Hayes Scholar Tamryn Fowler Traveled to Seattle for Unique Educational Opportunity

Fowler,Tamryn

Tamryn Fowler

Last November, Tamryn Fowler, BSN ’09 and a current student in the MSN program at the SON, traveled with Dean and Alumni Distinguished Professor Kristen Swanson, PhD, to the Virginia Mason Medical Center in Seattle, WA. Her trip was supported by the Hayes Fund, a fund created by Art Odom in memory of his mother Annie Lathan Odom Hayes. The fund is unrestricted and can be used at the discretion of the School of Nursing Dean. Tamryn has generously shared some reflections with us from her experience in Seattle.

Traveling to Seattle as a graduate student was a dynamic, once-in-a-lifetime experience. To be able to fly across the country to embark on a new learning opportunity was incredible. When I first arrived in Seattle, I remember riding in a ferry boat, saying to myself, “It is late at night, and I am riding in a ferry boat with the Dean. This is surreal!” It is difficult to explain the extent of gratefulness that I have toward Dean Swanson and my UNC School of Nursing family. I have only rode in a plane a handful of times in my life, but flying to Seattle last November changed my perspective of myself, my goals, and the meaning of investing in others.

The Dean saw this trip as an opportunity for me to learn more about the role of clinical nurse leaders at the Virginia Mason Medical Center. My academic pursuits in the graduate program are focused on being a nurse educator as well as a clinical nurse leader. Dean Swanson knew that Virginia Mason is a pioneer in executing the clinical nurse leader role in healthcare institutions. I learned how Virginia Mason recognized breakdowns in a patient’s healthcare experience, care fragmentations, and uncoordinated care, and how, in 2004, they began enhancing the effectiveness of front-line nurses, preventing redundancy in clinical practice, and promoting efficiency in coordinating patient care by introducing clinical nurse leaders at Virginia Mason.

I visited Seattle for three full days in November. I first attended the Virginia Mason Model of Care Inpatient Services Retreat, at which I had the privilege of hearing Dean Swanson speak about her theory, the Swanson Caring Theory, in front of hospital employees, including social workers, nurses, clinical nurse leaders, nurse manager, and patient care technicians. As a group, we talked about the organizational context for caring, recalled the five principles of the Swanson Caring Theory, described the phenomenon of compassion fatigue and associated coping strategies, and thought about ways to foster actions of caring on a unit-level.

This retreat reminded me that I am a part of something greater. Nurses have moments when we are hard-pressed from caring for severely-ill patients, but we must remember the beauty of connection and the privilege we have in being able to care for others every day. Dean Swanson emphasized the importance of believing in yourself, trusting your teammates, and honoring each individual you encounter. Listening to the staff’s personal patient stories and the Dean speaking about her theory, I was reminded that I have a purpose to care for others, advocate for them, and figure out what patients need and what they are going through. The Dean demonstrated how we are all the faces, hands, heart, and head of the hospital’s mission. I talked with several clinical nurse leaders at the retreat and learned firsthand what it means to be the keepers of a patient’s story. Patients rely on clinical nurse leaders to tell their story, their struggles, their needs, and promote a continuity of care for them.

On the last day, I met with Kelsey Rounds, a wonderful clinical nurse leader at Virginia Mason. He allowed me to shadow him to learn what a typical day is like for him.  It was a post-surgical floor, and we encountered many different patients with various needs. Kelsey mirrored confidence, resourcefulness, strong listening skills, problem-solving capabilities, creativity, and translated information effectively for all team members to understand the patient’s care. His role focused on ensuring safe verbal hand-offs among staff, making recommendations, organizing team rounding, demonstrating critical thinking, clinical judgment, as well as good follow-up and note-taking. He recognized the importance of listening to various perspectives while keeping the patient’s needs in the forefront.

I am incredibly thankful to the family of Ms. Annie Lathan Odom Hayes for providing me with the Hayes Award.  As the first recipient, I am very appreciative and absorbed everything during my visit to Seattle. I am grateful for the UNC School of Nursing family for organizing this trip, advocating on my behalf, and investing in me. This experience outlines the importance of constantly bringing your best self forward in all situations because you never know how your purpose in life will help someone else.

Thank you!

SON Marks Year of Self Study, Accreditation and Program Review

The SON’s baccalaureate, master’s, PhD and continuing education programs each conducted rigorous self study reviews and underwent external reviews over the last academic year. As a result, the School’s baccalaureate and master’s programs were reaccredited for ten years by the Commission on Collegiate Nursing Education (CCNE). The PhD program received a positive review by UNC-CH Graduate School representatives and external reviewers from other Schools of Nursing, and the Center for Lifelong Learning was re-accredited as a provider of continuing nurse education for four years.

“We should be very proud of meeting this challenge with such great success. Accreditation is a wonderful opportunity for self-assessment of our programs, structure, practices and processes and the thoughtful identification of areas for growth and change,” said Dr. Beverly Foster, director of undergraduate programs.

A key component of the BSN and MSN accreditation process was the self-study report the SON completed in 2011 and presented to the CCNE. Dr. Maggie Miller, assistant dean for operations and strategic initiatives, headed the faculty steering committee for the self-study report, which documented that the School met or exceeded the CCNE standards related to program quality and effectiveness.

The four-chapter self study spoke to the history and mission of the School and University, resources available to carry out the programs, development of curriculum and program outcomes. With faculty input, the study assessed the School’s administration, philosophy, curriculum, facilities, faculty, staff, students and more, using the process as an opportunity for quality improvement.

The CCNE self-study was also used as a basis for the North Carolina Board of Nursing’s decision to continue the baccalaureate nursing program on full approval status.

“Our national accreditation in nursing is built on a quality improvement model so that we are encouraged to constantly assess how well we are doing. We have now looked carefully at ourselves, and from these findings have identified some areas of focus to move forward into the future. It is an exciting time as we build on our solid foundation to be a pace setter in nursing education,” said Dr. Gwen Sherwood, associate dean for academic affairs.

PhD program faculty completed a self study for a Graduate School Program Review, assessing the program’s strengths, areas for improvement and future directions. The preparation of the self-study report was led by Dr. Suzanne Thoyre, director of PhD and post-doctoral programs. A team of UNC and external reviewers conducted a site visit and provided a highly favorable written report to the Graduate School detailing their findings and recommendations.

The SON’s Center for Lifelong Learning also underwent an accreditation review this year. The Center staff completed a self study in fall 2011 and submitted it to the American Nurses Credentialing Center (ANCC). The ANCC then conducted a virtual visit, interviewing CLL staff as well as past participants and presenters. The CLL was granted full accreditation by the ANCC through March 2016.

“The accreditation process helped our unit think about our many strengths and identify ways to improve so that we can continue to provide high quality CNE that’s relevant, cutting edge, and will ultimately help improve client care,” said Dr. Sonda Oppewal, director, Center for Lifelong Learning.

Dean Kristen M. Swanson expressed her congratulations for the School’s earned approvals.  “I’m very proud of the collective efforts of our faculty, staff, and students who came together for a successful year of programmatic self study, external review and accreditation,” said Dean Swanson. “It is a worthwhile pursuit to thoughtfully assess how well our actions measure up to our vision, and to identify ways to take that vision further.”

SON Nursing Education and Simulation Expertise Utilized in Kitui, Kenya

Patient safety and quality are at the core of healthcare education across the globe. Over the past year, School of Nursing faculty and Kenya Medical Training College (KMTC) health professionals focused on these concepts in the enhancement of a skills lab at KMTC Kitui’s Centre of Excellence for Family Planning and Reproductive Health Training in Kitui, Kenya, Africa. The skills lab was recently upgraded by Capacity Kenya to include state-of-the-art teaching tools and simulation equipment. UNC SON faculty lent their nursing education and simulation expertise to a skills training program in collaboration with KMTC faculty at the upgraded lab.

Carol Durham, director of the Education-Innovation-Simulation Learning Environment (EISLE), Darlene Baker, assistant director of ,  Sonda Oppewal, SON clinical associate professor, and Gwen Sherwood, associate dean for academic affairs communicated regularly via Skype with faculty in Kitui to develop the training program’s educational goals and discuss logistics. Darlene Baker and Sonda Oppewal then traveled to Kitui, Kenya, April 27– May 12, 2012 to assist in the implementation of the program.

Capacity Kenya and KMTC Kitui received USAID funding to create the Centre of Excellence for Family and Reproductive Health Training. The Centre aims to improve health outcomes in Northern Kenya in women’s health, reproductive health, and decreased maternal and infant mortality through strengthening the healthcare workforce. Capacity Kenya was created by IntraHealth International. Its mission is to improve healthcare in Kenya by enhancing the quality of training for healthcare workers in public, private, and faith-based organizations.

SON’s involvement in the project included assistance in outfitting the lab as well as facilitating a two-week training session for nurse lecturers at KMTC. Prior to the visit, UNC’s EISLE researched and made recommendations on simulation equipment to match the needs of the local constituency. IntraHealth purchased equipment including simple contraceptive displays, task trainers, and complex birthing simulators. The equipment was grouped into five categories for training: childbirth, maternal, infant, physical exam, and patient care skills.

The most complex piece of equipment new to the skills lab was Noelle, a human patient birthing simulator made by Gaumard Scientific. Noelle is used at UNC SON and other schools and hospitals to train nursing and medical students as well as professionals. The simulator connects wirelessly to a computer that can be programmed to take students through a range of scenarios that could accompany normal as well as complicated childbirth.  At KMTC Kitui, Noelle was renamed Mwende which means “loved one”. Mwende was accompanied by a newborn baby simulator that enabled students to practice newborn resuscitation, a skill which was impossible to practice before the simulator’s arrival.

Darlene Baker led the equipment training, guiding KMTC staff through all stages of use. The local staff helped open the boxes, gaining familiarity with the equipment before learning utilization procedures. To complete the learning cycle, the team went over storage and cleaning, or what Baker called, “long-term considerations for the sustainment of the equipment.”

“I went there to be the boots on the ground,” Baker said.

“My role was focused on facilitating the training process,” Sonda Oppewal said. “This included helping the group identify training expectations and guidelines, facilitating the faculty members’ involvement in developing simulations, and helping them consider ways to integrate the new equipment and simulations into the curriculum.” Dr. Oppewal also helped evaluate the training, and assisted faculty members in identifying ways the project could be evaluated over time and outcomes could be reported to Capacity Kenya. They also developed models to summarize their learning over the two weeks for the faculty to use as a resource.

Dr. Oppewal also followed up on work she and Associate Dean for Academic Affairs Gwen Sherwood did in 2010 with Capacity Kenya on creating an AHEC-like model for improving the healthcare workforce in Northern Kenya.  Dr. Oppewal met with the Nursing Council of Kenya and reported that a steering committee and subcommittees had been formed, and partnerships were being investigated to establish the Kenyan AHEC model.

About 15 KMTC Kitui nurse lecturers attended the sessions taught by the UNC team. The training schedule included time for each lecturer to practice using the simulators and to develop and practice teaching simulations. Next, lecturers practiced using the simulators and the simulations they developed as teaching tools with students. Thirteen students were arranged into groups for simulations the lecturers identified as having high priority for student learning: family planning, normal newborn delivery, newborn resuscitation, and normal newborn assessment.

For the lecturers, “It was an opportunity to provide hands-on experience with key patient care skills which previously had only been taught theoretically,” Baker said.

It was a collaborative experience, with KMTC lecturers coming up with their own ideas for simulation training. Baker said of the experience, “It opened my eyes to new ways to use equipment here.” Some of the equipment had never been used before by either UNC or KMTC instructors; these provided new learning experiences for the entire cohort.

Dr. Oppewal said the UNC team benefitted from seeing KMTC lecturers interact with their students. She noted the effectiveness of the Kitui lecturers’ method of having each student demonstrate and verbalize what they were learning, and the students’ recognition of the need for continual practice. “The lecturers were clearly invested in giving the best education possible to their students and the students were eager to learn all that they could.” Dr. Oppewal also remarked that the Kenyan practice of taking a midmorning tea break made room for spontaneous collaborations among colleagues.

By the end of the two weeks, the KMTC Kitui lecturers formed a Skills Lab Committee with the goal of making the skills lab available to the district hospitals and other KMTC campuses. The Committee expressed a desire to expand the skills lab program so that it could be used by nurses in continuing education.

Overall, Baker said the experience was inspiring. “People were already doing so much with so little, and now they have an opportunity to do so much more.”

 

HCS Alumni Change the System through Nurse Leadership

HCS Alumni Panelists

A group of Health Care Systems alumni returned to Carrington Hall on April 24, 2012 to share their professional experiences with current HCS students. Their message: big changes are happening in health care, and nurses are leading the way.

The alumni panel, organized by the SON Office of Advancement and Associate Professor Cheryl B. Jones, brought in almost two dozen HCS alumni dating back to the graduating class of 2004. Nurse graduates came in from across the country, many with remarkable reports on what they’re doing now.

The SON’s Health Care Systems Program offers master’s and post-master’s training for nurses who want to further their expertise in administration, education, informatics, quality and outcomes management, and clinical leadership. Often these nurses have extensive clinical backgrounds and seek to influence health care on a system-wide level. According to a recent article in The Atlantic Magazine, now is a good moment for nurses to effect change by rising to leadership positions.

“Our current students already have successful careers, but it’s amazing to think of the expanded roles and opportunities that lie ahead,” said Dr. Jones, who referenced the Atlantic article. Proof of this trend was all around the room and shared by former HCS students.

Take HCS ’09 grad Angela Newman, nurse manager at WakeMed Cary, who was asked to help improve the oncology unit at her hospital. After observing oncology staff, Newman had the idea of expanding her unit’s operations by opening an outpatient clinic for blood transfusions.

“I put a proposal together, sent it to my VP, and within minutes he sent it to finance,” Newman said. It was Newman’s story of creating a medical day treatment unit that inspired Jones to bring the HCS students back to share their stories.

Susy Koruth, ’10, the SON’s first Clinical Nurse Leader certified graduate, is having a big impact in a clinical setting.

“As you can see, I’m completely clinical,” Koruth said, wearing scrubs for her position as CNL of the main surgical floor at the VA Medical Center in Durham. Koruth is not only the first SON CNL graduate, but also the first CNL to work at the Durham VA.

“At first the hospital didn’t really know exactly what the CNL role meant,” Koruth said. “But now it’s taking shape.” Koruth’s duties include monitoring performance improvement indicators for all the patients on her floor as well as serving as a support resource and educator. She has found an easy way to explain what she does: “You know the attending doctor? I’m the attending nurse.”

Another nurse whose career speaks directly to the nurse leadership trend outlined in the Atlantic is Lindsay Gaynor, ’04. Gaynor, who pursued the administration track with a focus on health care policy, is now director of clinical services and innovation for a multi-specialty physicians group in Massachusetts. Gaynor’s group is preparing to act as a pioneer Accountable Care Organization with Medicare. As an ACO, the group will work together as a network of hospitals, physicians, and other providers, sharing responsibility for the health of a specific population, in this case, of Medicare recipients. In ACO formations, providers are rewarded with increased pay when their populations show measured signs of good health, like decreased hospital visits.

“This is my first time at the executive level and I feel like we’re really having an impact on national health care reform,” Gaynor said. “It’s the team-based, multi-disciplinary care the U.S. health system has been talking about.”

Trent Praytor, ‘09 and Dustin Williams, ‘09

Dustin Williams, ‘09, spoke about the expanded roles in informatics that are and will become more available to nurses in the future.  These roles include the chief nursing information officer who leads and guides informatics operations; serving on teams to facilitate and coordinate the adoption of electronic health record technologies and the achievement of “meaningful use,” and leading efforts to implement a variety of electronic documentation systems.

Panelist Nancy Gleason, ’08, uses her HCS training in her role as a supervisor in the pre-anesthesia clinic at UNC. “I was learning something that I really needed to know in my current role as nurse manager from the get-go,” Gleason said of the HCS program. Gleason’s subsequent work and research have focused on patient safety, nurse empowerment in decision making, and nurse managers’ job satisfaction. “At this point in my career I’m looking to advance the legacy of nursing,” Gleason said.

“The one thing that I am learning, thanks to this program, is how to be a director,” said Beth Hutchinson, HCS ’10, administration, director of the Duke Birthing Center. Hutchinson spent 25 years as a nurse manager in pediatrics before taking on the role of director at Duke.

Trent Praytor, ‘09, also spoke about leadership opportunities for nurses in non-traditional settings.  After graduating from the HCS program, Trent took a position as a director of critical and progressive care at MedWest Haywood Hospital in Clyde, NC.  This step gave him the opportunity to help the organization achieve critical patient and organizational outcomes.  More recently, he has taken on the role of chief nursing officer at AnMed Health and Rehabilitation Hospital in Anderson, SC.  This position enables him to put his education to work by leading nursing services outside of acute care, and to ensure that patients who need rehabilitation services get high-quality care.   This was the perfect opportunity for Trent to take the next step in his leadership journey.
Before wrapping up, Jones asked the HCS grads what they wish they had more experience in.  The same words kept coming up: finance, marketing, facilities design, law, data analysis, project management. Their remarks reflect the increasing duties being undertaken by nurses who graduate from the HCS program and have opportunities to move above and beyond the jobs they first trained for.

Dean Swanson attended the panel and offered this in her closing remarks: “Never underestimate the lens through which you ask questions as a nurse.”  Our current HCS students and our graduates will do this as they continue to expand the boundaries of health care change, innovation, and leadership.

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UNC Provides Care, Supplies on Service Learning Trip to Honduras

A group of 22 students and volunteers from UNC School of Nursing and UNC School of Pharmacy went to Honduras on a service learning trip during spring break 2012. The group joined the efforts of Compassion Med International in providing medical screenings, care, and supplies to local populations.

The group was led by SON’s Jean Davison, clinical assistant professor and family nurse practitioner. Volunteers included SON’s Rhonda Lanning, clinical instructor and nurse midwife, Elizabeth Prata, family nurse practitioner from UNC Center for Latino Health, and Christine Walko, PharmD from the School of Pharmacy.

The group conducted over 100 health screenings on local children before seeing over 150 patients per day at four different clinical sites. In addition, triage staff cared for minor complaints and handed out anti-parasitic treatments and vitamins. All told, the group saw more than 1,000 patients over the course of their trip, and distributed 20 food packets that could feed a family of five for one week.

UNC’s MedWorld helped provide the group with medical supplies to distribute to local hospitals and clinics. One hospital received endotracheal intubation equipment while its pediatric ward received beanie babies and toys.  Other supplies and medications were donated to Dr. Elmor Mejia, who is the only doctor with a hyperbaric chamber for treating injured Miskito lobster divers.

Before leaving Honduras, the group met with US Attorney David Arizmendi, vice consul of the US Embassy, who expressed appreciation for the group’s service.

View photos from their trip here.

Meg Zomorodi selected for Nurse Faculty Leadership Academy

Dr. Meg Zomorodi

SON clinical associate professor Meg Zomorodi, RN, CNL, PhD, was chosen to participate in the 2012-13 Nurse Faculty Leadership Academy. By pairing new nurse educators with mentors and NFLA expert faculty members, this 20-month intensive program seeks to develop leadership skills in new nurse faculty. Dr. Zomorodi will work with Dr. Judith Halstead, PhD, RN, ANEF, FAAN, from the Indiana University School of Nursing to enhance her leadership capabilities and SON’s Clinical Nurse Leader curriculum.

Dr. Zomorodi chose Dr. Halstead as her mentor because of her expertise in online education. The two will work together to develop ideas for an innovative, engaging online CNL program and revise two core CNL courses. They will receive additional guidance from Dr. Carol Winters of East Carolina University.

“I was so surprised by the first meeting and the wealth of knowledge that was in the room,” Dr. Zomorodi said. “It was in the first 5 minutes of meeting my mentor that I knew I had made the right decision.”

The Honor Society of Nursing, Sigma Theta Tau International’s Leadership Institute developed the NFLA with a grant from the Elsevier Foundation. The academy promotes faculty retention and high performing, supportive work environments through a challenging learning experience that gives new nurse educators the leadership skills necessary for their transition into the faculty role. The Academy chose 16 fellows from all over the nation to participate in its 2012-13 program.

By participating in the program, Dr. Zomorodi will gain unbiased perspectives from schools that face similar challenges, giving her valuable insight into leadership and course curriculum development. Dr. Zomorodi believes that her participation in the program will benefit not only her but the School as a whole.

“It is an opportunity for us to be seen on the national level and I know I will be provided with many ideas that I will share with the faculty,” she said. “It’s also an opportunity for us to build up the CNL program which will benefit our students, faculty, and the surrounding hospitals who are interested in the role.”

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