2020 WCN Annual Conference Keynote Address: The Evolution of Education and Leadership

Wisconsin Center for Nursing Annual Conference A Past to Celebrate: A Future to Shape Three Pandemics: The Evolution of Nursing Education and Leadership • Covid‐19

• Racial Injustice

• Economic Mary Beth Kingston, PhD, RN, NEA-BC Living in an Historic disasters September 11, 2020 Time

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Cracks have exposed problems in: Healthcare system Leonard Cohen Quote . Resources . Ability to respond to pandemic . Disparities

Society . Injustices “There is a crack in everything, that’s how the light gets in”. . Support for Vulnerable Populations . Economy An opportunity to lead…….

The Future of Nursing 2020-2030

Chart a path for the nursing profession to help Overview our nation create a culture of health, reduce health disparities, and improve the health and well-being of the U.S. population in the 21st . Nursing leadership and during crisis century. situations . Back to the future: We’re learning from the pandemic response Nursing leaders and innovative practices. What can we learn advocating and caring from early and past nursing leaders? for vulnerable populations . Starting at “home” – nursing leadership and diversity in nursing

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Similarities Between Pandemic and Nurse Leaders in Battle: War and Battle Epidemics . unrelenting So many examples…. . high personal risk Of course, Florence Nightingale in the Crimea, but a few others to learn from: . uncertain “enemy” . during the Civil War and . physical and mental fatigue beyond . inadequate resources . Philadelphia Visiting Nurses and the1918 . high numbers of fatalities Spanish Flu Epidemic . little time to process . Cliff Morrison and the Nurses of Ward 5B at . disparities in care San Francisco General Hospital at the beginning of HIV/AIDS

‘Independent’ Nurse in 1918 Influenza Epidemic “Spanish Flu” the Civil War. . Not enough trained nurses to provide care Brought needed supplies and then . Strong national nursing leadership (Jane served on front battle lines Delano and Clara Noyes) Lifelong career of . Nursing professional had developed a strong aiding people in times of conflict and disaster infrastructure: National Organization of Overcame extreme Public Health Nurses and Red Cross Town childhood shyness to and Country Nursing Service which quickly publicly speak This Photo by Unknown Author is licensed under CC BY‐ND throughout the moved into action country of her wartime experiences . Noyes telegraphed all Red Cross Divisions Clara Barton (1821‐ Testified at Congress “Suggest you organize Home Defense 1912) Founded the American Nurses… to meet present epidemic….. Red Cross provide nurses with masks.

Cliff Morrison and the Nurses of Ward 5B: HIV/AIDS Philadelphia Visiting Nursing Society . San Francisco General Hospital’s 5B was the first unit dedicated to HIV/AIDS care in the United States . Cliff Morrison proposed and implemented a caring, • Began providing care to people with infectious humane way to care for patients with HIV/AIDS diseases . He noted “I slowly found nurses who were interested. • Health Commissioner assigns all city nurses to There were not a lot of them, but those I hired were like the Visiting Nursing Society me—headstrong and passionate”. • 16,165 visits to 4,050 patients during the course of the epidemic, in one instance taking on 200 . Redefined the term family for patients with AIDS new cases in one day. . “If we can’t save everyone, we’re going to touch them • If you would ask me the three things . Found opportunity in adverse circumstances Philadelphia most needs to conquer the epidemic, I would tell you `Nurses, more nurses, . Activist for patient rights and dignity and yet more nurses.' Doctors we have enough of. Supplies are plentiful, buildings are offered us everywhere. We have many beds that might be opened to patients. But without enough nurses to tend those we already have, we are helpless.” Krusen, 1918 2 2020 WCN Annual Conference Keynote Address: The Evolution of Nursing Education and Leadership

Honoring the Past: Lessons learned Vulnerable Populations from “battle” situations . Nursing response was shaped by the political and current state of nursing and medicine . Importance of a strong nursing public health infrastructure . Need for a national planning process with nursing representation . Utilize a broad network of churches, social agencies and volunteers . Cooperation and Collaboration

Lillian Wald (1867-1940)

. Graduated from New York City Hospital Training School : . Organized classes on home nursing for Public immigrants on the Lower East Side . Recognized the impact of social and Health economic status on health Progressive . Felt a responsibility to bring affordable health care to this population . Founded the Henry Street Settlement

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Lillian Wald Mary Breckenridge • Founder, Visiting Nurse 1881‐1965 Service of New York . Graduated from St. Luke’s • Child advocate –public Hospital Training School in school nursing program New York. • Convinced Metropolitan . Studied public health Life Insurance to hire nursing at Columbia nurses University and received • Lobbied for workplace certificate in midwifery in London safety . Founder of the frontier • Persuaded Columbia to nursing service hire the first professor of nursing • 1921 founded the American Association of • “Health of the Nurse‐Midwives community affects the • Managed fundraising health of the individual” This Photo by Unknown Author is licensed under CC BY and publicity to keep This Photo by Unknown Author is licensed under CC BY‐SA‐NC the service going

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Mary Eliza Mahoney: Civil Rights Activist

1845‐1926 Nursing Leadership and Diversity in Nursing

This Photo by Unknown Author is licensed under CC BY‐SA This Photo by Unknown Author is licensed under CC BY‐NC‐ND

Mary Eliza Mahoney Mabel Keaton Staupers (1890‐1989) . First licensed African-American nurse. Nursing • Immigrated from Barbados and later program limited admission to one African- enrolled in Freedman’s Hospital School American and one Jewish individual in each of Nursing (now Howard University) training class • Director of nursing at the Booker T. . In 1908, co-founded the National Association of Washington Sanitarium ‐‐ the first Colored Graduate Nurses (NACGN) hospital in Harlem to treat African‐ Americans with tuberculosis . Director of the Howard Orphanage Asylum for • Instrumental in integrating African‐ black children in Kings Park, Long Island American nurses into the United States . Champion for women’s rights. After the military, enlisting the help of First Lady 19th Amendment was ratified in August 1920, Mahoney was among the first women who • Organized a national letter writing registered to vote in . This Photo by Unknown Author is licensed under CC BY‐SA campaign to successfully desegregate nurses in the Armed Forces • Leader in the effort for full professional integration of the American Nurses Assoc.

Historical perspective Historical Context . Education typically separate or limited . 1971, the National Black Nurses Association was . First professional nursing organization (evolved formed into the ANA) did not support African-American . Noting that African-American nurses had “very little nurses presence and influence in the leadership of the . WWI Red Cross application American Nurses Association . National Association of Colored Graduate . In 1978, first African-American ANA president was Nurses(1908) successfully lobbied to open the elected, Dr. Barbara Nichols! Followed by Dr. Army Nurse Corp to African-American nurses Beverly Malone and the current president, Dr. during World War I Ernest Grant . State organizations began to open membership . Today, continue to have low percentages of nurses during this time, but others persisted in restrictions. of color in association and healthcare delivery . The last state organization did not desegregate leadership positions. until 1961 and the last district – 1964.

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Lessons Learned: Diversity in Nursing What are the common themes? Leadership . Sense of outrage Systemic racism impacted health on so many levels: . Told their stories broadly and passionately . Barrier to an individual’s goals and livelihood . Importance of widespread social and . Perpetuation of disparities in care community action . Quality of life . Persistence and tenacity . Supply of nurses – wartime and crisis . Need to be in forums where decisions are . Too few nurse leaders of color = too few nurses of made color . Change happened very slowly . Political activism . Leaders learned to navigate the system . Champion of causes that impact humanity . We have much work to do and dignity

What is different? Specific Actions

. Globalization . Be outraged at injustice . Climate change . Tell the compelling stories . Technology . Self-reflect and challenge silence . Social Media . Optimize inclusion at your own workplace . Human “encroachment” . Examine hiring and promotion practices . Ensure broader perspectives in educational and clinical settings . Advocate for access and equity in care for all – focus on vulnerable populations

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Actions cont’d

. Focus on the environment . Integrate the social determinants of health across the care continuum . Normalize self-care and well-being . Nursing educational curriculum . Engage politically . Recognize and use the power of the nation’s 4M nurses to improve care, health, reduce disparities and address structural racism

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