Caregivers The quiet joy and hidden struggle of providing healthcare at home

2018 ANNUAL MAGAZINE DEAN’S MESSAGE POINTS OF PRIDE

STUDENTS 373 BACCALAUREATE A year ago, the National

46 MASTER’S Institute of Nursing Research TOTAL ENROLLED (NINR) released a strategic plan 754 290 DOCTOR OF NURSING PRACTICE identifying four areas of focus 45 PHD for nursing science:

Building the scientific foundation for clinical practice

Preventing disease and disability FUNDING Managing and eliminating symptoms caused by illness $2 MILLION $1 MILLION 7 Enhancing end-of-life and palliative care IN DONOR FUNDING IN STUDENT TRAINEESHIPS, ENDOWED CHAIRS SCHOLARSHIPS, FELLOWSHIPS Here at the University of Utah College of Nursing, we The University of Utah College of Nursing was rec- know we are ahead of the curve. Core groups of our ognized this school year by the American Association researchers are studying ways to boost caregiver re- of Colleges of Nursing (AACN) as one of the nursing silience; alleviate patients’ chemotherapy symptoms; education institutions that is most integrated into its manage diabetes and weight; diminish health dis- surrounding academic medical center. This collab- parities; and build technology to enhance healthcare oration allows us to work more efficiently in inter- RESEARCH FACULTY PRACTICE communication. professional teams with physicians, pharmacists and social workers to provide the highest-quality care for Faculty providers are using evidence-based inno- our patients. Our nurses—and student nurses—truly vations to transform patient care—for example, are leading and supporting new prevention and well- #23 500 6,000 facilitating new mothers’ use of nitrous oxide gas to ness programs, new models of care delivery, conti- NIH FUNDING BABIES DELIVERED BY PERSONAL CONTACTS THROUGH manage pain and anxiety during labor and delivery, nuity of care and integration with home and commu- (AMONG 800 COLLEGES OF NURSING) FACULTY MIDWIVES CARING CONNECTIONS GRIEF GROUPS and creating group therapy for those struggling with nity based services and resources. complicated grief. The College of Nursing already is working in line with Meanwhile, our nurse educators are putting those the National Institute of Nursing Research’s strategic $27 MILLION 23,000 pieces of research and practice together to update nursing science goals. Join us in the discovery! TOTAL GRANT PORTFOLIO PATIENT VISITS FOR INCARCERATED YOUTH PROVIDED BY NURSE PRACTITIONER our curriculum and provide unique experiential learn- FACULTY WORKING AT UTAH JUVENILE JUSTICE SERVICES CENTERS ing for interdisciplinary student hotspotting teams. Over the past school year, these student teams have been tackling the social determinants of health at local subsidized housing complexes and community DEAN PATRICIA G. MORTON, PHD, RN, FAAN clinics, one practical solution at a time. 2019 U.S. NEWS & WORLD REPORT # # # # RANKINGS OF 6 9 19 30 BEST GRADUATE NURSING INFORMATICS NURSE MIDWIFERY DOCTOR OF COLLEGE OF NURSING SPECIALTY TRACK SPECIALTY TRACK NURSING PRACTICE GRADUATE PROGRAMS SCHOOLS CAREGIVING 6 A growing, but largely unseen, group of family members is quietly providing the healthcare many Americans receive. College of Nursing researchers, clinicians and educators are poised to lead as caregiving takes precedence in American healthcare.

HOTSPOTTING 12 Eight interdisciplinary “hotspotting” teams of university students were dispatched this year to help at-risk patients at a Salt Lake County subsidized housing complex and community clinics. The program provided intensive hands- on healthcare for the patients and unique experiential learning for the students.

INNOVATING 15 Urged on by research and policy analysis from College of Nursing students and BirthCare HealthCare nurse midwives, University of Utah Health’s Labor and Delivery Department started offering nitrous oxide gas to laboring mothers.

GIVING 21 Generous past and present donors to the College of Nursing generate more than $1 million a year in scholarship support for 20 percent of students.

GATHERING 25 Alumni Weekend 2017 marked the first induction of the Half Century Society (graduates from the classes of 1947 through 1967), the Class of 2007’s 10-year reunion, the Distinguished Alumni and Young Alumni Awards, and the unveiling of the Faces of Nursing mural. It’s the doubts that haunt caregivers: The niggling thought that you aren’t doing enough, don’t know which questions to ask, didn’t press the issue with the doctors, that there was too much pain.

Even when caregiving ends, the uncertainty (AARP) estimate 44 million family caregivers lingers. provide unpaid care to an adult or child each day—about 16 million of them caring for a “As a caregiver, you have to be empowered and family member with Alzheimer’s disease. very assertive to get your loved one what they In economic terms, the care these part- need from the system,” says Leissa Roberts, ners, parents and children provide would be DNP, CNM, associate dean for faculty practice valued at $470 billion, according to a 2013 at the University of Utah College of Nursing. Dr. estimate from AARP’s Public Policy Institute. Roberts cared for her parents, Ben and Ellen as they declined over the past decade — her Most caregivers are older women. Most have father from lung cancer; her mother from other jobs. And just like professional health- Alzheimer’s disease — and eventually died last care providers, they’re burning out. Their year, he at 89; she at 83 years old. patients are living longer and with chronic diseases that exact a painful toll, not just on “Not everyone is a caregiver,” Dr. Roberts the patients, but on those who take care of adds. “Healthcare providers are not prepar- them as well. ing families to advocate for their loved ones. We’re not preparing families to make import- For nearly 20 years, College of Nursing re- ant decisions before they get to a crisis point. searchers have been delving into caregivers’ And we’re not doing as good a job as we experiences—how they become isolated, could in supporting families when they’re in how they communicate with healthcare crisis. We owe caregivers more.” workers, and how they recover from the death of their care recipients. A growing, but largely unseen, group of fam- ily members is quietly providing the health- “They are today’s silent patients,” says Linda care many Americans receive. Parents raising Edelman, PhD, RN, an associate professor disabled children. Children caring for their at the University of Utah College of Nursing parents. Young couples pushing through whose research focuses on injuries to older cancer diagnosis and treatment. Life partners adults living in rural areas. Most are women, CareGivers caring for each other as they age through many are part of the “sandwich generation,” Empowering the “Silent Patients” diabetes, cancer, heart disease and dementia. providing care for aging parents while sup- porting their own children. Others are aging The National Alliance for Caregiving and themselves. “It’s not surprising that caregivers American Association of Retired Persons are burning out.”

Bob Kaelberer has been caring for his wife Anne since she first showed signs of dementia in 2009. 6 nursing.utah.edu nursing.utah.edu 7 Still, caregivers perform the job tirelessly “The caregiving experience has changed me “You take and with little fanfare or complaint—often forever. It was the sweetest, toughest time of to the detriment of their own economic and my life,” she adds. everything a day physical health. When the caregiving role ends, many of these lay healthcare providers “For nearly 10 years it was an honor to care at a time. If you discover their own health problems—heart for my sister and parents. In the midst of their failure, complicated grief and persistent suffering was my sincere desire to give back, look at the whole depression. Economic problems—diminished provide the best possible quality of life and earning prospects and smaller retirement help them safely out of this world. Looking picture, it’s too accounts—are common. back I would do it over again because of my overwhelming.” “She took care of me for over 50 years. Sally Larkin Now it’s my turn to take care of her.”

Bob Kaelberer “Your normal standards that you had when alone, with little medical intervention, but a Ron and Sally Larkin’s Nancy Ward, co-chairwoman of the College deep love for them. But I really hope never you were together just have to go downhill lot of respite care and occasional meals from 35-year-old son Jake was born prematurely. of Nursing Development Board, cared for her again to relive the anxiety, fear and sleep slowly,” she says. “You have to enjoy every neighbors, his daughter and daughter-in-law. They worry what will sister, Susan Whittaker, when she was diag- deprivation associated with caregiving.” good moment. Every once in a while, some- An initially intense diagnostic battery of tests happen to him if they nosed with cancer. Susan died in 2006 after body comes to visit and you can walk around and doctor visits overwhelmed Anne, he says. die before he does. four years of treatment. A few years later, Ms. College of Nursing Advisory Council Member the block. Or someone brings a meal in. Ward moved back to Utah to care for her Annette Cumming, RN, found caregiving to “They wanted to get me into all these kinds parents, Dale and Gloria. Her mother was di- be the same trial by fire—and physical toll “Tomorrow’s always another day.” of programs and take all these tests that agnosed with Lou Gehrig’s disease (ALS) and on her own health. Her 77-year-old husband stress her out,” the retired Caterpillar tractor died in 2014. Her father had dementia and Ian Cumming declined after a diagnosis of Ms. Cumming, 71, is finally getting the hip salesman adds. “But I’m a farm boy. You learn Alzheimer’s disease and died two years later. dementia eight years ago. He died Feb. 2 at replacement she’s needed for a few years. things on your own. After nearly a decade of taking care of first their home in Jackson, Wyoming. She says a her sister and then her parents, Ms. Ward, 61 strong support network, a flexible approach, Bob Kaelberer, 86, has been caring for his “I don’t get blue. I don’t look ahead,” he adds. years old, says she still has not recovered— lowered expectations and a sense of humor 80-year-old wife Anne since she showed the “You can look ahead and what’s it going to physically or emotionally. are critical. first signs of dementia in 2009. He’s going it get you? Nothing. This is one day at a time.”

Who are America’s Who are they How does caregiving Building Resilience caregivers? What do they do? caring for? impact their health?

Recognize how challenging this role is: Get away from your situation • What do you bring to this role? • Don’t become “the only” in a caregiving situation 60% 24hrs 65% 21% • What makes your caregiving unique? • Do the good stuff—exercise, massages, vacations FEMALE OF CARE A WEEK, ON AVERAGE FEMALE HAD MAMMOGRAMS LESS OFTEN • What are the difficulties you will face? • Avoid self-destructive choices Set reasonable goals: Get a perspective 49 23% 69 55% • Goals for rehabilitation (attitude as well as • Short-term goals—obtaining care for your family functional) member YEARS OLD SPEND 41 OR MORE HOURS A YEARS OLD MISSED DOCTORS ON AVERAGE WEEK PROVIDING CARE ON AVERAGE APPOINTMENTS • Keep caregiving goals small and attainable • Long-term goals—preparing for future needs, • Remain flexible completing your relationship, developing as a human being, leaving a legacy of caregiving 7% 57% 59% 63% Get support and create a team ARE 75 YEARS OLD PERFORM MEDICAL/NURSING HAVE A LONG-TERM AGED 66-96 HAD HIGHER • Professional—doctor, nurses, social workers OR OLDER TASKS, INCLUDING INJECTIONS, PHYSICAL CONDITION MORTALITY RATES THAN • Informal—friends, family, church FEEDING TUBES, CATHETER AND NONCAREGIVERS • Say “Thank you” COLOSTOMY CARE 2017 sent her into a spiral of complicated grief. ing’s caregiving initiative. Together researchers Kaden, the second of her four children, was are addressing family caregiver preparedness, diagnosed with congenital Citomegalovirus health, psychological well-being, and adjust- (CMV) which led to developmental delays and, ment to death of their family member. College later, debilitating epileptic seizures. When she researchers are passionate about developing was with another son at a baseball tourna- new models of care that support the family ment, Kaden went into cardiac arrest while caregiver in providing care to the patient while staying with her parents. Coming back from his maintaining their health, she says. loss has been a struggle, the 43-year-old single mother says. He lived with her. She regularly “I’m beginning to see reminded Kaden to shower, take his medica- tion, how to heat food in the microwave. pleasures in life again,

“He was so much a part of my routine,” she instead of just going 100 “As a caregiver, you dedicate says. “He didn’t require constant supervision, miles an hour all the time.” but I planned on him living with me or some- your whole being. You wake up one else for his entire life. He was just so much Leissa Roberts, DNP, CNM knowing you’re going to have a part of my everything that I felt empty.” to take care of this person more An engineering firm administrator, Ms. Shields ultimately joined one of Caring than you take care of yourself.” Connections complicated grief groups Parents caring for disabled children face an and with additional therapy believes she is Leslie Shields inverse heartbreak: The fear of leaving a vul- climbing out of the “fog.” nerable adult behind when they die. “I have two college degrees and I couldn’t After Leslie Shields’ For younger couples dealing with a cancer Ron and Sally Larkin’s son Jake was born even complete some sentences,” she adds. “I disabled, 19-year- diagnosis, the caregiving role can be fleet- old son Kaden died prematurely in 1983. When he failed to thrive, allow myself to be really sad and mourn the ing, but no less intense. When 32-year-old suddenly of a heart doctors started to dig for causes: cerebral loss, and then I get myself out of it. My other attack last year, she Robyn Marchant was diagnosed with acute palsy, minor microcephaly, autistic tenden- kids deserve the mom I was for Kaden.” struggled to emerge myeloid leukemia in February of 2017, she from her grief. cies. Answers remain elusive. More than spent nearly 50 days in Huntsman Cancer 35 years later, Jake’s health problems have With a grant from the Alzheimer’s Associa- Hospital during chemotherapy treatment. mounted—type 1 diabetes, mild congenital tion and Cambia Health Foundation, Caring After 10 days at home, she returned to the heart disease, urologic surgery. After years of Connections Director Kathie Supiano, PhD, hospital for another month after a bone special education and summer camps and is studying the impact of group therapy marrow transplant. Her husband Kevin, 35, lining up neighborhood kids to hang out, on caregivers at risk for, or suffering from, shuttled back and forth from their home in Jake is more independent, but also more complicated grief after the death of their Santaquin, 60 miles south of Salt Lake City, isolated. He’s learned to check his most care recipient. at times bringing their four children with him. inappropriate impulses, but his friends have He says his and Robyn’s parents helped keep College of Nursing Associate Dean of Faculty Practice Leissa moved on, getting married and having chil- “The group dynamic is critical,” Dr. Supia- the young family afloat. Roberts, DNP, CNM, cared for her parents, Ben and Ellen, as they dren of their own, says Sally, 66. no says. “It requires pulling together people declined over the past decade. They died in 2017. with very disparate lives, but one common “I don’t feel like I did much. She’ll proba- “We’re 35 years into this and there’s no experience—caregiving—and changing be- “We are leaders in caregiver research and bly tell you differently,” Mr. Marchant adds. end in sight. It’s really becoming a concern havior in a positive way, changing attitudes education,” Dr. Ellington adds, “ultimately to “It was a lot of juggling back and forth and if we were to die before Jake,” says Ron and understanding, and developing new skills improve the care provided to families at our getting schedules worked out, spending Larkin, MD, a 68-year-old retired OB/Gyn to manage living with the loss that brought institution and throughout our state, and time with the kids, making sure they weren’t and member of the college’s Development you to the group. It’s the difference between inform national models of patient-centered, forgotten.” Board. “We’ll keep him with us as long as we support and therapy.” family-oriented care.” can. We hope he has a good life, but passes Robyn Marchant is approaching the one-year before we do.” Projects like Dr. Supiano’s are the foundation mark from her transplant. But, “there’s always of the college’s robust program of family Sources: that thought in the back of your mind that it For Leslie Shields, her 19-year-old disabled caregiver science, says Lee Ellington, PhD, a http://www.caregiving.org/caregiving2015/ can come back,” her husband says. son Kaden’s unexpected death in February professor and director of the College of Nurs- https://www.caregiver.org/caregiver-statistics-demographics

10 nursing.utah.edu nursing.utah.edu 11 LEARNING healthcare providers. Hotspotting is designed two PhD candidates in public health—was to provide both a more intensive, hands-on dispatched in 2016 to test the model with healthcare experience for the patients, and a one resident of Grace Mary Manor, a subsi- Transforming the Way We Teach unique learning opportunity for the students dized housing complex that is home to 84 Creating a Healthcare Team on the team. formerly homeless adults insured through a limited Medicaid expansion. This year, the “You have to shed some of your layers of pilot project initially funded by the Camden training to have a conversation with a patient Coalition of Healthcare Providers merged that’s nonmedical. It’s really counterintui- with Dr. Hart’s interprofessional education tive,” says Tim Farrell, MD, AGSF, a geriatri- project, which is funded by the Robert Wood cian, associate professor at the University of Johnson Foundation, Gordon and Betty Utah School of Medicine and director of the Moore Foundation, John A. Hartford Foun- University of Utah Health Interprofessional dation, and Josiah Macy Jr.Foundation. Education program, which administers the student hotspotting project. “Ninety percent In many ways, the experience was equal of health is determined by nonmedical fac- parts care management and social work, says tors. We do our students a disservice if their Dr. Hart. “The students are not bringing their entire healthcare training only focuses on the clinical skills into this experiential learning,” other 10 percent.” she adds. “They are going into patients’

The nebulizer was so smarts and practical solutions—figuring out Neighborhood how to ride the bus to the doctor’s office, “Ninety percent of health is close, but maddeningly finding fresh vegetables at the neighborhood determined by nonmedical grocery, applying for a job. For eight interdis- out of reach—locked ciplinary teams of university students dis- The Social factors. We do our students in his ex’s garage. patched this year to work with four residents Determinants Economic Healthcare a disservice if their entire And the man’s of the Salt Lake County Housing Authority’s of Health Stability healthcare training only focuses Grace Mary Manor and four other at-risk pa- on the other 10 percent.” uncontrolled asthma tients and their families, getting out of their At a wrapup session healthcare training to really hone in on what Tim Farrell, MD, AGSF Community Education April 7, University was undermining every their client needed was the whole point. of Utah Health faculty hotspotting other facet of his life. project leaders--Tim “It’s very easy for me to say, ‘Cut all sugar Farrell, MD, AGSF; For another formerly homeless client of the out of your diet and eat fresh vegetables’,” A team of university faculty including Dr. homes. They’re going with them to their Sara Hart, PhD, RN; Marilyn Luptak, PhD, University of Utah’s student “hotspotting” says Hailey McLean, an Honor’s College Farrell; Susan Hall, DNP, RN, an assistant medical appointments. They’re going with MSW; Kyle Turner, teams, back pain was debilitating. Turns out, student graduating with a degree in Health, professor at the College of Nursing; Sara them to meet their social worker. They are PharmD; and Susan he needed a new mattress. Society and Policy. “But if you’re living off Hart, PhD, RN, an associate professor at the showing up to better understand what the Hall, DNP, RN--met with a team from your Social Security check and spend half College of Nursing; Marilyn Luptak, PhD, real world is for the patients they will proba- the National Center Still another patient routinely visited Uni- an hour on the bus to get everywhere, MSW, an associate professor at the College bly care for in a real world setting.” for Interprofessional Practice and versity of Utah Health’s hospital for dialysis you’re going to make different decisions. It’s of Social Work; and Kyle Turner, PharmD, an Education, including treatments but had no primary care provider really hard to shop for vegetables.” assistant professor at the College of Pharma- “When you accompany people through their Hanna Pedersen, to connect the other facets of his declining cy; worked together to design the hotspot- real experiences, you better understand what Vince Leone and Gladys Antelo. health—nutrition, lab tests and immunizations. Tackling the social determinants of health— ting project and provide mentorship for the leads to those experiences and what drives the often unspoken personal characteristics hotspotting teams. They applied for grants, their health outcomes.” A refugee family just needed an interpreter and behaviors that have more to do with a pulled in stakeholders from the university’s to help them outside of their healthcare patient’s health than their genetics or the main campus and health sciences colleges When the pilot project was complete, the appointments. time they spend at appointments—is fun- and schools and then assembled the inter- faculty team expanded the scope—applying damental to the hotspotting process. The professional student teams. One pilot team— to be one of Camden’s four hotspotting hubs Sometimes, the simplest healthcare inter- Kaiser Family Foundation estimates that just including one student each from the School for two years, from 2017 to 2019. (Camden ventions have less to do with blood draws 10 percent of patients’ health and well-be- of Medicine, College of Nursing, College of has since transitioned the hotspotting hubs and clinic visits and more to do with street ing are determined by their interactions with Pharmacy, the College of Social Work and under the oversight of a new National Center

12 nursing.utah.edu nursing.utah.edu 13 INNOVATING earlier on, when they’re learning, we can have so much more impact.”

At the University of Utah, eight teams of Innovating Care four or five advanced students from differ- Returning to an Old Method of Pain Management ent colleges—Medicine, Nursing, Pharmacy, Social Work and Health—met with their patients once a week. Four of the teams The plan was for a working at Grace Mary Manor were required to have both a graduate nursing student and natural childbirth. a student from social Work. Individual stu- But seven hours into labor, at seven cen- dents were expected to dedicate about two timeters dilated, Vanessa Vest needed a hours a week. Students have used credits little help getting through the contractions. from the hotspotting project to fulfill practi- Rather than resort to an epidural, Ms. Vest cum requirements. chose her Plan B: nitrous oxide gas.

Dr. Turner, a pharmacist, says the stu- “It just made me relax,” she says. “I remem- dent teams follow a pattern of expanding ber everything, it just let me take a break.” non-drug-dispensing roles for pharmacists in both hospitals and community settings. Hotspotting students for Complex Health and Social Needs.) The Two hours later, her daughter Makaia For many students, that took some getting Hailey McLean, Lily Ferreira, first full year of student hotspotting wrapped Vest-Carr was born March 2. And Ms. Tamiyah Dinh and Shonti used to. Breisch focused on the up in the spring of 2018 with site visits from Vest takes comfort in knowing that her healthcare and social the National Center for Complex Health and newborn didn’t have heavy-duty, intrave- “At first, the students jump to their safest needs of one patient at Social Needs, affiliated with Camden Co- nous pain medications flowing through Grace Mary Manor, Salt point, the thing that’s most familiar—tradition- alition, and the National Center for Inter- her bloodstream. Lake County’s subsidized al healthcare needs,” Dr. Turner says. “But over housing complex for professional Practice and Education. Other “Finding the research to support it was key,” New mom the course of getting to know their patients, Vanessa Vest formerly homeless hotspotting hubs include Thomas Jefferson In the fall of 2017, University of Utah Labor Dr. Loveridge says. She enlisted the help of single adults. they start to see the need to take care of other used nitrous University in Philadelphia, Pennsylvania; and Delivery doctors and nurse midwives one of the “godmothers” of the return to oxide during things. It stretches them out of their comfort Southern Illinois University in Springfield, started offering the analgesic to mothers. nitrous oxide in the delivery room—Vanderbilt labor before zones and into an interprofessional role. the birth of her Illinois; and Samuel Merritt University in Oak- University School of Nursing Nurse-Midwifery daughter, Makaia, land, California. “It’s a great option for women who want to Specialty Director Michelle Collins, PhD, CNM, March 2. “The more we can teach our students that have something that helps them take the who spoke at a University of Utah Health they are a member of a team and how to fig- edge off, but they don’t want an epidural,” ure out where their scope begins and ends, “When providers are working with says Sara Hake, DNP, CNM. the better off we’ll be,” he adds. “It gives a mom a feeling complex patients, there isn’t a book. So far, a limited number of women have For the students, the experience required opted for nitrous oxide gas, says Dr. Hake, an of control over what is There’s no blueprint. But we do working together to juggle busy class and adjunct assistant professor at the University clinical training schedules, manage logistics know it takes a team.” of Utah College of Nursing. happening and lets her and get their patients’ needs met—all while Gladys Antelo navigating scope of practice issues that can Labor and delivery nitrous oxide is different stymie professional providers. concentrate on what’s most from the “laughing gas” dentists use. For one The Camden Coalition has documented the thing, the gas is mixed at lower concentra- efficacy of hotspotting, says Gladys Antelo, “You get to address a lot more components important—her new baby.” tions—50 percent rather than 80 percent. the national center’s hotspotting program of their care when you’re not associated with And laboring mothers administer the gas Sara Hake, DNP, CNM manager. Now, it’s just a matter of scaling up their doctor,” says Ms. McLean, who plans to themselves, inhaling as needed from a mask. to spread the student team-building experi- start medical school in the fall. “I want to go Grand Rounds early in the process. Love- ence nationwide. into a practice or a clinic where team-based Nurse midwives with the College of Nurs- ridge’s DNP project wrapped up in 2015, but care is a priority.” ing’s BirthCare HealthCare program pushed the policy did not change for two more years. “When providers are working with com- for the change after Danica Loveridge, plex patients, there isn’t a book. There’s no For now, the students are worried about the DNP, CNM, focused on the issue in her Polish physician Stanislav Klikovich first ex- blueprint,” Ms. Antelo says. “But we do know patients they’re now separating from. “The doctoral project. perimented with using nitrous oxide to help it takes a team. And if we can get to students Continued on pg. 38

14 nursing.utah.edu nursing.utah.edu 15 RESEARCH “One of the barriers is just lack of knowledge. If people know it’s an option, and a safe option, Tackling Health Disparities word of mouth will help it to grow.” Finding Answers for Disadvantaged Populations

Danica Loveridge, DNP, CNM

mothers in labor in 1881. Many U.S. hospitals The American College of Nurse Midwives THE RESEARCH QUESTION offered the gas through the 1930s and 1940s. released a position paper about the use of But that practice changed in the 1950s, when nitrous oxide in labor and delivery in 2011, What kinds of technology could help remove some of the Nitrous more powerful anesthetics that promised urging midwives be trained to offer the gas to biggest obstacles encountered by Hispanic adults with “pain-free” labor and knocked mothers out their patients. The American Society of An- Type 2 diabetes? Oxide use entirely pushed nitrous oxide out of favor. esthesiologists reviewed research the same in other year and suggested more study, but noted IMPACT Women started demanding more options “good safety outcomes” in Europe and Aus- The Community Advisory Board of Hispanic Adults with countries starting in the 1970s, when epidural anesthe- tralia, where a majority of laboring women Type 2 Diabetes assisted the research team in writing sia provided pain-free labor while awake, but use nitrous oxide. grants that included developing meaningful strategies to restricted movement and led to side effects. intervene--including community health worker support, 60% With nitrous oxide, laboring mothers can From that point, the number of U.S. hospitals peer support, mobile phone applications, continuous of laboring women in remain mobile, taking the tank and mask with offering the gas as an alternative to conven- the United Kingdom glucose monitoring, virtual reality programs, and a variety them as they walk the halls, sit on birthing tional pain medications started to grow. The of other devices. Then, the members used the devices balls or “slow dance” with their partners. University of California, San Francisco’s hos- themselves, providing feedback to the research team. The pital has offered nitrous oxide continuously Michelle Litchman Nancy Allen 50% community advisory board continues to be active even The gas doesn’t eliminate pain entirely, but for 30 years. The maker of Nitronox—Porter PhD, RN PhD, RN of laboring women in though the Patient-Centered Outcomes Research Insti- leads to a feeling of euphoria that helps the Instrument Division, Parker Hannifin—reports Australia, Finland and tute award has been completed. Canada women move through discomfort. The gas that nearly 300 hospitals and birthing centers takes 15 to 30 seconds to take effect and now make nitrous oxide available to laboring dissipates in the lungs almost as quickly. mothers. The University of Utah is one of the 80% first hospitals in the state to offer the gas. of laboring women “The best thing about nitrous oxide is that in Norway it allows a new mom to be present without Dr. Loveridge says about a dozen of her pa- THE RESEARCH QUESTION: feeling overtaken by pain,” Dr. Hake adds. tients have chosen to use nitrous during their How does culture impact the way Mexican American and “It gives her a feeling of control over what deliveries. She believes more will consider Euro-American non-Hispanic women make sense of pel- is happening and lets her concentrate on the option as they become aware of it. vic floor support changes after they have a baby? what’s most important—her new baby.” Continued on pg. 38

IMPACT:

Women commonly hear that it takes six weeks after having a baby to heal and get back to normal. But what’s 1881 1930s 1950s “normal”? Some new mothers experience urinary leak- Nitrous oxide first used as U.S. doctors start using More powerful anesthetics age, others have bowel problems, and a few may feel a Nitrous Oxide Marlene Egger a labor analgesic by Polish nitrous oxide in labor and which promise a pain-free bulge or new looseness in their vaginal area. Drs. Clark, PhD Just the Facts physician Stanislav Klikovich delivery delivery (and render mother’s Egger and Sanchez-Birkhead interviewed 90 women, unconscious) replace nitrous half Mexican-American and half Euro-American, many in U.S. hospitals of them first-time mothers. For some, the “parts” work Lauren Clark differently after giving birth. Others said rest would ease PhD, RN, FAAN 2017 2017 2011 1970s things back into place. Still others believed exercise would At the urging of the College of Nursing’s Nearly 300 hospitals and More U.S. hospitals start Epidurals are introduced get their bodies working and strong again. After analysis Ana Sanchez-Birkhead BirthCare HealthCare midwives, birthing centers offer nitrous to offer nitrous to laboring in U.S. hospitals, allowing of the data, the research team hopes to guide cultural- PhD, RN University of Utah Health’s OBES and to reduce pain and anxiety mothers mothers once again to ly-sensitive post-partum advice to mothers. “Ultimately, a Labor and Delivery begins offering remain conscious during smooth recovery is everyone’s goal,” Dr. Clark says. nitrous oxide to laboring mothers medicated births

16 nursing.utah.edu nursing.utah.edu 17 POLICY

THE RESEARCH QUESTION Healthcare Workforce Why are adolescents living in rural areas less likely to re- Utah Lawmakers Invest $2.6M to Prepare Future Nurses ceive the human papillomavirus (HPV) immunization? IMPACT Nursing practice and Mountains of data are preserved in existing immunization records, and Dr. Kepka is utilizing them to full effect. Dig- research are driven by ging into information collected by the National Center for the study of data and Health Statistics and the Utah Department of Health, she and her research team are studying vaccination rates in evidence, but so are Utah, the Intermountain West and the rest of the country nursing education and in an effort to better understand dramatic differences in HPV vaccination rates among survivors of pediatric and workforce policy. adolescent cancer. Over the past two years, Utah Nursing Con- sortium (UNC) members—10 of the state’s “We have a vaccine that prevents cancer,” Dr. Kepka says. nursing schools, including the University of “HPV vaccine should be recommended right along with Utah College of Nursing—applied the same Tdap, meningococcal and flu vaccines.” rigorous standards to a request for additional Deanna Kepka state funding to help prepare dozens more PhD “We want to find out what the contextual factors are to registered nurses each year. these missed opportunities. Why are kids getting all the others but not HPV?” At the end of the 2018 Legislature, the sci- ence-based approach worked. Utah lawmak- ers approved $2.6 million in funding along with a bill that lays out in detail how future funding will be divvied up and tracked. Millner hopes her legislation will help nurs- ing schools respond to those more specific THE RESEARCH QUESTION “This is an evidence-based approach to mak- workforce demands. Are community-based wellness coaches more effective ing decisions about funding nursing institu- at encouraging weight loss and healthy eating among tions,” said State Sen. Ann Millner, a Repub- “We know this will continue to be a need for minority populations? lican from Ogden and previous president of the future,” Dr. Millner said during Senate Weber State University. floor debate in February. “Now, we will have IMPACT a more thorough approach to making good Dr. Millner sponsored the “Nursing Initiative,” decisions when we appropriate funds.” Community Faces of Utah, a loosely-knit group of non- Senate Bill 147, through committees and floor profit organizations, helped identify 500 women in five debate during the 2018 Legislature. The bill With the support of the Utah System of ethnic groups—African-Americans, displaced Africans or sets up a process for determining nursing Higher Education, State Board of Regents refugees, Latinas, Native Americans and Pacific Island- workforce needs throughout the state, based and university presidents, the Consortium’s ers. After a 12-week wellness training program, coaches not only on nursing workforce vacancy num- 10 member schools originally had asked were able to navigate cultural sensitivities around weight bers, but on the types of vacant positions, Dr. for $4.5 million in funding, and pledged to College of Nursing and exercise. The coaches developed relationships with Millner said. graduate 275 new nurses in return. Over the Development the participants that went far beyond taking their blood Board Member course of the 45-day lawmaking session, pressure or measuring their waistlines. And after a year of Teresa Curtis met Sara Simonsen Over recent years, nursing workforce short- however, those figures were whittled away a regularly with coaching, most women met their goal of losing at least PhD, RN age numbers have fluctuated between nearly bit. With $2.6 million in funding, the nursing state lawmakers 5 percent of their total body weight. “The success of our to make the case 1,300 vacant positions in 2015 to just under schools project they can enroll dozens of work really depended on the relationship between the for the workforce 900 empty posts reported in 2017. Most of additional students starting in Fall 2018. initiative. coach and the woman,” says Dr. Simonsen. those jobs are in hospitals, but skilled nursing homes, home care and hospice agencies Still, Utah Nursing Consortium Program and psychiatric facilities also need nurses. Dr. Director Teresa Garrett, DNP, RN, an assis-

18 nursing.utah.edu nursing.utah.edu 19 GIVING tant professor, said the funding lawmakers residency and mentoring programs for new set aside is approximately the same amount graduates, clinical placements, advanced UNC members requested in 2017, and gives nursing education and faculty retirements. Consortium partners a chance to further A Legacy of Generosity expand nursing education opportunities. “It’s a great conversation to have,” added Scholarship Donors Help 1 in 5 College of Nursing And the process established College of Nursing Dean Trish Morton, PhD, with Sen. Millner’s bill will foster RN, FAAN. “Nursing is the largest healthcare Students Complete Their Educations continued discussion of nursing workforce in this state. The health of Utah workforce issues. depends on the health of this workforce.”

“This legislation gives us a really Development Board Co-Chairwoman Karen nice pathway to keep promoting Edson, who met with dozens of lawmak- our work for the next three to five ers over the Consortium’s smoothie snack years, until we get to the funding breaks, says the process of talking about the level we think we need to edu- nursing workforce has made state leaders cate enough nurses to meet the much more aware of the distinct educational state’s needs,” Dr. Garrett said. and training differences between nurses. “Hazel has a heart

Under the new law, the Utah “Legislators now know what a highly pre- of gold willing Nursing Workforce Information pared nurse is,” Ms. Edson said. “I think we’re Center (UNWIC), a service of the on the right track.” to reach out and Utah Medical Education Council benefit those will track which jobs are empty Weber State University School of Nursing and what type of nurses are best Chair Susan Thornock, EdD, RN, agrees. She most in need.” suited to fill them—registered believes Utah’s nursing institutions will have nurses, master’s prepared edu- to focus on providing the best education Utah Nursing Consortium cators or doctoral level practitioners and re- possible to their students. Project Director Teresa searchers. That UNWIC data will guide future Garrett shared policy talk (and smoothies ) with higher education appropriation requests as “As we move forward, we need to look Utah Sen. Jerry Stevenson, well as the outcomes—specific numbers of at our numbers, sharpen our pencils and At her death at the age of 98 last year, Ms. R-Layton. additional graduates—lawmakers expect the examine the quality of each institution,” Dr. Hazel Robertson started Robertson’s estate added another $700,000, state’s nursing schools to document. Thornock said. “The money coming in to bringing the total endowment to more us in the future is going to be based on the giving to the University than $1.6 million. Over the years, dozens of Dr. Garrett believes the legislation will ac- quality of the education provided. We need of Utah College of College of Nursing students have received tually help consortium members talk about to keep the Consortium a strong force in Robertson scholarships. difficult nursing education and workforce -is our state. That’s critical.” Nursing gradually. sues with lawmakers—including the need for In 1998, she set aside $10,000 to establish a While Ms. Robertson’s gift is larger than scholarship endowment named after herself most, annual scholarship donations to the and her husband—the Jack R. and Hazel M. college start as small as $1 or $5. Each year, Robertson Scholarship Fund. about $1 million in individual donations and Baseline Annual New Baseline USHE Funding interest accrues in endowments established School Enrollment AY2022 Annual Enrollment Request TOTAL “Since I always wanted to be a nurse, this to generate ongoing funding for student GROWTH Utah 128 32 160 1,750,000 was my choice for a little help to others who scholarships. During the 2017-2018 school UVU 100 20 120 272800 qualify and are willing to serve,” Ms. Robert- year, the college awarded just over $1 million 2018-2021 son wrote at the time, in perfect penmanship for student traineeships and undergraduate SUU 60 12 72 200,000 275 and on delicate stationery. and graduate scholarships. More than 130 Enrollment STUDENTS Growth Snow 40 10 50 300,000 students received some form of stipend. USU 81 87 168 1,110,000 Originally, she planned on giving $10,000 a Proposal year. But in January 1999, she followed up For some scholarship donors, the motivation Dixie State 80 16 96 275,000 with $40,000. The next June, she added a to help other students is broad. Others target 20% SLCC 180 40 220 315,000 $30,000 gift. By 2013, the Robertson schol- their support to particular specialties. Some GROWTH IN 4 YEARS Weber 343 60 403 328,400 arship fund had more than $360,000 in it. give to honor family members. Total 1,012 277 1,289 4,551,200 nursing.utah.edu 21 ALUMNI Longtime Development Board and Advisory University in 1980, then received a Master’s Council member Carl Laurella and former in Nursing Administration from the Universi- Nursing Early Assurance Program (NEAP) ty of Utah in 1986, and a PhD in 1996. “Our Director and Alumni Board member Vanes- education has been the catalyst to provide us Dare to Care Award Winner sa Laurella, PhD, RN, have supported the with great opportunities in our lives.” A Leader Emerges from Controversy with a Mission Carl and Vanessa Laurella, college over many years—including spon- PhD, RN, longtime soring NEAP students at Honors for Nursing, Although he has limited connections to nurs- supporters of the College renovating the third-floor reception area, and ing, Mark Griswold was inspired to give after Alex Wubbels is uncomfortable of Nursing, have established an endowed scholarship in establishing the endowed Vanessa Brown a family tragedy. The owner of an electrical with all the attention. her mother’s name. Laurella Pathfinder Scholarship to support company in Huntington Beach decided to establish a scholarship at the college on be- Nearly a year after body camera footage half of his niece, who lost her pre-term son, went viral of her being handcuffed and Henry Barraclough, at 19 weeks’ gestation shoved into a police cruiser by a Salt Lake after suffering a placental abruption and un- City detective when she resisted his de- dergoing an emergency Caesarean section in mand for a blood test from her unconscious April 2017 while living in Italy. patient, Ms. Wubbels still is a slightly uneasy role model. “For some reason, it just touched my soul,” Mr. Griswold says. “As a dad, as a grand-dad, She believes she did what any nurse would as a man, when you can’t fix something, have done to protect her unconscious pa- when it’s immediately in front of you, I tend tient from an invasive blood draw. And she to drive this way. This is where the rubber hits would do it again. But the reverberations the road for me: Maybe we can save some- of that day in July of 2017—both good and one from losing another child this way.” bad—have been persistent and more painful than she anticipated. Mr. Griswold’s daughter Natalie will graduate from the University of Utah in 2018 with a “In some ways, doing what I did that day was master’s degree in science and public health. the easy part. It’s been everything since then that’s been really hard,” Ms. Wubbels says. TOTAL IN SCHOLARSHIP Over time, Mr. and Mrs. Robertson were $1.1 M FUNDING DISPERSED benefactors in many areas at the Universi- So she’s taken a break from work, from Face- ty of Utah, with endowed scholarships for book, from email. She’s working on an article Those efforts on behalf of other nurses and Alex Wubbels, RN, received Bridging the Department of Orthopaedics and the the Dare to Care Award STUDENTS for publication in a nursing journal. And she’s the public have earned her the 2018 Honors 134 College of Health’s Physical Therapy Division. at the 2018 Honors for the Gap on a speaking tour of sorts—to the Graduate for Nursing Dare to Care Award, which is se- They established endowed chairs in Ortho- Nursing for her advocacy 25 PHD (7 Jonas Scholars) Nursing Student Academy (GNSA) in Atlan- lected each year by the Alumni Board of the of patient and nurse safety. 2017-2018 paedics, at the John A. Moran Eye Center ta in February, to the American Association University of Utah College of Nursing. 55 DNP (3 Jonas Scholars) and Huntsman Cancer Institute. School of Critical-Care Nurses (AACN) in Boston in May, and at many places in between. She “There’s no road map,” she says. “We all have Year 4 MASTER’S But nursing was personal for Ms. Robertson. never turns down the chance to speak to a fear of failure. And I can’t let this fail. It’s not 41 UNDERGRAD Utah students. It’s a responsibility built into about me. It’s about nursing as a profession “Hazel has a heart of gold willing to reach the mantle of leadership draped over her and patient safety. There’s just so much more out and benefit those most in need,” Ms. shoulders by circumstances and by choice. than me that this is about.” Robertson’s 1999 gift agreement with the college states. first-generation college students in nurs- Ms. Wubbels settled with the Salt Lake City As a member of the U.S. Olympic Ski Team, ing. (The Ophelia Flores Laurella Pathfinder Police Department and the University of Utah Ms. Wubbels has felt similar pressure before. “She had a desire to become a nurse herself, Scholarship for first-generation students in Department of Public Services for $500,000 A native of Colorado, she moved to Utah as but because of financial limitations facing the College of Humanities is named in honor last fall, and promptly made donations to the a teenager to join Rowland Hall St. Marks’ ski her, she was unable to do so. She helped and of Mr. Laurella’s mother.) Utah Nurses Association (UNA), the American program. After competing for the U.S., she cared for family. She is now able to help oth- Nurses Association (ANA) and the American enrolled at the University of Utah College of ers receive that nursing education that she so “At the core, it’s because we both are Association of Critical-Care Nurses (AACN). At Nursing and graduated in 2009. The Olympics, desired to have.” first-generation college graduates,” says Dr. the same time, she established a fund to help she says, were an individual sport. This time, Laurella, who graduated from Idaho State others gain access to body camera footage. she feels pressure for a worldwide “team.”

22 nursing.utah.edu nursing.utah.edu 23 ALUMNI

“I feel like I need to keep the momentum go- “Nurse Wubbels did everything right,” Dr. Ci- HALF CENTURY ing for the benefit of our profession,” she says. priano says. “It is imperative that law enforce- ment and nursing professionals respect each College of Nursing Dean Trish Morton, PhD, other and resolve conflicts through dialogue The first 30 Half Century RN, says Ms. Wubbels has a unique ability and due process.” Society inductees--members of the College of Nursing to connect with staff nurses. At the GNSA classes of 1947 through conference, audience members waited 45 During the 2018 Utah Legislature, lawmakers 1967--gathered during minutes to speak to her and take selfies. tweaked the state’s patient consent law in Alumni Weekend 2017. response to questions raised after the July 26 “She has a wonderful opportunity to be a incident. Ms. Wubbels figures the only way to leader of nursing and advocate for the pro- keep the issue at the forefront of the public’s fession and for individual nurses,” Dr. Morton mind and change policy so what happened says. “She has no idea of her impact, but by to her never happens again is to keep talking telling nurses they would have done the same about it.

“I want to make sure

The college’s first Alumni Weekend gathering with graduates, their families and friends started this never in 2017 with a new Half Century Society for members of the classes of 1947 through 1967; the first Young Alumni Award; a reunion for all the classes on the “Sevens;” and the unveiling of the happens Faces of Nursing mural. Each year, another class of graduates will be inducted into the alumni society. And in 2023, the again.” college will celebrate its 75th Anniversary.

thing she did, she reinforces all the clinical “This is the culture of nursing,” she says. “Our LISTEN and ethical values they learned in school and most important job is to protect our patient.” IntroducinA NEW PROGRAM BY THE ALUMNI ASSOCIATION bolsters their sense of professional camarade- rie. She just talks from her heart.” “I want to make sure this never happens Imagine yourself as a new undergraduate student walking again. I was very fortunate to work for an across the stage to accept your first stethoscope. You open American Nurses Association President Pam institution that had a policy. But there are U the box and find a letter from someone who has walked the Cipriano, PhD, RN, says Ms. Wubbels’ exam- a lot of nurses who work for institutions or path before you. LISTEN (Love Infused Stethoscopes To ple has advanced discussions about on-the- companies that don’t have policies to deal Educate Nurses) needs your support! job safety and nurses’ role as advocates for with these kinds of situations. This law just Your donation of $100 will provide a critical tool of nursing as their patients. gives us something to start with.” well as the encouragement that a new student needs for late-night study sessions, an IV stick in the simulation lab and that tough epidemiology class. GIVE NOW For more information contact: [email protected] | 801.581.5109 24 nursing.utah.edu ALUMNI CLASS OF 2007

“It was a marvelous event. It was compassion at its height -- remembering nurses who are no longer practicing.”

Maureen Shipp Glew, Class of 1958

Half Century Society inductees toured the renovated college building, tried out the Simulation Learning Center and listened to speeches from the Distinguished and Young Alumni Award winners. (From top to bottom) Ruth Cleckler, Class of 1965; Donna Nakashima; Dean Trish Morton, PhD, RN, After attending Alumni Weekend events, mem- FAAN; May Farr, Class of 1952; Lu Briggs, bers of the Class of 2007 celebrated their 10-year Class of 1952; Barbara Cooper, Class of reunion with a “tailgate” barbecue at the college 1952; and Joan Scott, Class of 1961. and bowling at the Union Building.

Anmy Mayfield, Debra Jamison, Emily Hardy, Daisy Khuu-Steneck, Lisa Ashton and Amber Pavlovich.

26 nursing.utah.edu nursing.utah.edu 27 ALUMNI ALUMNI DISTINGUISHED ALUMNI AWARD YOUNG ALUMNI AWARD

Kathleen Kaufman might have been a chemist-- The daily degradations of dementia and bent over a lab counter, working on quantitative Alzheimer’s disease take a toll not only on the analysis of plywood adhesive and oil and gas patient, but also their caregiver.

refinement. Founder and CEO of Solstice Home Health, in-home care she watched her Hospice and Palliative Care, Amy Hartman, grandparents receive, Ms. Hart- But she liked people too much. She taught as a clinical nursing instructor for RN, noticed the frustration among her clients man worked for several home 24 years at LDS Hospital and Intermountain a few years ago. In 2015, Ms. Hartman was health and hospice companies. So when a lunchtime conversa- Medical Center. During her career at the pivotal in bringing to Utah the University of Then in 2013, she decided to tion with her chemist colleagues college, Ms. Kaufman was known as a stick- South Carolina’s Dementia Dialogues pro- start her own—Salt Lake City- revealed high dissatisfaction with ler for drilling clinical skills, nursing history gram, a series of training sessions that help based Solstice. their jobs, Ms. Kaufman decided and writing. healthcare workers prepare caregivers for she needed to make a change. their family members’ successive losses of “I’ve always been drawn to the Six years after getting her degree “I’m very interested in the quality of nursing. I cognitive function. idea of creating care that makes in chemistry, she graduated with want nurses to know what they’re doing and a difference in our patients’ ev- another bachelor’s degree in why they’re doing it,” Ms. Kaufman adds. “I “People who are in the throes of caring for a eryday quality of life, health and nursing and never looked back. want them to be very proficient.” parent or spouse give and give,” Ms. Hart- wellness—keeping the geriatric man says. “If you don’t understand why your population healthy and able to Now, nearly 40 years after that Ms. Kaufman is equally dedicated to remind- loved one keeps trying to wander off, or why age in place,” she says. decisive career switch, Ms. ing future nurses of the proud tradition behind they’re becoming aggressive or verbally abu- Kaufman received the Univer- their profession. For years, she dressed as sive, it can tend to devastate relationships. Ms. Hartman is president of the sity of Utah College of Nurs- Florence Nightingale for the college’s biennial Utah Hospice and Palliative Care ing’s 2017 Distinguished Alumni Lamp of Learning ceremonies. Ms. Kaufman “Just understanding what’s happening in Organization and a board mem- Award for her lifetime of work is the unofficial keeper of LDS Hospital’s— their loved one’s brain can help caregivers to ber of the Alzheimer’s Associa- advocating for students, working and the state’s—nursing history, including de-personalize some of what happens in the tion’s Utah Chapter, the state’s nurses and their patients. co-authoring a book, Celebrating the First pathophysiology of the disease,” she adds. Alzheimer’s and Related Dementia Coordi- Amy Hartman, RN, a 100 Years: LDS Hospital, 1905-2005. She has nating Council, and the Utah Association for graduate of the Class Kathleen Kaufman, “Nurses are a vital force in healthcare and we donated an extensive collection of nursing of 2004, received the Ms. Hartman’s work as a nurse entrepreneur Home Care. MS, RN, Class of 1987, need to be heard,” she says. “People have no textbooks and history tomes to the college. college’s inaugural received the College on behalf of those suffering from dementia Young Alumni Award idea what nurses do to ensure they receive of Nursing’s 2017 and their family members has earned her Meanwhile, Dementia Dialogues’ reach during Alumni Distinguished Alumni high quality care and that patients’ rights are “People need to remember that there were Weekend 2017. recognition as the University of Utah College around the state has increased. Alzheimer’s Award in recognition protected. We have a responsibility to share folks who came before them who were really of her long career of Nursing’s first Young Alumni Award winner. State Plan Specialist Lynn Meinor says the the knowledge we have.” pioneers and tremendously brave and very as an educator and first session has expanded under the over- advocate for nurses. creative,” she says. “We’ve had many, many Ms. Hartman grew up in Salt Lake City. sight of the Utah Department of Health. Two The oldest of 10 children, 67-year-old Ms. great leaders.” Her father worked in finance and sales, more annual sessions of the basic knowledge Kaufman grew up on dairy and beef farms in her mother was a business owner. While course have trained more than 50 healthcare rural western Pennsylvania. She studied chem- Throughout her long career teaching future the mother of a young son, she earned an providers and caregivers, including social istry at Grove City College, graduated in 1972, nurses, Ms. Kaufman also was dedicated to associate’s degree in nursing from Salt Lake workers and case managers. A five-county and worked for a few years testing plywood the Utah Nurses Association and its advocacy Community College in 1998 and worked as area in rural southern Utah holds workshops glues and at a secondary refinery. Eventually, for the profession on Utah’s Capitol Hill. an acute care nurse for a few years before weekly. Ms. Meinor says the demand for such she switched to nursing, graduating from the completing the College of Nursing’s RN to BS easily adaptable education programs will University of Maryland in 1978. Her husband While she retired from the College of Nursing program in 2004. only increase as Utah’s population ages. Jack Comeford’s job at Dugway Proving in 2012, State Rep. Raymond Ward, R-Bounti- Ground in Tooele County ultimately drew the ful, says he still expects to see Ms. Kaufman in The same year, she took a job as director of “It’s taken off,” she adds. “I can’t keep up with young family west. Ms. Kaufman enrolled at the halls of the Capitol during lawmaking ses- nursing at a post-acute rehabilitation facili- how many are being taught.” the College of Nursing, graduating with a mas- sions. “She has been tireless in her advocacy,” ty and found her life’s work. Inspired by the ter’s degree in physiological nursing in 1987. Continued on pg. 38

28 nursing.utah.edu nursing.utah.edu 29 ALUMNI FACULTY NEWS FACES OF NURSING FACULTY APPOINTMENTS

Over the decades, portraits from every successive Kristin Cloyes, PhD, RN College of Nursing graduating class were posted Assistant Dean of the PhD Program throughout the building – a tangible tribute to the After many years of teaching in the college’s PhD Program, Dr. Kristin Cloyes now leads the doctoral program. Originally a theatre graduate, Dr. Cloyes received her skilled healthcare providers passing through its Bachelor’s of Science in Nursing from the University of Washington, a certificate in doors each year. women and gender studies, a Master’s of Nursing, and a PhD in Nursing from the University of Washington. She joined the College of Nursing in 2005. Her research But when the college was remodeled in “This installation is about us—nurses—and seeks to better understand the communication and support needs of Lesbian, Gay, 2010, hundreds of photos were sent to be ar- the part we play in our community,” said Bisexual, Transgender, Queer (LGBTQ) caregivers of advanced cancer patients. In chived at Marriott Library, leaving blank walls Brenda Luther, PhD, RN, an associate profes- 2018, Dr. Cloyes was recognized as one of the University of Utah’s Distinguished in their place. The germ of an idea took root sor and alumni board member. “When I meet Teaching Award winners. in the Alumni Board—a mural incorporating my patients, I’m most likely not the first nurse portraits from the 70 years of the college’s they have met. The competence and caring Faces of Nursing donors Joe and Margaret “Pinky” history at the University of Utah. of the nurses before us created the trusting Viland. relationships that we only build upon.” Marla De Jong, PhD, RN, FAAN In the fall of 2017, through a generous Professor and Chair of the Division of Acute and Chronic Care donation from Joe and Margaret “Pinky” Ms. Viland, a graduate from the class of After being on the front lines of transforming patient care within the U.S. armed Viland, the “Faces of Nursing” installation 1984, is glad college alumni can once again forces, Dr. De Jong will be at the forefront of education and research excellence at The Faces of Nursing Mural was unveiled. Hundreds of graduates’ photos return to the building and show their children the College of Nursing. Dr. De Jong--who earned her Bachelor of Science in Nurs- includes more than 2,000 are color-mapped to create an image of the and grandchildren their graduation photos. individual portraits of ing from Grand View College in Des Moines, Iowa in 1988, a MS in Nursing from college’s Florence Nightingale statue. In it, “Nursing meant a lot in my life,” she said. “Ev- College of Nursing alumni, the University of Maryland in 1996, and her PhD from the University of Kentucky in faculty and staff. look for student pictures from the first days eryone who is a nurse should be very proud 2005--served a long career in the U.S. Air Force. She began active duty service in of the college in 1941, all the way through they made it through this hard discipline. I’m 1989 and worked as a critical care nurse, infection control officer and nurse manager the classes of the 2000s. so proud to say I’m a nurse.” at Air Force bases in Nebraska, Texas and Mississippi. In 2006, she deployed to Bagh- dad, Iraq for a 10-month post as program manager overseeing trauma care. More recently, she served in senior leadership positions at the Department of Defense Blast Injury Research Program Coordinating Office, TriService Nursing Research Program, U.S. Air Force School of Aerospace Medicine, and, finally, at the Uniformed Services University Daniel K. Inouye Graduate School of Nursing, where she served as Associ- ate Dean for Research.

Jackie Eaton, PhD Gerontology Interdisciplinary Program (GIP) Director

Sometimes, summer jobs come full circle. During breaks from her theater stud- ies at Brigham Young University, Dr. Jackie Eaton worked as a nursing assistant in assisted living centers talking to older adults about their life experiences. Fast forward a few years and Dr. Eaton has put her background innovating arts-based communication tools to use as the new director of the College of Nursing’s Ger- ontology Interdisciplinary Program (GIP). Dr. Eaton earned her master’s degree in gerontology from the college in 2003 and her PhD in 2016. Her research-based play, “Portrait of a Caregiver, which explores aging and caregiver needs, has been performed throughout Utah.

nursing.utah.edu 31 FACULTY NEWS FACULTY RETIREMENTS Lee Ellington, PhD Robert S. and Beth M. Carter Endowed Chair

Dr. Lee Ellington is a communicator. A clinical psychologist by training, Dr. Elling- Lynn Hollister, MS, RN, Associate Professor ton has focused her 15 years of nationally funded research on health communica- tion—among family members, patients and clinicians. Her work has been critical Longtime College of Nursing Associate Professor Lynn Hollister, MS, RN, retired to identifying gaps in the current health-care system, particularly in supporting in December. In many ways, she was the keeper of the flame. Over a long career informal and family caregivers. As part of her selection for this endowed chair, Dr. in acute care and more than two decades of teaching at the University of Utah, Ellington is leading the college’s Caregiving Initiative, with a focus on transforming Ms. Hollister imbued her students with the values of nursing--patient safety and the healthcare system to fully integrate family caregivers in support of patient care, privacy, inter-disciplinary collaboration, transparency. It was hard to complete the while also sustaining caregiver health. college’s undergraduate program without attending one of her classes. Known for her dry wit and folksy “Lynn-isms/Interventions,” Ms. Hollister earned multiple teaching awards, including the Utah Nurses Association’s Excellence in Clinical Teaching and the University of Utah’s Distinguished Teaching Professor Award.

Lauri Linder, PhD, RN Acute and Chronic Care Division Vice Chair Diane Kiuhara, MS, RN, Assistant Professor With over 20 years of experience as a pediatric oncology nurse, Dr. Lauri Linder Assistant Professor Diane Kiuhara, MS, RN, translated three decades of experience has focused her research on symptom management for children and adolescents at University Hospital to enrich baccalaureate student learning with an emphasis with cancer. With the help of the University of Utah’s nationally recognized Ther- on leadership concepts, nursing across systems and populations, and quality im- apeutic Games and Applications lab (the GApp Lab), she has developed software provement. During 31 years at University Hospital, Ms. Kiuhara worked to develop that helps adolescents self-report symptoms after chemotherapy treatment. She oncology nursing as a specialty and established clinical settings for oncology also is a member of the new Consortium to Study Symptoms in Adolescents with services, resulting in a career-long collaboration with expert hospital nursing staff Cancer (CS2AC). Dr. Linder also received the Association of Pediatric Hematology/ and faculty from the College of Nursing. Those relationships enabled the creation Oncology Nurses (APHON) 2017 Novice Researcher Award. of the inpatient medical, gynecological oncology and bone marrow transplant units at University Hospital, as well as the Infusion Center and 2nd floor clinics at Huntsman Cancer Institute. She joined the College of Nursing faculty in 2007.

Andrea Wallace, PhD, RN Scott Wright, PhD, Associate Professor Health Systems and Community-Based Care Division Vice Chair Associate Professor Scott Wright, PhD, first came to the College of Nursing as a Dr. Andrea Wallace found her way to nursing by way of psychology and organis- research associate in 1987. In the ensuing 30 years, Dr. Wright left his mark on ger- mic biology, and after working in health policy in her native Colorado. In over 15 ontology research, education and clinical practice. With a background in human years working as a nurse scientist, Dr. Wallace has focused her research on devel- development and life course theories, he also taught as an Associate Professor in oping and implementing evidence-based innovations into clinical settings, in par- the Department of Family and Consumer Studies. Dr. Wright coordinated graduate ticular, the quality of chronic disease care for vulnerable patient populations with studies at the university’s Gerontology Center, which was renamed the Center on asthma, diabetes, depression, and chronic back pain in Colorado, North Carolina, Aging and, finally, became the college’s Gerontology Interdisciplinary Program. New Mexico, and Iowa. Since coming to Utah in 2016, she has been engaged in Wright specialized in autism spectrum disorders in adulthood and aging, investi- multiple studies focused on how existing technology can be leveraged to facilitate gating the roles of technology in an aging (post-aging) society and retirement “hot communication among and between healthcare providers, patients and commu- spots” including the Intermountain West. His gerontology courses emphasized nity service providers distance learning.

32 nursing.utah.edu nursing.utah.edu 33 FACULTY NEWS AWARDS

Katherine Supiano | PhD Jennifer Clifton | DNP, RN Daniels Fund Ethics Initiative, Ethics in Education Award University of Utah David Eccles School of Business Appointed member, Juvenile Health Committee National Commission on Correctional Health Care (NCCHC) 2018 Award Winner for Excellence in Psychosocial Research Social Work Hospice & Palliative Care Network (SWHPN)

Valerie Flattes | MS, RN Katherine Sward | PhD, RN, FAAN 2018 Regional Geriatric Nursing Education Award Fellow in the American Academy of Nursing (AAN) Western Institute of Nursing (WIN)

Sara Hart | PhD, RN Ana Sanchez-Birkhead | PhD, RN Daniels Fund Ethics Initiative, Ethics in Education Award 2017 Ildaura Murillo-Rohde Award for Education Excellence University of Utah David Eccles School of Business National Association of Hispanic Nurses

34 nursing.utah.edu nursing.utah.edu 35 FACULTY NEWS

AWARDS Gerontology Interdisciplinary The application process takes two years of evaluation and Program: A “Program of Merit” assessment by AGHE, including “mapping” all gerontology courses. In the end, the College of Nursing’s interdisci- AACN Award: Integrating Nursing colleagues in the University of Utah Health system,” said plinary master’s program was recognized for its academic Education Into a Health System Dean Trish Morton, PhD, RN. “This truly is a group effort Aging is a complex process that involves every system in excellence, support from college leadership and faculty to work more efficiently, collaboratively and innovatively the body. training and rigor, including: within our interdisciplinary teams.” By design, academic health centers are built with siloes— As a result, providing care and support for those who are • Innovative ideas for both program and financial growth independent health education institutions, separated As the healthcare providers often closest to the patient, aging takes a team—nurses, physicians, pharmacists, phys- • A “solid” interdisciplinary gerontology curriculum first from clinics, then from the larger health system and, AACN leaders say, nurses have a unique role to play in ical therapists, nutritionists and social workers. By defini- following AGHE competencies ultimately, from payers and insurance companies. healthcare transformation. tion, educating those caregivers—the study of gerontolo- • Committed relationships with local communities gy—must be interdisciplinary, collaborative and innovative. • Required internship hours that exceed AGHE guidelines Eventually, of course, all the disparate parts have to come “Nurses serve a central role in the management of AHC’s • Outcomes-based assessment of graduates together to provide the best patient care. But breaking down patients and their families,” the Manatt report said. That explains why the College of Nursing’s Gerontology the built-in structural divisions is easier said than done. “Health system leaders should look to nurses to lead and Interdisciplinary Program (GIP) has been recognized as “We appreciate and embrace the vital importance of support prevention and wellness programs, new models one of the best in the country. preparing students to work with and service older adults, In 2016, the American Association of Colleges of Nursing of care delivery, continuity across transitions in care set- and to help students understand the challenges older released a report from Manatt Health, “Advancing Health- tings, and integration with home and community based The Association for Gerontology in Higher Education adults face now and in the future,” Associate Dean of care Transformation: A New Era for Academic Nursing,” services and resources.” (AGHE) named the college’s master’s program one of Academic Programs Barbara Wilson, PhD, RN, wrote in calling for significant changes in the way nurses are inte- 13 “programs of merit” in 2018. The rating is considered the college’s submission. grated into health systems. And in 2017, the University of In a 50-page report, College of Nursing administrators a “stamp of excellence” verifying the program’s quality Utah College of Nursing received AACN’s inaugural “New documented efforts to form strong partnerships within for prospective students and funders, says GIP Director Along with the University of Massachusetts Boston, Ithaca Era Award” as the nursing education institution that has the University of Utah Health system, including a robust Jackie Eaton, PhD. College and Missouri State University, the College of Nurs- made the most strides integrating into a health center. faculty practice, extensive nursing research and interdis- ing’s program maintains the designation through 2022. ciplinary care at system clinics. “This status sets our program apart for its academic rigor “This award recognizes all the hard work of our clini- and collaborative approach,” Dr. Eaton says. cians and academic faculty to work as partners with our

Researcher Project Funding Agency Grant

Kristin Cloyes Cancer Caregivers Interactions With The Hospice Team: Implications For End of National Institutes of Health (NIH) R01 Supplement $100,000 Lee Ellington Life and Bereavement Outcomes

Improving Quality of Obstetric and Neonatal Care Through Mentoring and University of California, San Francisco Susanna Cohen $325,177 Simulation Training: A Collaboration in Bihar and Uttar Pradesh Bill & Melinda Gates Foundation

Lee Ellington Interdisciplinary Training in Cancer, Aging and End-of-Life Care NIH National Institute of Nursing Research (NINR T32) $1,782,880 Kathleen Mooney

Research Deanna Kepka Statewide Assessment of HPV Vaccination Among Childhood Cancer Survivors NIH National Cancer Institute (NCI) $152,000

Grants Telementalhealth: A Promising Approach to Reducing Perinatal Depression in Gwen Latendresse Utah Department of Health $298,458 (2017-2018) Utah’s Rural & Frontier Communities Driving Out Diabetes, A Larry H. Miller Wellness Initiative Michelle Litchman Larry H. and Gail Miller Family Foundation $410,062 Medical Director, Diabetes One Day Education and Care Program

Grief Support Groups for Frontier and Rural Utah: A Pilot Study to Develop and Evaluate Tele-Health Distance Technology to Provide Grief Support and Develop Cambia Health Foundation $127,660 Katherine Supiano the Bereavement Care Professional Workforce in Utah Alzheimer’s Association $149,999

Group Therapy For Dementia Caregivers At Risk For Complicated Grief.

Jia-Wen Guo Personalizing Cancer Pain Care Using Electronic Health Record Data NIH National Institute of Nursing Research (NINR) $286,542

36 nursing.utah.edu nursing.utah.edu 37 Dean Hotspotting Continued from pg. 14 Patricia G. Morton, PhD, RN, FAAN students are really grieving having to say goodbye,” says Dr. Ana Maria Lopez, MD, Associate Vice President for Editor Susan Hall, DNP, RN, assistant professor at the College Health Equity and Inclusion at the University of Utah of Nursing. Health Sciences Center, is enthusiastic about the pro- Rebecca Walsh gram. In many ways, Dr. Lopez says, it flips the way Design And their patients are hoping to connect with another healthcare providers are educated. hotspotting team, says Kay Luther, lead case manager at Wesley Thomas, YUMI Creative Grace Mary Manor. “The homeless population doesn’t “Often how we’re trained is that a medical student has to Photography often access healthcare, or if they do, they do it through be taught be a physician and nurse has to be taught by a one-off, emergency visits. They’re kind of neglected,” Ms. nurse,” she adds. “As a med student, you could learn from Kristan Jacobsen Luther says. “Hotspotting has turned out to be this really a social worker. You could learn from a community health Charlie Ehlert helpful, targeted thing that has helped our clients. Every worker. That is such a rich experience.” single one of our clients could benefit from this.” For the grantors, the initiative is aimed at changing patient College of Nursing College of Nursing The hotspotting program will pick up again in the fall care. And the only way to accomplish that in a meaning- Advisory Council Alumni Board of Directors with eight more teams. For the team of faculty managing ful way is to transform the way students are educated, Beth Cole Melissa Alm the project, the question now is: Where to go from here? says Carla Dieter, EdD, RN, project coordinator with the Annette P. Cumming Matthew Anderson National Center for Interprofessional Practice and Educa- Tim Dee Therese Aschkenase “It’s a labor of love for all of us—having students in the tion. “Are you changing the culture? Is practice changing? Nancy Giles Terese Cracroft real world. It provides better care and understanding for Is it being ingrained in what you do?” Dr. Dieter asks. Robyn Carter Keller Nichole Faught Ranuio the patient,” says Dr. Luptak. “But it is labor-intensive and Carl L. Laurella Teresa Garrett (Co-President) expensive at this level of development. You can’t possibly “It needs to be part of the curriculum. Everyone needs to Frederick Q. Lawson Chris Johnson put every student through this kind of experience—yet. We be able to say, ‘We don’t educate our students any other Norma Matheson Yuri Kubotera don’t have this all figured out. But that certainly is the goal.” way. It’s not voluntary,” she adds. “I don’t think anyone’s Joanne McGillis Vanessa Laurella there yet. That’s why we’re pushing people.” Joyce Rice Deena Lofgren Claire D. Ryberg (Chair) Brenda Luther Gail McGuill College of Nursing Development Innovating Continued from pg. 16 Nanci McLeskey Board Amber Pavlovich “One of the barriers is just lack of knowledge,” she says. health system with putting U of U Health doctors and Alicia Bremer-Wharton Robin Phillips “If people know it’s an option, and a safe option, word of nurse midwives ahead of the curve in Utah. Besides Love- Katherine Broadbent Dianne Stewart (Co-President) mouth will help it to grow.” ridge’s initial work, a second doctoral student helped de- Jane Coats Denise Ward velop the policy and an undergraduate RN to BS student Teresa Curtis Ms. Vest discovered the option after listening to a podcast helped Labor and Delivery staff design and implement Karen Edson (Co-Chair) and asked her midwives to have it available—just in case. education and training programs. Melissa Hansen Ronald Larkin “I would recommend it to anyone who’s planning on go- “This shows how the College of Nursing is able to change Brian Lloyd ing natural, but has things change in the course of labor,” care from an academic perspective,” Dr. Roberts says. Kathie Miller she says. “Our students were at the forefront of transforming and Bonnie Newman updating care every step along the way.” Robyn Rollins-Root Leissa Roberts, DNP, CNM, the college’s associate dean Nancy Ward (Co-Chair) of faculty practice, credits the synergy of an academic Mary Wilkes Short Shannon Wilkes David Wolach Distinguished Alumni Continued from pg. 28 he writes, “and because of that, she has become a strong College of Nursing voice, able to push Utah policy in the direction of compas- sion for patients, to make sure that the voice of nursing is 10 South 2000 East heard and treated with respect by Utah policymakers.” Salt Lake City, UT 84112

38 nursing.utah.edu 10 South 2000 East Salt Lake City, Utah 84112

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