The New Face of : Expanding Advocacy with Leadership, Creativity, and Vision

he image of the traditional bedside nurse of the last century—white stockings, crisply ironed skirt, and starched cap—is now a distant memory. But the core tradition of care and compassion remains, along with a continued commitment to serve as patient advocates in an increasingly complex medical system. These days, nurses are taking this core tenet of Tadvocacy and coupling it with their drive for improvement, creativity in solving problems, and vision for the field of nursing. The result? New opportunities, more intriguing career paths, and emerging leadership roles. There is no question that today’s nurses face a more complex and chal­ lenging working environment than their predecessors. are more seriously ill as now primarily serve people with emergency or catastrophic health issues. The amount of administrative work required of nurses has skyrocketed. And technological advances have completely changed how nurses perform many basic tasks. However, in the midst of these paradigm changes, Hopkins nurses have not only adapted, they have thrived. In fact, nurses are taking a stronger stance on behalf of patients than ever before, leading interdisciplinary initiatives to ensure that patients receive care that is the safest, highest quality, and most ethically sound as possible. Nurses at the Johns Hopkins University School of Nursing (JHUSON) and the Johns Hopkins hospitals are applying their expansive knowledge of patient care to broaden their responsibilities as clinicians. And they have gone to great lengths to ensure that they are able to perform their jobs to their fullest potential, even taking the lead to By Elizabeth Heubeck reform state laws. Illustrations by Robert Neubecker The articles that follow share a few examples of the leadership, creativity, and vision of Hopkins nurses—all of whom are contributing to the expansion of the profession.

28 J o h n s H o p k i n s N u r s i n g Training Leaders for Nursing’s Future “To be an effective leader, one must have passion, a vision, and the appropriate tools. Hopkins helps define, determine, and develop these essential elements,” says doctor of nursing practice student Cheryl Bridges, MS, MBA, ACNP, who works at the Johns Hopkins as a nurse practitioner. “The profession of nursing, unlike medicine, public health, or pharmacology, has a unique position in the health care arena in that it approaches the patient from the perspective of the ‘whole’ system. We therefore have a duty to be our patients’ advocates.” Other JHUSON graduates echo that mantra. “It’s a Hopkins tradition for nurses to always question the process and try to make it better. People there who do, end up rising through leadership roles,” says Deborah Baker, BS, MSN. She should know. Having earned her baccalaureate degree from JHUSON in 1992, Baker returned to the school to obtain her MSN in 1997, then a Business of Nursing Certificate in 2001.

S p r i n g 2008 29 Now, she is Director of Nursing Achieving Competence Today (ACT), Surgery at Johns Hopkins Hospital a program funded by the Robert and president of the Johns Hopkins Wood Johnson Foundation. As part Nurses’ Alumni Association. of a multi-site national pilot, Hopkins The school’s faculty assembled teams of graduate nursing, acknowledge their emphasis on medical, and health administration nurse leadership and autonomy. students to participate in the planning “Sometimes, in the culture of of quality improvement projects. In medicine, the nurses’ perspective this interdisciplinary setting, nursing is dismissed. I want my students students demonstrate the unique to embrace the knowledge and perspective they bring to the table— perspective that they bring and not and learn how theirs fits in with other apologize for it,” says associate health care disciplines. professor Cynda Rushton, “It’s not often enough that we sit DSNc, RN, FAAN. down together and think about how At Hopkins, professors do we can provide better care as a team. If more than talk the leadership we can establish more communication talk. They give students among physicians, nurses, and real-life opportunities to administrators, then I believe the walk the leadership walk. quality of health care will improve by One such example is leaps and bounds,” says Peter Cornell

“If we can establish Prepare to Care: New Nurses, Aging Patients more communication among physicians, Geriatrics offers surprises to those for nursing students to learn about who associate it exclusively with this population is the need to nurses, and nursing homes. Today, except collaborate with multiple disciplines. administrators, then for maternity and pediatrics, “Most patients don’t have just one approximately 50 percent of hospital illness; they have multiple complex I believe the quality patients are 60 or older. As a result, problems and may be taking a dozen of health care will according to Johns Hopkins University different medications. Tanner adds, School of Nursing Assistant Professor “A myocardial infarction does not improve by leaps Elizabeth (Ibby) Tanner, PhD, RN, manifest the same in a 50 year old and bounds.” “every nurse should be prepared as it does in an 85 year old.” To to care for older adults in hospital differentiate, nurses must develop —Peter Cornell ’03, CRNP ’06 settings.” Unfortunately, most a high level of problem solving, providers, including nurses, have not communication and assessment been trained to do so, but skills in addition to old-fashioned that’s changing. compassion, and then offer solutions “Issues in Aging” is now a that fit the patient’s social, physical required first semester course at and economic resources. That’s a JHUSON. “We’re pioneers in this tall order. field,” said Tanner, who is also A mitigating factor: “The goal is teaching a multidisciplinary seminar not necessarily to resolve all of the on the care of the complex older geriatric patient’s medical problems,” adult, another first for the school. Tanner said. “An important goal is to She notes that what’s paramount improve quality of life while focusing

30 J o h n s H o p k i n s N u r s i n g ’03, CRNP ’06, who participated in the ACT program in 2005 when he was an acute care nurse practitioner student at JHUSON.

Reaching Beyond the Call of Duty Time and time again, graduates from JHUSON programs demonstrate how far they can go professionally when their natural leadership qualities are cultivated in an educational atmosphere that not only accepts, but rewards, these traits. Consider Brenda Blunt, who graduated in 2006 from the school’s baccalaureate program. After less than W ill K irk two years as a registered nurse at Johns In addition to her duties as a nurse in the Neonatal Intensive Care Unit, Brenda Blunt serves Hopkins Bayview Medical Center’s as chairperson of an interdisciplinary Perinatal Bereavement Committee at the Johns Hopkins Neonatal Intensive Care Unit, Blunt Bayview Medical Center.

your attention on each individual’s are expected to visit seniors in their on Aging and Retirement Education social and emotional well being, as homes and share a meal. (CARE). Most of the patients she well as the physical care.” Among the A solid foundation in the care works with now have dementia. “I many satisfactions that come from of older adults also has practical knew what to expect,” Tyler said. caring for older adults: “We can learn advantages. “Nurses who are “That makes it easier clinically. so much from them.” prepared for this work are highly Professor Tanner is a great mentor.” Kitty Poon ’06, who is pursuing her sought after in a myriad of settings, Tanner, along with Dean Martha N. graduate degree in nursing, agreed. including acute care, emergency Hill, PhD, RN, FAAN, has been publicly “I’m amazed by their resilience,” she room, psychiatry, oncology, etc.,” recognized by the John A. Hartford said. Since 2004, Poon has been a Tanner said. Foundation Institute for Geriatric volunteer in the Service Awareness Megan Tyler ‘07 is a good Nursing for her work in content through Geriatric Education (SAGE), example. She credits her nursing mapping and including strategies for a community service program which school leadership experience with the teaching the core competencies of matches students from the Schools of JHU-wide multidisciplinary Geriatric geriatric nursing. She is also the first Medicine, Public Health and Nursing Interest Group organized by Tanner as nursing faculty to be affiliated with with seniors living independently. instrumental in being selected for her the Johns Hopkins Center on Aging The goals are to reduce elder job as a staff nurse in the special care and Health, which now includes loneliness by fostering friendships unit at Anne Arundel Medical Center. faculty from the Schools of Medicine, between the generations and to As a student, she also participated Public Health, and Nursing, all broaden the students’ perspective in Grand Rounds at Bayview Medical working together on the forefront of of older adults outside of a medical Center and one of her clinical aging research. setting. Volunteers, usually in teams experiences was with the Baltimore —Susan Middaugh of two and from different schools, City Health Department’s Commission

S p r i n g 2008 31 has added to her nursing responsibilities One of the current goals of the the role of chairperson on the unit’s bereavement committee is to support interdisciplinary Perinatal Bereavement grieving families according to their Committee. Blunt did not seek to carve preferences and values. Under Blunt’s out a leadership role for herself in the direction, the committee has closely NICU. But after just a short stint on examined how specific populations cope the unit, she was prepared to lead this with loss. “We’re looking at different important initiative. cultures and how they grieve, so we “I’ve always been a caretaker,” Blunt don’t impose our practices and ideas on says. Now, in addition to caring for her them,” Bunt explains. infant charges, she’s making sure family The committee will pass on this members of NICU patients are taken knowledge to other NICU nurses. “It’s care of—specifically, family members of about making nurses more comfortable patients who don’t survive. supporting families who are dealing As a NICU nurse, Blunt was trained with a loss,” Blunt says. Many NICU to care for the youngest and frailest of nurses, exceptional at caring for the infants. There is nothing in her job most delicate infants, have no idea how description that requires her to respond to support a family broken by grief. to the needs of family members too, but Blunt has no qualms under these circum­ instinctively, she recognized the need stances. “It’s an honor to be able to help and took action. “I’m assertive when I families in such a tragic time,” she says. need to be,” Blunt says.

Interdisciplinary Training Eases Pain Research

Sharon Kozachik, PhD, RN had since 1985, are expected to train always worked with human subjects in two or more areas of expertise: B ill D enison until she became a Postdoctoral behavioral/social science, biomedical, Fellow in the Interdisciplinary or clinical research. Training Program in Biobehavioral Funding for the program comes Pain Research. Now the focus of from the National Institutes of her clinical research, how analgesics Health’s Roadmap for Medical affect sleep and the effects of Research, which fosters new disturbed sleep on pain, has shifted organizational models for team to animals. science and aims to better quantify That’s the kind of radical change clinically important symptoms and that the training program engenders. outcomes, including pain, that More importantly, being part of a are difficult to measure. The five- research team that brings together year grant is a first for the School mentors from the Johns Hopkins of Nursing, according to Gayle G. University Schools of Nursing and Page, DNSc, RN, FAAN, Director of Medicine has given her “a broader the Center for Nursing Research. view of ongoing mechanisms Page also co-directs the training that impact pain,” Kozachik said. program with Professor Jennifer That’s because research fellows like Haythornthwaite, PhD of the School Kozachik, who has been a nurse of Medicine. Sharon Kozachik, PhD, RN

32 J o h n s H o p k i n s N u r s i n g Enhancing Patient Some might balk at these increasingly stringent regulations. Dennison, along Care Systems with colleagues in the hospital, instead In recent years, hospitals have become has initiated creative and practical increasingly accountable for their interdisciplinary solutions performance. Governing bodies like that both satisfy the demands the Centers for Medicare and Medicaid imposed by today’s increasingly Services (CMS) and The Joint complex health care system and Commission on the Accreditation of provide practicing nurses and Healthcare Organizations (JCAHO) physicians tools they need to have ramped up hospitals’ accountability give high quality care. considerably, threatening financial “Nurses are in a great consequences for those who don’t position to participate comply. “These accrediting bodies are and lead interdisciplinary saying ‘We’re going to make you report teams,” says Dennison. how you’re doing, compare you to other She counts herself among organizations, and pay you according to them. “Nurses are rich your performance,’” explains JHUSON with ideas of what assistant professor Cheryl Dennison, patients, providers, and PhD, ANP, a nurse researcher who has systems need.” dedicated her professional career to In her latest interdisciplinary projects that achieve interdisciplinary improved patient outcomes. research project, Dennison hopes to dramatically boost Hopkins physicians’ and nurses’ use of standardized, evidence-based guidelines to treat heart failure, a major public “Nurses are in a great health problem that costs $33.2 billion position to participate annually. Through a $400,000 grant “Pain is bigger than any single from the National Institute of Nursing and lead interdisciplinary disease,” Page said. “Only by Research at the National Institutes teams. Nurses are rich banding together will we conquer it.” of Health, Dennison is leading an One of Sharon Kozachik’s two interdisciplinary team from the hospital with ideas of what mentors, Page is especially pleased in the ambitious project of developing patients, providers, and about the opportunity to grow multi-faceted electronic clinician new researchers and the chance for decision support tools (CDS) that apply systems need.” members of her profession to take specifically to managing heart failure in —Cheryl Dennison, PhD, ANP, the lead. “Nurses are ideally suited to the acute care setting. this work because they see the whole Ideally, her work will result in higher assistant professor patient, they know who’s contributing utilization of the treatment guidelines, to care, and they are in a position thereby improving patient outcomes to coordinate it.” Aside from formal and lowering health care costs. Along qualifications, she thinks curiosity the way, the outcomes of her research and a willingness to take risks are may help satisfy stringent standards necessary to succeed in the program. imposed by accrediting bodies. Kozachik fits the profile. Although The task, which sounds relatively still a Fellow, she has recently secured simple, is anything but. It has involved funding from the National Institute of several steps, beginning with engaging Nursing Research to pursue her own an interdisciplinary improvement team, line of research. —SM then developing a key stakeholder

S p r i n g 2008 33 assessment, cataloguing all existing Patient Safety Manager for Johns information systems, recruiting and Hopkins Medicine, have stepped holding nurse and physician focus forward to lead the effort. groups, pilot testing paper-based versions A former labor and delivery nurse, of CDS solutions, converting them to Paine knows firsthand the issues electronic versions, and meticulously within any modern hospital that can following up with assessments, thwart patient safety. “There’s more feedback, and revisions. documentation required. Patients are Dennison’s work involves even sicker. The technology to treat several targeted initiatives. patients has become more complex. Nurses are completing It’s hard out there, on the front line,” online education modules she says. on managing heart failure; Generally, there is no single element standardized patient that presents challenges to patient education materials safety—just as medical errors are rarely have been developed. the result of one employee’s mistakes. And, computerized That’s why Paine and her staff approach provider order sets have the challenge of creating a safer been implemented at hospital environment for patients by critical junctures—upon looking at system-wide solutions. admission and at dis­ This perspective, believes Paine, charge. “We didn’t reflects the way nurses in general want our efforts to approach their work. become too diffuse… “Nurses think holistically. We look we’ve carved out a at the whole patient. With patient feasible approach,” safety, we look at the whole system— she says. how one part relates to the broken part While acknowledging of the system,” Paine says. the research project’s limited The Patient Safety Net is one parameters, Dennison nevertheless example of this system-wide approach forges ahead with ideas about potential that Paine and her colleagues have As hospital operations future applications. “As the hospital implemented at Hopkins. It’s an online and patient caseloads introduces these new technology safety reporting system whereby any systems, they also increase our ability staff member can report events that become ever more to capture data on the quality of care. involve harm or near harm to a patient. complex, the issue of This allows us to monitor the effects “As soon as a front-line reporter clicks of our interventions.” ‘submit’, the report goes automatically patient safety reigns She adds, “We have fabulous nurses to the appropriate people,” Paine says. paramount. and physicians here. But if the system The system takes a proactive, isn’t set up for providers to provide the interdisciplinary approach to patient best care, it can be challenging. It’s an safety. “We focus on those events of issue of creating a system that allows lower harm that may fly under the radar good nurses and doctors to provide screen. We fix them before somebody the best care.” gets hurt,” Paine says. The patient safety team accom­ Ensuring Patient Safety plishes this goal by gathering a multi­ disciplinary group weekly to review As hospital operations and patient reported events that could lead to caseloads become ever more complex, potential harm and discussing collective the issue of patient safety reigns solutions. “We now recognize that paramount. And, once again, Hopkins teams which don’t work together don’t nurses like Lori A. Paine, RN, MS, provide as safe care,” Paine says.

34 J o h n s H o p k i n s N u r s i n g The team stays busy. Each week, Online Nursing Research LINCs Caregivers Together the Patient Safety Network receives between 250 and 275 event reports; After working many years in Clinical instructor Krysia Hudson, MS, that’s 11,000 per year. These impressive transplant nursing, Assistant Professor RN and alumna Megan Hoffmann, numbers indicate what Paine had Laura Taylor, PhD, RN discovered BSN also collaborated on the LINC hoped for: a proactive approach to that online resources for caregivers project. Since the network launch, patient safety is taking hold at Hopkins. of living kidney donors were participants have shared tips to nonexistent. That’s changing, thanks alleviate fatigue, minimize pain Driving Discussions to Taylor’s new online intervention and scarring, ideas about food, for Ethical Care study, the first of its kind to be diet, and travel. conducted at the Johns Hopkins Members of the transplant team The medical technology available to University School of Nursing. at Johns Hopkins Hospital, including today’s health care providers is more With mentorship from professor Transplant Coordinator Pamela advanced than ever before. While these Marie T. Nolan, PhD, RN and a Walker and Director of Clinical sophisticated advances allow clinicians Dorothy E. Lyne grant from the Transplant Research Dorry Segev, MD to perform life-saving techniques, school’s Center for Nursing Research, recruited 16 caregivers to the closed they sometimes create unintended Taylor’s goal is to give caregivers the study. Participants are asked ethical challenges, like when and to information and emotional support to complete three surveys. Taylor what extent to use such technology on they need and help transplant teams is proud that the response rate patients. All too often, patient-centered prepare families before and after has been 100 percent. With ethical concerns get buried in the fast- the procedure. additional funding, she hopes to paced hospital setting—particularly Taylor has created a web-based expand the study. —SM when no one knows quite how or when discussion board to initiate the sensitive dialogue these where caregivers, issues deserve. using pseudonyms to At Hopkins, the complex ethical protect their identity, questions that have grown parallel to can exchange practical the rise in medical innovations are tips on ways to make the intentional focus of open dialogue the donor, usually a between providers, patients, family spouse or relative, more members, and other involved parties. comfortable. “Every This discourse takes place in the living kidney donor is context of the Johns Hopkins Ethics so generous. We want Committee. Created some 20 years them and their families ago by a group of committed Hopkins to feel confident in clinicians, the committee ensures that their decision making,” no single person or group needs to face Taylor said. The difficult ethical questions alone. The study also offers an group makes itself available to consult opportunity for clinical with patients, family members, and the research between patient’s medical team. the School and JHUSON associate professor Cynda the Hospital. Rushton, DNSc, RN, FAAN says, The Living Donor “Nurses have the closest and most Information Network sustained contact with patients and for Caregivers (LINC) families. Because of that proximity, went live at the end they witness the suffering of patients of May 2007 with very intimately.” technical assistance So, it was no surprise when Rushton from Frank Hoey and was chosen to serve as co-chair for a Fred San Mateo of W ill K irk committee that coordinates a diverse the IT Department. Laura Taylor, PhD, RN group of health care professionals to

S p r i n g 2008 35 advocate on behalf of patients. “We acknowledging that prior to 1999, the try to provide a systematic process, to committee was comprised primarily create an open dialogue—a space where of physicians. “Now, we have a much people can hear each other differently. more balanced membership that brings We are not the judge and jury.” diverse and important perspectives,” Many times, it’s not the end result she adds, noting an increase in the of this dialogue that counts. “We number of chaplains, social workers, help to slow down the process and and nurses on the committee. facilitate a conversation among Speaking from experience, Rushton patients, families, and the health care openly extols the virtues that nurses team that may not have happened bring to the committee. “Nurses before this. Even if decisions don’t have the closest and most sustained change, people feel as though they’ve contact with patients and families. been heard,” Rushton says. As a result, we often have the deepest When she took the helm of the com­ relationships with them. Because of mittee almost 10 years ago, Rushton that proximity, we witness the suffering aimed to increase its interdisciplinary very intimately. We also are involved in leadership. She relishes the results of trying to coordinate an often-complex having met those goals. “We needed to and diverse group of healthcare increase the voice of nurses, of commu­ professionals to try to advocate on nity members, and others,” says Rushton, behalf of the patients,” she says.

Youngest PhD Student Works to Curb Teen Violence

As an undergraduate, Jessica Roberts in sociology and nursing from the services to youth who are runaways. Williams pursued a dual degree University of Florida. “I was interested This February, Williams defended in how that understanding of society her PhD thesis, which dealt with could be applied to health issues, identifying patterns in adolescent W ill K irk to change and improve health,” at relational aggression and violence the practical level, says Williams. in dating—physical, psychological, Understanding the structure of and emotional. She will soon earn society and the ways in which that the distinction of being the youngest structure can influence our lives— graduate of the PhD program at the especially our health—is what School of Nursing. propelled Williams from her initial Williams’ plans for the future interest in sociology into the Johns include teaching and continuing Hopkins University School of Nursing her research in order to develop (JHUSON) PhD program. intervention techniques that school Throughout her studies at Hopkins, nurses and others can use to help Williams has helped adolescents to stem violence. “I felt strongly about develop healthy relationships and going straight through to the PhD prevent violence. She has worked program,” says Williams. “I wanted on an intervention program aimed to end up working on research, at preventing bullying in schools and developing theory, and creating new has served as a health educator for knowledge for the discipline, and so Fellowship of Lights, an organization this path made sense for me.” Jessica Roberts Williams that provides emergency shelter and —Diana Schulin

36 J o h n s H o p k i n s N u r s i n g Breaking Down Barriers Some pressing conversations about patient care extend far beyond the borders of medical facilities. Consider the work of JHUSON associate professor and nurse practitioner Julie Stanik-Hutt, PhD, ACNP who, in just four years, drove discourse that paved the way for nurse practitioners to practice their profession to a broader patient popula­ tion. A nurse practitioner by training, Stanik-Hutt served between 2002 and 2006 as the Legislative Committee Chairperson for the Nurse Practitioner Association of Maryland, an organization which recently named her president. Before 2003, a glitch in Maryland law precluded nurse practitioners from being designated primary care providers to patients carrying HMO insurance. Given W ill K irk the large number of patients with HMOs Jo Walrath, PhD, MS, RN (left) and Julie Stanik-Hutt, PhD, CRNP-AC, CCNS and the current physician shortage, that small glitch created a big gap in care for Between the Ears Throughout the Years many Marylanders—one that Stanik- Hutt was determined to close. Although nursing roles and uniforms for graduates has grown, many daily “Some places, especially rural and have changed over the years, the tasks associated with bedside care underserved inner city areas, only have profile of who makes a good nurse are still the same, says Associate nurse practitioners. If insurance won’t hasn’t. “You must have a deep Professor Julie Stanik-Hutt, PhD, accept a nurse practitioner as a primary respect for humanity and diversity, CRNP-AC, CCNS and President care provider, you don’t get the care you be flexible and above average of the American College of Nurse need,” Stanik-Hutt says. intellectually,” says Assistant Professor Practitioners. “We admit and She describes the long and tedious Jo M. Walrath, PhD, MS, RN. “Most discharge patients, check their process that ensued. “We went to bat importantly, you have to be clear vital signs, put them on bedpans, [for those populations]. We went to the about your values and your behavior administer IVs and medications, take legislature and, for several years, had a must be congruent with them.” care of their hygiene and nutrition, lot of opposition. Then, a movement The Johns Hopkins University and offer support to the family.” within organized medicine on the School of Nursing baccalaureate Stanik-Hutt believes the skills physician side said ‘Let’s collaborate; program “offers a good solid founda­ needed for bedside nursing— let’s see if we can make an agreement’. tion in basic nursing,” according to observational, critical thinking, and I worked out a compromise with Walrath. Early professional courses problem solving abilities—build physicians, and testified in support of a start with the student interviewing better health care leaders. Nurses bill that physicians originally opposed. patients. The ability to critically listen who become proficient at applying It passed, and Governor Erlich signed is fundamental, a core competency these skills to patients and families it,” Stanik-Hutt says. that every class emphasizes. Prior to can engage the same tool kit when While working with top state law taking a patient’s history, students working with a nursing unit or officials, Stanik-Hutt has remained true learn to ask targeted questions, skills remedying a dysfunctional system. If to her role as patient advocate. “It’s they will use later with the patient’s asked to come up with a new symbol something that nurses are—advocates family, among colleagues, and for a nurse, Stanik-Hutt says it would for their patients. If you see something throughout their career. be a brain: “Nursing is what happens that isn’t right and it needs to be fixed, Though the range of opportunities between your two ears.” —SM we fix it,” she says. n

S p r i n g 2008 37 A Nursing Vocation for Each Generation

had no intention whatsoever of alumni. Their nursing careers, though becoming a nurse,” says Matthew similar, started nearly 30 years apart. Zinder. “I was in the arts, I “Patients would look at me like I wanted to be a photographer. was from Pluto,” recalls Herb, who I’ll never forget the moment was among the first men to graduate Imy father brought me into his home as a Hopkins nurse in 1971. In the office, sat me down, handed me his hospital, Herb would change in the business card, and said ‘I want to add doctor’s locker room with the other your name to that card.’ He probably men. In school, he was once asked to was expecting me to laugh at him, but I leave a class during a film on breast thought maybe I should look into it.” self-examination. “They thought Today, Matthew and his father my presence would make the female Herb Zinder are co-owners of Zinder students uncomfortable.” Anesthesia Associates, providing When Matthew attended Hopkins surgery-center anesthesia with a staff in the 1990s, men comprised about of more than 20 nurse and physician 5 percent of the nursing workforce. anesthetists. They are also the first His only recollection of gender bias in father-son pair of Hopkins nursing school was when the class was taught to conduct a physical assessment. “They’d only ask the male students to volunteer to be examined—because their shirts could come off,” says Matthew.

nita and Wendy Shauck also Agraduated from nursing school about 30 years apart. Both are alumnae of Church Home and Hospital: Anita graduated in 1942 and Wendy in 1975. As a child, when Wendy accompanied her mother to work she was relegated to the patient waiting room. “I always wanted to know what was going on

38 J o h n s H o p k i n s N u r s i n g A Nursing Vocation for Each Generation

upstairs where the nurses and doctors training. Thirty years later, in 1975, By Kelly Brooks-Staub were,” admits Wendy. “I remember Wendy entered the workforce with a Photos by Christopher Myers telling my mother I wanted to be a salary of $13,000 per year, doctor. But in that era, you were a which is the equivalent nurse, a receptionist, or a teacher.” of just over $52,000 in Anita noted her daughter’s interest. today’s dollars. The summer of Wendy’s 14th year, Both parents when school was out, “I said to Wendy are proud to see ‘why don’t you come and try it out?’ So their children in she came down to the hospital and she successful nursing liked it,” says Anita. careers. Across “I did what my mother suggested,” the generations, says Wendy. “I was a candy striper then these nurses share a pinkie then a health aide then an a compassion LPN then an RN. And that’s how I and desire to became a nurse.” work directly While Anita spent her nursing with patients and career working directly with patients— advocate for their in hospitals, the Navy, and even at an best possible care. insurance company—her daughter, Says Herb Zinder: Wendy, has spent a greater amount of “When I went into time worrying about paperwork and private practice, insurance. “You always keep the patient I felt like I first, in spite of the tons of paperwork was building or computer ‘input’ time. Today’s something patients see you typing on a laptop that might not and they are curious at first, but the have a future. client ultimately prefers the ‘personal I want to see interaction’ over technology.” These this business changes in health care led Wendy to grow and an office job with Medstar Health support future Visiting NurseAssociation participating generations.” n in quality assurance reviews. This enables her to facilitate an integrated delivery of care to the patients from behind the scenes while also fulfilling payor requirements. Mother and daughter laugh when comparing their earnings as new nurses. When Anita began nursing in 1942, she earned $1 per hour, the equivalent of $13.23 today. She paid $50 to enter her nursing education program, and another $50 after six months in

S p r i n g 2008 39 Where in Baltimore is the Hopkins Nurse?

Charlie Alexander, MSN/MBA ‘02 Susana Vega ‘07 President and CEO Nurse Clinician The Living Legacy Foundation Johns Hopkins Hospital

What I do: Guide the clinical and strategic What I do: Work as a nurse at the Johns direction—and lead over 100 staff members—for Hopkins Hospital in Weinberg 4C in the the organ and tissue recovery program for the Department of Surgery, volunteer at two State of Maryland. The program facilitates over organizations supporting Baltimore’s victims 600 local organ transplants and thousands of of intimate partner violence—House of tissue transplants every year. Ruth, Maryland and Adelante Familia—and take graduate courses at the Johns Hopkins Why Baltimore? Baltimore has the unique mix of University School of Nursing. academia, culture, access to the ocean, mountains, and Chesapeake Bay. For me it provides the ideal Why Baltimore? I love Baltimore for not balance between work and pleasure, while offering denying what it is, with all its quirks and vices a great mix of small town and city life appeal. and charm. It thrives with its own unique character and strength of spirit in the face of troubles. It’s real.

40 J o h n s H o p k i n s N u r s i n g Doris Addo-Glover ‘92 Deborah McCleary, RN, BSN Senior Clinical Quality Specialist Patient Care Manager, Medical ICU and Rapid CareFirst BlueCross BlueShield Response Team Johns Hopkins Bayview Medical Center What I do: Manage cultural diversity and health disparities initiatives, administer What I do: Manage the Medical Intensive Care cultural diversity training, and develop Unit and Rapid Response Team at Johns Hopkins partnerships with communities and Bayview Medical Center. I lead an exceptional institutions. team of dedicated nurses, techs, secretaries, and nursing students to provide cutting-edge care for Why Baltimore? I have lived in critically ill patients and those in crisis. the Baltimore area for over 20 years. Baltimore has much to offer—warmth, Why Baltimore? I love living on the edge of friendliness and so much more in the city where I can access the culture (concerts, academic institutions, health care plays, aquarium), dining opportunities (LOVE the facilities, careers, art, social life and crab and crabcakes!), an international airport, and history. This is a town after my heart! even outdoor recreation. Baltimore provides us a gateway to great neighborhoods and the world!

S p r i n g 2008 41