Fall 2021 issue of ForwardNursing MagazineFile: SoN-ForwardNursing-Fall-2021-web.pdf
By Wendy Vardaman
Preceptors challenge themselves to mentor nursing students for the good of the profession. Along the way, they provide feedback to students and faculty about students’ progress, model effective nursing practices and ways of thinking, introduce students to interprofessional practice, and help students understand how to incorporate evidence-based strategies into practice. While students learn and practice nursing skills under the guidance and observation of their preceptors during work hours, preceptors also contribute their own time outside of work to prepare and to communicate with faculty.
“I was successful at my job [because] I had great training and good preceptors who supported and helped me. That was such a big part of my becoming a nurse.” —Emily Schumacher ’10
Though precepting is unpaid, the rewards include sharing knowledge with the next generation of nurses, providing support and mentorship to others, and giving back. Emily Schumacher ’10, DNP’18, CPNP, APNP, says her own student experiences with preceptors motivated her to take on the challenge. “I was successful at my job [because] I had great training and good preceptors who supported and helped me. That was such a big part of my becoming a nurse.”
A preceptor for over five years, Schumacher first worked with registered nurses before taking on doctor of nursing practice students during the pandemic. A pediatric nurse practitioner at UW Health in Developmental Pediatrics, Schumacher is a provider in the Autism and Developmental Disabilities Clinic at the Waisman Center. She and the team she belongs to help children and their families accomplish their development and behavior-related goals.
“I work in a fairly unique area. I’m the only NP in Developmental Pediatrics. I think it’s helpful for people working in the system to have awareness of developmental disabilities and autism, and support and resources for children who have disabilities in Wisconsin.”
Being supported on her “bad days” made all the difference to Schumacher. “Having someone to support you and point out the things you did well and to share their stories of messing up but things turning out okay is important.”
Schumacher also notes the importance of maintaining constructive communication with students. “I end my day making sure we touch base, even if it’s been super crazy, to give them one statement of praise and one thing to work on.”
Additionally, Schumacher demonstrates how to maintain a healthy work-life balance in a challenging profession. “I want the students I work with to know a little bit about my personal life and what I do to stay healthy. I do yoga, I work out frequently. I have a two-year-old and leave work at a reasonable time to be with him. When I spend time with my family, I don’t check work emails. I want students to understand setting those boundaries so they don’t get burned out.”
Precepting has its challenges, Schumacher acknowledges. She learned early on to have clear expectations and a review process in place at the beginning of the semester so that students get the most out of their time with her. Schumacher also says having supportive colleagues can help find bandwidth at work. She advises having conversations about one’s desire to precept before starting.
For those considering precepting, Schumacher recommends taking the half-day online “APP Preceptor Workshop.” Offered through the UW–Madison Interprofessional Continuing Education Partnership (ICEP), the workshop is geared toward meeting the needs of busy clinicians who precept physician assistant (PA) and DNP students.
The workshop helped Schumacher decide whether to try precepting and where she would find support in the role. School of Nursing faculty are, she says, “extremely reachable and helpful. They’re really responsive. I definitely felt supported that way.”
Schumacher counts her relationships with new nurses among precepting’s biggest rewards. Writing recommendations to help nurses get their “dream job” after graduating, following a nurse’s success, seeing students grow and learn for themselves “what they can accomplish and what they can do by the end” of just a semester, and learning from students are part of the preceptor experience. “If you’re thinking about it,” she says, “just do it.”
This fall, the School of Nursing honored the nursing Class of 1971 as they celebrated the 50th anniversary from graduation. While preparing to begin their nursing careers, the 1971 graduating class experienced tremendous change during their nursing education — both on campus and throughout the world — including witnessing Vietnam War protests and the lowering of the voting age to 18. There were 148 graduates from 1971 who went on to transform health care systems, serve others selflessly, and embody the Wisconsin Idea.
In conjunction with celebrating this milestone, the class established a legacy gift to the School of Nursing. The Class of 1971 Diversity, Equity, and Inclusion Student Support Fund is a new, permanent endowment that will provide financial support to underrepresented students who demonstrate financial need. With over $52,700 raised to date, this fund will support retention efforts for students to engage in professional development opportunities and activities that will support their nursing education.
Barbara Brown ’71 explained, “It was only fitting that our class established an innovative fund that will be fulfilling an unmet need. Our legacy fund will continue to grow over time and will enhance the experience of nursing students as they prepare to become health care leaders and change-makers.”
Class of 1971 Celebration Committee Members: Barbara Brown, Laurie K. Glass, Linda Hurwitz, Connie Keyes, Pat McCowen Mehring, and Lynne O’Donnell
Class of 1971 Reflections
Members of the Class of 1971 share their experiences and memories of their time at the School of Nursing and their careers post-graduation.
Significant Experiences or Memories of the School of Nursing
“Petitioning [Dean Valencia Prock] and School leadership to make the wearing of nursing caps optional.”
– Barbara Brown ’71
“I felt at home at the School of Nursing, but I do clearly remember going to clinical at University Hospital with the National Guard lined along the way to give us safe passage during the Vietnam War protests. One evening, the Memorial Library was tear-gassed and had to be evacuated. It was something I will never forget.”
– Linda Hurwitz ’71
“An OB rotation with Captain Sue Frazier, Barb Brown, and Laurie Glass. Pre-clinical inspection, we showed up for clinical with white shoe polish on our forearms (much to our dismay) after a fast application in the car on the way to the hospital.”
– Lynne O’Donnell ’71
Favorite or Significant Nursing Roles Throughout Career
“1. Geriatric nurse practitioner in a VA nursing home at the Milwaukee VA in the 1980s. 2. Acting Director for Research and Evidence-Based Practice for the VA Central Office in Washington, D.C. where I had the opportunity to travel to various VAs across the country.”
– Beverly Priefer ’71
“I became a physician’s assistant as my husband was a family practice physician and needed help. Through helping my husband as an RN/PA, we established the first free-standing Minor Emergency Center in Austin, TX in 1977. We were one of the first in the country. We handled everything from colds to heart attacks. What an adventure!”
– Diane Siedschlag Ela ’71
“Serving as a professor, teaching all levels in a university college of nursing; and developing my expertise as a nurse historian, including historical research and directing a nursing history center which includes 1 of only 6 nursing museums in the country.”
– Laurie K. Glass ’71
Ways Nursing Education Influenced Career/Life Path
“I worked in hospitals and office and clinic settings after graduation before switching to a career in IT. I spent many years supporting IT in the White House complex. I found my nursing skills invaluable: setting and resetting priorities; working with difficult people and evolving technology.”
– Linda Tolkan ’71
“The solid background enabled me to work in an acute care setting, becoming the nurse manager of a unit, and then transition to healthcare administration for the Medicaid Division in the state of New Mexico.”
– Rita Sheski Wood ’71
“Having my BSN and MSN has allowed me to practice in a variety of roles–teaching, consulting, facilitating expanded roles for nursing in the outpatient or ambulatory care setting. My UW nursing education was particularly helpful as a foundation for my career in ambulatory care. My interest in interdisciplinary care and working with multidisciplinary health care teams was clearly inspired by my UW education. The emphasis on health promotion and continuity of care across care settings were also critical to my ambulatory nursing career.”
– Connie Bresina Keyes ’71
Impact of School of Nursing Faculty, Leadership, and/or Staff
“Bev LaBelle McElmurry shaped my nursing foundation. Her patience, insight, respect, support, guidance, and ability to teach us to learn from each other was phenomenal.”
– Barbara Brown ’71
“Erna Ziegal who taught obstetrics. She had a magic way of making you feel capable. If there was something you didn’t know she always let you know that she would give that information and you would be great. She was the best role model. We had many wonderful teachers and another that remains pivotal was Jan Anderzon.”
– Louise Juliani ’71
More about the 50th Celebration at the School of Nursing
By Caitlin Clark
Nancy Foreman Kaufman ’71 lived and breathed the Wisconsin Idea. She dedicated her life to the service of others and demonstrated impeccable leadership through her numerous personal and professional endeavors. For over 50 years, she dedicated her career to population health, public policy, and the profession of nursing. She practiced in acute health care settings, public health administration, a national health foundation, and a large health care system. She tirelessly supported the next generation of nurses in advocating for positive health outcomes for all, especially among the most marginalized populations. She also aspired to ensure that the expertise of nurses is represented in all health care arenas.
After receiving her bachelor of science in nursing from the School of Nursing, she went on to become the first nurse to be admitted and receive a graduate degree in Administrative Medicine from the UW School of Medicine and Public Health. She held positions in Wisconsin’s government from 1971 to 1991 and, in her last post, was the deputy director of public health for Governors Thompson, Earl, and Dreyfus. She served for twelve years as the vice president of programs at the Robert Wood Johnson Foundation. She served for five years as the vice president of philanthropy at Aurora Health Care. She was the founding principal of the Strategic Vision Group, a health consulting firm based in Milwaukee, Wisconsin.
Nancy served in numerous leadership positions throughout her career, including on the Board of Scientific Counselors for the Center for Disease Control’s National Center for Infectious Diseases, and as a member of the National Advisory Councils for the Agency for Health Care Research and Quality (AHRQ), the National Institute on Drug Abuse, and the Department of Health and Human Services Interagency Council on Smoking. Nancy also worked on global health issues with the World Health Organization (WHO) and the United States Agency for International Development (USAID), in Geneva at the World Health Assembly and tobacco treaty negotiations in Europe, Asia, and Africa. She was a Fellow in the American Academy of Nursing.
Perhaps one of her most rewarding experiences, though, was giving back to the University of Wisconsin–Madison. Nancy chaired the School of Nursing’s Board of Visitors and the School of Medicine’s External Community Grant Review Committee. She was also a member of the School of Medicine and Public Health’s Dissemination and Implementation Advisory Committee. She also treasured her time mentoring UW nursing students. In 2019, Nancy received the Nurses Alumni Organization (NAO) Distinguished Achievement Award in recognition of her service to not only the university, but her career in public health policy change in Wisconsin, nationally, and globally.
In an interview with School of Nursing staff after receiving the award, Nancy was asked why she gives back to the university. She said, “I am a big believer in paying back time, talent, and treasure to the institutions that gave me the skills to launch and succeed in my public health career.”
In early 2021, Nancy’s health began to decline. With a poor prognosis, she and her husband Ira Kaufman decided to establish a fund in her name to support the School of Nursing. The Nancy Kaufman Leadership and Public Health Fund was created, in close collaboration with Ira, to honor their request. Ira and the Kaufman family have asked that any gifts in her honor be directed to support this fund. It reflects not only Nancy’s lifetime of impact on health through the nursing profession and health policy but is also an expression of Ira’s deep love and admiration for Nancy. Though the School of Nursing community deeply misses Nancy, her legacy will stay with us forever.
Honoring Nancy Kaufman
Dr. Barbara Bowers, PhD, RN, FAAN was a School of Nursing faculty member for 37 years. She started as an assistant professor and ended her career as a professor and the School’s associate dean for research and sponsored programs, and Charlotte Jane and Ralph J. Rodefer chair. Her research focused on care of older adults and the workforce that provides care for them, including family caregivers, paid caregivers, certified nursing assistants, nurses, and others who care for people who are older and/or permanently disabled. Bowers also founded the School of Nursing’s Center for Aging Research and Education (CARE) to bring together researchers, clinicians, community members, educators, and others committed to improving aging and building the skills and capacity of those who care for older adults.
Now in retirement, Bowers continues to mentor PhD nursing students as a professor emerita at the School. She serves as the chairperson of the Advancing Excellence in Long-Term Care Collaborative, a national not-for-profit organization that provides a forum for its members to discuss diverse perspectives, policies, regulations, and environmental trends that affect post-acute and long-term services and supports. She also serves as an associate editor for The Gerontologist, the official journal of the Gerontological Society of America.
The Bowers Fellow
In 2021, the Bowers Fellow was established in recognition of the legacy Bowers has created as a nurse educator, researcher, and philanthropist. The Bowers Fellow is the newest giving level within the Bunge Society, and it honors and thanks those who join Bowers in creating their own nursing legacy by including the School of Nursing in their estate plans.
We sat down with Dr. Bowers to ask her about her experience adding the School of Nursing to her estate plans.
ForwardNursing: Can you tell us about the gift that you and your husband Ian have made to the School of Nursing, specifically the one that you’ve included in your will, and what it will be used for?
Barbara Bowers: We’ve thought long and hard about this as most people do about what will happen to their resources when they’re no longer here. We wanted to leave something that would allow researchers, clinicians, and teachers to continue doing the good work in care of older adults in particular. So, we decided to eventually leave all of the resources that we have in our estate to the School of Nursing. A lot of this [process] was thinking about how to make the gift be used in a general realm of an area that we were interested in, but not to tie the hands of the people who would be making those decisions about how to use it in 20 or 30 years into the future. The way we decided to do that was to talk more about what’s important to us, what our values are, and not to say it has to be used [in a specific way].
We’d like this to be used for faculty development in [the area of aging and care for older adults]; helping students who are struggling and maybe have fewer resources than others; and for continuing development of CARE because I don’t think this integration of teachers, clinicians, community members, and researchers is a common thing. [But] everything needs resources to run and nobody wants to pay for operations, so…if it needs [to be used for] basic operations to keep [things] going, that’s fine.
FN: How were you and Ian introduced to estate planning and that it was viable option to make an impact at the School of Nursing?
BB: My parents did a lot of giving so I saw that as I grew up. I [also] remember there was someone who came from the UW Foundation several years ago to the School of Nursing before we moved into this building who was talking about helping people give to things that will make them feel really good. They said that giving needs to be set up in a way that it’s as helpful for the donor as it is for the recipients, and I think that’s really true — to be able to think that what you have earned and worked for over the years is going to be used for a long time to come, to support things that are important to you, that you value even though you’re not going to be here to see it is a gift to me and my husband. We have three children who are going to be getting something, obviously, from our estate for their lifetime. Part [of the estate] will go to the university and part to them as a trust fund where they will get a certain amount every year…and then [the rest will] go to the university.
FN: Can you tell us a little bit more about your experience establishing this gift, the process, and what you learned through it?
BB: I think it was really helpful to talk through it with people from the Foundation who were gentle, they were not heavy-handed. I mean, basically this was our decision to do whatever we wanted; they were very accommodating but gave us information that was important about how to structure this and that’s when we came to a decision [to] just say what’s important to us and hope that whoever is making decisions in the future will take that into consideration. I think understanding and looking at how it’s given out, which is the four and a half percent a year that gets generated from the gift and I guess that’s no matter what the income is on the fund. So, to understand how that’s done was helpful. It was an easy process; they were very helpful and as I said not at all heavy-handed. We felt supported, we didn’t feel rushed, we didn’t feel pressured…I think they were very good at being helpful but not pushy.
FN: What advice do you have for others considering making a gift to the School of Nursing?
BB: It feels nice; I think it’s rewarding, certainly for the donors…I know I’ve said this several times but just be flexible and be clear [about] general preferences but don’t make it too specific. I just think it feels really nice, so if you feel connected to the school and you had a good experience here, it’s a really nice thing to do.
“I think you just can’t… unless you’ve seen it, you can’t appreciate the incredible impact of even a small gift; you know, a gift that allows an undergraduate student to go to their first conference and show a poster and have people come by and be really interested in what they’ve done. I mean, this is what inspires people to go on in their education, to feel really good about the profession that they’ve chosen…those gifts are just crucial. So big or small, I would encourage people to donate and enjoy.” —Barbara Bowers
FN: The School of Nursing has a big milestone coming up in 2024 as we celebrate our centennial anniversary. In your opinion, how has philanthropy impacted the last 100 years to help us obtain the success we have now, and how can alumni and donors make an impact on the next 100 years of nursing?
BB: I don’t think everybody is aware of how much impact a gift can make when it’s used for things that are not the basic operating costs. They’re usually supplements, whether it’s for students to be able to continue to stay enrolled or to have a decent quality of life, or for faculty to continue their research or develop better educational programs. When I think of, for example, the Schulte gift, as long as I’ve been here it’s been crucial in terms of bringing in visitors that were really important for the professional development of students and faculty, for helping new assistant professors get going on their research, for sending students to conferences where they get inspired and excited about things.
I think you just can’t… unless you’ve seen it, you can’t appreciate the incredible impact of even a small gift; you know, a gift that allows an undergraduate student to go to their first conference and show a poster and have people come by and be really interested in what they’ve done. I mean, this is what inspires people to go on in their education, to feel really good about the profession that they’ve chosen…those gifts are just crucial. So big or small, I would encourage people to donate and enjoy.
It’s wonderful if you can do it while you’re still here — instead of just a legacy gift — where you can see the impact. I had a brother-in-law who said, “Giving with a warm hand instead of a cold hand.”
Create Your Legacy
If you’d like to learn more about including the School of Nursing in your estate plans or other forms of giving, contact our Development Team!
Director of Development
Associate Director of Development
Addressing Mental Health in Nursing One Crucial Conversation at a Time
By Megan Hinners
Silence is Not Always Golden
“When in doubt, talk it out.” It’s an idiom that we seem to have ingrained in our brains throughout childhood as we are taught to address and tackle a wide array of issues and conflicts with the power of our words. Yet, by the time we reach adulthood, the culture of clamming up and suppressing our thoughts, concerns, and feelings is celebrated and encouraged across a variety of professional and personal aspects of our lives.
The cultural norm of clamming up instead of speaking up is no more evident than with topics related to mental health. The stigmas associated with mental illness are plentiful, and negative connotations abound as both public and self-perception lead to discrimination and adverse thoughts, opinions, and reactions. For those who struggle with any form of mental illness, stigma and discrimination can lead to increased difficulties, harder recovery, and the desire to keep their struggles to themselves.
According to recent mental health statistics, nearly one-in-five U.S. adults will have a diagnosable mental health condition in any given year. Forty-six percent of Americans will meet the criteria for a diagnosable mental health condition at some time in their life. However, more than half of people with mental illness do not seek help for their disorders. For nurses, it’s even more of a challenge to acknowledge and accept that mental illness can take its toll.
The Robert Wood Johnson Foundation Interdisciplinary Nursing Quality Initiative (INQRI) found that 18% of nurses exhibit symptoms of depression, compared to the 9% found in the general public, and while data from the United States is limited on the toll that COVID-19 has taken on nurses, a 2020 JAMA Network Open study found that 50.4% of 1,257 health care professionals in China were experiencing symptoms of depression while working throughout the pandemic. The study also showed that they were experiencing increases in anxiety, insomnia, and distress.
Yet, nurses are less likely to seek support or treatment for mental health-related concerns. Mental Health America notes those in helping professions such as health care workers often struggle with asking for help for themselves. As ones who are typically doing the helping, it can create feelings of vulnerability and weakness to admit they themselves need assistance.
Difficult Conversations are Crucial Conversations
For some nurses, the stress and anxiety-inducing situations can begin even before their careers begin. The rigors of nursing school are tough, especially as a semester winds down and final exams loom on the horizon. Add onto that the stress of pandemic-induced challenges and the final few weeks of an academic semester can be downright daunting.
As the 2020-2021 academic year started to draw to a close, School of Nursing faculty saw the need to address potential mental health concerns of their students. “We found that it was coming up a lot in conversation,” said Assistant Professor Elliot Tebbe, PhD, LP. “Our faculty were wanting to support their students but did not exactly know how they should go about it — what support they themselves should offer, or what support could be provided to connect students with other services on campus.”
Tebbe partnered with Gina Bryan ’99, MSN’02, DNP’12, APRN, FAAN, clinical professor and psychiatric mental health certificate coordinator at the School of Nursing, and the two put their heads together to compile resources for School faculty and staff to utilize that would help them work through difficult conversations with their students should the need arise. In addition, they opened up office hours for colleagues to provide consultation services for any faculty or staff member who needed additional ways to discuss questions or concerns regarding the mental health of their students.
“There was a lot of initial discussion about what we could offer students,” Tebbe added. “We looked at the viability of trying to get a support group together, but time was a big factor in what we could and couldn’t make happen before the end of the semester. So, we whittled it down to compiling a comprehensive list of services, as well as the resources that we created for our faculty who may be having concerns about a student’s well-being.”
One of the resources was a mental health flow sheet that guided faculty through crucial conversation starters utilizing tough, but important questions about an individual’s mental health; questions that addressed conversations about mental health concerns with open, honest dialogue that supports empathy and understanding of an individual’s struggles.
Shifting from Mental Illness to Mental Health
For nurses, opening the doors to begin having those same types of crucial conversations, asking for assistance, and addressing mental health concerns head-on should begin with a foundation built on understanding and empathy. By normalizing these conversations about mental health and offering social and peer support for those who may be struggling, nurses can help erase the stigmas associated with mental illness. In addition, being honest about one’s own personal struggles can help mainstream the importance of openly addressing mental health concerns. Through building connections and creating straightforward and honest dialogue supported by compassion for an individual’s struggles, nurses can help shift the perception from that of illness to health.
“For a long time, mental health just meant, ‘What disorder or disorders do you have?’ But now we’re really giving attention to the fact that mental health is its own separate aspect of well-being.” —Assistant Professor Elliot Tebbe, PhD, LP
“One of the things that stands out to me is that there has been a big shift that I have noticed in conversations surrounding mental health versus mental illness,” Tebbe said. “As a society, we are starting to tease those apart. For a long time, mental health just meant, ‘What disorder or disorders do you have?’ But now we’re really giving attention to the fact that mental health is its own separate aspect of well-being. I think that destigmatizing mental health is so important because it means that we get to situate it for what it is, which is an aspect of well-being, just like physical health is an aspect of well-being amongst all the other domains of health. By having conversations and moving the topic into the realm of casual conversation versus this thing that we do in secret behind closed doors, it opens the door for connections to other people. The research is very, very clear that connection with others has enormous positive benefits. It’s also enormously helpful in terms of mitigating harm of various negative experiences. That’s the power of connection. Part of destigmatizing mental health is giving space for us to show up as our whole selves, including the parts that are suffering, including the parts of us that are in a lot of pain. I think there’s acknowledgment of the fact that people are struggling right now, and it’s opening up opportunities for conversations on a global scale.”
You are Not Alone
The most important phrase for nurses to remember when it comes to mental health and mental illness is simple: You are not alone. For nurses who are struggling with whether they should open up about their concerns or mental health struggles, you are not alone. For those who have concerns about friends and colleagues within nursing and health care, let them know they are not alone.
If you or someone you know is struggling with mental illness, substance abuse, or thoughts of suicide, there are resources available to help:
- If you are in immediate crisis, call 911
- If you or anyone you know is having thoughts about suicide, call or text the National Suicide Prevention Lifeline toll-free at 1-800-273-TALK (8255),
- If you or anyone you know is struggling with substance abuse as a result of mental health issues, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662 HELP (4357), www.samhsa.gov/find-help/national-helpline
There are also nursing and health care worker-specific hotlines, documents, and websites that address tackling the challenges surrounding mental health concerns.
- Mental Health America (MHA)
Mental Health America’s resources for COVID-19 workers help health care workers address fears and offer advice for various coping strategies.
- American Nurses Association (ANA) Resources
The ANA’s “Mental Health Help for Nurses” webpage offers advice and resources for nurses struggling with stress, anxiety, fear, intrusive thoughts, or depressed mood. The organization also offers webinars and short videos to help nurses assess their mental health needs and find support.
- Anxiety & Depression Association of America (ADAA)
The ADAA’s website can help nurses connect with a therapist and offers a useful guide to the various types of therapy available. Visitors can also find information about managing anxiety and depression as well as information about ADAA’s free peer-to-peer support communities.
- National Academy of Medicine (NAM)
NAM’s website offers strategies to support health and well-being during the COVID-19 pandemic. NAM’s strategies include actions clinicians can take to support their own mental health as well as strategies for healthcare leaders and managers to support their staff.
- National Alliance on Mental Illness (NAMI)
NAMI offers resources for a wide range of mental health issues. The NAMI HelpLine (1-800-950-6264) provides callers with free referral information and support Monday through Friday.
By Mel Freitag, PhD
I’ll never forget a comment made during one of my first years of teaching at the School of Nursing. One of the ways I framed all of my classes was that future nurses would be working with communities instead of for them. A critical way to teach this is by flipping the power and inviting the community in as experts of their own experiences, offering best practices and guidelines to the future nursing workforce.
One such group of community members were called “Mothers in the Neighborhood.” They identified as mothers and community leaders who volunteered for their local health center. Through their community-based model, these mothers and grandmothers would go door to door to let their neighbors, friends, and family know about what the health center provided. After the group had shared their experiences with the class, a nursing student shot up her hand. “As a future white nurse, how do we HELP you? What should we do?” One of the community leaders paused and then said, “When you come to my neighborhood, don’t assume you know how to help me and my people before you talk to us. Ask us what we need. We know what we need more than you do.”
My nursing students usually had a debrief group after each of our presenters to process and have a space to put their thoughts in the larger context and concepts of the course. During the debrief that day, I told them that if they took nothing else away from this class, it was the lesson that was shared by the community member: don’t assume, ask. Remember that you do not know what is best for people before you ask them what they need. Remember that you do not have all the answers, nor should you. Remember that it is okay not to know. You are there to serve — not fix or help or save them.
Remember that you do not know what is best for people before you ask them what they need. Remember that you do not have all the answers, nor should you. Remember that it is OK not to know. You are there to serve — not fix or help or save them.
Diversity, Equity, and inclusion are often discussed in lofty and abstract terms, with vague statements or plans or strategy. Yet the impact of service, especially within a profession like nursing, is much more palpable, human, and real. In her 1999 groundbreaking article titled Helping, Fixing or Serving?, Rachel Naomi Remen, MD, wrote on the distinction between the three, “Serving requires us to know that our humanity is more powerful than our expertise… our limitations serve; our wounds serve; even our darkness can serve. My pain is the source of my compassion; my woundedness is the key to my empathy.” Serving requires us to know our own shortcomings. Acknowledging our own experiences — good, bad, and ugly — makes us who we are, better practitioners, and more prepared to heal. It means knowing that patients are not the only ones who experience life — grief, loss, addiction, anxiety, depression. Nurses do, too.
Serving also means being aware of how “helpful” mindsets can be experienced as patronizing or even unwelcoming, especially because nurses are still predominantly white. One of my colleagues, a graduate student who identified as Black, shared that they were often asked, “Can I help you?” when they were walking through buildings on campus, and they noticed that their white colleagues were not asked the same question when in the elevators or walking through the halls. Even though the question here can seem benign (much like “where are you from?”), the impact of assuming that they do not belong in the building can be harmful and distrustful. It is up to all of us to cultivate a culture where everyone feels a sense of belonging, and sometimes that means examining our own behavior.
It behooves us then to socialize the next generation of nurses to intervene in unjust situations, to advocate, and to acknowledge our own blind spots. To name racism, sexism, and homophobia, and to do it when we are a bystander and recognize when someone has created harm. It will be messy, imperfect, and we are never done. We may get it wrong or say the wrong thing; it just means we have to get up and try again. In order to dismantle harmful “helpful” environments, we have to break the silences of oppressions within our own lived experiences. In order to have an authentic culture of health, everyone needs to be willing to make mistakes regardless of their status or degree or rank, admit them when they happen, apologize, and learn to do better. And then do it again and again.
Vulnerability, saying you don’t know, staying curious, keeping it real, learning from mistakes, accepting progress not perfection, that is really where both individual and collective healing begins.
To serve is to be vulnerable; not knowing every language, every custom, every ritual, every food. In order to heal, we need to also be healed; be open to the idea that we were wrong, that we don’t know, that we can’t save everyone. We are not immune to life. We are not saviors, but we can be healers. We are not exempt from realizing our own shortcomings. When we fix or help, we assume something is broken and we can mitigate it with our own expertise or knowledge – but it creates distance. Westernized views of medicine and health do not view the patient holistically; and nurses can be at the forefront of not only patient care, but health care provider self-care. Vulnerability, saying you don’t know, staying curious, keeping it real, learning from mistakes, accepting progress not perfection, that is really where both individual and collective healing begins.
The more we create spaces where we share these stories with our students, with future nurses, with our colleagues, the more we can truly serve those around us. To serve is to collaborate. Servant leadership is about empowering others, and we can only do that if we see ourselves as servants of our students, of our colleagues, and each other. If we want to truly build leaders for a better society and improve health outcomes, it has to start with us.
As the proverb goes, “Weak leaders expect service; strong ones give it.”
Built on a Tradition of Military Service
Since the UW–Madison School of Nursing was founded in 1924, Badger nurses have been making an impact in the military ranks. Whether it was during times of war or in times of peace, changing lives through serving one’s country has been a point of pride for many Badger nurses.
Opening its doors between the first and second World Wars, the School of Nursing was established at a time when answering the call to serve was at the forefront of conversation in nursing. The impact of military service on the School began right from the start thanks to the support from the School’s first director and Professor Emerita, Helen Denne Schulte. Before making her way to UW–Madison, Schulte served her native country in the ranks of the Canadian Army Nursing Corps during World War I.
As the School began to build itself on the foundation of believing that a rigorous education was essential for effective nursing practice, Badger nurses who found their way into the military ranks found themselves fully prepared to make an immediate impact. Throughout the ensuing years of the School’s infancy, many students served in the United States’ war efforts during World War II in both the Army Nurse Corps and Cadet Corps.
Almost a century later, the early influences of military service on the School of Nursing continue to help guide Badger nurses as they serve their country through the various forms of military service. In recent years, some of our Badger nurses have completed their degrees while actively serving in the military (including finishing coursework while deployed). Others have gone on to serve as government officials in the Department of Veterans Affairs (VA). More have gone on to serve in a variety of positions and ranks throughout our Armed Forces and in VA hospitals and clinics. No matter how you have served or are serving, we thank you for your service and dedication to our country.
Tell Us Your Story!
As the School prepares for its centennial celebration in 2024, we want to highlight the many ways Badger nurses have served in the military ranks or been involved with veterans’ affairs. Whether you were drafted or enlisted; served in times of war or times of peace; are active duty, Reserve, or National Guard; discharged or retired; or found your way to the School of Nursing after serving in the military, we want to tell your story!
Alumni who are interested in being featured can fill out a questionnaire and submit photos or may contact firstname.lastname@example.org for inquiries or further assistance.
Badger nurses impact communities around the world
By Jessica VanEgeren
No matter where their journey takes them, Badger nurses share a goal: to change lives through their strong commitment to service. Whether it’s bedside care, nursing research, or addressing global health issues — such as poverty and access to care — service makes an impact on individuals, families, communities, and systems around the world.
For School of Nursing alumnus Sam Carlson ’18, RN, that commitment to service began long before he became a nurse. Carlson joined the U.S. Air Force immediately after graduating high school, serving as a munitions systems specialist building bombs and missile systems. Though he worked 14-hour shifts for six consecutive days, Carlson started volunteering at the base hospital on his day off. He found it to be a rewarding contrast to his military job.
While volunteering, Carlson learned it is U.S. military policy to provide emergency medical attention to anyone in need. Soon after, he witnessed an Iraqi mother, a large load on her back, running toward the base’s main gate. Troops were pointing guns at her and telling her to stop, but she kept running, set the load down at the gate, and ran away.
When he and others approached the bundle, they found two children covered in kerosene burns. They grabbed the children and rushed them to the hospital where they were hydrated, stabilized, and rushed off to surgery.
“That was really powerful for me to see,” Carlson said. “I remember thinking, ‘at least in this hospital, we are trying to do good.’”
He knew then that he “had no interest in staying in the military.”
“If you are a doctor, a nurse, a surgeon, or a tech working in a hospital, you’re doing something good for someone. You are trying to make their life better,” he said. “That’s when I realized I needed to be in the medical profession.”
Breaking the Poverty Cycle
After five years of service in the military, Carlson went to Kenya in 2012 to work for Beacon of Hope, a faith-based non-government organization (NGO). He and his then-wife ended up helping to establish an NGO of their own, Action Two Africa. The couple partnered with a local social worker, who helped provide the funding to get his vision off the ground.
Action Two Africa focuses on education as a means of breaking the cycle of poverty. It focuses its work in Kiambiu, a poverty-stricken area outside of Nairobi that is home to more than 100,000 people, and provides scholarships for impoverished children to attend private schools.
Carlson said students languish in the public schools. A private education is the only way to make it to a university, “which is the gold standard of success.”
“The government technically pays for education through secondary school, but the problem is the government is also corrupt,” he said. “You have entrenched politicians who steal money from people, leverage their power to make money and allow their children to thrive, while these poor communities stay poor.”
And because the stratification between rich and poor is “extreme and so close together,” the private schools are within walking distance of Kiambiu.
“There are malls just like in America, with people buying purses, shoes, video games, and electronics. And you can walk right out of the mall and one block away there are literally children passed out on the street sniffing glue,” he said.
Carlson brought these experiences back with him to Madison in 2013 and began earning his bachelor’s degree in nursing. He currently works at a VA clinic on the border of the Navajo Nation in northern Arizona. Like in Kenya, he navigates the effects of poverty when treating patients. His life experiences and education have taught him that he needs to take the time to talk to his patients, listen, and understand how their circumstances and culture affect their health and health decisions.
“I hear the phrase, ‘you can lead a horse to water,’ so often and it’s so aggravating to me,” Carlson said. “I understand people’s frustrations, but I don’t think that is a fair way of painting someone’s situation. At the end of the day, we all want the same things: we want to be healthy, we want to be happy, we want to go home to our families, and we want to live good lives.”
Improving Access to Care
In 2008, Amal Abu-Awad, PhD’11, MSN, RN, left her home in Jerusalem to begin earning her PhD in nursing education as a Fulbright scholar at the UW–Madison School of Nursing. By the time she came to Madison, her professional resume already was impressive.
She had a bachelor of science in nursing from the Arab College of Medical Professions at Al-Quds University in the Palestinian West Bank; a master of science in nursing with a focus on neonatal and pediatric nursing from the University of South Carolina Columbia; and had papers published in scholarly journals, including “Overcoming Challenges in Nursing Education,” published in 2006 by Bridges: Israeli-Palestinian Public Health Magazine.
Now with more than 30 years of clinical and nursing education experience and nursing licenses in Palestine, Jerusalem, South Carolina, and Wisconsin, Abu-Awad continues to use her knowledge to improve the lives of Palestinians and all residents who live in Gaza and the West Bank.
After graduating from UW–Madison in 2011, she became the director general of education in health for the Ministry of Health in the Palestinian West Bank. She remained in that role until earlier this year when she was named the chief nursing officer of Augusta Victoria Hospital in East Jerusalem.
Augusta Victoria Hospital (AVH) is a program of the Lutheran World Federated Department for World Service in Jerusalem. It was started in partnership with the United Nations Relief and Works Agency (UNRWA) as a major health care facility in Jerusalem after the 1948 war to care for Palestinian refugees.
Her employer is the only hospital to provide radiation therapy for cancer patients in the Palestinian territories and is the only health care facility in the West Bank offering pediatric kidney dialysis. In addition, they offer other specialized treatments not available in most hospitals in Palestine, such as cancer care, hematology and bone marrow transplantation, dialysis, pediatric care, and long-term care facilities.
“I wanted to work at AVH to serve a very special group of patients who have limited services [available to them] related to their disorders,” said Abu-Awad during a Zoom interview from her office in Jerusalem. “I wanted to be an advocate for these patients, to contribute to their treatment, and to support their families.”
One hurdle the hospital encounters when providing care is the inability of Palestinians to come and go freely between the territories and Jerusalem. Years ago, the hospital worked with the Israeli Civil Administration to issue permits for Palestinian patients and their families to enter Jerusalem to access the hospital. Now, the hospital offers a busing service that allows Palestinian patients to cross through the Israeli checkpoints with their approved travel permits.
The hospital also has a program that allows Palestinians who need extended care, such as radiation therapy, to stay at a special hotel just for patients, eliminating any risk that medical care could be disrupted by denied access at a checkpoint.
Abu-Awad explains that because she lives in Jerusalem, she has a Jerusalem ID that allows her to move freely throughout Jerusalem and the Palestinian territories.
It is now her job to advise senior executive management on the best nursing practices, create retention programs, plan new patient services, and coordinate day-to-day operations of the nursing department.
“The UW–Madison School of Nursing has improved my capacity in three essential components: research, education methods, and the translation of research into practice,” she said. “These three components are the foundation I am using to fulfill my duties as chief nursing officer of Augusta Victoria Hospital to improve the quality and safety of nursing services to our patients.”
It is also her job to promote the hospital’s image — the mission, standards, and values of the Lutheran World Federation and the Palestinian community the hospital was created to serve 73 years ago.
“I totally agree with the importance of knowing and interacting with the patients. This is key to knowing what they are suffering from and what can be done to help them,” Abu-Awad said. “This approach to care is universal. It is simple but very essential with all patients, regardless of their culture, gender, or religion.”
“I totally agree with the importance of knowing and interacting with patients. This is key to knowing what they are suffering from and what can be done to help them.” — Amal Abu-Awad, PhD’11, MSN, RN
Answering the Call to Care
Jessica Starich ’07, RN, CPN, first went to Africa while she was a nursing student at UW–Madison, traveling to the small town of Maseno, Kenya. “We were there for about three weeks,” Starich said. “I just loved the experience.”
It was this trip that set up the dueling passions of her life: working as a pediatric oncology nurse at Duke University Hospital and being called “Mama Jess or Auntie Jess” by children at Jemo House, a home she would establish in 2012 to care for children orphaned by HIV/AIDS.
Her path to opening the house was at times dangerous, and a leap of faith made possible by support from her family and her strong religious faith. As a volunteer at a local orphanage in Maseno, Starich stumbled upon information that the orphanage was “highly exploitative and atrociously mismanaged” by the woman who was running it.
She went to the police and to local churches with her concerns, but no one offered to help her.
“In a country with an overwhelming number of under-served children, sometimes a relatively safe place to sleep with access to food is considered to be good enough and better than some. But I strongly believe that a child who is unloved and forgotten suffers as much as a child without enough to eat,” she said. “I knew before I took this woman on that I had to have a place for the children to go.”
She was 25. Over the next year and a half, she sent money to the orphanage, despite what she knew, and returned numerous times. She began working with another woman in the village to try and get children out of the orphanage and into another home. They began succeeding, one child at a time, until they got to the point where they were focusing on finding the relatives of four children.
One day, as she was packing up and getting ready to head to the airport, a woman on a motorcycle pulled up to her door.
“She starts asking me, ‘Are you Jessica? Are you the nurse trying to take these four kids?’” Starich said. “In my mind I was thinking, ‘I don’t know. It depends on who you are.’”
The woman turned out to be a schoolteacher who had temporary custody of four of the children at the orphanage. She had put them in the facility thinking it would be better for them while she looked for a more permanent place for them to live.
The woman pulled a document out from her bag that stated the magistrate and the children’s extended relatives granted Starich custody of the children. Starich recalls the paper just read, “We give custody to Jessica.”
“There was no last name because that doesn’t matter over there. The paper was signed and stamped. All I had to do was sign my name,” she said. “Just like that I had four kids. That’s how it started. I now have the great honor of being one of their mother figures.”
In 2014, she launched Too Little Children, a nonprofit with an annual budget of $45,000. It oversees Jemo House and the Pad Project, a program started by her twin sister, Emma Stober, that provides reusable maxi pads for girls and women in impoverished areas of the world.
Too Little Children operates on the belief that children need more than food and shelter to thrive. Education is key. And in a country with no credit system, children must pay upfront to attend school; roughly $800 for high school and $3,000 for college. Jemo House now has six high schoolers and three college students attending Kenyan universities.
Her advice for anyone reading her story: If this is your calling, go for it. She recommends finding a contact to help you along the way, taking the time to understand a community’s problem before working with locals to fix it, and being resilient.
“We are all looking to be happy and find joy,” she said. “It is wonderfully joyful. It is worth the jet lag, all the sleeping in airports, weird food — and the occasional intestinal distress that comes along with it. Any profession that helps people indirectly, directly brings joy. That is why we do the majority of what we do.”
Global Health at the School of Nursing
These stories are just a few examples of the impact Badger nurses are having around the world. For nursing students without these lived experiences, the School of Nursing presents numerous opportunities to expand their own experiences through immersion programs and listening to the stories of professors and alumni who have served in a variety of global health roles.
“It is a really good opportunity for people, especially if they have never been overseas before and been exposed to poverty. I’m not saying poverty doesn’t exist in the States — it certainly does,” Carlson said. “But it can look very different overseas.”
Badger nursing students are required to take the three-credit course, “Social Justice in Local and Global Settings.” The School also offers a 13-credit, undergraduate certificate in global health, as well as study abroad and immersion programs in Ireland, Malawi, and Thailand.
Additionally, the School’s doctor of nursing practice students can join the UW’s physician assistant program and practice their primary care skills in an immersion program in Belize. The School of Nursing also partners with the School of Medicine and Public Health to offer graduate and capstone certificates in global health.
“If you are coming to the UW’s nursing program, it is a great place to expand your global knowledge and your opportunities to work globally.” — Karen Solheim ’73, PhD, RN, FAAN
“If you are coming to the UW’s nursing program, it is a great place to expand your global knowledge and your opportunities to work globally,” said Karen Solheim ’73, PhD, RN, FAAN, clinical professor and global health program director at the School of Nursing.
Global health teaches students a mindset that is about more than setting foot in another country. It is about learning respect and being curious about every patient’s story — it is recognizing that we are not intrinsically different from each other.
Service in the form of leadership is inherent to nursing. Through careers in research, education, practice, policy, and beyond, nurses recognize and seek to mitigate factors and conditions that impact health. In addition to intervention, investigation, dissemination, and education that are the primary focus of their professional roles, nurses also regularly contribute their leadership in other ways to advance the profession and society.
Nurses participate in and lead committees that facilitate change, create impact through professional organizations, serve as grant and manuscript reviewers, and disseminate knowledge as contributors and editors of scholarly journals. Other service comes in the form of advocacy from the bedside to the classroom to the boardroom. Nurses also effectively advocate for policies and legislation to advance societal health and equity, and to address the needs and well-being of the workforce. The scope of nurses’ impact through service is as broad as the profession itself.
Regardless of the circumstances in which it takes place, the core of service is identifying needs and acting in response. It is no wonder this is inherently a part of the nursing profession. The scientific process of nursing begins with assessment and diagnosis, and advances through the remaining stages of the process to outcome identification, planning, intervention, and then evaluation. This process, now commonly taught as the acronym ADOPIE, is ingrained during our nursing education. Then, no matter where our personal and professional lives lead, the habit of assessment, intervention, and evaluation continues to frame the way we see and respond to the world around us.
The American Nurses Association (ANA) website states, “Beyond the time-honored reputation for compassion and dedication lies a highly specialized profession, which is constantly evolving to address the needs of society.” I appreciate that this statement reinforces that nursing is a balance of compassion and dedication with the specialized skills and knowledge it requires. I often speak to this as the art and science of nursing when I welcome new students into nursing. The ANA statement also aligns with the mission of the School of Nursing and is reflected in the way our alumni provide leadership through their service to the profession and society.
Dedication and compassion, coupled with knowledge and expertise, are often the traits that compel nurses onto the “right” path for their journey. This issue of ForwardNursing focuses on Badger nurses who have acted in response to events, circumstances, and needs they have encountered in the communities or world around them. An important theme in the articles is that in addition to the life-changing impact their actions have on others, an outcome of the leadership and service of these nurses is often a change in their own perspectives, career paths, and lives.
I hope you will be proud as you read about the actions taken by the individuals whose stories are featured here. They demonstrate skillful responsiveness to the needs of the profession and society. This is consistent with the 100-year legacy of the School of Nursing, and it represents our aspirations for the next generation of Badger nurses.
Linda D. Scott