Hayes Scholar Tamryn Fowler Traveled to Seattle for Unique Educational Opportunity


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!

Hypertension in African Americans

The School of Nursing congratulates Debra Barksdale who was notified today that her K23 (Mentored Patient-Oriented Career Development Award) has been funded by National Institute of Nursing Research (NINR). The title of her grant is, “Hypertension in Black Americans: Environment, Behavior, and Biology. Debra’s mentors for the grant are Joanne Harrell (UNC-CH SON) and Susan Girdler (UNC-CH SOM). If you are interested in learning more about Debra’s grant, see below for the abstract from her proposal – or just ask her. I know she would love to tell you about it.

Hypertension (HTN) is a major health problem for Black Americans: as a group they have the highest rate of HTN in the world. HTN develops at younger ages, is more severe, and leads to more adverse clinical outcomes and higher death rates for Blacks than for Whites. Chronic psychosocial stressors (e.g., daily hassles, racial discrimination and financial strain) are believed to contribute to the development of HTN. The purposes of the proposed mentored patient-oriented research career development award are to provide the necessary training experiences so that the candidate can achieve independence as an investigator conducting biobehavioral research and to begin to address the question of why some Blacks develop HTN while other Blacks do not. The training goals are to 1) expand knowledge of cardiovascular physiology and pathological mechanisms leading to HTN; 2) obtain expertise in the assessment of psychosocial stress and the integration of measures of psychosocial stress with physiological indices of stress; 3) obtain expertise in impedance-derived measurement of total peripheral resistance and to become skilled in the assessment of cardiovascular and neuroendocrine responses to acute laboratory-based stressors; 4) become proficient in the design, conduct and analysis of longitudinal studies and associated advanced statistical methods; and 5) disseminate results of research and develop a fundable R01 proposal. The candidate will engage in a 3-year intensive, supervised career development plan that will include: a) formal course work in HTN, stress, and advanced research methods; b) hands-on laboratory experiences with her mentors, consultants, and specialists; c) interdisciplinary experiences such as journal clubs, seminars, and conferences; and d) participation in mentors’ research team meetings. To compliment the training, the candidate will conduct a study to examine factors related to HTN in 128 Black men and women between the ages of 25 and 55. The study will compare Blacks with and without HTN for differences in indicators of allostatic load (sleep blood pressure, sleep total peripheral resistance, cortisol awakening response, and obesity); in chronic psychosocial stressors (daily hassles, racial discrimination, and financial strain); and in the moderating effect of positive and negative emotions, religious coping, and John Henryism active coping on the influence of chronic psychosocial stressors on indicators of allostatic load. A team of experienced researchers will serve as mentors and consultants in the areas of a) HTN and cardiovascular disease, b) physiological and psychological stress, c) biomedical assessment, and d) design and analysis of longitudinal research.

Chief Nursing Officer Retention and Turnover Studied by SON Professors


Cheryl B. Jones, PhD, RN, FAAN, Donna S. Havens, PhD, RN, FAAN, and Pamela A. Thompson, MS, RN, FAAN, are the winners of the American College of Healthcare Executives 2009 Edgar C. Hayhow Award for their article “Chief Nursing Officer Retention and Turnover: A Crisis Brewing? Results of a National Survey.” The article appeared in the March/April 2008 issue of the Journal of Healthcare Management.

The award will be presented on March 25, 2009, at the Wednesday morning Hot Topic Session #2 during the American College of Healthcare Executives 52nd Congress on Healthcare Leadership in Chicago.

ACHE grants the Hayhow Award annually to the author(s) of an article judged the best from among those published in the Journal of Healthcare Management, ACHE’s official journal. Named in honor of ACHE’s 14th Chairman, the Edgar C. Hayhow Award recognizes outstanding contributions to healthcare management literature. The article was selected by ACHE’s Article of the Year Awards Committee.

In their article, the authors present findings from their study on chief nursing officer (CNO) turnover and retention in U.S. hospitals. One of the major study findings is that approximately 62 percent of respondents plan to make a job change in the next five years, with about one-quarter of those set to retire. These results can be used by healthcare leaders to develop strategies and policies for recruiting and retaining CNOs and to ease the transition for CNOs and other staff when CNO turnover occurs.

Jones is associate professor, University of North Carolina at Chapel Hill School of Nursing; Havens is professor, University of North Carolina at Chapel Hill School of Nursing; and Thompson is CEO of the American Organization of Nurse Executives in Washington, D.C.

Nurse Executives Give 2009 Researcher Award to Donna S. Havens

Chicago, IL (Friday, January 30, 2009)

Donna Sullivan Havens, PhD, RN, FAAN, is the recipient of the American Organization of Nurse Executives (AONE) 2009 Nurse Researcher Award.  This award recognizes a nurse researcher who has made a significant contribution to nursing research and is recognized by the broader nursing community as an outstanding nurse researcher.

Dr. Havens is a professor in the school of nursing at the University of North Carolina at Chapel Hill where she teaches and mentors doctoral students studying health care systems and outcomes. Havens’ career includes a rich blend of roles in nursing practice, academe, administration and research.  Her contributions to the profession are derived from a sustained pattern of research and leadership aimed at shaping environments for quality nursing practice and quality patient care.

Havens is one of a few researchers who is defining and translating evidence-based practice for executive nurse leaders and managers.  For more than 20 years, she has studied, published widely, consulted, and presented nationally and internationally about the nursing practice environment, focusing on nurse executive leadership and turnover, professional nursing practice, staff nurse decisional involvement, and magnet hospitals.  She describes the purpose of her work as “Designing systems to promote desired outcomes (how to do it and how to make it stick)”. She has made unique contributions to understanding how to implement and sustain features of professional nursing practice as demonstrated by more than 200 multi-national and cross-disciplinary citations of her work in 42 journals and in six current technical reports that influence health policy including “Keeping Patients Safe: Transforming the Work Environment for Nurses.” (Institute of Medicine, 2004).

Havens’ research has been knowledge generating as well as translational and her research has influenced policy and fueled initiatives to enhance the nursing practice and patient care environment.  She developed the Decisional Involvement Scale, an instrument which is being used extensively in the United States and internationally to identify levels of actual and desired staff nurse decisional involvement and to identify potential opportunities for change and to monitor change.

Havens’ translational research initiatives are guided by the literature on capacity development, positive organizational scholarship, complexity science and participatory action research that demonstrate true partnerships between research and practice to improve nursing practice and patient care.  She is the principle investigator of two five-year research initiatives aimed at translating what has been learned from research about the nursing work environment and outcomes into evidence-based leadership and management to improve the quality of nursing practice and patient care in hospitals.  The two studies, “Building Capacity for Better Work and Better Care” and “Spiraling Upward for Nurse Retention and Quality Care,” are funded by the Health Resources and Services Administration agency of the U.S. Department of Health and Human Services.  Havens also served as the principle investigator of a study entitled “Why and How do Hospitals Pursue Magnet Recognition?” which was funded by the Robert Wood Johnson Foundation.  She collaborated with AONE chief executive officer Pamela Thompson, MS, RN, FAAN,  and Dr. Cheryl Jones, PhD, RN, FAAN, associate professor, health care systems, University of North Carolina at Chapel Hill, to conduct critical research on nurse executive turnover in a study entitled “Chief Nursing Officer Retention and Turnover: A Crisis Brewing.”

Havens has been a member of AONE since 1992 and served on its Helene Fuld Trust Expert Advisor Team in 2002-2003.  She is a fellow of the American Academy of Nursing (AAN) as well as a member of AAN’s Expert Panel on Quality and Expert Panel on Magnet Advancements.  She is a member of the American Nurses Association, AcademyHealth and a former member of AcademyHealth’s Dissertation Award Committee.  She serves on the National Advisory Board of the Forum for Shared Governance and is a former member of the American Nurses Credentialing Center’s Research Institute. In 2007, Havens received the Best Podium Presentation Award for “Designing Systems to Promote Desired Outcomes (How to Do It and How to Make it Stick) – A Model for Implementation” at the International Nursing Administration Research Conference.  She is also the recipient of the Villanova University Alumni Distinguished Contributions in Nursing Research Medallion.

Havens earned a diploma in Nursing from the Grace New Haven School of Nursing at the Yale Medical Center in New Haven, Conn., a BS in Nursing from Cedar Crest College in Allentown, PA, an MSN from Villanova University, and a PhD in Nursing with an emphasis in health services research from the University of Maryland.  She completed post-doctoral research on the organization of nursing and outcomes in the Center for Health Outcomes and Policy Research at the University of Pennsylvania School of Nursing.

About the American Organization of Nurse Executives
The American Organization of Nurse Executives (AONE) is the national professional organization for nurses who design, facilitate and manage care. With more than 6,000 members, AONE is the voice of nursing leadership in health care. Since 1967, the organization has provided leadership, professional development, advocacy and research to advance nursing practice and patient care, promote nursing leadership excellence and shape public policy for health care. AONE’s 48 affiliated state and metropolitan chapters and its alliances with state hospital associations give the organization’s initiatives a regional and local presence. AONE is a subsidiary of the American Hospital Association. More information about AONE can be found at www.aone.org.

Katherine Wilson: A Voice for Oncology Nursing

Katherine Wilson graduated from the School of Nursing with her BSN degree and as a Sigma Theta Tau inductee in 2004 during her battle with small cell lung cancer. She was not a smoker. After a valiant battle and six recurrences, Wilson died in February 2005 at the age of 28.

Before her passing, however, she wrote about her experience with cancer for a School assignment. Her writings were published posthumously this year in the Clinical Journal of Oncology Nursing. The publication also includes the award-winning photo of Wilson and her father John. Her mother Anne took the photo and entered it into the 2006 Lilly Oncology on Canvas art competition. The photo won first place in the Best of the United States Overall and Best of Family Members, Friends, or Caregivers categories.

To read Wilson’s entire article and see the photo, click here:


Carolina Nursing in Honduras Over Spring Break 2009

The Honduras Service learning trip is alive and well! We have done over 1,000 health screenings and de-worming tx and vitamins to mostly children. We have a team of 33 students and volunteers. In addition to health screenings, we have done feeding programs at very poor community centers in Honduras. Our days are very long but spirits are good. It is a great team.

-Jean Davison, UNC Chapel Hill School of Nursing Faculty Member

Idea for a Documentary Film: Biobehavioral Observation and Nutritional Evaluation Laboratory

By Norma Hawthorne, director of advancement

During the week we learned how to make documentary films based in the village of Teotitlan del Valle, Oaxaca, Mexico, our instructors Erica Rothman and Mikel Barton kept reminding us that the experience was more about the learning process than in making a polished finished product.  We reminded ourselves of that over and over (our instructors did, too) as we were challenged by what came our way.  I learned how important it was to shift, flex, adapt, and stay focused.  Others who attended would have their own experiences to share, I’m sure!

What story would I tell?  Would it be specific enough?  How quickly could I learn, let alone master, the editing software?  Would my Spanish be sufficient to enable me to ask impromptu follow-up questions of the person I was interviewing?  Would I be able to go deep enough to tell a compelling story with the help of a translator?  Can I operate this hand-held video camera without it shaking?  Am I going to get the right b-roll?  Will this story be interesting enough?  Is there enough action?  How do I make subtitles?

The film we made in Mexico will not win us an Academy Award.  But, that was not the point!  The point was to learn enough to come home and know how to create a documentary film in my own community.

Today, I met with directors of the UNC Chapel Hill School of Nursing Biobehavioral Observation & Nutritional Evaluation Laboratory to tour the facility and discuss donor naming opportunities.  What they do is fascinating.  In a home simulated environment, nurse researchers study the interaction between infants and mothers to determine how early cues influence feeding and early onset of obesity.  Other researchers look at the interaction between depressed mothers and children and how psychiatric mental health treatment can bring about behavioral change in the quality of those interactions.  Other faculty are studying the feeding behaviors of frail and/or demented elders.  Nutritional deprivation in hospitals and nursing homes is significant because of the time it takes for elders to eat.  Another nurse researcher is looking at obesity in children, especially Latino children, and is using the laboratory to capture and assess findings.

What is learned in all the studies will be used to train parents, patients, family caregivers, home health and long-term care workers, aids and medical professionals.  Faculty and graduate students can also be trained.

This is an exploding area in health care education.

Behavior is videotaped in the Observation & Nutritional Evaluation Laboratory, then scored according to a recognition system to validate what behavioral characteristics promote or detract from good health.  Researchers modify packaged systems for specific health behaviors. Video is really important, one director says.  It is minimally invasive and helps to see and examine behavior and environmental interaction.  They also know that there are behavioral and biological interactions.  Body chemistry changes depending upon the environment. They have learned through these studies that both behavior and biology can change.

My wheels are clicking!  They have videotaped footage (b-roll).  They have a professional videocamera and film editing software.  They have people power who know how to do this!  We need to conduct interviews with faculty and subjects, and voila, we’ll have a documentary!  I propose this to them and they’re excited.  This is what it means for me to bring it home!

The laboratory was recently created and we are seeking private funding from a foundation or individual donor that will put their name on the laboratory to underwrite the work that is being done there to improve health care.  Please contact me if you know someone or an organization that would help us.  Norma_Hawthorne@unc.edu

Carolina SON Alumni Trip to London, March 7-14, 2009

Florence Nightingale, Big Ben, The Tower of London, Trafalgar Square

A Week in London with Your Carolina SON Alumni Association

7 Nights — Saturday, March 7 to Saturday, March 14

Send me an email if you have an interest in participating in this or future international trips to London: Norma_Hawthorne@unc.edu

Program Description:

You will join Clinical Assistant Professor Laura Nasir, MSN, RN, FNP-BC, Associate Dean of Academic AffairsGwen Sherwood, PhD, RN, FAAN (who also heads our international nursing programs), and a group of very talented graduate nursing students for this innovative, academically-focused, fun and exceptional week in London. Both leaders are SON alumni.

You will explore the demographic, historical, cultural and organizational characteristics of health care in England. You will participate in discussions of major health problems and organizational responses in England and observe major health care and nursing settings. You will identify personal experiences as you participate in cross-cultural learning and compare the US and UK health care systems.

You’ll have plenty of free time to explore London, attend theatre, enjoy museums, shop and dine out.


  • Visit the Nightingale Museum
  • Explore the National Galleries and Buckingham Palace
  • Participate in private sessions at King’s College
  • Meet groups and associations such as the London Health Observatory
  • Hear from local experts about healthcare and nursing in the U.K.
  • Share your experience with graduate nursing students, other alums, and knowledgeable faculty

Limited to 5 alumni participants.

Estimated Cost: $1,995-2,195 per person (includes lodging and breakfast). Does not include air travel, insurance, meals, entertainment, incidentals such as taxis, ground transportation and gratuities.

Optional Continuing Education Credit: $399 per person. We estimate that this trip will offer 25-27 CEUs approved by ANCC. (30 CEUs are required every two years for North Carolina relicensure.)

Carolina Tops Peers in Undergraduate Nursing Program Evaluation

At a recent faculty meeting, undergraduate program Director Beverly Foster, PhD, presented evaluation results from a survey conducted by our 2006-2007 BSN graduates. More than 79 percent of them completed the comprehensive survey that was conducted under the auspices of the American Association of Colleges of Nursing (AACN). Survey results were extraordinary. In all dimensions, UNC-Chapel Hill School of Nursing topped the six schools in the AACN database that we selected as our leading peers– all the nursing schools that exist within research extensive universities as classified by the Carnegie Foundation and all the nursing schools (approximately 215) in the AACN database. Students indicated that we were outstanding in overall program effectiveness, role development, core knowledge, technical skills, core competencies, professional values, classmates, facilities and administration, course lecture and interaction, work and class size and quality of nursing instruction. “Although there is always room for improvement in any educational program, we are clearly excelling with respect to our peers … in every category,” said Linda R. Cronenwett, PhD, RN, FAAN, dean of the School of Nursing.


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