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12-1998 Yale Nurse: Yale School of Nursing Newsletter, December, 1998 Yale University School of Nursing
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Recommended Citation Yale University School of Nursing, "Yale Nurse: Yale School of Nursing Newsletter, December, 1998" (1998). Yale School of Nursing Alumni Newsletters and Magazines. Book 36. http://elischolar.library.yale.edu/ysn_alumninews/36
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Dlstmgu1shrd ncndeuuc, cluucw11, researcher, n11d mmtor, Marjorie Fu11k ·s~ (R), A"ocwtr Professor 111 tl1e Adult Adm11ud Prnclice Nursmg Program (Cnrdiom;w/ar Specwlty), perw11ijie; the "Yale Nurse." Her wrm1t re,cnrch, full,tcd by the Hewlett -Pncknrd Corporal tOll, illvolt,es atrial fibrrlln twu iu pn tiellls rllschnrged after cnrdwc ~~~'~'!'-''Y· Marge h pictured wztlzllt•r former studeuts lrme Stuksl11s '96 (L) 1111d Nn11cy Lorm:e '96 (C). CLINICAL RESEARCH: Building Upon YSN's Tradition of Leadership With this issue of the Yale Nurse we Co-Editors bring news of the research activities Barb.ra Reif of our faculty, students, and alum Kate Stephenson '94 nae/i. You will hear about the ongo ing worl-. of individual scholar inves Contributor tigators, as well as the thoughts of Colleen Shaddox those who facilitate the scholarship of Photo Credits others, notably, Dr. Margaret Grey, Chn' Anderson Associate Dean for Research Affairs, joy Bush and Dr. Ruth McCorkle, Director of Michael Marsland the Center for Excellence in Chronic Others Illness Care. As we advance our research and scholarship agenda, we are particularly mindful of the December, 1998 unique mission of YS , to contribute to better health care for all people. The mission clearly shapes the ways CO NTENTS in which we take up our research and From the Dean...... l scholarly activities. Editors' Corner...... 2 Cntll<'r'llll' L. Grllo" As the fa culty has begun discussion Catherine Gilliss: Leadership Through Change ...... 3 of the mission, goab, and governance structure of our Center for Excellence in Chronic Illness Care, they have given voice to our overriding concern: Ruth McCorkle: A New Model of D•sco,•cry...... 5 that inquiry grow<, from clinical practice and return; to shape improved clinical practices through direct care, program development and implemen l\largaret Grey: A Passion to lmprO\·c Patient Care...... 7 tation, and policy. Th" is e\emplified in the worl-. of Dr. lis h Knobf, who Research at YSN...... 9 regularly cares for women with breast cancer and addresses their symptoms in her research, and b) Dr. Gail Melkus, who regularly cares for women NMP Grads Hold Oi\'erse jobs ..... 1I with non-insulin dependent diabetes and i> studyi ng ways to improve the Yale School of Nursing Opens outcomes of their care. YSN's e>-plicit support of clinical practice among our Office of Research and Policy...... 13 faculty investigators distinguishes us from other schools of nursing. Colleagues in Caru1g Project...... l4 Through the development of our Center for E>.cellence in Chronic Illness In Memonam...... 16 Care the YS community is e\ploring new ways to align ourselves with one The E\ped1tion Nun.e...... 17 another and advance our >cholarship and educational programs in the name AYA News...... 21 of improved health care. Our Center will be offiCially inaugurated at a YS Yale School of ursing Offers Convocation .cheduled for February 2, 1999. Dr. Patricia Benner of the lnterd1>eiphnary Spirituality Univer,ity of California at San Francisco will 1-.eynote this gathering. Dr. and Healing Program...... 22 Benner's worJ.. has addressed skill acquisition in nursing ("From Novice to Y.1le-Chona Nursing Exchange· E'perf') and ha<, rendered visible the formerly invisible work of nursing Then and Now...... 23 that makes a difference to patient care. Given YSN's commitment to patient Gr,1cc Project Update...... 27 care, the selection of Dr. Benner as our speaker is particularly apt. Please l lumor· plan to join us for thi., '>pedal celebration. Is L.1ughter the Best Rx ...... 28 r,,culty \Joles...... 30 Finally, as we approach the holidays, I join the faculty and students in wish Student News...... 3 I mg you and your llwed ones peace and joy now, and throughout the Cia:-,~ '\Jc\\'!>, ...... ):! coming year. ommallon for D"tingu.-hed Alumnae/! Catherine Lynch Gilll'>s Aw<>rd' 1999 ...... J4 Dean and Profc.,sor There have been numerous seminars, guest lectures, and other events takmg place over the Fall, 1998 semester and scheduled for Spring, 1999.
• The Offi ce of Research and Policy has scheduled general research seminars th rough April, 1999:
• September 30, 1998 Recruiting Critically Ill Patients fo r Clinical Research, Marge Funk '84
• October 21 , 1998 Post-hospitaliza tion Referral to Home Care and Sub~equen t Rehospitalization for Medicare Patients with Congesti ve Heart Failure, Cassy Pollack '83
• November 18, 1998 Developing Theory to Explain Mid-life Women's Responses to Illness, Tish Knobf '82
• january 27, 1999 Preventing Peri neal Dermatitis in the Elderly, Courtney Lyder
• February 24, 1999 Developing an Instrument to Screen E'ce~s i ve Psychosocial Sequelae to Genetic Testing for Breast Cancer, jeannie Pasacreta
• April 21, 1999 Increasing Adherence to Antiretroviral Therapy, Ann Williams '81
• The YS Center for Health Policy and Yale- ew Haven Hospital co-spon~o red an Advanced Practice ursing Fo rum on 0\•ember 4, 1998. The discussion centered on, " Politics, Pohcy, and Power: Building a Coalition of C Ms, NPs, CNSs, and other AP s to Add res~ the I s~uc~ that Affect Us and Our Patients."
• Dr. Deanne Messias, Indiana Wesleyan University, visited the Yale campus as part of an in terdisciplinary lecture series sponsored by the Council on Latin American Studies at Ya le. While in New Haven Messias presented a lecture to the YSN community on November 9, 1998 entitled, "Women's Work and Health: Transnational Perspectives of Brazilian Women in the United S t a t e~."
• Ullabeth Larsson, a Swed ish nurse and internationa l scholar who serves as President of the European Council on Cancer Education, visited YSN on November 10, '1998. She joined students and faculty for an informal lunch discussion which addressed her research in ca ncer, research in communica tion, and her work with her own doctoral students.
• On November 18, 1998 YSN held a special reception in honor of a number of young ew Haven artists and their fa milies from the Hill Community whose paintings are currently on display at the School. This exhib it was part of the International Festi val of Arts and Ideas that took place in ew Haven earlier this year and we were fortunate enough to be able to hang some of the works in the School in celebration of this local talent.
Any faculty or staff member at YSt can be contacted by E-mail using the standard format: fi [email protected] u
Please be sure to send any changes of address and/ or telephone numbers to the Student and Alumnae/ i Affa irs Office, P.O. Box 9740, 100 Church Street South, New Haven, CT 06536-07-10. We want to be able to stav in touch with our alumnae/ i! -
Apologies to Donna Mahrenholz who was misidentified as Denise Mahrenholz in the photo on page 23 of the September, 1998 issue of Yale N urse.
2 countrv, not onlv to look at some traditi~nal schoiarlv work with U>, Catherine Gilliss: but abo to worl.. with the faculty around i ~., ues of clinical scholar Leadership Through Change 'hlp, an area where they have always e"elled. The alumnae/ i will be rccei1·ing more information ,1bout these visits. It's my hope that many of them will be able to JOin US. hen people tall.. about and of the college. The Pro1 o.,t .tnd Cathcnnc Gdlt.,,, the word President Lenn arc' cry 'upport Y : How does the research tradi W"cncrg(' come' up lime and i,·e of us. Their ,-ision of Yale i;. to tion here compare with that at our again. A fitting word to connect to have a more integrated whole. sister schools of nursing? this new J ean who 1mmcd1atclv o,et CLG: It b truly unique. YSN's mis about organi;ing more and differ Y : How will tha t integration ~ion b to impr01·e health care ent ways for YSN student-, fuculty, benefit YS ? through preparing leaders in prac and ~ taff to interact with each other CLG: We continue to develop tice, education, and research. What and with their counterpart .,trong relationships with people 111 di.,tinguishcs this school is that it throughout the Un" cro,ity. other discipline;, :,o that we ha1 c doc> focus on health care. The fac Catherine Gill1.,., o,ecm., to be c1 cry interdisciplinary tc,1ms 111 practice ulty have a long history of practice. where at once, '>hak1ng hand ~. and research. We can c~ t end our The re.,earch that they are doing meeting new people, and (mlracu capacity .,igmficantly by buildmg ha:, obl"ious and d irect benefit to lou.,ly) rcmcmbcnng the one'> <, lw'~ bridges with other people through the health care of people. lursing met already. De,m Gil It,,', energy out the Un" c r~1ty. 1., an applied science, and this goe~ far deeper th,m that, ho\\C\ cr ~hool hao, ne1·er lo~t sight of the She b ,,bo po.,.,c.,,cd of,, 1\ealth of Y : You've reached out a good fact that application is at the heart intellectual energy u·., 1\ hat 1-.eep., deal beyond the University as of any mquiry that we make. her doggedly pur<,umg a re~earch well. area that ~he dc<,cribc., '""me~~~ CLG: Yes, we're bringing 111 a num Y : And what about faculty and science." And 1t'' ult imatelv wl;at ber of vi~itor~ th1s year, prommcnt students w ho see themselves as drew her to the \ale School.of nur e researcher~ from MOtmd the cli nicians? ur.,mg, ,, .,chool c~pcncncing c~ponenha l growth 111 1b rc~carch acti\'ities. The dc,,n·~ t<:hl.. will be to foster thi., growth and to guide it in a way that build., upon YSN'~ tradi tion of clinical " holaro,hip.
Dean Gillbs talked with )il/c NIIN' about her p l un~.
YN: What brought you to Yale? CLG: I am drawn to th1' facult1· at thb pomt m lime bccau.,e of the challenges that arc 1mmcd1atcly before them and bcc.1uw of the" a1 the) dc1 eloped their ,tratcgJC plan: \\'e are pOI.,cd to m,1l..c '1g111ficant ~trid eo, forward 111 the .,trcngth and prommcncc of th1., '>(hool, bulldmg on our long e,tab!J.,hed core mb .,lon. It'' a lime m the un11 Cr-lt) ·., hi>ton when Yale 1., particularly mtcn.>.,ted 111 mtcgrating the School ot ursing into the" or!.. and actil ities of the other gradLJ.ttc o,choob Clllltt•mtt'L
3 CLG: Actua ll y, I believe you'd be hard pressed to fi nd anyone in this Catherine Gill iss school who does not see herself or himself as a clinician, no matter BSN: Duke Universi ty how much time the person is spend MSN: The Catholic University of America ing on research. That's an enormous ANP Certificate: University of Rochester piece of who we are here. I remem DNSc: University of Cali fo rnia, San Francisco ber Ann Williams saying, "Even Post-doctoral Fellow: University of California, San Francisco when I'm in my research office, I'm Toward a Scie11ce of Family Nursi11g, Gill iss, et al., Addison-Wesley, 1989, a clinician at heart." just as our cli n American Journal of Nursing Book of the Yea r Award, Pediatric ical root inform our research, our Nursing Book of the Year Awa rd scholarly pursuits should inform Elected Fellow of the American Academy of Nursing, 1995 our work as clinicians. Some faculty Outstanding Nu rse Practitioner Educator, National Organization of may never conduct externally fund Nurse Practitioner Faculties, 1995 ed trials that are experimental in President, National Organization of Nurse Practitioner Faculties, 1995-96 nature. But those faculty should also develop questions and models of care. It's important that we develop clin ica l curiosity in our students, teach them to ask why, teach them YN: What's "messy" about it? are very hard, naturally. But the to evaluate research to aid them in CLG: The instruments are all com decision to come to Yale was easy. the care of patients. Again, we come promised in some way. It's qui te As you know, my husband, Tom, back to the delivery of health care difficult to collect data from the and I arc from Connecticut, and our and how that's accomplished in the fa mily, from the multiple members child ren arc both attending East best interests of our patients. of the family, and then know what Coa~ t colleges. This is a homecom to do with it. Some people ca ll the ing for us. And my father and YN: In your own career, what field "mom sociology," because the brothers arc Yale College graduates, spurred your interest in researc h? tempta tion is to let mom speak for so we were always very much a C LG: I went into a master's pro the whole family. Traditional quan Ya le famil y. As I sa id earlier, this is gram at the University of Rochester titative methods are difficult to a particularly significant time in the to become an ad ult nurse practition employ here, but those are the School's history. We have an oppor er. Through a Robert Wood johnson methods that help you get fu nding tunity to gain even greater promi Foundation fellowship, I was for cl inical trials. So the challenges nence through the support of the encouraged to become cli nica ll y are grea t - on many levels. Yale ad ministration and through curious. Dr. Loretta Ford, who was the exciting and growing body of Dean at Rochester, impressed upon YN: So you' re not just concerned resea rch being done at YSN. We me that we would not move for with conducting research, but have cha llenges, to be sure. We ward in nursing without the ability with changing the ways in which need to work toward greater d iver to conduct sound research and also research may be conducted? sity on the faculty and student lev to document the outcome of our C LG: Ve ry much so. At UCSF, I els. We need to collaborate with practice. taught a doctoral cour eon theo nurses throughout the State and the ries of research methods and the nation to see that our profession YN: Why does your work so often study of the fa mily. I think that gets the resources it needs and the focus on families? extending theoretical thinking is respect it deserves. But we come CLG : I went into doctoral stu dy among the most important activi from suclt a slr011g base. The alum very interested in groups. I wanted ties that takes place in doctoral nae/i I've had the pleasure to meet to focus on the group that most studies. When the course was over, are true leaders in the best trad ition influenced health ca re and health most students said that it was the of the School and the University. care outcomes, and that was the best course they ever took. That's Our students are bright, committed family. ! look at life threatening ill because the classroom was a place people who will take nursing to ness, because that's an event in to think hard. new heights. I became a nurse which the role of the whole family because I wanted to make a d iffer is especially critical. It's a messy sci YN : Was it hard for you to leave a ence in people's lives by bettering ence. It's compelling though, satisfying job, pick up, and move health care. There b nowhere that l because I've always believed that across the country? can better fulfill that ambition than it's important to stud y things CLG: The logistics of closing down Yale School of Nursing. that matter. one house and opening another • 4 nities within the University a nd Ruth McCorkle: within the State to work with fan tastic people. I knew that our focus A New Model of Discovery on policy would also stretch me. YN: How do you see that policy focus playing out in the Center for Excellence in Chronic Ill ness Care? RM: At YSN there is a real empha sis on cl inical research a nd on poli uth McCorkle's varied career for Advancing Care in Serious cy. Frequently having a clinician as in nursing began at a diploma Illness before com ing to YSN to a principal in vestigator will help us Rschool and in cludes service in found the Center for Excellence in to create a new level of knowledge Vieh1 am as an Air Force nurse and Chronic Illness Care and to chair discovery tha t will have more work co-founding Hospice of the doctoral program. promise for its application. In nurs Seattle. After beginning in ing research we have some stellar med/surg, she chose to specialize YN: Why leave an established accomplishments, but w here we've in oncology in order to get more Center to start a n ew one? failed is in the dissemination and sustained patient contact. Ru th was RM : I'm a person who doesn't like the application of those accomplish the first research chair of the to achieve things a nd then ride on ments. Maki ng policy the overarch Oncology Nursing Society and has them. 1\·e got to be constantly ing framework - it 's brilliant. It done landmark work in cancer achieving and striving. I also will allow us to create a new trans nursing, education, a nd cancer con believe tha t you have to work with lational model. We hope that it's trol re~ea rc h. She directed the people smarter tha n yourself who going to jump start practice in a University of Pennsylvania's Center stretch you, and I ~aw the opportu- ne\v \vay.
Ruth AlrCorklc (C) «•tth YS.\Ifnmlt•tmembers Alartlm S
5 YN: What directi on do you see research at the Center taking? Ruth McCorkle RM: We are going to explore care in HIV I AIDS, cancer, cardiovascular Diploma: Maryland General Hosp ital disease, and d iabetes, which will BS: University of Ma ryland give us d iscreet populations to MA: University of Iowa stud y. Our focus, however, won't be PhD: University of Iowa on disease. We are interested in Elected Fellow of the American Academy of Nursing, 1979 how all these areas overlap. For Elected to Institu te of Medicine, National Academy of Sciences, 1990 lack of a better term, we'll be look ANA Nurse Scientist of the Yea r, 1993 ing at the experience of chronic ill Oncology Nursing Society Distinguished Researcher Award, 1994 ness, questions about function and about family. Again, our clinical ori entation allows us to look at these questions in a unique way. you go into that a bit? said, "Good luck." I appreciated YN: What will the makeup of the RM: Yes, I maintained a prac tice that human connection. On the center look like? unti l 1990, when I was d iagnosed other hand, there was nobody in RM: This is going to be a multidis wi th breast cancer. It was hard to the clinic that explained simple ciplinary tea m of researchers that see patients going through things li ke where to put lab slips. It draws on the strengths of Yale chemotherapy and natura ll y associ was confusing, and I had plenty on Univers ity. By co llaborating with ating that with myself. I needed to my mind alread y. I began to see Med icine, Public Health, and other step back from it, and so shifted to what we could do to help patients areas, we'll be able to demonstrate full -time research and teaching, get through the experience. how the whole becomes greater although I have started to get than the sum of the parts in health involved clinica lly again. YN: And you're in a position to care. Of course, we will have an pass that insight along. emphasis on scholars who are also I remember I'd sort of taken offense RM: What I'm doing now is ed ucat clinicians. l also believe that it's a few years earlier when I read ing the next generation of nurse very im portant to have a health Gilda Radner's book about her researchers. I'm responsible for nur· care consumer on board. There will experience with ovarian ca ncer. She turing and developing the best p ro be opportunities for pre- and post said that people reall y could n't gram to do that and for developing doctoral fellows, as well as students help you unless they'd been there the best Center in the country so in the master's program, to collabo themselves. It negated so much of that they will get the best training. rate with us. what I'd tried to d o in nursing. Bu t There is a real opportuni ty here to when I was treated in my own clin change the way we approach ca ring YN: You talk about approaching ic, I began to see thin gs di fferently. for people with chronic illness and prob lems like a clinician. Of I really appreciated it when the how the public views nursing and course, you've stopped seeing woman fillin g out the papers for its role in that care. patients on a regular basis. Can my mammogram looked at me and •
Friends of NINR
Over 600 guests from all over the Donna Shalala, was guest speaker graduates. The YSN group United States attended the and recipient of the 5th Anniversary included Doris Bloch '54, Friend s of NINR (National Commemorative Award. YSN host Margaret Cushman '76, Dean Institute of Nursing Research) ed a table and took the opportunity Catherine Gill iss, Margaret Grey banquet held in Washington, DC to highlight Catherine Gilliss's '76, Judy Krauss '70, Luc Pelletier on Sep tember 16, 1998. Secretary appointment as Dean and to intro '82, Cassy Pollack '83, and Lisa of Health and Human Services, d uce her to some of the DC area Summers '83.
6 Y :The stepping up of the research effort at YS N is very Margaret Grey: A Passion apparent, both in activity and dol la rs. What kinds of things are you doing to spur that growth? to Improve Patient Care MG: We're doing a number of thmg~. mcluding creating opportu mtic'> for people to worl.. together around compatible interests. I'm pro' 1ding a lot of consultath·e scr ' ICC~. lil..e reading drafts of grants O\ er and O\'Cr again. The research ., w mner of the 1998 Applied 1960s who came up with the 1dca offi ce is abo offering support ser- Nur>mg Re;,earch Award, that practice could dri\ e theory in ' 1ccs that faculty require to do AMargaret Grey i'> a naltona ll y the way tha t re;earch dri\'C> theory. research work Of course, the recogni/ed '>C holar. What b perhap' We\·e built the doctoral program School is also looking ahead to find not na tionally known b that on that tradition. out where the holes are in our Margaret al<,o maintain' a practice rc;carch capabi lities. Research is w here ; he provide., care for youths One is much more lil..ely to find certainly a priority in recruiting fac with Type I diabelc'>. After 'eemg elsewhere that a rc.,carchcr formu ulty. the fin.t doctoral ' tudenl<, graduate lates a question and a methodology last May from the DNSc program mrd then forms a partner<,h1p w1th a Y : The climate of research ,he establi,hcd at Yale, Margan~! clinician. At Ya le, the problem' throughout the University must ha' turned over the management of come directly from the prachcc, '>O help. the doctoral program to Ruth they're not "i,·ory tower," C'>Olcnc MG: One of the major reasons that McCorl..le. A., A'>'>OC iale Dean for questions. I came bad. here is the recepti,·e Rc.,earch Affair.,, '>Ill' '>pend' an nc~; to doing research collabora- in crca~mg amount of her lime help Y : Does that affect the way that ll\ ely, particularly with colleagues ing other faculty to de\ elop their the findings are applied? at the School of Medicine. There is O\vn research Cil recr~. MG: Absolutely. In d~>semmaltng , a recognition by faculty that the we ha\'e a commitment to go bacl.. chmca l problems we are dealing Y : Do you find it difficult bal to that clinical base with our find Wi th arc bigger than any one of our ancing your roles as clinician and ings, not just to traditional rc;carch dbCiplines. Ri ght now I'm working researcher? meetings. I find that the work we with colleagues from the School of MG: That'; the whole point: I do do resonates with clinician; in a Medicine and Main Campus on a research lwmus(' I ha' c a practice. I way that it wouldn't if the que; project to prevent obesity in adoles practice to !..now what's going on tions were more esoteric. I hear cent girb. In many institutions, with my patients and to ch,mge the things like, ''I'm so glad yotr stud these kinds of opportuni ties arc way tha t care is deli' ered. It's ju; t ied this. I didn't know how to go really hard to pull off. That project like a busy marri,lgc. My pr,lctice about looking at it." is also going to include community- ma l..cs my teaching real, and my research energi/e'> C\ erything I do.
Y : We talk quite a bit at YSN about clinical research. But other schools of nursing will say that Margaret Grey they' re part of that tradition as well. What makes Yale d ifferent? BSN: University of Pitt; burgh MG: Other ..chool., do clinical MS : Ya le School of ursmg re-earch, but on!\· recent!\ ha' e DrPH: Columbia Unl\·ers1ty they engaged th~ nohon ~f the Elected Fellow of American Academy of ursing, 1990 re.,earcher a'> chn1cian We ha\ e the Distinguished Fellow, ational Association of Pediatric urse Associates longer hi'>ton Rheta ugh Dumas and urse Practitioners, 1990 '61 p1t111ecred the 1dca ol cliniCal Distinguished Alumna Award, YS , 1991 re,carch when -.he wa., at 'Yale \o\e Applied Nursing Research Award, A A, 1998 ah.o had a te,lm of '>ociologi.,ts, Dicl..off and }ame'>, on (,,n!lty 111 the
7 ba,ed organi/ations. We have good thrilled to have he r. She'; making a a.., cil mCian<,. In some places, people relationships with ; trong communi real contribution. IIJ...e that would begin doctoral ty prm ider; li ke Hill He,1lth Center 'tud1 a' 1f the1 were an emptr and Fair I Iaven Health Center. It's Y : Does the tradition of clinical slate: And the\ certain!\ wouldn't not just us "coming down from the ly-based research you describe h aH~ man\ fa~ul t 1 the\; could looJ... ivory tower;" 1t's a real partnership. influence the doctoral program? to as role ~1odeb .' I'm );, ing proof Right now we ha1 e a doctoral stu MG: Our doctoral program a ttrach that vou do not ha1·e to g11 e up dent, Carmen Adams '00 CD Sc), students who arc eli moan<., who praciiCe to do re~arch. doing work with Latina~ at Fair want to do research ba..,ed on clml Haven He.1lth Center, and the) ,ue cal practice and build on the1r <,kill' •
Mnrgnrct Gre~
8 betc~ IS treated. The study found that mtensh·e interventions- typi callv the use of an insulin pump or muitiple injections daily, as well as four or more daily blood tests - reduced long term complications. Desp1te the widespread adoption of faculty continue to distinguish themseh·es by their abili thts regimen, managing diabetes in ty to conduct research with dramatic ram ifications for adolescents remains difficult. The clmical practice. Three recent examples of the e~ ce ll e nt biological changes of adolescence work YSN ha~ done in this area are: Associate Dean for Research make e'en those without diabetes Affa irs Margaret Grey"s work with adolescents with Type 1 di abe te~. rt!<,~Stant to insulin. These biological Associate Professor Jeannie Pasacreta's exploration of the psychosocial issues are compounded by psy ramifications of genetic testing for breast cancer susceptibility, and chosocia I ones. Associate Professor Susan Cohen's research on alternative therapies for menopausal symptoms. Whi le the conditions that the research address A;, Grey puts it, "Teenagers in par es are varied, these nurse scholars are all e"ploring inter ventions that ticulM arc difficul t because they're empower patients to make choices about managing thei r own hea lt h, teenagers." Factors ranging from and so e'emplify Yale', vision of nursing and nursing research. resentment of parental control over 'cheduling injections, to fea r of appearing strange in front of their Teaching patients to cope with friends can prevent adolescents diabetes and with adolescence from takmg the necessary step to manage their diabetes, she said. A team of Yale rc.,earchcr<, led b\ Margaret Grey '76 found that · Helping women deal with disq ui teaching copmg ''-'11' to ,,dole
9 announcement that tamoxifen, pre tive information available about the Cohen i-. current!\· on research viously used to treat breast cancer, efficacy and even the safety of these leaH? to conduct a' ~ tudy of actually lowered the breast ca ncer therapies. acupunc t ure'~ effec ti \·ene~s in rate 45 percent among high ris l-. rehc\·mg menopausal symptomo., in women in a clinical trial. 'Thi; gives Susan M. Cohen, Director of YSN's breast cancer sun·i,·ors. Though women more moti va tion to go Adult urse Practitioner Program, stud1es ha\ e confirmed acupunc through genetic testing," ; he s.1id . is undertaking studies to e'plore ture''> utility 111 pain relief, Cohen " Prior to the tamo,ifen trial, the two al ternati\·e therap1es sa1d that more im estigation must only option open to women who acupuncture and the herb blacl-. be done to determine what sites found that they had a brea;t cancer cohosh. Cohen's research ha., been g l\ e relief for menopausal symp susceptibility gene was to undergo guided not by a particular intere'>t toms and how many treatments arc p rophylactic ma; tcctomy and / or in alternati,·e medicine, but by her neces-.ar) to see a benefit. oopherectomy:· Pasacreta cautioned interest in women's health. that an incrca;ed demand for genet "Women have been told, 'Tal-.e your ic testing could motivate industry to estrogen: but they are clea rly not market that service strictl y-for-prof comfortable doing that," said it, without providi ng the counseling Cohen. that women need. "The concern ini tially was that it could be marketed While estrogen can prevent o;teo like a home pregnancy test," sa id porosis and help relieve hot nashe; Pasacreta. The tests for breast cancer and other discomforts ,;,sociated susceptibility genes often do not with menopause, there is also a yield clear-cut results, she explained. suspected relationship between the Without a detailed e'amination of a hormone in its pre»eription form woman's fami ly hb tory and associ and breast cancer. While most ated counseling and educa tion, it is physicians will prescribe e;trogen difficult to determine who should be for menopausal women, le~; than tested . half these women will fill the.r pre scriptions, said Cohen. Within a year, some studies show, only 20 percent of the women for whom estrogen was prescribed will be s,..,, M Coheu taking the hormone. Menopause is a natural process, Some women turn to herbal thera said Cohen, and not all women pies. But Cohen caution; that any want or need interventions to con one can call herself or himself an trol ib symptoms. But the baby "herbalist." Great claims ca n be boomers entering menopause do made by herbalists and the popular fa ce challenges that their mothers press, as is the case of St. John's did not. "If you have a hot nash in Wort, touted as "Natu re'; Prozac," the middle of an important busine>s a safe, non-prescription anti meeting, it may be a much bigger depressant. "St. John's Wort is a deal than if you hm·e one while bad choice for people with severe you're doing the laundry," she clinical depression," sa1d Cohen. explained. In a culture that routine "We need more good, scientific ly mediCates headaches and colds, studies on herbal therapies." the demand for inten·entions }t'allmt' Pn"'llcrt'ln around menopause is predictable, Cohen has already wor!..ed w1th a Cohen added. 'This is the first gen Giving women the alternatives graduate student on an encourag eration of women who ha,·e been they want ing pilot study of b lacl-. cohosh and able to control their fertil it\':· she plans a larger study of the herb\ noted. "Today's menopau~1l Menopausal women who fear the effectiveness controlling hot na~h women e'-pl'CI to ha\·e more control ill effects of prescription estrogen es. The herb has been used for at m cr their bodies than their mother~ are presented wi th myriad altern,l least 300 years for the relief of did. I'd 111-.c to be able to offer thc'e tive therapies to manage their "women's complaints" and is women alternati\ es that arc well symptoms, but there is little objec- native to the eastern United State;. tested," ;a1d Cohen. •
10 NMP Grads Hold Diverse Jobs
Bv Donna 1\ 1. ~ l ahrenholz, R.\!, PhD, Case Management Department of school of nursing. After spending Director, ur~ing ~ l anagement and Danbury Hospital, Danbury, CT. the first year post graduation in a Policy Program, YS, She feels that the course~ in health home care agency, Fran Gwinnell policy, legal is;ues, and knowledge 1s now a nurse manager in a pri- of home care practice and policy ' ate-duty nursing agency that pro The objective of the Nursmg have been very beneficial in her vides high-tech sen ·ices such as tra Management and Poltcy Program is current po;ition. Thb past summer cheostomy care and ventilator care. to prepare nur~e~ to mtegrate con Lea Ayers was in transition from Beth Lad a is working as a Senior cepts, knowledge, and skills of her first job after graduation to a Associate with CurranCare, a management and policy for posi new one in another state. She had nurse-owned consulting company tions of leadership aero~; delivery been working as an adminb trator based in Chicago. TI1is summer she settings. The program b designed of a nurse-owned ; taffing agency in wa~ working with a hospital-based to provide didactic and practica l Ma achusetts. In the time Le,, had home ca re agency helping the e'pericnces in management .111d been with the agency, staffing agency become profitable while policy. Student ~ arc required to take demands changed dramatically delivering ca re across the continu a set of core co ur -.c~ and then are with home care subcontracting for um. She feel> that her e'perience at able to select e•ght credit; of elec nur;e; and aide; C\'aporallng. She '\ S prepared her for her position, tives to augment their s l..tlls and noted an increase in requc'ts for e~pcctally the courses in the Home knowledge 111 .ueas of their chotec. pri\·ate sen ice ~taffing, but a stable Care and Community Health Thb allows the ind1vidual ;tudent level of use for long-term staff She Management and Policy track. to gain the s l..ill ~ and !-.now ledge and her husband relocated to a Mariette McCourt is working as needed for future leadership role; ; mall town in New Hamp,h•re ~ t aff to the Connecticut Medicaid of his or her choo,mg. The ma;tery where she is current!} worl-.mg a, a 1\ lanaged Care Council in Hart ford, of these ad\ anced conceptual skills part-time instructor in a unl\ erst!) CT. She frequently sees YS is necessary to articulate the prob lems, solutiom,, goal'>, and -.trate gies of the deli\ cry of health care.
The ursing Management and Policy Program's roots are in for mer YS programs and specialities, such as the community health clini cal specialist program and nursing systems. The first graduate of the program in its current iteration was Carol Ann Wetmore in 199-1 . Carol Ann is employed as,, Parh1crsh1p !\tanager at Q,ford Health Plans in Connecticut and continues to work part-hme as an mstructor m the pediatnc rotation of YS. ·~ Graduate Entr) Program m Nur-.ing.
A sun ey wa' '>Cnt out th.- past summer to all graduates of the pro gram to determme current employ ment. Five 1996 graduates returned the ;un C). Crystal Ahn b \\ orl..ing as a clinical c.1se coordm.Hor in the Atteudmg tlte Apn/ rt•crplrou !IWI' Fmu Cu•u.el/ ·9611..) nwl Mant'lte McCourt ·96.
II A receptio11 ho11ori11g 1998 grnrluntt•s wns held i11 April, 1998. Pnst program grnduntes were i11 11ited to ntte11d. (L to R) Moirn O'Neill '98, Nn11cy TrnClf '98. n11d Jmrc Regmr '98.
Assistant Professor Sally S. Cohen the Connecticut Nurses' Association various stages of their careers. '80 and the current students when as Director of Region 3 and in the Moira O'Neill, after taki ng the they travel to Hartford on field Delta Mu Chapter of Sigma Theta summer off, has been interviewing trips. This fa ll I had a conversation Tau . She feels that YSN increased for a wide range of jobs. As this with CT State Senator Toni Harp, her ability to use data and informa article goes to press, she is in final Co-chair of the Public Hea lth tion in decision-making and manag negotiation with an agency. j ane Committee, who was most compli ing. She states that the most inter Regan has been working wi th mentary about Mariette's work. esting aspect of her work is with Paula Milone-Nuzzo at YSN assist Senator Harp stated that she hoped committees and the work needed to ing two Chinese nurses learn more more nurses would follow in implement changes, while the most about management and home Mariette's footsteps! reward ing aspect is when she is health. jane will go to China as a able to recognize the high perfor Chia Fellow ea rly in 1999 to learn Members of the Class of 1997 are mances deli vered by her staff. more about nursing in China. She now in their second year post grad Brooke Karlsen is the Associate also is working with Paula on a uation. At the time she returned her Di rector of Materials Management survey for the Department of questionnaire, Susan Brink was and Purchasing at YNHH. This Public Health that is looking at working as a senior systems analyst position enables her to work with VNA well-baby clinics. Nancy at the Hospital of Sa int Raphael in clinicians to standard ize products Tracy is a clinical supervisor in a New Haven. She assists in the and reduce unnecessary expense in home care agency here in analysis of hospital workfl ow purchase of supplies, equipment, Connecticut. processes in a team with other hos and services. She feels her elective pital personnel in order to create courses at the Department of As these brief snapshots indicate, clinical system changes. She feels Epidemiology and Public Health Nursing Management and Policy that the information and knowl and the School of Management, graduates are prepared for a wide edge she gained from the group plus the acquisitio n of written and variety of positions in many differ project course and the Uses of Data oral presentation s kills along with ent settings. For more information in Decision-Making course have working and analy zing data, are about the program, contact Donna helped her in the positions she has very helpful in her current job. At M. Mahrenholz, Program Di rector, held. Cindy Czaplinski is the the time of the survey Irene at (203)737-5391 or e-mail her at Nurse Manager of the Nursing Markham was a d irector of nursing [email protected]. Resource Pool at Yale-New Haven at a long-term care facility. Hosp ital (YNHH). She is active in This past year's graduates are in • 12 Yale School of Nursing Opens Office of Research and Policy
YS. ha~ offictally opened its Office faculty members offer testimony at cardiovascular, and d iabetes care of Re~earch and Polte), marking the the ~ta te and federal level on issue; by drawing upon the e'pertise of School's enhanced emphasis on of heal th care and nursing practice. the YS fac ulty and the Yale facul rc~ea rch to compliment its long The Center also sponsors forums ty at large. .,tanding tradition of clinical c'cel linking research and policy on ~u ch lence. topics as managed ca re. "Yale School of ursing has assem bled a trulr eminent team of nurse The Office of Rc.,earch and Polic} YSN is de\ elopmg a Center for researcher~ ." said YS Dean wtll facilitate the .,cholar;,hip of the hcellence 111 Chronic Illness Care, Catherine Gill iss. "I am proud of YS facu lty and community, offer under the direction of noted cancer their schola rl y work, for its e'Cel ing administrative ~upport and researcher Ruth McCorkle, who lence and insight and for its clear consultation ;crvicc; in grant devel also direct;, YSN's doctoral pro potential to reform policy and opment and management, writing, gram. The fir<.t of several planned practice. It delights me that our ;.ta tistical analyse;, and database centers for e"ellence at YS:-.J, it \nil students can benefit from their management and development. The advance re.,earch 111 AIDS, cancer, mentorship." • office is headed by A~socia te Dean for Research Affai r~ Margaret Grey '76, who is also Ya l e'~ Figure I: YSN Extramural Research Independence Foundahon Profe~~o r of ur~tng . In addition to Grants Activity, 1993-1998 encouraging schoiMshtp through 25 .------out the YS community, Margaret
will continue her own widely rec 20 +------~r- ognized research on the adaptation . 93·94 of children and their fa milies to 15 +------· 94-95 chronic illness. " n1e ~ tated mis~ ion .95-96 of this ~chool has never changed; 10 t----c- 0 96-97 we want to contnbute to better . 97-98 health care for all people," said 5 Margaret. " Research and scholar 0 ship, because their impact is so NIH broad, offer our faculty and stu Other Funded dents a wonderful opportunity to \\'Or!-- toward that goal. As our 1997 -1998= I 0 months re;.earch and ~cholarship are tran., lated into policy and practice, we not only ad,·ance the health of our Figure 2: Growth in Research Dollars own patients, we advance health (In thousands) care itself." 2500 .------
The Office of Rc.,eMch and Policv 2000 ------..r------r--- • 93-94 includes The Center for Health · LJ 94-95 Polte}, dtrected by Sally S. Cohen 1~0 .----~~----==----- '80, Assistant Profcs-,or. The Center sen es as the foc,11 point for policy d~<,cu~sions withtn the School of 500 'lur-.ng and factlttates hnl--age 0 among clinical nur.,mg practice, Total Total NIH re.,earch, and pohc\ Lnder the atl', Total Dollars lndirects ptce' of the Center, Sally and other
13 Colleagues in Caring Project
By Donna M. Mahrenholz, RN, PhD, sons representing various profes order to collect data that the} detcr Director, ursing Management sional and special interests group~ mmcd to be important to the de\ el and Policy Program, YS from all areas of the State. Judith opment of a plan for the future Krauss '70 served on the Stccnng nur~mg worUorce in Connecticut. Committee prior to her retirement The~e April, 1998 :,un •eys were The Colleag u e~ in Caring project is from the YSN deanship. Donna M. distributed to employers of nurses a national project partia lly funded Mahrenholz now serves on it. a::.ki ng about future plans for by the Robert Wood Johnson Three task forces were initially employing licensed nurses com Foundation (RWJF) to address the appointed: the Task Force on the pared to present practices; to vari need for collabora ti ve planning and Future Health Care Delivery ou:, persons involved in healthcare implementation of nursing work System, the Task Force on the regarding thoughts on the future of force actions and policies. RWJF is Workforce and Education, and the health ca re in the State and nurses' one of the largest of the private Task Force for Future Data roles in this fu ture; and to schools foundations in the United States Collection. The activities of the:,e of nursing and their faculty about which fund health care their plans for the future studies and projects. In education of nurses. Also August, 1995 they during this time, 21 focus announced the project groups were conducted and requested proposals. wi th various licensed The Connecticut League nurses throughout the for ursing (CL ) devel State. These focus groups oped and submitted a were led by graduate stu proposal which success dents from all schoob of fully competed against 56 nurs ing in the State applications to become in under lhe supen•ision of August, 1996 one of the 20 Barbara Witt and sites nationally which Kathleen Heinrich at the were awarded 3-year University of Hartford. grants. Two YSN students, Leslie Farkas '98 and Helena The Connecticut Chmielowicz '98 led Colleagues in Caring focus groups with sup (CIC) Project built on new port fro m YSN faculty and expanded existing member Jeannie relationships to establish a Pasacreta. statewide consortium of providers, educators, pro Prior to the abm·e su r fessional organizations, veys, the Research policy bodies, and third Advbory Group (RAG) party payers. This consor- Donna M Malrrenlrol: was established to a~~•~t tium is evaluating the with data collection and Connecticut nurse workforce needs task forces varied, with the Ta,J.. analy::.os. Sally S. Cohen '80 and and educational resources in order Force on the Future Health Care Donna M. Mahrenholz serve on to develop a plan to meet the health DeJi,•ery System using available this committee. The RAG e'\am care needs of the citi.£ens of statewide data to produce a report ined e'\i~t ing data a\'ailable 111 the Connecticut. TI1e consortium's that descri bes the salient fact;, and q,1te and nationallv. It ::.oon became work is accomplished through a fi gures which will impact the apparent that no agency had an Ill steering committee and task fo rces. future of health care delivery, and depth "picture" of the current The Steering Committee, which the other two Task Forces develop Connecticut nurse worJ..force. meets regularly, consists of 25 per- ing surveys and other methods in [ ~to mated number> were a\'ailable
14 Colleagues in Caring Project the other two licenses. The data registered nurses in Connecticut from these samples were analyzed work in hospital settings, but at a a nd the RN data were compared lower proportion. There are more wi th national data obtained from Connecticut RNs employed in from the federal government calcu the a tional Sample Survey of RNs long-term care than are reflected in lated from data obtained in the conducted by the Division of the national figures. 1l1ese national ational Sample Surveys of ursing. See Table 1. Similar data show that the New England Registered Nurses conducted by national databases for LPNs and and the West North Central areas the Division of Nursing, APRNs are not available. were more likely than other a reas Department of Health and Human to have higher proportions of their Services, and actual numbers of RNs nurses employed in nursi ng homes licensed APR s, LPNs, and R s or other extended care facilities. were available from the CT The average age of nurses national Department of Public Health a nd ly and in Connecticut is over ~0 . A Graduate degrees are held by 11.2% the State Board of Nurse lower percentage of licensed RNs of Connecticut's registered nurses. Examiners. But no actual counts arc employed in Connecticut than Connecticut, along with with demographic data describing nationally; also in Connecticut, a Massachusetts and Rhode Island, the current nurses in Connecticut lower percentage a re employed are three of the four states with the were accessible. full-time. Consistent with the highest proportion of registered national data, the largest number of nurses with graduate degrees. 1l1erefore, the first project was to establish a database which described the nurses in Connecticut. Even though all licensed nurses renew their state TABLE I Comparison of Employtd Rtgisttrtd Nunes in CT & US. 1996-1997 licenses a nnually and a re asked a fe w questions on their renewal applications, these data are not Conn «ticut us 1996 1997 1996 compiled by the Department of N=657 N~646 As /ndJcated Public Health into a database. 1l1e Connecticut State Board of urse EMPLOYED 78 1% 78 7% 82 7% Examiners reported that ~8,721 reg (in nursing) istered nurses (RNs), 11 ,230 AVERAGE AGE 448 45. 1 42 3 licensed practica l nurses (LPNs), (in nUising) and 1,419 advanced practice regis tered nurses (APRNs) held licenses SETTING N % N % Nm2S,256 in the State in April, 1997. A ran Hospital 329 501% 278 43 0% 601% Comm!PHealth 98 14 9% 110 dom sample of these nurses who 170% 131% LTCINH 84 128% 77 11 9% 81% renewed in 1996 and in 1997 were Amb Care 55 84% 56 87% 85% abstracted by two YSN graduate Student Hlth 19 2 9"/o 36 56% 3.0% students, Amy Drescher-Crumpley Nrsg Education 5 08% 4 06% 23% '99 and Barbara McCloskey '00 Other 51 7 8% 66 102% 4.9"/o No Response 16 23% 19 2.9% under the supervision of Donna M. 0 04% Mahrenholz and wi th the coopera HIGHEST DEGREE Nng-Relattd Education tion of the Department of Public N~29,766 Hea lth. Diploma 201 306% 175 271% 272% Associate 125 190% 130 20 1% 317% Bachelor's 229 34 9"/o 213 33 0% These abstractions took place in 32.0% Master's 72 II 0% 79 122% 8.9"/o March, 1997 and july, 1998. The ini Doctorate I 02% 3 05% 06% tial year 1996 was chosen, so these Other 3 05% 10 1.6% data could be compared with the No Response 26 40% 35 54% 01% national 5ample that the Division of Source CT D•ta from Mahrt-vholz. OM. ( 1998) [)gmptaop oh R•odom SwnJeofl Soret Nnm• in CI 199§ &. Nursing had collected on registered 1.222 Report subauued 10 CoUeap;s m Carmg CoDD«:OCul COOSMJum, Walliogford, CT nurses in March, 1996 and pub US Dati from The Rcngenrd Nws Pooul•hoo tmd1ngs from !be Nahma! Sampls Survey ofRegWro:;d lished in December, 1997. The Nupet Mvch !996 Of\'1SJOO ofNursmg. Bureau of Health ProfessKMU. Ue.tltb RCSOW'CCS aod Scmccs APRNs were over-sampled because Admuustnboll.. 0cpartme:D1 of Health aod Humu Sc:n•tee~. I997 of their low numbers compared to
15 APRNs (1996: 62.-l"o and 1997: Average Work Hours per Week 69.1" .. ) hold a master's degree as their highest degree.
As Reported by Licensed Nurses, Future Activities 1996 & 1997 35 Two new Ta>l-. Forces, one focusmg on nur>ing deliver~ and sernce 34 +------and another one on education, hm·e 33 been created to use the collected 32 data in formulating a plan for the 31 future. The collected data from the 30 initial tasl-. forces, data from the focu; groups, and the random sam 29 ple were presented at two meet 28 ing;, one at Mystic in September, 27 1998 and one to the nursing leaders 26 in service and education in October, HrfWk ALL APRN RN LPN 1998. Plans continue to be devel oped so that the fu ture nursing workforce will have the requisite skill; and knowledge in order to APRNs work full-time (>36 hours) than meet the health care needs of the RNs (1996: 55.3"o and 1997: 53. l"o) citi7ens of Connecticut in the 21st APR s have the highest percentage and LPNs (1996: 51.0"o and 1997: century. of licensees employed (1996: 93.3"o .t2.3"o). Because the APRl s were and 1997: 90.7"o). The average over-sampled, comparisons of hours worked per week of all employment settings need to be For more information, contact licensed nurses in Connecticut have done with caution. The highe.,t per Donna M. Mahrenholz at YS or decreased in the two yea rs exam centage of APRNs (1996: 38.-l"o and Diantha McMorrow, Project ined. See Table 2. A higher percent 1997: 37.5"o) work in ambulatory Director, at the Connecticut League age of APR s (1996 and 1997: 6-t"o) care. As expected, the majority of for Nursing. •
Florence Wald Reception IN MEMORIAM Doris Baxter (Pinkney) All ison Former Dean '26 died August 3, 1998. Florence Wald was honored by her Elizabeth R. Walters '32 friends at The Date of death unknown. Connecticut Hospice on the occasion of her induction in to j osephine Riley johnson '34 the ational died August 18, 1998. Women's Hall of Fame with a recep Elizabeth Tucker Smith '47 tion held at d ied September 15, 1998. Bittersweet Farm in Branford, CT on Eleanore L. Hayden '57 August -1 , 1998. d ied on October 18, 1998. Many of Florence's friends and col Yn/e Nurse received notice of the leagues from YSN death of former YS faculty had the pleasure of attending this wonderful acknowledgment of Florence's many accomplish member, Margaret A. Colli ton, ments. Standing behind Florence (L to R) are Margaret Grey, Colleen on September 2-t, 1998. Shaddox, Marge Funk, and Henry Wald, her husband.
16 The Expedition Nune
By Moira 0' eill '98 down to 2,500 feet at the cold condition. Cindy was the only Colorado Ri' er, seemingly clo~e. yet e'l.ception. She had prepared for se,·en miles of s"·itchback; away. the trip by joining Weight Watchers When my fnend O\ er the winter, as well as an aero jane lll\'lted me to Despite aggressive warning '>lgn' bics class for "the over 50." JOin a group h1!-.mg about the dangers of hikmg unpre Unfortunately, she had not pre the Grand Cam·on pared, we met numbers of people pared her feet for the rigorous hike after graduutio;, la;t with inadequate footwear, water into the Canyon. Assessing the spring, I thought -.he wa; invit ing supplies, food, and even hats. I monstrous blisters that had formed me as a fellow hiker, not a~ a nurse. found my progres~ slowed by fre on her feet, I had the feeli ng she Her husband Peter argued with quent stops to administer the Fir;,t was more than unaccustomed to friend Ron about who would hil-.e Aid I knew little about, mostlv long walks. I reckoned she had neare~t to me, en;uring prompt applying mole sl-.in to sore fee t, in never walked barefoot in her life. CPR during the descent into the addition to sharing food, water, and Because of her determina tion to Canyon. I ju;,t chuckled and nod hat;,, all of which we earned in reach the bottom, she never ded my head and lingered at a e\tra,·agant .1 nd burdensome abun revealed the pain she was experi nursing home med cart, contem dance. Our pacl-.s were filled w1th encing in her boots. plating the theft of a few nitroglyc high energy snad.s, trail m1x, car erin pill'> for my Fir<,t A1d l-.1t. rots, fruits, and anchm•1e,. We We had three days at Phantom Becau~e I '"a" a "Yale ur~c," no decided anchovies were a fine mter Ranch to reco,·e;, stretch out, and one would accept that I kne\\ noth ''ention for a,·oiding elcctrOI) te prepare for the a seen t back to the ing of Fir'>t A1d! imbalance. It is not uncommon for rim. The group took short day hikers in the Call\'On to over hikes, feeling more fi t each day. Once at the Grand Cam on our hydrate with wat;_.r, further compro Cmdv could not tolerate much group of nine, r,mging .111 age from mising sodium levels already wall-ing. I was torn. To allow heal twelve to 70, met the-1:00AM bu' depleting through perspiration. We ing I advised her to re t, but to to the South Kaib.1b trail head at were also a group of anchO\·y keep muscles from stiffening, I Yal-.i Point. In the early morning lo\'Cr>, a special breed. Cindy and advised her to walk. She slept most darkne~s \Ve \VCrc a rag-tag bunch Ron were exceptions; their taste> of the three days. I suspected she with hab a'l-.ew, hydration ;y,tem were not so exotic. They carried was sedating herself for pain. The tubing ;winging behind, and layers packets of orange juice and peanut night before our hike out, I stood of mismatched clothing. Only one butter crackers. She e\plained that staring at a red cro son the steps member, Cindv, looked well coifed she had recentl y been told that she of the park ranger's bungalow. I and stylbhly out of place. Still , had hypoglycemia. A cousi n had already knew that people who using hiking pole., and treading ad\'ised her that orange juice was a hiked in, hiked out; that mules carefullv, ,111~ '>teadilv de.,cended good remedy. I didn't have time to were not an option unless you rode in to the. can von ahe~d of U'>. review a diabetic diet with Cindy, in on one; that even those willing Sc\·enty-yea·r-old Peter disappedred or the value of protein and complex to pay the 52,000 fee for a heli at the front of the pack a., \\ell. carbohvdrates. I wa> on a h1!-.e, copter ride had to be in life or \Vith gouty !-.nee'> firm I) bound m truly n~t e'l.pected to be on call the death circumstances for pilots to ela;tici7ed wrap,, he '>et a bri'>l-. whole time! risk the dangerous air currents and pace, appearing onh nm' and then hm1ted landing space of the in the d i'>tance, nxlehng or stop At the bottom of the Canyon, Canyon. Still I hoped the ranger pmg for a .,n;tel-. jane and I brought Phantom Ranch welcom~d us w1th could offer me some sage advice. up the rear, ,oon O\ ercome b\ heat cold showers and bunk beds. After Perhaps the blisters should be and e\ertlon aftl'r '>pendmg too solid naps, our e"1.ped1tion team met lanced. I argued against that, wor much of the cool, 'haded mornmg and took inventory. Despite e\haus· rying about the dusty, mule-conta hour' ga.,ping ,1t the <,eenery The tion from heat and the physical minated Canyon floor. But she had South " a1bab tra1l .,l-.1rh ndge; over duress of walking downward for nothing more to offer than a know 7,000 feet abo' e '>Ca level, wmding ;,e\•en miles, we all seemed in good ing, sympathetic look. I returned to
17 the Bright Angel Creek where I had left Cindy soaking her feet in the cold spring water. We made plans for an early start and a slow, steady pace.
At 3:00AM I heard Ci ndy get up. Jane hesitated in the early hour, but I recognized that Cindy was driven. She had a long day ahead and we all had a hot climb up the nine and a half mile Bright Angel Trail. It was critica l that we get through Devil 's Corkscrew, a canyon cove wi th a propensity for excruciatingly hot trapped air, and make it to Indian Gardens, the shaded halfway point, before the heat of the day began. In the dark we re-packed duffels for the mules to carry out, and minimized our pack weights to fluids and food to eat on the hike. Ron couldn't find his fla shlight, so jane held hers while he consolidated bags. We were on the trail just after 4:00 AM. As we set out, we quietly planned that I would stay behind until Indian Gardens, monitoring Cindy's progress and repairing anything I could . Then jane would switch wi th me until Three Mile Resthouse. Cindy set out ahead , but was soon overtaken by the group. Ron caught up and stayed at her side. After about a mi le, she stopped and asked me to apply more moleskin. There really was no place to put the stuff; her feet were two enormous blisters. By 10:00 AM we met up with the rest of the group at Indian Gardens. Well pleased with our progress, we ate and Cindy fell asleep. I left ahead with the boys and immedi ately felt the scorch of the desert sun. This would be a long day.
Our party spread out along the / Bright Angel Trail. I paired off Mo11·n 011 South k111l~1l• Trntf nt O'Ntlli BuilL'
18 The Expedition urse son who left at -1:00 PM as the dav people on the trail with blisters and COIIfilllll'd began to cool. Jw.t the previous d·a) no water. What was I, the Grand a woman was near death with heat Canyon urse? ll1ey should have w1th Peter "ho..,e pace ,Jowed m e'haustion, requiring e1·acuallon heeded the Park Serl'ice signs. I the heat Bet\\een lnd1an Garden~ by chopper. An Australian fellow moved on and caught up with Lars, and the nm, there"' en little was the first to describe Cind1 and the 12 year old, who graciously 'hade. We ... topped frequent!) Ron a> two of the hil-.ers who' were waited near the trail head to finish whene1 er there wa' an outcropping turned bacl,.. With gray hair, spiff) fi r~ t. but with company. Shortly offenng e1 en mche' of ' hade. It hats, and hiking poles, Cindy and after, hi brother Anders arrived. wa, at '>UCh a 'POl that Jane caught Ron were easily identifiable. We We headed for the snack bar and up to u<.,, w1 thout Cindy in tow. She came to understand that this cou ordered every dairy product we e'plamed that Ron m-.bted Cmdv ple would not resume their ascent could get our dusty hands around. get re;ted, that they would be fi n'e, until -!:00 PM a ~ the sun moved Although the food at Phantom that Jane -,hould get moving. We across the sky and away from the Ranch was e'cellent, especially lingered '>Ome time, sharing trail Canyon trail. wi th our anchovy accents, dairy tales with pa;sers-by. Soon we start products were limited d ue to the ed hearing rumors of hil-.cn, being From Three Mile Resthouse I neces;ity to transport everything by warned away from leaving Indian moved on alone. Trai l traffic now mule. We found a spot and slurped Gardens. The temperature was was heavy with day trippers and away, awaiting the rest of the team. climbing to over 100 degrees, and mule trains. The d ay trippers were with no shade above the Garden;, just out of their cars at the rim, few By 6:30 PM everyone was out of the rangers were advi;ing ,,gain; t hil,. with hats or hil-.ing boots. Many Canyon except Cindy and Ron. ers a~cending. It wa' !.aid that a lacked water or snacl-.s. I was hot, Reviewing their predicament, I esti hiker leaving Indian Garden<., at my pack was too heavy, and I mated they were out of food, had 11 :00 AM in the heat of the sun wanted to get to the rim. After a no fla;hlight, and no jackets. would arrh eat the nm after a per- while, I could care lc~., about the Although we had packed well with
Arrr PIIl,\' at flluwtom Rauch nt tlze bottom of tile Cmntoll Somt• pt•oplc lrlll't'f lht• ''ensy way.
19 Moirn (()with Ciudy nud Rou, the "Cr111you pntieuts," the dny nftcr the rescue
provisions, we had not anticipated the canyon after dark; beyond that, liant night. But this night, as I that Ron and Cindy would be in the they could not say. Our group dis descended once again to find Canyon an extra six hours. I also cussed measures to take. I volun Cindy and Ron, the first thing that remembered back in the early hours teered to go back after Ci ndy and struck me was the darkness. There of the day that Ron could not find Ron with supplies and flashlights. was no moon. Wi thout benefit of his flashlight, and doubted they Everyone wanted to go. I suggested fl ashlight, there was nothing, only had carried jackets in their one it was too dangerous for the kids to blackness. I shone my light on the lightened pack. Considering hike down in the dark and that trail at my feet. A little to the side, Cindy's reports of hypoglycemia parents should stay with them and the light was ineffectua l. TI1ere and unavoidable exhaustion, we (especially 70 year old parents). was nothjng to reflect off but thou could assume she was in trouble. I Finally I argued that one idiot in sa nds of feet dropping d ownward. spoke with a ranger early in the the Canyon at nigh t was better I grazed the canyon wa ll with my evening who gave me another of tha n even idiots. free hand guiding my way down those knowing looks and explained the path. At one point I was study that the Park Service was just not I packed sandwiches, drinks, fruit, ing the wall for a formation I equipped to keep tabs on everyone jackets, and flashlights, then set recalled from earlier that day and in the Canyon. There were caches out. When we had fi rst arrived at suddenly fe lt the ground under my along the trail with emergency the South Rim of the Grand feet change dramatically. I shone radios for hjkers who were in trou Canyon a week before, the moon the light back around and discov ble and knew about them. The for was fu ll and the canyon was ered I had missed a switchback and mer criteria eliminated Cindy and bathed in a blue brilliance. Night wandered off the trail. It was one Ron. I knew they would not find time was the only time I could look of the few places with room to the rad ios. What did the rangers at the Canyon; otherwise it was just maneuver off the trail; it could easi think about private citizen rescue too overwhelming. I remember ly have been a sheer drop, a ~ober attempts? Well, of course they dis feelin g it would be really lovely to ing thought. I resumed the hike, couraged anyone from hiking into hike the Canyon in the cool, bril- moved slowly and held my jacket
20 The Expedition Nurse and saw before me a sn1<1ll wi'>p of paneled room is said to have been a COiltillltl'd light and two agoni7mgly ,(ow fa,·orite of Tedd y Roosevelt's. moving bodies coming towards me. Evervone was dressed in real clo~c The wmd wa~ commg up and I stood in the middle of the traal clotl{es and brilliant Southwestern the de~ert air was qllld.l) coohng. with one hand on my hip and the jewelry. The food was excellent a nd o ther shining the light m the darec "e e\tra\·agantly ordered e\·ery In the dar!.. of the n1ght, the mo~t tion of Cindv and Ron. I '-a1d, "You course pos~ible. Cindy, sitting next a~toundmg thmg "a~ the number ot are late for dinner," and Cind\ bur't to me, quietly shed her sandal and people on the trail The ma1onty into tears. I offered them sandw1ch placed her foot discretely in my lap seemed to be teenager~ . Some, hl..e e that Cindv declined; then she ate to show off her bli ters. Yes, they Cindy and Ron, had been caught two. In the glee of being reunited, were Iike nothing I had e\·er seen, while returnmg. Others were look Ron stepped bacl.. to mal..e a point monstrous eruptions disfiguring her ing for people and ~ till other~ and came perilously clo'>e to the pedicured foot. But during dinner? seemed to be thrill scel..er, . It was ed ge. He d id have a nashlight, but it Only a nurse would be treated to not long before I gave away nash was just a pen light with waning such a delightful dinner com·ersa lights, a jacl..ct, and sever a I food battery power. They had been mov tion piece. It is the beauty o f being a item~ to some very an,ious hikers. ing up the tra il in measured steps nurse. People feel com fortable warned the individuals withou t (the goal was 30), then stopping to revealing their most intimate a ffli c nashlights o f the dangers ahead. rest and turning o ut the light to con tions to you. They also feel comfort They seemed to tal..e heed, then serve the batteries. In the relative able falling in under your wings, asl..ed if I were a ranger. When I ~a i d darkness, they did not appreciate con fi d ent in your ability to get them no, they dismis'>ed me and moved the proximity of potential dba~ter out of danger or ill health. It's what on. Maybe I should have e'plained I that was beyond the trail · ~ edge. I like about being a nurse. was a nurse; that tend~ to carry a bit Once fed a nd juiced, we all re,umed of we1ght. Contmumg down the their measured pace. The (a -,t two jane says that on the next Canyon trail, I worried about Cindy and Ron miles out o f the Can von tool.. about h1l..e I can go as a private citizen and now worried about a lo t of two hours. I followed behind, Illu hil..er, but I still find myself intro other people, too, hopmg not to hear minating the trail a t their feet and duced at dinner parties as "the sudden long, dbappearing screams. distracting them from their d iscom E\pedition urse." I have bo ught a fort with cheerful chatter. smaller pack. It rides higher to I descend ed into the Cam·on about assure a lighter weight and has less two miles. My na~ hli g ht ~'· as enor The ne't nig ht we had a celebration room for e'tras like the First Aid ki t. mous, showering the trail w1lh light. dinner in the private dining room at 1-lowe,·er, I'm no t sure I can leave After a time, I came around a bend the El Tovar restauran t. The richly that kit behind! •
commuting student I drove to and from egate;, both fo rmally and informall y. AYANEWS New Haven without ever \'enturing Rafael A. Porrata-Doria, Jr. '77 JD, By Linda Demas '89, onto the Old Campus? And, I had my Chair of the Associati on of Ya le own thoughts about what it would be Alumni, had earlier asked if I would AYA Representative, YSN like to mix with those Yalics. Perhaps I sen•e on the Nominating Committee would finally learn my way around! for the Board of Governors. He Sometime la't June Barbara Re1f, YS 1m plied, with a chuckle, that if it D1rector of Student and Al umnae/ i What a fabulous treat! Marvel Davis appeared that the School of Nursing Affa1rs, called '"th an mntahon to '70, a member of the AYA Board of was on a mission to take over the AYA, scn·e as one of the representatl,·es Governors, welcomed me at the morn tht;, was not an iUusion! Maureen from the School of ursmg to the mg breakfast for first-hme delegates and Doran '71 currently sen•es as Vice A"oc1ation of Yale Alumno, begmnmg guided me through Initial confusaon;, Cha ~r ! I found myself enthusiastically '"th the Fall, 1998 A'>>embly Llll The Assembh· on the m,·olved m this acti\•ity and look for "Now why would I want to do that>" "lnternahon;{hzation of Ya le" pro\ ed to ward to contmued contact with other I a~l.ed , thml.mg I had already sen·ed be an e\citing and stimulating three members. as we work to present a slate ) SN as a ' tudent representatln> to days on campus. We explored how Yale, for election at the Spring, 1999 GI'SC), a ) t;S:\AA Board officer, and tn an economic and communication age, Assembly UV, "The Yale Faculty." a Co-edator of \ilk'""'' "\\ell. we will internationalize at home and would nl'l'd to get together at least abroad, acknowledgang the multifaceted AnAYA delegate serves a three-year twin? a year." Barb replied proce;,s that such an effort will encom appomtlnent, attendmg Assemblies m Hmmnm1...l am ea~v! pass. In addition to Yale facu lty, adman the autumn and >pring. Lucky me! 1 astra tor>, and alumn 1, anternataonal and get to do ttuJ; five more times. TI1anks, Does at surpri;e YOU that a' a YSl\ American undergraduate;, engaged del- Barb and Marvel!
21 Yale School of Nursing Offers Interdisciplinary Spirituality and Healing Program
ale School of ur~mg launches care possible. In a 199-l Gallup '> Ur· Health Care'· is taught by Ann its spirituality, healing, and vey, 9-l percent of pahenb reported Ameling '67, Professor of 'ur"ing. Yhealth care curriculum thb fall that their spiritual health was a:. and the Re v. targaret Edgerly, with "Spirituality and Health important as their physical health, Dirl>ctor of Relig ious Mini~tric~ at Care," a graduate course dc~ign ed and 77 percent felt that physician" Yale-New Haven Hospital. for divini ty, nu r~ing, and medical should consider their spiritual Studenb intere>ted in enrolling in students. The cour~e i ~ part of a needs. Furthermore, a growing "Spirituality and Health Care" or larger YS initiative to train health body of research s upports the mea "Alternati,·e and Complimentary and pastoral profe~~ionab to care surable healing effects of fa ith and Therap ies" should call Professor for people in a way that acknowl spirituality. "Spiri tuality and Amcling at (203) 737- 1791. • edges the connection between the physica l and spiritual. The project, undertaken in collaboration wi th Ya le Divinity School and Yale-New Haven Hospital, i ~ supported by grants fro m The Teagle Foundation, Inc. and the john Templeton Foundation.
In addition to "Spintuality and Health Care," the multicultural cur riculum includes "Alternative and Complementary Therapies." The final components in the curriculum will be " Li ving With Dying," a course e'amining the need ~ of ter minal patienb and their families, a nd a clinical practicum where the student works under the ~ uperv i sion of an experienced provider to use spiritual a sses~ men t and sp iri· tuall y based practices in direct patient care. These cour~es are pla nned for the Fa ll of 1999 a nd Spring of 2000. Additionally, in the spring semester of 2000 YS will host a one-time symposium of lead ing authorities in spirituality a nd health care. The symposium (date TBA) will be open to the entire Yale community.
Yale School of ursing, Yale Divinity School, and Yale· ew Haven Hosp ital agreed to collabo rate on the new curriculum based ~,, ... on the premise that appreciation of patients' spiritual beliefs is an essential component in the provi sion of the highest quality health
22 By Pamela Minarik, R , MS, Associate Professor, Yale-China Nursing Exchange: Psychiatric-Mental Health ursing Program, YS
HENANDNOW ''1'1•e 11ezocr /leeu so hnppy," sny YSN sl11de11/ Jill Pntto11 '99 of the eight weeks sl1e sp<'llt studyi11g cm·dinc cnre 1111rS111g 111 Chn11gshn. Whnt mnde the experience so wom1erful wns. "having n life thae; daily co11tnct l!'ifl1 the /w,; pttnl stnff; duma nt [rie11ds lwmes, rather tlm11 111 rcstn11rn11ts; i11 short n11 llll' he Yale-China Association, founded in 1901 to promote mutual understanding between China and the United States, is marked by ongo ing collaboration that enriches all its particapants. Yale-China became involved in nursing in 1908 when ina Gage, RN, arrived in Chang ha in Hunan Province to work as a nurse and then later as Dean of the H; iang-Ya School of ursing. Hunan Medical University (HMU) in Changsha was started in 1914 with the sup port of Yale facul ty and the Yale China A;sociation and is the largest in central China. The relationship between Yale and the people of Changsha has su rvived natural dis asters, wars, and ultimately a three decade hiatus during which the political climate prohibited Western involvement in the region. Yale School of ursing Professor and Yale-China Association Trustee Ann Williams '81 met with Chinese colleagues in Changsha in 1995 to e:..plore a renewed nursing exchange. As a result of her 1995 visit, Ann, a specialist in the treat ment of AIDS patients, returned to Changsha in August, 1996 with fou r colleagues for more detailed discussions about possibilities for collaboration. The group included Jane Burgess, Coordinator of the YS -based Connecticut AIDS Pamda M1111mk «•tlh L1 }t'ufl.lt•t' Jw,b 23 Marjorie Funk '84, expert in car urses in China traditionally bed">. ,ome with air mattresses for diac critical care nursing and casual attended two- or three-year co urse~ skin protection and most with a rat status RN at Yale-New Haven a fter secondary school. Until tan mat for coolness; and few prr Hospital (YNHH) CCU; Paula recently there were no BS pro va te rooms or rooms wi th toileb Milone-Nuzzo, specialist in com grams in China, but now HMU, Some rooms had arr conditioning munity health nursing; and Pamela among others, has created a Facult} dependmg upon the condition of Minari k, (the author) specialist in of ursing to provide instruction 111 the patient or the type of equip psychiatric nursing and the subspe a baccalaureate program. ursing ment 111 usc. Mam· famih· members cialty of psychiatric consultation and medical practice combine both were in attendanc~ . providing food liaison nursing and Y HH Western medicine with diagnostic and personal care to the patient. Psychiatric Consultation Liaison and inten•entional technology, urse Specialist. Staff members of surgery, and pharmacotherapeutics, Regbtered nurses appe Dumer 111 Chnugslm with (L toR) Li YeuMt•l, Pnmeln Mmnnk, n11d l 1 Lt•:/u 11•1th her daughtc1 24 A pt~lrnrt nxmr at tlu· Hw U:mg Cwm llo~p1tnl 111 Bt•rJmg lab coat<. supplied by the h o~ pital. research fellowship funded by the study community health care in a urse;, wear ca p~ with ~tripe~ des Wilbur Downs Interna tional Health market economy and consult with ignating hierarchical rank. Travel Fellowship, conducted a American colleagues. They visited descriptive study of ST segment such diverse care settings as A number of potential collabora monitoring at the CCU at Xiang-Ya YNHH, a hospice, a community tive project;, tha t were identified at Hospital (affili ated with HMU) based well-child clinic, an occupa the time of the 1996 vi;,it have come with the help of Zhang Qiong, car tional health clinic, a pre-hospital to fruition. Projcch currently in diac care nurse at Xiang-Ya care site, and a visiting nurses' progress are the following: Hospital. They also interviewed associa tion. Two members of the CCU nurses about their practice as delegation, Yang Min and Li Lezhi, 1) HIV/AIDS trnmmg program nt part of a study comparing demo will remain at YS through H1111flll Medim/ Lillil'<'Nilf j1111d1'd /ly graphic characteristics, patient care December on Chia Fellowships to n grn11t fnllll t/11' w,n/d A IDS priorities, patient teaching meth continue studying community Fmmdntw11 ''' <':'lnb/t,;/1 t1 '''nt'> of ods, and job satisfaction. Zhang health nursing under the guidance "tram the trmllt'r" u~~rksh 25 Hospital. Chia Fellowship;, which throughout the hospital. Pamela'' 1111d Psl(dualric J\lllf'liiS Cnrt' are administered through the Yale visit to the Second Affiliated 1'/llllllliiS. Pamela 'v1inariJ.. taught m China As>ociation, arc awarded to Hospital in March, 1998 included a fi,·e day "train the trainer" pro public health scholars for the pur lectures about psych1atric con,ulta gram at Hui Long Guan Ho,p1tal m pose of developing projects that tion liaison nursing; a<.<,e"ment of Be1jmg planned by ~larly~ Bueber, will improve the public health in communication and p'>ycho>ocial R; , 'viS, and Kathleen DeGr,l71a, Changsha. Jane Regan '98 is abo a assessment sJ..ilb and learnmg R~ . both Amencan psychiatnc Chia Fellow. After worJ..ing with needs of nursing s taff, as well"" nur,es. Cons ultation ha> contmued Yang Min and Li Le.~: hi at YS to training; inten·iews of two patient' b) e-mail. develop their community health on the burn and plastic surgery projects, she will go to Chang>ha unit and one patient on the P'ychi For all of U> mvol\ed in the Yale wiU1 them to help implement the atric unit; and planning for further Chin,, ursing Exchange, our rela projects. training. In july-August, 1998, Li tionshipS with our Chinese col Le<:hi, the Vice Director of ur,ing leagues prm ide an exciting and ~) Psyc/,intric Cousultntiou Linisou at Second Hospital; Yang Min; and stimulating two-way exchange of Nursiug Program. urse leaders Elizabeth Steinmiller '98 partici expertbe. As Paula Milone- U/.lO and clinical nurses at the Second pa ted in the development of a said, "We're gai ning new per>pCc Affil iated Hospital of HMU arc col training program for the Second tivcs about the world. We arc laborating with Pamela Minarik to Affiliated Hospital. UnfortunMcl y, learning how people view health, develop a psychiatric liaison nurs the effects of the floods in China illne», a nd hea lthcare delivery >y!. ing program with the goal of have been so devastating that the tcms in other cultures." enhancing the psychological and training program initially planned Information about the Yale China emotional care of hospitalized for the fa ll has been postponed. ur>i ng Exchange is available on patients. First proposed in 1996, the world wide web at this program is part of the overall 5) /ulmsive Trn111111S 111 http:/ / www.yale.edu/yalechin/ ab hospital strategy to implement Commu11icni10II Sk11/,, Mt•utnl Stafu, out/ about.html holistic and patient-centered care ASSt'Ssmeul, Psychosocial A'''''""ml, • Group photo tnkt'll, SIIIIIIIIL'r, 1998, New H m•c11 , CT. (L toR! 1i'rrlf Hntb 26 Grace Project Update Bv Ann William~ '81, RN, Data collectiOn tor GRACE con cated "hedules make the~c regi EdD, Profe~sor, YS l cluded th1s fall. The GRACE mt?n' 'erv dt?manding. In a sene~ re~arch team b now engaged m ot focu;, group> and survey,, \er the l,,_t three vear~, analy~i~ of the data and al'o m '>e\ GRACE researchers learned that more than 200 women hv eral follow up and supplemental women who understand the pur mg "1th HIV 1n '\e" 'tudies. Although the chmcal tnal po'e of the tht!rapy and who havt! a 0 Ha\ en, mam of whom had data analysis is not complete, the ptNh\ e relahon,hip with their pri not pre' IOu-,l y n~ce1\ cd H IV care, n~~ ults of baseline descriphn? data mary care provider appear to be enrolled m GRACC. GRACE analyses han~ been pre;,cnted at more likely to adhere to the med (Gynecologic Reg1men' Addre~~in g several intemational meeting;, and ication schedule. Candida E\' " lion 'chedule<,. The new project, won1en with imrnunc "tupprc"''ion. unreliable, and that women w1th a " h1ch \\Ill begm in the Spring and hi-,torv of cocamt! u'>e arc ll'"' hkch will probabl) not be called GRACE, Participation m GRACE, a random to rct~m for scheduled pch ic ' w1ll mcludc men as well as women. ized, double-blmded, placebo-con e~amination~. There Me many unanswered ques trolled chnical tnal, reqUired \\eek tions about the best strateg ies to ly u;,e ot mtra\ aginal ' uppo'!tones Currenth· the GRACE te,,m "' 1mprmc adherence. Although th1s and ~em 1 -ann ual '>tUd\ \ l'lh that focusing-on the challengt! of med 'tud) Will be conducted in HI V included mten leW'> a;,d peluc ICa tion adherence for HI\' mfectcd ptNtne mdl\ 1duals, the knowledge C'\amination"t. women. The new pharmacolog1c gamed ~hould be of ,·alue for those therapies for HI V arc' cry t!ffcctl\ c. II\ mg with other chronic illnesses. GRACE got underwa~ through the but the numerous pllb and compli- de,·elopmcnt of a comprehen;,1ve • community outre,,ch progr.lm. The ;,tudy team di-,tributcd information about GRACE through AIDS clini ca l care ;,en•icc-,, drug treatment prog ra n1 ~, ~ocia l ..,crvicc agencies, church pre;,entation-,, commumty acce~' teiC\'Ision, and billbo,ud;,. TI1e GRACE -,taff mcluded women familiar w1th the \.ew H,,, en com mumty and "ethmcalh d1ver;,e. jane Burge'>', \IS, \Cit\J, i' the Project \tanager TI1e team worked to re.1ch HI \' pos1h\ e women m the commumt ~ b\ e'tabll'hmg tru;,t and legllunac\ '1a 'h.ued l,mguage, h1, tory, and culture \!though the GRACE 'taft d1d not pro' 1de rou tine health care 'en ices. the\ did faCilitate referral' and appmnt menh, work1ng Ill encourage all HI\' po,ltl\ e women to enter the health care "'tem. 27 HUMOR: 15 LAUGHTER THE BEST Rx? By Kate Stephenson '94 patients' positive responses to the doctor's appointments, d iagnostic project, which was ca lled The tests, and family functions, to na me he relationship between mind Humor Ca rt. "We e ven had a three a few. I encourage patients to keep and body as it relates to minute slot on Action 8 News," a Feel Good File for refere nce a t any Thealth and illness is a com recalls TI1ielma n. "Even tho ugh time." plex one. Much evidence in the sci people think, 'Cancer--funny?', it is entific and medical literature points fa r from the truth. But using humor Sometimes, as Mary jean has led to the detrimenta l effects that stress, for cancer s 11·ess management is a support groups on humor as a cop fear, anxiety, and depression can beneficial tool in dealing w ith the ing skill, the situation itself becomes have on the immune system. Pet disease." Her project's results humorous. "I distributed a ha nd therapy has been used in settings of showed that 90 pe rcent of patient out, '25 ways to cope w ith stress.' chronic disease in order to lift participants ag reed that humor Item number six was, 'Dance naked patients' spirits. It wo uld seem helped to ease their problems and in front of your pets.' It so ha p intuitive that if certaiJ1 emo tiona l 100 percent agreed that in their pened tha t a local newspaper sta tes contribute to declining experience humor was an effecti ve reporter attended and interviewed health, or even exacerbate illness, way of coping. A ll patients a lso some from the gro up. One patient then perhaps others may enhance agreed that it helped if their nurses with lung cancer started laug hing healing. However, few formal a nd doctors had a sense of humor. a nd told the repo rter that she did investigations have been done to Mary Jean reca lls talking w ith her number si>. . Who knows if she was look at the positive effects humor patients about the use of humor and joking, but the way it ca me out in may promote on physical well how many sha red stories of how the article made it sound as if I was being. humor helped them to forge new quoted as saying that! Well, you rela tionships in stressful times. lt can imagine the ri bbing I received had a lso been a benefi cial distrac fro m my nursing, medical, and Mary Jean Thielman '92, who tion technique for severa l pa tients. ad ministra tive colleagues!" graduated from YSN's CNS She remembers, "Humor can help Oncology Specia lty, has always had the body, mind, an d soul. Several of On a more serious note, Mary jean an interest in humor. During her my patients said, 'When I use reminds us tha t humor may have study at Yale, she had an opportu humor, I'm not using a lot of energy some important physiological bene nity to present a class on behavioral worrying about things l cannot fits such as improved relaxation, techniques in Dorothy Sexton's change; and 'Making light of things a ltered perception of symptoms, course. She was approached by puts other people at ease when they a nd perhaps improved immunolog Tish Knobf '82 to see if she was know I have cancer. "' ical function. "There is increasing interested iJ1 helping her, the Ya le interest in psychoneuroimmunolo Co mprehensive Cancer Center, and Mary jean's approach to patients is gy linking immune responses to our Yale-New Haven Hospital's one of teaching coping skills, w here emo tional experiences. For e>.am Auxilia ry launch a humor program she tells patients that they cannot ple, laughter ca n decrease serum for patients on the gynecologic change the realities of the siruation, cortisol levels an d negative moods oncology fl oor. but they can a lter the way they seem to decrease killer T-cell num respond to the situation. "[ feel tha t bers and the salivary lgA response. Mary Jean recalls the enthusiasm of humor is one thing tha t people can TI1ere is more research on humor the gyn-onc nursing staff and the ta ke w ith them wherever they go-- and groups in the psychiatric litera- 28 Humor: Is Laughter the Best Rx? C011fi1111L'd ture, a., well · She 111-.e., to ' hare a quotation w 1th patient~. which she view~ a~ a philosophiCal way of approach111g life: Humor'" mwtltcr of lit<' S Victor Fra nkl Mn 11 '> Scnrclt for Men11 111g On October 30, 1998 YSN staff mem bers w ho have served YSN and Yale Ma ry jean believes tha t humor is Long Term well fo r varying lengths of ti me were bene fi cial, but it mu>t be u>ed ho nored w ith the traditiona l appropriately. She use~ three crite Service luncheon and g ifts. ria for determinong the correct u~e Pictured (L to R) are of humor: tim111 g, recep t i\·cne>~. Luncheon Dean Catherine a nd content. Humor would be Gilliss, Karina Da nvers inapp ropna te 111 a ti me of cris1s, (10 years), Sheila Saunder (15 years), when the care gl\ er IS unfa miliar Donna Epps (20 with the patient, or when the years), Cathy humor 1s at the patient\ e'pense. Zawalich (10 vears), She offer> some II P• on usmg Barbara Reif (25 humor: you d on't ha\ e to be a years), and stand -up comic--JUSt ha\ e a cheer Lillian Hale ful, spirited ap proach; a'se s the (20 years). othe r person's frame of mind and be receptive; laughter should restore a person's dignity and self worth, w hereas sarcasm can d estroy these; adminb ter the cor rect dose. Mary jean cu rrently works as a CNS in Radiation Oncology at Midstate MediCal Center 111 ~ l e ri den, CT. She,., the co-facilita tor of the Bosom Buddie>, a support group for women w1th breast can cer. She ha., g" en pre.,entations on the use of humor a., a stress man Ruth ~ lcCo r kle, Di\Sc agement techmque to profe,~ionals, Program Chair, showed hm,·e\ er, she promote> the use of up at the luncheon in humor predom111antll through her her Halloween costume cancer support group <,eSSIOth. She as The Shooting Star, and her hu.,band live in challenging anyone 111 South111gton, CT. the future to top her ingenUity • and creati\·ity! 29 State Women's Amateur al meeting and conference, Championship. Marge has been a "Breakthroughs in Nursing," in champion golfer for many years Acapulco, Mexico. Faculty and continues to play as much as her schedule allows. Pamela Minarik, Associate Professor in the Psychiatric-Mental Notes Courtney Lyder, Associate Health Nursing Program, and Professor in the Gerontological leslie Nield-A.nderson, Associate Nurse Practitioner Track, wrote a Professor, also in the Psydliatric chapter for former faculty member, Mental Health Nursing Program, Margaret Beal '82, Associate James Fain, in Jim's recently pub along with YSN 1998 graduates, Professor in the Nurse-Midwifery lished text, Readiug, Uuderstaudiug, Jeannie Dilworth, Janice Jones, Program, presented, "A Phase One aud Applyiug N11rSi11g Research: A Paula Nash, Kristin O' Donnell, Study Exploring the Efficacy of Text mtd Workbook. Philadelphia and Elizabeth Steinmiller, co Acupuncture on Symptom Distress (1998): F. A. Davis. Courtney's authored an article, "Difficult and Quality of Life in HI V-lnfected chapter is entitled, "Interpreting Patient Behaviors: Identification, Ind ividuals and Their Significant and reporting research fin dings." Assessment, and Intervention." The Others," at the Third Armual article was accepted for publication Nursing Research Conference at Gail Melkus, Associate Professor, by the American ]o11ma/ of N11rSi11g. Yale-New Haven Hospital, October, Adult Nurse Practitioner Program, 1998. The study is being conducted and diabetes researcher, has been Jane Karpe Dixon, Professor; with Leslie Nield-Anderson, notified of a grant renewal from the Kimberly Lee '95; and Leslie Associate Professor, Psychiatric Donaghue Foundation for her work Nield-Anderson, Associate Mental Health Nursing Program. with nursing interventions for Professor; have co-authored an arti black women with NIDDM, as well cle entitled , "Random assignment Clarice Begemann '90, Program as of new funding from the Bayer and patient choice in a study of Instructor in the Adult Nurse Corporation in support of her alternative pain relief of sickle cell Practitioner Program, has been research in diabetes care and edu anemia," accepted for publication in elected President of the Connecticut cation services for black women in the Wesler 11 joumnl of Nursiug Nurse Practitioners Group. the greater New Haven region. Research, Vol. 21 (2), April, 1999. Leslie and Jane also presented an Marge Funk '84, Associate Paula Milone-Nuzzo, Associate abstract, "The Nurses' View of Professor in the Adult Advanced Professor and Chair of the Master's Operational Redesign: The Living Practice Nursing Program, won the Program, was inducted into the Experience of Professionalism," at Women's Club Championship at American Academy of Nursing on the Third Annual Nursing Research the Yale Golf Course last August November 1, 1998 at the Conference at Yale-New Haven and placed Sixth in the Connecticut Academy's 25th armiversary annu- Hospital, October, 1998. Preceptor Workshop he Third Annual Preceptor Recognition TWorkshop was held on Friday, September 18, 1998. Welcoming remarks were made by Dean Catherine Gi l!i ss, after which Associate Dean Cassy Pollack moderated a panel presen tation, "Putting It All Together: Integrating Teaching, Practice, Research, and Policy." YSN fac ulty panelists included Sally Cohen, Gai l Melkus, Paula Milone-Nuzzo, and Geralyn Spollett. Afternoon small group discussions rounded out the program. Pictured are pro gram participants (L to R) Geralyn Spollett, Gail Melkus, Catherine Gill iss, Cassy Pollack, Sally Cohen, and Paula Milone-Nuzzo. 30 Kristin Cooke '00, a ftr't year ~pe Carol Whelan '99, enrolled 10 the ational Health Service Corps Ctall\ ' tudent 10 the GerontologiC,l l ANP Post !\ laster 's Program, ha<, (new recipients) 1'\u r'ie Pracllllo ner 1 rae!-, ha ~ pub two recent publications to her cred Helena Albertin l"hed t\\'o article,. Cooke, K., it: Ch rome Renal Failure- on Amy Alderson Kreyd atus, t\-1., Atherton, A., a nd Dialysis Management for the Sekou )one~ Thoman, 1:. ( 1998) The effect~ of Pnma n • Care Pro\"ider, Amenca11 jenmfe r Wright even10g light e'posure on the <, )eep jaumnlfor Nurse Prartllw11ers, july, of e ld erly women e'prc>> IOg sleep 1998, pp. 21 -33; and chapters, Renal National Hemo philia Foundati on co mpl a int ~. foun llll of Brlw1'iom/ Failure, H en1aturia and Proteinuria, Sher Viera M ~rl tci11c, Vol. 21 ( I), 103- 11~ ; and and Hypokalemia and Tabloski, P., Cooke, K., and Hyperkalemia, in P rill/111"1/ Care - A NCAA Postgraduate Scholarship ll1oman, E. ( 1998) A p rocedure for Collnl>ornltl'<' Prac/IC<', Ba iley, Buttaro, Amy B urn~ withdrawal of .,Jeep medtcation in and Trybulski, Ed'>. ew Yorl-: elderly wo1nen w ho have been Mosby, june, 1999 (in prc.,s). Nurses' Educational Funds, Inc. long-term u"~ r., . fmmtnlt~{ Man beth Pomeran tz GmmlologKnl Nurs111g, 24 (9), 20-27. The fo llowing students ha\·e Oncology N ursing Socie ty Reb ecca Edwards '99 and j e nnifer recei\'ed scholarships and / o r granh Karen Martin Mel nnes '99 ha\ e been ,eJected a, for the 1998-99 academiC year: co-rcciptent' of the RIChard D. PEO Scholarship Frisbee Ill Foundatio n Scholar<. htp American Association of C ritical Am) Drescher-Crumpley for 1998-99. The .,chola"htp wa> Care urses Deborah Rm ner established 10 memor) o f RIChard Elizabeth Sah ·aggio D. Fm bec Ill w ho d tcd of acute Stewart B. McKinney Foundation leul-cmta in 1989 a nd b awarded American Cancer Society Chnstina Kim annually to,, student or o, tudenh Karen Martin w ith an mtcre>t m oncolog} nurs Yale Club of ew Haven American Red Cross (Su mmit Area ing. Rebecca and jenntfer ,ue both Chapter) jeffrey Agli enrolled in the Adult Ad vanced Katherine Wy rough Philip Stearns Practice Nu n, mg Prog ra m. Con necticut Association of urse Ya le University Women's Recruiters Organization Kyung-Hee Lee Tara Coleman Deborah Ro\'ner George B. Boland Scholarship Sher Viera Trust jana Manassee YSN A lumni Fund Scholarships Brian A rev International O rder of King's Marie Bot;i t a ti bu~ Daug hters and Sons icole Btdlingmaier Carrie Hrubala Laura C irilo Robert Deegan Ja panese Medical Society Sheila Rina O ta m Hui Geen Rachel Kay Heid i Sweeney '99 and Rob lloyle Kennedy T. Friend Scholarship Kerrv Ma;cio an nounce the arm al ot Peter Elame Alpern So u~ ya Routray 1\tbon Ho\ le, born on October 15, Kimberley Ru ~se ll 1998, at 7 pound.,, I 'i o/ lletdt ;., a Leo po ld Sche pp Foundation Meghan Sawyer fina l \car .,tud ent 111 the Pt\. P Amy Drescher-Crump ley C harlotte Sma rt (Chron ic Illness) Program. Deborah Rovner Thomas Wilk 31 Sally Pullman '44 through published a book publkations, research, entitled, "Letters professional activities, and com Home: Memoirs mmtity service. of One Army Danuta Bujak '81, Nurse in the Assistant Professor in the FNP Beth Cheney '89 was recently Southwest Pacific in Program at the University of appointed to the Board of Directors World War II," chronicling her cor Maryland School of Nursing in of the a tiona) Association of u rse respondence to family and friends Baltimore and Clinical Instructor at Practitioners in Reproductive from her tour in New Guinea and the University of Maryland School Health. Since Janua ry, 1997 she has the PhjJippines. lt is available for of Medicine, presented a poster, been Women's Health Coordinator purchase directly from he r for $20 "Predictors of Outcome in Early at Wi nd ham Community Memorial plus tax. The YSN Refe rence Room Lyme Disease" at the Fourth World Hospital in Willimantic, CT per also has a copy gracious ly donated Congress on Myofa scial Pain and forming prenatal care and providing by Sally who can be reached at 10 Fibromyalgia in Silvi Marina, Italy local women's health sen ·ices for the Wells Road, Granby, CT 06035. in August. State's breast and cervical cancer screening program. Beth li ves with Karen Stolte '65 recently received Kate Ti mbers '81 1eft private prac her husband, Rick Mendes, and the Regents Award fo r Superior tice in April and accepted the posi their son, Alec, 2, in Columbia, CT. Teaching from the University of tion of Program Director for Mental Oklahoma. She is a CNM and pro Health Services at Petaluma Va lley Sherry Rinell '90 a nd her husband, fessor at the Uni vers ity of Hospital in California where she Rod, joyfully a nnounce the birth of Oklahoma College of Nursing and opened a new geropsychiatric unit. their fourth daughter, Chloe li ves in Oklahoma City. The hospital also acquired a partial Ve ronica, on June 15. Chloe is also hospital program a nd Kate was welcomed and nurtured by her Sharon Schindler Rising '67 was preparing for a JCA HO survey teenage sisters. Lindsay, Melissa, inducted iJltO Fellowship of the when she wrote to update Ynlc and Rebecca. American College of Nurse Nurse. Kate lives with her husband Midwives during its May, 1998 Bob and thei r children Amelia, 1-l, Annual Meeting in recogni tion of and Elizabeth, 11. her achievements in p roviding health care to women and infants. Jacquelyn Jordan '82 has moved Sha ron currentl y practices at Stay from Connecticut, w here she was We ll Health Center and Center for Associate Professor of Nursing at Women's Health in Wate rbury a nd Western Connecticut State at the Women's Ambulatory Health Universi ty, to accept a position at Services at Hartford Hospital, both Howard Unjversity in Washington, in Connecticut. She is also an DC as Assistant Dean of Associate Clinical Professor at YSN Undergraduate Nursing. and she li ves in Cheshire, CT. Martha A. Q. Curley '87 was Charlotte Houde-Quimby '72 was inducted as a Fellow of the inducted into Fe llowship of the American Acade my of Nursing in American College of Nurse ovember, 1998. N ursing Fellows Midwives during its May, 1998 of the AAN are recogniLed for hav Annual Meeting in recognition of ing demonstrated outstandiJlg con tributions to nursing beyond their her achievements in providing Tit~ Rmt'll {t11 11illr J\ Jcfl .....a Rcllt'(,:fl. health care to women a nd infants. professional position requirements Lmd c:>atf, aitd Cliftlt' 32 Michelle Bolles Vitale '93 and her hu~band , Rob, announce the birth of their d aughter, \.1adebne Anne, on june 8. She wetghed 6 pounds, 1-1 ounces Michelle Kennedy '94 married T. Anthony Prisco on September 6, 1998 tn Tunkhannock, PA. Classmates in attendance included Rachel Hutson, Deirdre Murty Marcus, and Kate Stephenson. Michelle and Tony live in Alexandria, VA and she continues her work at the VA Medical Center in Wa;hington, DC. She recently published, "Influenza viral infec tions: Pre;cntation, prevention, and YSN 199-l cJa.;,.~mafe.;, at Altcllt'lfc> kc'mlt'dt(' St•ptrml't'Y il't"ddmg. CL to Rl J....alt' Strpllt'IIS..lll treatment,' Tltc Nur"' Prnct•l""'"' a"'l !-J'tlU::-;t• Fmuk }orda11, .\ ftdn•/k; 1i.mtt f'n.;.al. tlu.· Srtltmt. Ot'trdn• Alr1rty A. l arot~. lwldmg foumnl, 23(9). liaughlt'r Hayt''-· llud 'J> Ann Oswood '9-t ,md her hu, band, Mark, ,mnounce the btrth of thctr She has now a~>ts t ed in more than East Bal..er; fi eld Community Health >econd son, Thoma'> Marl-., born 500 births since graduatton and ,., Center. june 2-1 , wctghmg 10 pound;, 2 thankful for her cxpenence at ) S 1 o unce~. Ann work. parl-ttme a; a Kathy Myint-Hpu '98 is worl..ing a~ nurse-mid " ife in a pri' ate practice Elizabeth Marlow '96 co-authored, a P1 P in the Pediatric Stem Cell in St. Lout>. She" the ftr;t C 11\ 1 in "Stop diabetes! An educational Transplanta tion Unit at Georgetown the practice. model fo r Natt,·e Amencan adoles H o~pt t al. She was recently married cents in the pre\'entton of d tabetes, and now l i ve~ in Washington, DC. Linda Buzby '95 writes from Ben Tile Dwbete,: Educator, j ul/ Aug 1998, Lomond, CA w h en~ ; he reports with Ga il D'Eramo Mell..us and Margaret Potts '98 took a position at enjoying her current po;ition as Anna Marie Bosma. She li ve; in the Lunenberg Medical Center in C M at Kaber in Redwood City. Bakersfield, CA w here she worh.s at Virginia this fa ll. kmtlll Calht'rlllt' St,mlt-ll 4l't1' lJtlrH Ill Rt'l't'r.ta Frome .. ''-lb m1d fame' 'tltmh'tt em A-largt• Funk '8.J mzd Akdt(d/·Sur:.;:tcal .1\JIIr'mg Progrilm. Cardun'ascular Nursmg gradua te~ Apnl 2o. Pltl$, wnghmg , 111 ; ll'!<. Both fmm tlte Cia~~ L~{ 1991 ft•ldmtft•d tlu· i.Pt'ddm:.;: oj dn .. .,matt• Pm,nma Smt<'?kncltmrd ou Au~u.;; t 1 1\.fom 1111d [lad 11rc '"'''f' Lu(J..!/ l\mtla 9, 1998. I L to RJ Mmxc. £1lt'<'ll Mo\dt><>. l'n~>ll11111, f..nre11 MeA my, <111d Pa lncrn Bn·s-c; 33 Return by March 1, 1999 to: Barbara F. Reif YALE UNIVERSITY SCHOOL OF NURSI G Alumnae/i Affairs Office 100 Church Street South P. 0. Box 9740 ew Haven, CT 06536·0740 NOMINATION FOR DISTINGUISHED ALUMNAE/I AWARDS 1999 The tradition of honoring outstanding alumnae/ i was started at the hme of YSN '~ 50th Anni\•ersary celebration m 1973. It is a very special opportunity to honor co ll eagu e~ and cJa,smates who have distinguished themseh·es w1th special talents and achievements. The YUS AA Board again so li ci t ~ your nominations of YSN alums who you feel should be recogni/ed in this way. These awards will be presented at the Reunion Banquet in june. The deadline for receipt of your nomina tion is March 1. Please ~end a ll nominations and supporting documentation to Barbaru Reif at the above address. Review the criteria below and provide as much specifi c information as possible to indicate the ways in which your nominee meets these criteria. You may wish to solicit help from your fri ends or colleagues. A curriculum vitae would be helpful, if one is available. The committee will also see!.. additional information on nominees where nee· essary. Criteria for eligibility for nomination: Achievement in and outstanding contributions to any of the following categories: Teaching and scholarship Clinical practice Leadership Research in clinical nursing Community /Society YS growth and development Explanation: I. How is the achievement or con tnbution beyond the normal e~pec t ation of the activity or position? 2. How is the achievement or contribution unique and innovative, having more than local impact? 3. Describe how the service to YSN /community /profession b continuous and sustaining. 4. How do the activities contribute to the development of new dimensions and directions in nursing? ~------ Your OMI EE: ______CLASS ______Class ______Your ame------Add ress ______ Phone ( __ ) ------ 34 Yale University School of Nursing Alumnae/i Association Non-Profit Org. U.5. Postage 100 Church Street South, P.O. Box 9740 PAID New Haven, Connecticut 06536-0740 New Haven, CT Permit No. 470