge, ridiculously loud." After 9/11, in the administration of President George W. Bush, she helped create the national Volunteer Medical Reserve Corps, which organizes units of volunteers—many of whom have medical and public health backgrounds—to assist emergency workers in preparations for emergencies and, when needed, pitch in to help when they occur.
"She is like a sponge, her wealth of knowledge is amazing, her level of care and concern." —Patti Childers HOME AGAIN Back in Chattanooga after 2012, she volunteered at the Veterans Administration Outpatient Clinic and worked at testing sites in the county when COVID-19 hit. With her background, she was part of the discussion when the idea of a community health office was raised and gave some ideas about approaching the CDC and other health-oriented groups for advice. Then came the phone call and the job offer to run the Community Health Office. "Am I looking for another 30 years before retirement? No, but if I can help set this up, if I can be the catalyst that helps set that up..." Five months after the office began, her schedule is swelled to bursting with presentations to municipal and community groups, attending conferences and, obviously, dealing with COVID. Once the pandemic is under control, though, the Community Health Office can turn its attention to the issues it was created to address, she says. "The focus will be health disparities in populations, to issues and concerns around the social determinants of health. How much people know about their health. What they need to do to remain healthy or regain their health. "There are so many places we can make a dent in this and improve the health. Because if we improve the health of the least healthy in our population, we improve the health and the economic welfare of the entire community, the entire city, the entire county." She can't help herself from helping, she insists. "My mom and my siblings tell me I'm—quote— 'tenderhearted.' OK, I mean, if there's something going on with somebody, I want to help fix it or whatever."
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WHAT DEMENTIA FEELS LIKE Understanding and supporting those with dementia by Shawn Ryan
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The tasks were simple ones. Put on your pants. Buckle your belt. Easy-peasy.
And it would have been for Hannah Smith. But the goggles on her eyes made everything fuzzy and gave her double vision. Bulky gloves made it near impossible to feel anything. Shoes had spiky lumps in them, making it hard to stand or walk. Headphones blared noise and people's voices were lost in the din. "I put on the pants backwards. I didn't see where the belt buckle was. It was so hard, and it's embarrassing, but it's so humbling to see that it's hard to even do simple daily tasks that you've done your whole life," says Smith, a fifth-level student in the School of Nursing at the University of Tennessee at Chattanooga. Donning the pants was just one task she had to attempt during the Virtual Dementia Tour, something all first-level students in the School of Nursing must undertake. The goal is to give students an idea of the challenges people with dementia face every day. In the exercise, which lasts eight minutes, students are given several tasks to complete—or try to—while wearing all the devices on eyes, hands, feet and ears at the same time. The purpose is to imitate what it's like to have dementia. "It really gives you a greater understanding of how difficult it is to live with dementia and be so frustrated because this is something you've been able to do always. This is your daily routine, your daily life. That's kind of sacred," Smith says. Some students have come out of the exercise crying, says Kristi Wick, assistant professor and Vicky B. Gregg chair of gerontology in the UTC School of Nursing. It can be an overwhelming experience to live as
someone with dementia, even for a short period of time, she explains. "Many people report profound sadness and/or grief because they know or have cared for a person living with dementia and this experience provides a new understanding of the challenges dementia presents," she says. "This is especially true for primary caregivers as they reflect on their experiences. There may be feelings of guilt or wishing they had known earlier how to help their loved ones. "In addition, some people report thinking about their own mortality as well as their own health and wellness along with their personal plans or desires related to aging successfully." When the exercise is completed, students discuss the experience with someone trained to deal with such issues "to allow time and a safe space to process these feelings and to recognize ways they can provide support in future clinical practice or as a caregiver," Wick says. Valerie Rutledge, dean of the College of Health, Education and Professional Studies, took the Virtual Dementia Tour two years ago. Her father had suffered from dementia and is one of the reasons she took the tour. "That was an important part of my decision in addition to wanting to see what the experience might be with regard to our faculty/staff and students," she says. "I think the end result for me was clarification of some of the confusion and mixed signals that can occur when the sensations and input become overwhelming. "Sympathy and empathy are critical to being aware of how
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much a person's behavior can be changed. In many ways, it is not only a physical/virtual experience, but it is also a lesson that allowed me to 'walk in someone else's shoes' and grasp the various types of reactions that result from dementia both for the person affected and for those who are friends/ family/caregivers." Prior to his Virtual Dementia Tour, Peter Nguyen, a third-level nursing student, had worked with dementia patients in a hospital during his first semester. Some were difficult; some refusing to cooperate; some being combative. "It was really frustrating," he says. "Why won't they let me put on a blood pressure cuff? Why can't I take their vitals? It was something that I didn't really understand." The dementia tour completely erased those questions, he says. "It was enlightening. It makes sense why they're so agitated and frustrated, and why they just can't really cooperate. It really opened my eyes and made me feel for them." A Brock Scholar in the Honors College, Smith currently is having a personal experience with dementia. A year after being diagnosed, her 82-year-old grandmother is quickly descending into it, she says.
"It has helped me be a better nurse, a better human being. I think it helps you have more empathy for people in general, not just people with dementia, but people who suffer with illnesses that you might not necessarily see when you look at them." —Hannah Smith
"My grandmother loves to cook for me, and that's something that's really difficult for her to do now," Smith says The Virtual Dementia Tour not only made her be "a better granddaughter," Smith says, it has helped in other ways. "It has helped me be a better nurse, a better human being. I think it helps you have more empathy for people in general, not just people with dementia, but people who suffer with illnesses or things that you might not necessarily see when you look at them. I think it helps with patience and kindness and just being a better person." 18
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Nurse practitioner graduate program changes locations by Shawn Ryan
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Acute Care Nurse Practitioner student Oscar Guzman-Cruz, top, and Family Nurse Practitioner student Mitchell Eton, bottom, work in the new nurse practitioner simulation lab rooms located in Davenport Hall.
ith undergraduate and graduate students both needing practice, things were getting tight in the Nurse Practitioner program’s simulation lab. "I had a hard time scheduling in our simulation space just because there's always so much going on there," says Amber Roaché, who works with graduate students as Nurse Practitioner program coordinator for the University of Tennessee at Chattanooga. To lessen the squeeze, a plan was formulated to give graduate students their own simulation labs, Roaché says. "We started looking at spaces on campus, off campus, that potentially our graduate program could use for the simulation space," she says. The search eventually landed back on campus on the third floor of Davenport Hall, located catty-corner across Oak Street from the Metro Building, where the School of Nursing and current simulation labs are located. The graduate program nurse practitioner students moved into Davenport Hall on Aug. 1, Roaché says. The space will be totally dedicated to the doctor of nursing practice program’s nurse practitioner program, which usually has between 35 to 40 students, she says. A total of six simulation rooms are available in Davenport. Four will have UTC and Chattanooga actors portraying patients who are "experiencing" various maladies. The other two contain equipment such as chest models for practicing chest-tube insertions, arms for the insertion of arterial lines and pelvises to teach how to perform pap smears or prostate exams. All rooms have digital cameras to record students' work for review with them after the simulation exercises. "They hate watching themselves, but it's really helpful because they can go, 'Oh yeah, I did that really well.' Or 'Oh, I see what you're saying,'" Roaché says. While students are in the simulation rooms with the actors, faculty will be outside, watching through an observation window and grading the students, an added—but necessary—level of stress, Roaché admits. After the simulations, faculty members will meet with the students to go over what was done right and what needed work. "We debrief one-on-one with the student right after, and then we debrief as a group with the students and the actors," Roaché says. For nurse practitioners, working in simulation labs "is phenomenal," Roaché says. "Students have an increased sense of self-efficacy and their ability to go in, see a patient, look at that scenario that the patient presents and work through whatever problem it is, whether it's diabetes or high blood pressure or a cancer diagnosis that the student is having to give the patient and be able to do that in a safe environment."
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Acting the P FEATURES
Nursing and theatre students collaborate
on training exercise for both by Chuck Wasserstrom
Taylor is a 17-year-old with a history of asthma that has become increasingly troublesome. She's in the examination room with a cough, and it's getting harder and harder for her to breathe.
This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services under grant number T94HP30920 and title, ClinicalAcademic Network for Developing Leaders.
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Chanda Okyere is asking questions, trying to figure out the triggers that have caused Taylor's latest issue. The situation is getting serious. But Taylor's lying. Well, not exactly lying. Acting. There are four Taylors on four different examination room tables in the University of Tennessee at Chattanooga's School of Nursing. Each is a UTC undergraduate theatre major participating in a simulation collaboration with students in the nurse practitioner program. Having the students pretend to be patients in emergency situations gives nurse practitioner students a chance to practice the steps needed in such situations without someone's life on the line, says Amber Roaché, coordinator for the nurse practitioner program in the School of Nursing. Simulations utilizing theatre students have been taking place at various points throughout the year. "One of the biggest changes we've made to our graduate program is having the simulated patient actors come in and portray real patients for our students," Roaché says. "They are able to get the hands-on training and do everything they need to do with a patient in a safe, controlled environment, and we can provide feedback immediately so they know what they’re doing well or where they may need some improvement. Okyere knew her Taylor—theatre student Maegan Whitlock—wasn't really in respiratory distress, but it sure felt like it. They both were using a script, yet both were improvising, Okyere explains. Neither knew what the other person would say, just like an actual examination room. "She was thinking through what you were asking her," says Okyere. "As I was doing the simulation, it helped me to get a realistic flow of everything. It was good to work with an actual person versus using a mannequin because the responses were real. UTC.EDU/NURSING
"Not knowing what the next answer is going to be, in my head I'm running a couple of different scenarios. Based on what she tells me, I can move on. Anything I asked, she answered right away. And she was very believable, so I didn't feel like it was an actor. I felt like I had a real patient." Roaché says seeds for the partnership were planted a couple of years ago after having a difficult conversation with one of her patients about a diagnosis. She shared the story of having a student with her in the room and asking the student to leave because of the rapport she possessed with her long-time patient. "I realized after we got out that it was such a disservice to the student; at that point, until they get into practice, they weren't getting experience having some of these difficult conversations with patients or experiencing some of these things," Roaché says. Having previously met Laurie Melnik Allen, executive director of the Arts Based Collaborative at UTC, Roaché reached out to her with an idea of mixing nursing and acting. Allen jumped at the chance. She has utilized the services of community actors in other collaborations, saying that she is always looking for ways to use theatre for nontraditional purposes. "Roleplay is something that helps a lot of professions helping to contextualize experience and prepare," she says. "Along with that, there is the opportunity for students in theatre to understand career pathways that may
Part not be visible to them yet. Seeing how their craft can be utilized in different ways beyond just performing a role in a play is huge. "For the performer, they're utilizing so many of their skills: Improvisation, thinking on their feet, responding in the moment, being true to their character. Authenticity is still really important because it has to be as real-world as possible to make this a rich learning experience for the nurse practitioner students, but also the theatre students as well." During the nursing simulations, each actor went through four or five rounds playing Taylor, with examinations taking about 20 minutes. Faculty, including Roaché and Allen, observed from behind a glass window. Combining healthcare and theatre might seem a little odd, "but once you get into it and you start seeing how theatre and some improv really plays well into being a simulated patient actor, the students really get into it," Roaché says.
Nursing student Chanda Okyere examines theater major Maegan Whitlock in the nurse practicitioner simulation lab. This nontraditional collaboration between the nurse practitioners and theater programs allows nursing students to simulate real patient care and exposes theater students to alternate career pathways and improvisation practice.
KRAUSE AND COREY STANDARDIZED PATIENT CENTER OPENS
Rebecca Corey
Richard A. Krause
Through her gift this summer, Dr. Rebecca Corey MSN' 99, DNP '12 honored her longtime friend and mentor Dr. Richard A. Krause by funding the Krause and Corey Standardized Patient Center. Krause served the medical community for more than 40 years as a gastroenterologist. He was an advocate for both patients and nurse practitioners, hiring the first nurse practitioner in gastroenterology in the Chattanooga area—Rebecca Corey. The Krause and Corey Standardized Patient Center is located in a newly renovated area in Davenport Hall on the University of Tennessee at Chattanooga campus. Four patient exam rooms are fully outfitted for nurse practitioner students who will have UTC and Chattanooga actors portraying patients who are "experiencing" various medical
complaints. Students will assess them and develop a plan of care. In this standardized, controlled experience each “patient” works from a script and each student who evaluates them is graded on the same skills and interventions. “This is not role-playing, this is truly acting," said Chris Smith, director of the UTC School of Nursing. “Each standardized patient receives rigorous training to maintain a consistent, highly realistic portrayal. "They’re also prepared to give feedback to the students on communication and interpersonal skills, which is a plus. The students learn immediately what went well from the patient’s perspective. We are now fortunate to have a space dedicated to this highly effective teaching modality.”
UNIVERSITY OF TENNESSEE AT CHATTANOOGA SCHOOL OF NURSING
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Keeping up with the times by Shawn Ryan
T
o comply with a shift in the profession, the Master of Science in Nursing Practice is being eliminated in the University of Tennessee at Chattanooga School of Nursing. Starting in January 2022, students who wish to become an advanced practice registered nurse must enroll in the Doctor of Nursing Practice (DNP) program to pursue a graduate degree in nurse anesthesia, adult gerontology acute care nurse practitioner or family nurse practitioner. Students with a Bachelor of Science in Nursing (BSN) will directly enter the DNP program for those three concentrations. Students currently pursuing a Master of Science in Nursing (MSN) will be able to finish the program and earn their degree. The final class of those students will graduate in 2023. The decision to eliminate master's level programs is happening in nursing schools nationwide. Currently, nine universities in Tennessee offer MSN to DNP degrees and 11 have BSN to DNP programs. "For probably the last 10 years, there has been a push to make the doctorate as entry-
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level for advanced practice roles. This has really picked up steam in the last five years," says Amber Roaché, coordinator of the Nurse Practitioner program in the School of Nursing. "So it was kind of looking at the big picture and saying, 'OK, if these others are saying the doctorate should be entry-level, then we need to move there as well.'" Making the Doctor of Nursing Practice the entry-level program meets new accreditation requirements from the National Organization of Nurse Practitioner Faculties as well as the requirements of Council on Accreditation of Nurse Anesthesia Educational Programs. The change covers all advanced practice concentrations in the Nurse Practitioner program at UTC. "Nurses who will graduate from our DNP will still sit for their certification exam and be certified registered nurse anesthetists or CRNAs," says Linda Hill, coordinator for Nurse Anesthetists. "They will still qualify to get their advanced practice nursing license from state boards of nursing, whether it's Tennessee, Mississippi or wherever they go
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ALUMNI NOTES
practice. And they will still do exactly the same sorts of things that nurse anesthetists do in the operating rooms." Beyond medical doctors, other health professions such as pharmacology, occupational therapy and physical therapy, podiatrists and optometrists are steering toward doctoral degrees that focus on practice rather than the heavy research focus of a Ph.D. Both Roaché and Hill say the move is a positive change. Practice combined with research can create valuable results, Roaché points out. "It's actually taking it to that next level and saying, 'This is an issue I see in my clinical practice,' whatever that might be. Maybe it's patients aren't being called back in an appropriate time or aren't receiving their lab work in an inappropriate amount of time. Or maybe the providers aren't documenting something they need to be documenting in the electronic medical record. "If you see it in your practice, you run it as a pilot and say, 'OK, this is what we've done in our practice, and this is what has worked.' Then you take it to other practices and ask, 'Are you having the same issue? Here's what we saw. Here's what we've done to fix it. Are you interested in this?'" Hill adds that, along with preparing students even more thoroughly to step seamlessly from the university into their medical careers, the Doctor of Nursing Practice program has the added benefit of teaching students to be leaders. "It's important that they are educated with a strong focus on leadership and leadership in health care and health policy and health care economics and ethics and diversity," Hill says. "Because we will—and we do—affect health care change. "This brings us with more power, so to speak, to the table when we are talking about legislative issues, when we're talking about health policy change issues."
CHARLES HAMMER '20 DNP was promoted to operations manager at Hospital Corporation of America’s Capital Division Transfer Center in Richmond, Virginia.
MELISSA HUMFLEET '16 DNP was named nursing program coordinator at Southeast Kentucky Community and Technical College in Cumberland, Kentucky.
JAMES TED NELSON '20 DNP has been named director of nursing at AdventHealth in Davenport, Florida.
ANGELA BASHAM-SAIF '20 DNP has been named associate chief nursing officer at Methodist Hospital in San Antonio, Texas.
RHONDA ADAMS SCOTT '84 BSN was hired as the market chief operating officer and president of CHI Memorial Hospital Chattanooga.
Opposite photo: Linda Hill, coordinator for Nurse Anesthetists, left, and Amber Roaché, coordinator of the Nurse Practitioner program
UNIVERSITY OF TENNESSEE AT CHATTANOOGA SCHOOL OF NURSING
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School of Nursing Dept 1051 615 McCallie Avenue Chattanooga,TN 37403
SAVE THE DATE
NightinGala JOIN US FOR A NIGHT OF CELEBRATION AT THE PEYTON 3146 BROAD STREET | CHATTANOOGA APRIL 22, 2022 6:30 P.M. UTC.EDU/NURSING