Tag: COVID-19

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Amid Transition, School is Poised for a Promising Future

A School in Transition

When she applied to teach at the George Washington University, Crystel Farina, Ph.D.(c), RN, CNE, CHSE, knew very little about the School of Nursing or the university. “I applied solely because the dean was Pamela Jeffries,” said Ms. Farina, director of simulation and experiential learning.

Crystel Farina aiding students in PPE fitting
Ms. Farina aiding students during on campus PPE fitting

A doctoral candidate at Notre Dame of Maryland University, Ms. Farina joined the Nursing School in August 2017. She had been aware of Dr. Jeffries, Ph.D., RN, FAAN, ANEF, FSSH, and her work on simulation since 2004, when Ms. Farina was teaching at Chesapeake College in Maryland and grew interested in simulation and nursing education.

“She was the one in all the articles who was teaching me how to actually do simulations,” Ms. Farina said of Dr. Jeffries, whom she first met in 2015 at the National League for Nursing’s Leadership Development for Simulation Educators. Dr. Jeffries was one of the “giants of simulation,” who formed a faculty group leading the program.

“It was like seeing a rockstar,” she said. “Oh my gosh, it’s her!”

Dr. Jeffries, who recently stepped down as dean at the School of Nursing—a role she held from 2015 to 2021—to become dean of Vanderbilt University’s nursing school, turned out to be “very down to earth, very relaxed, and very warm and fuzzy,” Ms. Farina recalled.

Crystel Farina

“I applied solely because the dean was Pamela Jeffries. She was the one in all the articles who was teaching me how to actually do simulations.”

– Ms. Farina

“Once I got over the awe of sitting with the godmother of simulation, it was very easy to have a conversation and talk about what we were doing at the college level, what we needed to do for nurse practitioners, and simulation in health care education,” Ms. Farina said.

This characterization of Dr. Jeffries as a down-to-earth, amicable rockstar is a common refrain among those who know and have worked with her. And the dean’s departure to Nashville, Tenn., comes amid a larger transitional time at the school and at GW.

Of course, the COVID-19 pandemic has disrupted many best-laid plans. From an academic and administrative perspective, the School of Nursing was lucky to have put certain programs and processes in place prior to the pandemic, which helped mitigate some remote- and digital-only growing pains.

Pamela Slaven-Lee, D.N.P., FNP-C, FAANP, CHSE, senior associate dean for academic affairs and clinical associate professor, now serves as interim dean of the School of Nursing. GW recently announced that Mark Wrighton, chancellor emeritus at Washington University in St. Louis, will begin serving as interim president in January and will fill that role for up to a year and a half.The School of Nursing was about two-thirds of the way into its strategic plan when the pandemic began, requiring that in-person activities shut down in mid-March 2020. Despite this hurdle, the faculty and staff were able to fulfill the goals of that plan. And, although her departure was eminent, Dr. Jeffries saw to it that the next strategic plan was in place before she left. As she and her colleagues reflect on her legacy and vast achievements at GW, they see a bright future for the school, which has already earned national accolades that are more typical of much older and more mature schools.

The View from ‘Athens of the South’

Reached by video chat in Nashville, Dr. Jeffries said she hopes people will look back on her GW legacy as six years of bringing the school to another level. “We grew—maybe from adolescence to young adulthood,” she said.

Dr. Jeffries is very proud of starting GW’s doctoral nursing program and building up the breadth and depth of the school’s research base. “It still needs to grow more, but the quantity and quality of our research efforts have definitely scaled up,” she said. She also takes pride in the school’s No. 22 ranking for nursing graduate education by U.S. News & World Report and successful school-wide health policy branding.

Joe Velez speaking with construction crew at VSTC
Joe Velez, GW Nursing’s Executive Director of Operations, speaking with crew at remodel project

Six years ago, when Dr. Jeffries came to GW—after serving as vice provost for digital initiatives at Johns Hopkins University, and before that as an associate dean at Hopkins and at Indiana University Bloomington—her priorities were to build upon the foundation her predecessor, Jean Johnson, established as founding dean some five years prior. Having inherited high-quality programs, Dr. Jeffries wanted to take the school to the next level.

“I had an analogy of a three-story house. Dr. Johnson built the first floor. I had the second floor, which continued to build on our reputable programs,” Dr. Jeffries said. “To build the research base on the third level, I wanted to start a Ph.D. program and to diversify revenue, because we were very tied to tuition dollars and enrollment numbers.”

Dr. Jeffries started a professional development office called Ventures, Initiatives and Partnerships (VIP), and she sought to improve the school’s national rankings. She aimed in five years to move the school into the top 25 graduate programs in the U.S. News & World Report rankings. (It previously ranked No. 58.) It took six years, but the school bested that goal by three slots.

Pamela Jeffries headshot

“I had an analogy of a three-story house. Dr. Johnson built the first floor. I had the second floor, which continued to build on our reputable programs,”

– Dr. Jeffries

In the 2022 U.S. News rankings (the Georgetown-based publication ranks schools based on the prior year’s data, which can sound like predicting the future), the Nursing School is also tied for No. 28 in the category of “Best Nursing Schools: Doctor of Nursing Practice” with Oregon Health and Science University; University of California, San Francisco; University of Texas Health Science Center at Houston; and Washington State University.

In the U.S. News specialty nursing school rankings, the GW School of Nursing is No. 8 in “Best Master’s Nurse Practitioner: Family,” and is tied for No. 6 in “Best Master’s Nursing Administration” with University of Alabama at Birmingham and University of North Carolina at Chapel Hill. And in the U.S. News online nursing program rankings, GW is No. 2 for “Best Online Master’s Nursing Programs for Veterans,”No. 3 for “Best Online Master’s Nursing Administration Programs,”No. 7 for “Best Online Master’s Nursing Programs (tied with University of Nevada, Las Vegas), and No. 7 for “Best Online Family Nurse Practitioner Master’s Programs.”

Creating a doctoral program to help train nursing scientists was necessary to become a top-tier school, according to Dr. Jeffries, who also is proud of starting the school’s Center for Health Policy and Media Engagement. The latter draws upon the school’s location in the nation’s capital.

“I don’t think I would have changed anything if I could have read the tea leaves and known COVID was going to hit in March 2020,” Dr. Jeffries says. “In fact, we actually prepared ourselves not knowing it was happening.”

Pivoting Online 

Prior to March 2020, the Nursing School had already begun assembling the necessary personnel to strengthen its creation and delivery of online programming. Dr. Jeffries hired e-learning specialists, instructional designers, videographers, a graphic designer, and a director of online learning and technology.

“I’m glad that was done, because that served us well in COVID,” she said. “We already had online education going at GW Nursing, but I put more resources and support into building a team.”

She also brought on a team to help run the expanded simulation center on the Ashburn, Va., campus, home to a state-of-the-art Objective Structured Clinical Examination (OSCE) center. “They had to pivot during COVID to produce and really facilitate faculty with the virtual simulations,” Dr. Jeffries said. And after lockdowns ended, that team facilitated safe in-person lab simulations.

Karen Whitt monitoring OSCEs
Associate Professor Dr. Karen Whitt monitoring OSCEs at VSTC simulation lab

During the pandemic, Dr. Jeffries would wake up each morning and ask herself what she needed to get through the day.

“I built community with our faculty, staff, and students,” she said. There were weekly town hall meetings for nearly 70 weeks, and Dr. Jeffries helped staff leaders, who had never managed people remotely, and professors, who could not see their students in person, navigate the new normal.

“We did keep community together,” she said, noting the school’s instructional continuity in particular. “Our students graduated on time for the most part.”

“Some of us thought—I was one—we could come back in three or four weeks,” she said of the beginning of the pandemic. “I stayed very focused to get through. I always had to hold it together. Someone has to be the leader.”

Looking forward, Dr. Jeffries notes that telehealth is poised to be a game changer for the profession, and she expects the pivot online will continue even after the pandemic is in the rearview mirror. There is a need for telehealth competencies and full integration into curricula, she said, and nursing schools ought to teach students to assess patients via digital platforms, such as Zoom. Patients are also increasingly tracking their own health data, something nurses should take advantage of.

“We’ve got to be mindful of that,” Dr. Jeffries said.

She looks forward to continuing to see the School of Nursing’s programs flourish, as well as new programs emerge. She expects the healthcare landscape to continue to change, and thinks public health is a priority, particularly the focus on health equity that COVID exposed, as outlined in the National Academy of Medicine’s report “The Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity.”

“I see the next five years as a little different. Right now we are transitioning in COVID, but we are still in COVID. But our antennas are up for different things,” she said. “I think we’ve learned we can do things differently.”

Big Shoes to Fill

Dr. Slaven-Lee, now interim dean, came to GW two months before Dr. Jeffries did in 2015. She was excited to join a young school, about five years old, and the opportunities that its youth presented. Dr. Slaven-Lee served previously in a leadership role at Georgetown University and looked forward to returning to teaching. That was not in the cards, however.

“Dr. Jeffries developed our matrix structure with two communities and academic programs, and made a lot of infrastructure changes. With that, it opened up a lot of leadership opportunities,” Dr. Slaven-Lee said. “I came here saying, ‘I want to go back to teaching and not so much leadership.’ As is often the case, I ended up back in a leadership role.

Interim Dean Slaven-Lee at vaccine clinic
Interim Dean Slaven-Lee (center), Patsy Deyo and Assistant Professor Dr. Maggie Venzke meet with Va. Del. David Reid at GW Nursing-run COVID-19 Vaccination Clinic.

”Dr. Slaven-Lee worked closely with Dr. Jeffries on developing the simulation program, which “became a signature part of our academic programs,” and building the academic affairs unit. “Really further developing all the things that you do as your school continues to mature—evaluation plans, standardizing how you evaluate your academic programs, master plans of evaluation, standardizing how you evaluate each course, clinical placement models, all those sorts of things,”she said.

In the past six years, Dr. Slaven-Lee has seen GW’s reputation soar and has noticed changes in the applicant pool. She does not think anyone else applied for the same job she did in 2015, but now, “The caliber of the candidates that we see trying to come to GW and join our faculty community is outstanding.”

Part of that, she thinks, is the national recognition the school has received in rankings. “Considering how young the school is—we’re 11 years old—that’s absolutely remarkable that we’ve been able to accomplish that,” she said.

Since becoming interim dean on July 1, Dr. Slaven-Lee has drawn on what she learned from working with Dr. Jeffries, whom she called “a great mentor.” She also is very focused on the school’s strategic plan.“

The strategy I have in my mind is to stay focused on the school. Stay focused on our students, faculty, staff, and strategic plan,” she said. She is also focused on enhancing the curriculum with an eye toward diversity, equity, and inclusion, she said, as well as the “Future of Nursing”report.

Pamela Slaven-Lee

“The caliber of the candidates that we see trying to come to GW and join our faculty community is outstanding.”

– Dr. Slaven-Lee

“It’s not just, ‘Hold everything steady until a new dean comes.’ It’s ‘Continue on the upward trajectory.’ Holding things steady would be a disservice to the school. We’ve got to keep things moving upwards,” she said. “I’d be derelict in my duty if I just tried to hold things steady. When you’re ranked 22, that takes some work. You can’t just hold steady. You’ll fall backwards.”

Dr. Slaven-Lee expects the school’s rankings to continue to improve, and like Dr. Jeffries, she anticipates that there will be online and hybrid programming and teaching in the future. She also echoed Dr. Jeffries’ thinking about the school’s unique role in the heart of Washington, D.C.,and in northern Virginia.

“We want very much to brand and distinguish ourselves as the school of nursing that’s about health policy,” she said, noting that most GW School of Nursing researchers focus on health disparities and inequities.

“The juncture where it all starts coming together is the research informing the policy informing the practice. It’s not something we are trying to be. It’s something we are actually becoming,” she said. “We want to leverage our position in the nation’s capital.” The school also developed a dual Master of Science in Nursing and Master of Public Health degree, which matches renewed interest in that intersection.

She aims, she said, to fill Dr. Jeffries’ big shoes.“Dean Jeffries is an incredible leader. She is very well known for being a great communicator. She always had a vision,” Dr. Slaven-Lee said. “She did so much in the just six years she was here.”

The Power of Simulations 

Dr. Slaven-Lee, Dr. Jeffries, and Ms. Farina—the director of simulation and experiential learning, who chose to apply to work at GW because of Dr. Jeffries—all point to simulation as one of the areas of greatest change at the School of Nursing in the past five years.

Dr. Slaven-Lee said it was “absolutely pivotal for the development of our programs” to require all faculty to be trained in best practices for simulations. “Simulation is a pedagogy that is incredibly powerful. By virtue of that, if it’s used inappropriately, it can have negative impacts on the students’ evaluation and development,” she said.

Simulation training on campus is also a signature event for the school and for students. “These are big events. That’s how they know the campus. It’s about developing alumni. We’re known in the community for being expert simulationists,” she said. And many professional societies and vendors come to GW for talks on best practice simulation.

GW Nursing students in VSTC Simulation Lab
GW Nursing students in virtual reality simulation room.

“It’s not uncommon to see a whole panel of GW faculty talking about simulation,” Dr. Slaven-Lee said.

Ms. Farina’s tenure at GW has seen sustained growth in the school, she said. When she began working at the school, there was summer enrollment for the first time; there had only been spring and fall terms previously. And some of the conferences and other events that provided the most momentum in pushing the school forward centered on simulation.

Much of that success is owed to Dr. Jeffries, who played an essential role in securing funding for renovations of the simulation center and for expanding its offerings.

“She was really supportive in ensuring that I had the authority to request that all faculty had a standard of education for simulation before they came and facilitated simulation experiences,” Ms. Farina said. She noted that Dr. Jeffries was also involved in creating a massive open online course (MOOC), in which more than11,000 learners have enrolled and participated.

GW Nursing School students now do a lot of virtual and face-to-face simulations, and the curriculum is aligned with didactic content, skills labs, and simulations.“It’s all lined up that way so that they can apply everything they learned each week to providing simulated patient care,” she said. “They sit in lectures; then they learn a few skills; and then they are able to apply all that knowledge to providing care for that simulated patient.”

Ms. Farina hopes the nursing program continues to expand and thinks the school has a shot at top 10 in the U.S. News rankings. She also expects the school to become, in the next two years, one of 2,000 accredited by the Society for Simulation in Healthcare. “It shows that our simulation is high fidelity, high quality,” she said of that accreditation.

Collaborative Culture

Majeda El-Banna, Ph.D., RN, CNE, ANEF, had previously taught at several nursing programs, large and small, stateside and abroad—including Al-Zaytoonah University of Jordan, where she was dean of the School of Nursing—before arriving at GW in 2013. She began as adjunct professor and is now associate professor, chair of acute and chronic care faculty community, and director of the Registered Nurse to Bachelor/Master of Science in Nursing (RN to BSN) program.

“GW really attracted me with the mission and vision,” she said. And when she started teaching at the school eight years ago, “I said, Oh my goodness!This is the place where I want to be.” She has been extremely happy at GW since.

Majeda El-Banna
Dr. Majeda El-Banna speaking to a classroom of Accelerated B.S.N. students.

Where some of her colleagues may think the School of Nursing’s growth has been meteoric, Dr. El-Banna, who has taught in nursing programs for more than 20 years, was part of one school that tripled in size in two years. That was a little more of a dramatic pace than she has seen at GW.

Still, when she first arrived on campus, the nursing program was small enough that communication could occur in a more ad hoc fashion. As the school grew, there needed to be more formalized processes.

She credits Dr. Jeffries’ establishment of the Ph.D. program as a very significant and difficult feat, and the faculty communities that Dr. Jeffries pioneered—the school’s take on departments—have facilitated growth, cooperation, and mentorship. When Dr. El-Banna compares Dr. Jeffries’ approach to communication between faculty and staff, spread across the Foggy Bottom and Virginia campuses and many others remote across the country, to those she has observed at other schools, she thinks what the School of Nursing has achieved is remarkable in this regard.

During Dr. Jeffries’ tenure, faculty was encouraged to collaborate on research, and research funding increased. A buddy system paired new hires in their first year with seasoned colleagues who helped them acclimate to GW. And the dean also welcomed faculty, staff, and students to her home regularly, including for holiday parties.

Majeda El-Banna

“GW really attracted me with the mission and vision. I said, Oh my goodness! This is the place where I want to be.”

– Dr. El-Banna

“How did she have the time to hold so many social events in her house?” Dr. El-Banna wondered. “That is different from other schools.”

The “culture of collaboration” at the School of Nursing is one of the things that attracted Dr. El-Banna initially, and which has kept her happily at the school. Dr. Jeffries would ask faculty members where they saw themselves in a few years, and once she knew their plans, would provide guidance on necessary future steps. She would also keep her eyes and ears open for future opportunities, which she would share with faculty.

“I don’t know how she remembers all the things about all the faculty,” Dr. El-Banna said. “It’s amazing.”

When she reflected more on the changes she has seen at GW during Dr. Jeffries’ tenure, and the culture she foresees continuing, Dr. El-Banna reached for an affable metaphor. “It feels more like a family,” she said.

AUTHOR Menachem Wecker

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Community-Based Project Aims to Increase Local COVID-19 Vaccination Rates

Nurse giving vaccine to patient

A George Washington University School of Nursing researcher received $1 million in federal support for a new initiative to expand and evaluate COVID-19 vaccine access to increase vaccination rates among communities in the Washington, D.C., region that have been disproportionately harmed by the pandemic. 

Working with community partners, Y. Tony Yang, the endowed professor in health policy and executive director of the Center for Health Policy and Media Engagement, will target racial and ethnic minority groups, including African, Hispanic and Asian communities, living in east and southeast Washington, D.C., Northern Virginia and Southern Maryland. 

Full story in GW Today

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GW Nursing Researcher to Study the Response of U.S. Navy Aircraft Carrier, Fleet Surgical Team, and Hospital Ship Nurses to COVID-19

Navy ship at sunset

In Spring 2021 Dr. Catherine Wilson Cox received federal funding from the TriService Nursing Research Program (TSNRP) to gather first-person narratives from shipboard nurses when confronted with Coronavirus disease 2019 (COVID-19) and other potential public health emergencies. By doing this study, she hopes to support future shipboard nurses’ acumen and skill development necessary for the provision of competent care regarding the suppression and transmission of infective diseases while underway. 

COVID-19 presents a unique challenge to U.S. Navy ships due to the provision of health care for essential personnel within the close confines of a shipboard setting. The major components of control of the current pandemic include social distancing, isolation of sick patients, and quarantine of exposed persons, yet none of these is easily achieved while at sea. Balancing operational readiness with the management of any public health emergency while underway potentially exposes vulnerabilities to potential adversaries. For example, in March 2020 national news was made when at least 36 crew members from the aircraft carrier USS Theodore Roosevelt tested positive for COVID-19 and had to be quarantined in Guam. This crippled the show of force to U.S. rivals that is critical to U.S. Defense policies, as well as sidelined the ship until contingency plans could be made. Because prevention of disease in the military is key to ensuring a fit and ready force, U.S. Navy nurses who are forward-deployed at sea on aircraft carriers, on amphibious assault ships via fleet surgical teams, and on hospital ships are integral to the mission of responding to any worldwide emergency. 

“The study cannot build on previous research because the phenomenon of interest has never been described in the nursing literature,” said Dr. Cox. “The significance of this study is that the knowledge gained will expand the discipline of nursing’s understanding of shipboard nursing and its role in the face of public health emergencies. This in turn will support future nurses’ expertise and skill development necessary for the provision of competent care regarding the suppression and transmission of infective diseases while underway.” 

For the research study, Dr. Cox will interview 30 nurses and will include up to 10 participants per type of ship (n=30): nurses who have deployed to aircraft carriers (n=10), with fleet surgical teams (n=10), and on hospital ships (n=10) within the last 12-24 months (preferably, the last 12 months). She hopes to start the interviews this summer, once the IRB (Institutional Review Board) approvals are received. Then data analysis will occur (late summer/early fall) with findings being disseminated in early 2022. 

Dr. Cox is a retired U.S. Navy Nurse and Associate Professor in the undergraduate program at GW Nursing. As a retired military nurse, she was eligible to compete for TSNRP grants. According to the Uniformed Services University, “TSNRP facilitates nursing research to optimize the health of military members and their beneficiaries. Active duty military nurses from the U.S. Army, Navy, and Air Force as well as Reserve and National Guard Nurse Corps officers, and retired military nurses, are eligible to apply for grant awards. It supports nurses in all phases of their research careers.” This is the third time that Dr. Cox has been funded by TSNRP, the first time as a novice researcher during her doctoral studies, another mid-career, and now as a senior nurse scientist. Dr. Cox hopes more GW Nursing faculty and students with military affiliations consider submitting grant proposals to TSNRP.

AUTHOR Catherine Cox

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Using Information Technology to Improve Health

GW Digital Health Summit logo

GW’s inaugural Digital Health Summit looked at how technology has transformed the healthcare landscape.

The Digital Health Summit immersed George Washington University in the world of health care as defined by digital technology, bringing together over three days an interdisciplinary group of educators, clinicians, health system leaders and industry innovators.

GW Nursing Dean Pamela Jeffries said the COVID-19 pandemic made clear the necessity to adopt digital health solutions for the delivery of health care using technologies that are rapidly evolving and innovative approaches that connect patients and families in communities with the health care system.

The summit was co-hosted by GW Nursing, the School of Medicine and Health Sciences, the Milken Institute School of Public Health, the School of Engineering and Applied Science and GW Medical Faculty Associates. Over three days in mid-April, sessions offered discussions on topics such as what academic institutions can learn from practice institutions, how to translate innovation from the corporate sector to healthcare and using digital health for evidence-based practice and research.

Screenshot of Digital Health Summit session
Screen shot from Digital Health Summit session

The virtual assembly heard from among others imminent corporate leaders such as Heather Cox, chief digital health and analytics officer for Humana, Kristi Henderson,  senior vice president for the Center of Digital Innovation at Optum Health, and Karen DeSalvo, chief health officer at Google Health.

“So much of what we need to do as the next phase in using data and technology in health care is simply just making sure that we have the right information and that we have transparency in operability and accessibility and understand consent and privacy,” Dr. Salvo said.

Bringing the three-day virtual summit to a close, Dr. Jeffries and Marc Garbey, CEO of ORintelligence, an information technology firm and consultant to the GW School of Medicine and Health Sciences, engaged Dr. Salvo in a “fireside chat” where she shared her experiences as an internist new to digital technology. She found herself providing urgent care during Hurricane Katrina at a time where she was unaware of digital technology—including not knowing what a text message was.

“There was a little envelope on my phone that wouldn’t go away,” she said, laughing.

From clinical and public health work she moved on to policy as an assistant secretary for health in the Department of Health and Human Service in the Obama’s administration, where she helped to bring federal health policy in line with the rapidly evolving field of telehealth. She currently leads a team of experts at Google Health in technological health care innovation.

When Dr. Jeffries asked what was the major challenge to digital health systems, Dr. Salvo said “equity.”

“The pandemic has, as many crises do, shown a spotlight on the fact that even a virus that theoretically should have an equal impact on a community. . .has a different impact because there’s already so much difference in access, outcomes and other underlying health issues,” she said.

Dr. Salvo said addressing these inequities would take more than just great medical care. Public health systems would have to be modernized and comparable social care data scaled up. “We were not as well trained in the U.S. context about understanding that most people’s health is driven by where they live and learn and work and play,” she said.

But if the pandemic revealed inequities, it was also a key driver in the uptake of telehealth, she said, “and clearly showed us that technology is a viable option in the digital toolbox.”

“It is so much easier to connect with someone to get the help you need…when that can be done virtually,” said Dr. Salvo, adding that it is essential the next generation of doctors and nurses are trained to use those digital tools.

She reminded the audience that Google is first and foremost a consumer company that has partnered with companies such as Fitbit Inc. and Mayo International Health on projects. As a business, Google has an incentive to share data, she said. “We’re all connected, and so the data has to be all connected in ways that are private and secure,” she said. “That allows us to not miss what’s coming next that might be impacting the population’s health or a person’s health.”

AUTHOR B.L. Wilson

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Media Summit 2020

camera in foreground, woman in background

In December of 2020, the GW School of Nursing’s Center for Health Policy and Media Engagement co-hosted1 a follow up to last year’s inaugural Media Summit for Nursing Organizations. The goal of the Media Summit is to improve the representation of nurses in the media.  

This work took on greater urgency over the past year, during which time the COVID-19 pandemic has dominated healthcare and the media. Nurses may have been featured in the media more than in years past, but often they were portrayed as heroes, angels, victims, or strictly bedside caregivers. Despite the fact that nurses are also thought leaders, scholars, innovators, policy influencers, and the backbone of healthcare systems, nurses and nursing organizations are still rarely the go-to for the science and evidence. Nurses have valuable knowledge, unique perspectives, and stories that deserve to be told and represented in the media.  

The 2020 Media Summit convened leaders from 20 nursing organizations seeking to improve the representation of nurses in the media and enhance their media engagement skills. The participants discussed challenges and successes they have had implementing lessons from last year’s Summit. Some nursing organization representatives said they have noticed a trend of media requests seeking to portray nurses in a stereotypical manner. Others, who had success building relationships with journalists since the previous Summit, suggested that once your organization has a connection with journalists, you can begin to redirect their questions, pivoting away from discussing only bedside care to discussing the ways in which nurses are well-rounded leaders, in healthcare and policy.   

At the 2020 Media Summit, we also hosted two journalists: Sheree Crute, director of communications at the National Institute for Health Care Management Foundation, and Courtney Stewart, vice president of strategic communications at Missouri Foundation for Health. These esteemed panelists advised our nursing leaders on many media topics, including how to navigate the current polarized media environment. 

Sheree Crute told attendees that “sitting comfortably in the center is almost not possible,” so to consider, what are you willing to say and what you are willing to be known for. As she stated, “nurses have important stories. Finding people who can tell them factually, effectually, and efficiently is the challenge.”  

To have the greatest impact, Ms. Stewart advised the diverse group to hone in on their organization’s specific audiences based on their niche or comparative advantage. Responding to the many participants who expressed wanting to see the underrepresentation of nurses and the media’s narrative around nurses change, she said that journalists do have a responsibility in this, including educating themselves on better understanding the complex roles of nurses. However, it is also partially up to nurses and nursing organizations to make themselves known, pivot the narrative, share unlikely stories, and come up with creative ways to enter conversations. She told our attendees to build relationships with journalists now, even in small ways, and that those relationships are what will, down the road, make the more in-depth healthcare and health policy conversations that nurses want to have possible. 

1. The Center for Health Policy and Media Engagement looks forward to continuing these conversations and partnerships in 2021. 

AUTHOR HALEY STEPP

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A Pioneering Model

Patsy Deyo at SON vaccination clinic

The student-run COVID-19 testing center, which got up and running in record time, offers an inspiring blueprint for the future, nursing experts say.

When Mark Tanner came to GW’s Virginia Science and Technology Campus weekly to get tested for COVID-19, the former assistant dean for the bachelor of science in nursing program parked adjacent to Enterprise Hall. He entered the building, scanned his GW badge, and walked up to the registration desk, where nursing students scannedQR codes on testees’ phones to call up their appointments, verify names and birth dates, and scan test tubes that would contain their samples. From behind plexiglass, the students—who were gloved and masked—wrote Dr. Tanner’s name and birth date on the test tube and verified his identity with his GW ID or license.

Dr. Tanner took his test tube and walked down a hall in the building’s former cafeteria, which was sufficiently capacious to accommodate the center, to one of six testing booths. If it was a busy time of day, he could wait a few minutes, but often he went right in. He would hand his test tube to the nursing student (gowned, gloved, and clad in an N95 mask and face shield), and the latter verified his birth date. Dr. Tanner had taught many of these students in first-semester didactic courses, but the students would invariably stick to protocol.

“Every experience I had, they always ask, ‘Hey. How are you? Have you done this before?’ even though they knew who I am, and they knew I’d done it before,” he said. “They’re doing the things that they should be doing. They’re neither relaxing nor taking anything off. There’s a sense of pride knowing they’ve come to our program; they’ve come this far; and they’re doing well with this very important task.

Each time, the student explained the procedure to Dr. Tanner, directed him to sit and drop his mask below his nose, and swabbed 10 seconds per nostril. The student nurse placed the swab in the test tube, broke it off and capped it, and then Dr. Tanner was ready to go. A courier picked up samples twice daily from the site, at noon and at 4 p.m., for delivery to Foggy Bottom for processing in a GW lab. Dr. Tanner usually had his results, which he could check via a mobile application, within about a day.

“It’s been very well and smoothly run,” he said. “I’m rarely there for longer than 5 to 10 minutes from the time I stand in line until the time I’m back in my car.” There’s a huge amount that happens in a very short clip, and the testing center did that more than 500 times per week at its peak. But equally as impressive is the speed with which the COVID-19 testing center was created and launched and how effective it has been during these difficult and uncertain times.

Karen Drenkard
Dr. Karen Drenkard

An ‘Aha Moment’

When GW announced in March 2020 that it would be going virtual, the School of Nursing was already well poised for online instruction, which it had been doing previously, but clinical placements became a problem when area hospitals said they couldn’t accommodate student-nurses. The Commonwealth of Virginia ruled that simulations could count for clinical experience, so that semester’s students could graduate.

“But then the new group comes in. What do you do with the new group? Summer, fall, and now spring. We really were beginning to scramble a little bit,” said Karen Drenkard, associate dean of clinical practice and community engagement. 

By early summer, Dr. Drenkard was representing the Nursing School on GW’s pandemic task force and was co-running the task force’s health and wellness subcommittee. As the university moved toward bringing essential community members back to campus, there was a need for a COVID-19 surveillance polymerase chain reaction (PCR) testing program. Two testing centers were created in Foggy Bottom—one for symptomatic and the other for non-symptomatic people—and by mid-August, Dr. Drenkard had a mandate to create and operate a testing center on the Virginia campus for the 550 faculty, staff, and students, who reported there for work. 

“I’m not sure when we had the aha moment, but it’s 25 miles away, and the students have their clinical labs in Ashburn, the employees work in Ashburn, and we have housekeeping staff, faculty, students, and essential staff that are all going to be there,” Dr. Drenkard said. 

The semester was slated to begin some two or three weeks after the Nursing School received direction to start the testing center, so Dr. Drenkard—who had only been at GW for about a year—needed to move very quickly. The former chief nurse who spent a decade at the five hospitals of the Inova Health System, had served also on the Northern Virginia regional emergency preparedness disaster task force for the hospital alliance right after September 11, 2001. 

“I had a lot of disaster management experience, and I had operations experience,” she said. 

Dr. Drenkard corralled a group, which included people she hadn’t met before and who hadn’t met one another, and oriented everyone toward the goal and looming deadlines. “We were able to break down a lot of barriers very quickly,” she said. She also brought aboard two people with whom she had worked previously and upon whom she knew she could count.  

She enlisted Bonnie Sakallaris—who was chief nurse of the Alexandria, Va., hospital system and had worked with Dr. Drenkard at Inova—as the COVID-19 testing center director. “She was thinking that she was going to retire. I called her on Aug. 12 and said, ‘Would you be interested in doing this with me? I have no idea how long it’s going to last, but it’s going to be crazy. Do you want to come with me?’” Dr. Drenkard said. “She called me back in two hours and said, ‘Yes. I do.’” 

“When you’re a nursing executive or a hospital administrator in the executive suite, you stand up new programs frequently, and often without a whole lot of notice. I had never opened up a testing center before, but both Karen and I have on multiple occasions, with very little notice, developed a whole new program, staffed it, and opened it up,” Dr. Sakallaris said. “There are organizational things that you know you have to do. This was not foreign territory.” 

Dr. Drenkard also hired Patsy Deyo, M.S.N. ’14—who is in her Ph.D. dissertation phase in translational health sciences at GW’s School of Medicine and Health Sciences, and who worked previously in academic affairs at the Nursing School—to run student-nurse educational training. 

“I knew we could do it. I wasn’t sure how,” Deyo said with a laugh. “There were so many moving pieces and so many different things that had to happen in such a short time that anywhere along the lines there could have been hiccups that would have impacted our being able to do it.” 

The group secured supplies (including the highest level of personal protective equipment, PPE, that it could to protect the student nurses), drafted colleagues from different parts of the university, and found ways to involve students. (It also created and ran a flu vaccination clinic adjacent to the COVID testing center, as a “one-stop shop,” for two weeks in October.) 

“I said, ‘If I’m going to put students who aren’t licensed yet in a situation where they’re exposed to some people who could possibly have COVID, they have to have N95s, face shields, gowns, and nitrile gloves,” Dr. Drenkard said. “We used very stringent infection control, and none of my testers ever got COVID.” 

From the start, staff members were very open with the student nurses, asking how the process could improve and what challenges could be foretold and skirted. “We kept modifying what we did based on what they were seeing and said, ‘No idea was too crazy or far-out to try,’” Dr. Sakallaris said. 

Students have expressed to Dr. Sakallaris something quite similar to how she feels herself: that as the pandemic unfolded, she felt drawn to the front lines to do something useful and to be part of the solution.  

“This offers that opportunity,” she said. “It’s very gratifying to know that you’re doing something really important to manage and eventually stop this pandemic. That feels really good. It’s fun to see a plan come together.”  

And though the group went into creating the clinic expecting there would be great lessons but also initial glitches, the process went surprisingly smoothly from the start, according to Dr. Sakallaris. “There was no chaos,” she said. “It was all really well controlled.” 

students in PPE getting instructions
Nursing student volunteers in PPE receiving instructions

Charge Nurse 

Throughout the day—10 a.m. to 4 p.m. on Mondays and Thursdays, and 10 a.m. to 2 p.m. on Tuesdays and Wednesdays—student nurses rotate through three roles: registrar, tester, and charge nurse. One student is charge nurse in the morning, and another takes over after lunch. That person is in charge of ensuring the center has adequate inventory and supplies, oversees lunches and breaks, and enforces social distancing and masking protocols in the center. She or he also delivers test samples to the courier for transport to the Foggy Bottom lab. 

Veronica Nguyen—who worked at the testing center during the spring 2021 semester—found it nerve wracking the first time she served as charge nurse. Only one other student from her group had held the charge nurse position before, and Nguyen trained with Dr. Sakallaris and with that previous charge nurse.  

“You worry about keeping everyone happy and running daily operations as smoothly as you can,” Nguyen said. “Especially for someone with limited leadership experience, it can be daunting to delegate tasks and make decisions. However, developing my leadership skills in a setting like the testing center was incredibly helpful.” 

Faculty provided a safe learning environment to facilitate student growth and development, and debrief sessions at the end of the day helped the team address collectively issues that arose during the day. “This time allowed me to reflect on my role and work with my peers to improve,” Nguyen said. “I’m thankful that the testing center created this role. These experiences can help us develop our leadership style and practice as we go into our jobs as full-time nurses.” 

Working at the testing center also helped Nguyen bridge the gap between didactic knowledge and practical nursing skills. “The testing site represents a crossroads of our nursing education, training, and experiences at clinical. At the center, we can practice practical skills like properly donning and doffing PPE, participate in patient education, and learn among peers,” she said. “The testing site offers opportunities for team management and building leadership skills.” 

Another student nurse who worked at the testing center spring 2021, Timothy Barksdale, also found that the experience connected directly to what he was learning in his classes. “I am learning about COVID procedures in all my clinicals and classes, so the PPE requirements and general knowledge is very intertwined,” he said. “This clinical has absolutely raised my confidence in patient care as a whole and with COVID specific protocols.” 

When Seneka Lea worked at the center during that same semester, she discovered there’s a lot more to the center than just swabbing noses and scanning test tubes. 

“I was surprised at the number of individuals tested at the Virginia campus everyday, and then more so at the Foggy Bottom campus. Before my experience, these numbers didn’t really mean anything to me,” she said. “But in understanding the importance of surveillance and contact tracing on preventing outbreaks in our GW community, it is impressive to see how many individuals we test on a weekly basis.” 

Lea learned something different from each of the three roles at the testing center. As a tester, she learned to ensure sample quality and to reassure patients (nasal swabs aren’t fun, she assures). As registrar, she fine-tuned customer service skills and attention to detail. And as charge nurse, she learned the importance of teamwork and assuming responsibility. 

Normally—when it’s not a pandemic—student nurses don’t get a lot of primary care experience, because their clinical experiences tend to focus on acute care.  

“This is a real chance for them to see how a primary care, very-specialized clinic works, and to see all the roles that go into making it happen. It gives a different experience than we’ve been able to provide in the past, and it really allows them to understand the full picture of what’s going on,” Dr. Tanner said. “It’s a hopefully once in a lifetime opportunity to work through a pandemic and to provide this service.” 

student wiping down chair
Nursing student volunteer wiping down chair

Student Innovations 

In addition to their assigned roles as registrar, tester, and charge nurse, students also kept their eyes and ears open and made an impact on important parts of the testing center processes, center staff said. 

One nursing student read the label on a sanitizer bottle and questioned testers taking the swabbed specimens where they needed to go and only then coming back and sanitizing chairs. The instructions said the sanitizer had to sit for a minute before cleaning to be effective. After the student approached staff with that realization, the center process changed. Now, testers spray the chair and let the sanitizer sit while they deliver the specimen. By testers’ return, the sanitizer has done its magic and is ready to be wiped down. 

On another occasion, students got the idea to help Spanish-speaking facilities and housekeeping staff on the Virginia campus understand more about COVID in their mother tongue. One of the students, who was fluent in Spanish, provided the text for the educational materials. “The students felt that it was very important to do this project,” Deyo said. “It was so well received.” 

“The students were really picking up on knowledge deficits among groups of people coming in to get tested and were able to put together educational materials to address that,” Dr. Tanner said. “They served a really good role. They were the ones who noticed that and brought it to the faculty, who were overseeing and working with them.” 

In another instance, students suggested minimizing the distance between the donning and doffing site and testing booths, so they wouldn’t have to walk through the entire testing center in full PPE. A new, closer space was identified, with the students’ help, and students set it up, sanitized it, and arranged supplies, Deyo said. 

In normal times, students have less of an opportunity to bring fresh sets of eyes and ears in their clinicals and to provide feedback that revolutionizes processes, according to Dr. Tanner. 

“Absolutely, there are people who may have those ideas, but the nature of this being a new clinic, really gave them more a sense of freedom to go ahead and say, ‘Hey. I’m seeing this,’” he said. “When you’re a student and you’re going into a well-established clinical site, you see something, but you may wonder why they do that. You may ask that question, but it’s not going to be very typical—I certainly know that as a student I wouldn’t have felt comfortable being like, ‘Hey. You guys should change this.’”

student administering flu vaccine
Nursing student administering flu vaccine

Looking Ahead 

As Dr. Drenkard thinks back on all that GW was able to accomplish with its COVID testing, she thinks the university sits squarely in the top tier of those who showed leadership in pandemic management and surveillance. “The capacity to stand something up quickly and to use students who are in clinical training as a resource—these are all really important assets,” she said. 

Dr. Drenkard also thinks that the testing center broadcasts an important and broad message about nursing. “As a profession, we’ve struggled a little bit to really shine as leaders, and this was an example of a combination of so many things going together,” she said. “Nursing and nurses taking on leadership and a nurse-led testing site and center shows what can happen and shows people what nurses are capable of.” 

There will almost certainly be testing in some form over the summer, and the hope is that need will greatly reduce by the fall.  

Now that COVID vaccinations are more prominent, the testing center has shifted to reduced hours. But there is still a potential role the center will play in vaccinations going forward.  

It was able to do that with a flu vaccine clinic that the Nursing School stood up adjacent to the COVID-19 testing center, which provided flu vaccines in two weeks to everyone reporting to the Virginia campus who wasn’t already vaccinated. “The thing that we could really look at and see how we can incorporate is working on vaccination clinics,” Dr. Tanner said. 

“It’s great to know we can do it on such a short time frame and make it effective. We hope that we don’t have to do it again that quickly,” he said of the COVID testing center. “Academics are made to move kind of slow and deliberate; it’s not the same thing as the clinical environment. But knowing that we were able to do that is a great thing to know and if we have a similar situation—which goodness I hope we don’t—it’s great to know that we were able to do that.” 

Dr. Sakallaris agreed. “There’s going to be another crisis at some point, so this is the lesson that I would take away from that: When there’s a crisis looming, take a look at what your students can do, what can they learn from this, and how can we marry those two things. I think that’s been the most valuable thing,” she said. 

“When there is a crisis, when there is something new going on, it’s a significant opportunity for learning for your students. Use that. Staffing this with student nurses is unique,” she added. “Other places have tested college students, but they’ve used contract labor and that sort of thing. I don’t know of any other place that has used their student nurses.” 

And, of course, their flu vaccination clinic is likely to return in future flu seasons, as it has operated in the past. “It is a really good opportunity for student nurses to do IM (intramuscular) injections,” Deyo said. 

AUTHOR Menachem Wecker

Posted on

Nursing Resilience Amid Disruptive Times

GW Nursing volunteer at COVID testing site

The year 2020 was supposed to be special at the George Washington University School of Nursing. The World Health Organization had designated 2020 as the International Year of the Nurse and the Midwife, and the school was to celebrate its 10th anniversary. Dean Pamela Jeffries was planning an April gala at the Army and Navy Club, and programming would, Janus-like, look retrospectively on the past decade and ahead to the next 10 promising years.  

“That was a big deal for us,” said Dr. Jeffries. “We were ecstatic.” 

Then the pandemic hit, postponing the gala first a few months to August, and then subsequently a year to April 2021. With students and families needing support more than ever, GW Nursing brought new urgency to scholarship campaigns already underway, and the school continued to plan a health summit—albeit in digital form—addressing educational gaps in health professions.  

“We have to stay current with timely topics and needs within our health care profession,” Dr. Jeffries said. 

Helming a school amid a pandemic isn’t easy, but adapting and even shining under pressure in uncertain, stressful circumstances is muscle memory for nurses, whose patients’ conditions may fluctuate by the minute. “We deal with uncertainty all the time,” Dr. Jeffries said. “If I’m in patient care, my Tuesday looks different from my Wednesday. The practice environment changes by the day. So does the academic one.” 

As a nurse with a background in critical care, Jeffries was familiar with the need to be ready for change. “I could have a pretty stable patient come in the unit at 10, but by 11, he could be in respiratory arrest or cardiac arrest,” she said. “I always had to be prepared to deal with emergencies, because I never knew what emergency might be in front of me.” 

The past few months have been exceedingly difficult for almost everyone, and these have been particularly trying times for nurses on the front lines of the public health crisis, as well as for their colleagues in the nursing academic setting. As the pandemic rages amid a period of social unrest and protests demanding social justice, it’s more important than ever for nurses and nurse faculty to prioritize self-care and their own mental health in addition to aiding their patients and students. 

Stories of GW Nursing faculty, staff, students and alumni could fill many tomes, but here is a sketch of several important happenings in and around the school’s community.  

GW Nursing COVID Testing helpers

A Drastic Change 

When COVID-19 hit, Dr. Jeffries drew upon her nursing experience to think critically and to prioritize what to do first, second and third. “We just take command,” she said of nurses broadly. “We’re operational. We just lock in.” 

On March 13, the school moved to a fully remote workforce, with faculty, staff and student safety being the paramount concern. At the time, people weren’t wearing masks, but Dr. Jeffries instructed everyone to go home and mitigate risk by doing things like washing hands extra carefully. After addressing safety, she said she turned her attention to what her faculty and staff needed “to maintain structural continuity and to make sure that our students can progress.” For those slated to graduate in May, there was concern over how to ensure they met vital competencies.  

Concerned about staff morale, Jeffries set up weekly meetings with managers and directors to ask what they needed and to talk about how best to support a remote workforce. The meetings helped them calibrate. “That’s what we do as nurses,” she said. “We look at human responses. We look at whether they are stressed, anxious or sad.” 

Jeffries also set up weekly town hall meetings with faculty and staff, which continue to draw more than 100 participants. “We’re here together. We’re a community,” she told the group. “Nurses build community, because when you’re caring for a patient, you include the family. Do they have the resources they need? I don’t want to give someone a prescription for a medication they can’t fill.”  

After reassuring the GW Nursing community, Jeffries emphasized the importance of discussion. “As nurses, we communicate well. We are the most trusted profession,” she said. She placed transparency and team building at the forefront of the school’s administrative response. The environment she fostered broadcast to the entire school community that everyone was in this together. 

“That communication link was important. They were hearing from me. I was giving them all the information I had in real time. That was crucial,” she said. “That carried over from my nursing days when establishing a line of communication with your patients was your top priority.” 

Every town hall meeting, Dr. Jeffries ends with an inspirational quote. “In the beginning, I would bring those, but now I have faculty or staff closing the meetings with their own quotes.” She also had to slow herself down at points, knowing she tends to operate at warp speed. 

“Sometimes I had to remind myself, ‘Hey Pam. Pause here. Let them catch up.’ As dean, I might see the big picture ahead of other people, or I might have a vision that others don’t see,” she said. “As a leader, it’s important to tap into your emotional intelligence to know that when you lead, you have to bring your team along. You can’t be so far ahead.” 

Meetings of a critical-decision team Dr. Jeffries assembled, which had been a daily occurrence at the outset of the pandemic, scaled back to thrice weekly, and now are held two times a week. The team had succeeded in keeping the school up and running in the face of so much uncertainty. “Things were changing rapidly,” Dr. Jeffries said of the early days. “As a leader, you’ve got to be flexible and nimble.” 

Among the things the team has tackled are procuring remote proctoring software for exams delivered digitally, unifying communication so there are no mixed messages going out to different parts of the community, and “Fun Fridays,” where faculty and staff gather online for half an hour to discuss things other than work.  

The latter was in its 24th week at the time of the interview in August, and Dr. Jeffries said participants had shared with the group pictures of their children, of a road trip to Niagara Falls, of home remodeling and renovations, and of pets. One brought the trivia game Kahoot! for everyone to play, and another shared about a new mask-making hobby. Dr. Jeffries showed the group rocks she paints and leaves on a path for people to take or move around.  

“It’s nothing but fun,” she said. “It becomes a stress release.” 

Looking forward, Dr. Jeffries has no more access than anyone else to a crystal ball, but she has seen promising signs in the way GW Nursing has rallied together as a community. The faculty and staff have exceeded Dr. Jeffries’ expectations in their kindness and support, and the prior week, a student anonymously gifted $7,000 in support of scholarships. “It’s wonderful to know this particular student felt so supported through this stressful time that she wanted to acknowledge it through philanthropy,” Dr. Jeffries said. “For the student, $7,000 was probably a lot of money.” 

Dr. Jeffries added that pandemic has been compounded by social unrest and protesting following the May 25 death of George Floyd. With the help of Sandra Davis, assistant dean for diversity, equity and inclusion, Dr. Jeffries penned a message to the public stating unequivocally that the school will not tolerate racism, bias and discrimination and the continuing cycle of health inequities across our nation. Every Tuesday at 7 p.m., the school holds virtual forums called “Continuing the Conversation,” to discuss structural racism.  

“We’ve embraced the need to bring more awareness and change to systemic racism and doing so requires us to bring  anti-racism into our classrooms, into our working relationships, and when we are in clinical settings,” Dr. Jeffries said. She is inspired by the vulnerable and highly personal stories shared by many faculty, staff and students, and is proud that the school has fostered an environment where members of the community feel safe doing so. 

One person, a black woman, shared with the group that at least while quarantined at home during the pandemic, she no longer worries about the safety of her children, who are black teenagers. “That was heavy,” Dr. Jeffries said. “People haven’t walked in other people’s shoes. Those stories were so striking.” 

Ric Ricciardi and Army Surgeon General
LTG R. Scott Dingle, Army Surgeon General with Dr. Ricciardi

Duty Calls

If life were a movie, a grizzled Richard “Ric” Ricciardi would have been splitting firewood at the end of a long driveway when Department of Defense officials drove up and told him the world needed him to come back to work. It wasn’t that dramatic, but the DOD certainly caught Ricciardi off guard when it asked for his help to lead COVID-19 operations and public health response at General Leonard Wood Army Community Hospital at Fort Leonard Wood in Missouri. 

“Originally, I was shocked to be honest with you. I was retired from military service. I just figured I would never put on a uniform again,” said Dr. Ricciardi, director of strategic partnerships at GW’s Center for Health Policy and Media Engagement and a professor of nursing. He is also president of Sigma Theta Tau, the international nursing honor society. 

The military’s ask wasn’t that unusual, however. As a 66P (family nurse practitioner), Dr. Ricciardi had worked at the Agency for Healthcare Research and Quality (AHRQ), part of the U.S. Department of Health and Human Services, and he was very familiar with public health models. Where most Army colonels had retired or were working in administrative roles, Dr. Ricciardi kept one foot in clinical practice his entire career and was still certified to practice as a nurse practitioner in Maryland. 

“It really wasn’t my Ph.D. that got me called back. It was that I was still practicing as a clinician,” he said. “For me, they kind of got a twofer.”  

When the initial shock wore off, Dr. Ricciardi felt a sense of pride and honor. “I’ve always been very proud of this country, the American dream and what the country stands for,” he said. “To be asked by the Department of Defense to participate in a national emergency—I felt honored to be asked. If your nation calls and really needs you, if there’s something I can do to make the world a little bit better during a national emergency, I definitely should consider it.” 

Before making the big decision, Dr. Ricciardi talked to his wife—who was supportive—and to Dr. Jeffries, who gave him the green light on GW’s end. He said yes to the DOD, received his orders, and then things moved very quickly.   

At the fort, Dr. Ricciardi works out of an old dental clinic overseeing screening of incoming populations and setting the fort’s public health responses to prevent potential spread of the virus among trainees. Part of that means designing training “bubbles” for recruits and arranging sleeping accommodations in safe ways. (Trainees sleep head-to-feet and feet-to-head.) Dr. Ricciardi didn’t want to identify the fort’s population but said he has screened people “in the thousands.” 

“When conducting training in the field in a COVID environment, it’s about really trying to figure out if there are other ways to do something, like scaling a wall, in a different way, or questioning whether that activity is really something that is required in the training to ensure competence. Can that be left out? Can you just have the person do it on their own?” he said. “The critical element is trying to have reasonable assurance that when people are training together that you have done all that you can to minimize the risk of COVID transmission, such as removing the individuals that either have COVID or are at risk for developing COVID.” 

In high-pressure conditions, self-care is important for health care workers too, and Dr. Ricciardi relaxes by going on walks in the nearby Ozark Mountains. (He posts his stunning flora and fauna photos on Flickr and also writes poetry.) “It’s one way for me to unwind,” he said. “I’d never been to this part of the country before, so it’s quite striking how beautiful the countryside is. The good news is you’re out in the countryside by yourself. There’s no risk of COVID.” 

Dr. Ricciardi said photography and writing help him escape temporarily from overwhelming times with the global economic challenges, systemic racism and the pandemic. But looking forward, he is optimistic about some of the promises of telemedicine and virtual health care, which can handle certain health conditions more efficiently, and cheaply, than an in-person office visit.  

“COVID, in some ways, has been an opportunity for health care to advance and improve its efficiencies, effectiveness and customer service via telehealth and other modalities,” he said. “The paradigm of primary care will change to allow for more of this innovation around telehealth to be incorporated routinely in a visit.” 

“I think consumers are going to demand it and say, ‘I didn’t have to get in my car and drive. I could actually see my provider without leaving work. It worked out well. Why can’t I keep doing that?’” he added. “I suspect for certain kinds of medical issues, consumers will demand it.”      

GW Nursing pediatric clinical education instructors Kristen Stevens, Betsy Choma, Jennifer Walsh
(from left to right) Kristen Stevens, Betsy Choma, Jennifer Walsh

Clinical Simulations 

Pediatric clinical education instructors Betsy Choma, Kristen Stevens and Jennifer Walsh, who work as a team, have also found ways to adapt to social distancing requirements in ways they think will improve teaching even after there is a readily accessible and effective vaccine. 

When the pandemic forced hospitals to turn away nursing students for clinical rotations, the three instructors put their heads together to find a solution. In mid-March, one cohort of students still had a few weeks left, but the summer group needed to do its entire clinical component virtually. 

It was helpful to know ahead of time for the summer that the three would be designing the didactic (lecture) and clinical portions to complement one another, according to Choma. “The three of us were able to sit down and plan out, ‘OK. If we are talking about respiratory in lecture, let’s have respiratory case studies in clinical,” she said. 

When students see patients in hospitals, they never know what patient they will get at any given hour of any given day, but simulation allows for more customization. “It’s actually nice to be able to tailor and bring the student into the virtual classroom,” Choma said.  

The three could essentially put their pedagogic fingers on the digital scale and design vignettes to ensure students got to see, virtually, every relevant kind of patient. That gave both depth and breadth to the learning, and could bring examples virtually—say of child abuse or vaccine hesitation—that students otherwise wouldn’t necessarily experience. 

In an unexpected way, the virtual nature actually brought the patients to life, Choma added. 

“There are pros and cons of both. We obviously would love our students performing patient care. We’re nurses. That’s what we train for. That’s what we all want,” Walsh said. “With the COVID pandemic, we didn’t really have that opportunity, but we still had to provide a quality education to these students to get them out into the workforce.” Providing the course online allowed for “more synchronously connecting the didactic and clinical learning.” 

The program had previously used simulations and in-person teaching, and Stevens said the three of them found the two approaches to dovetail well. “In simulation you have a safer environment, and you can try things without the same degree of consequence, and so the thinking is very different,” she said. “Versus when there’s a child crying in front of you when you have to talk to the parent.” 

In the fall, students will be learning in hospitals and virtually, and the trio expects even when everything returns to normal to continue to tailor simulations to lecture topics. “As our pediatric curriculum features simulated patients and scenarios increasingly, we look forward to maximizing use of our high-quality simulation lab,” Choma said. “I think we are really going to see the value of simulated scenarios, because we can’t predict the outcomes, but we can control the environment.” 

“We learned so much with this transition to virtual,” Walsh said. “I think there’s no doubt that we will continue to evolve and continue to bring what works best for the students in the future.” 

Leah McElhanon, B.S.N. ’18, M.S.N. ’19

Finding the Silver Lining 

Before the pandemic changed everything, Leah McElhanon, B.S.N. ’18, M.S.N. ’19, had a plan. She was going to work at a clinic and save enough money until she could hang her own shingle. In March, she realized she had to detour. 

McElhanon was furloughed from the Dallas clinic where she worked. Unsure when she could return to work, she decided to volunteer at the Federal Medical Station in Santa Clara, Calif., as part of the medical team for the nonprofit Team Rubicon. There, she cared for COVID-19 patients before her deployment ended. 

Earlier this year, she started a pro bono practice on the side and began a new job recently as medical director for a COVID testing initiative, which she said is trying to find better and safer solutions to medical problems. (She didn’t want to say a whole lot more about the effort, which is in its infancy.) 

McElhanon has heard from former classmates and colleagues, and she said everyone is physically, mentally and emotionally worn. She felt some inertia initially, when there was some hope that there might be a big breakthrough, but she is prepared now for a long haul. 

Nursing school taught McElhanon to keep a poker face for the benefit of her patients, but in the face of COVID, it’s tough to be stoic. “It starts to wear on you,” she said. She currently has a very close family member in the hospital. Despite a resilient nature, she finds it devastating to be unable to care for her relative. Hospital policies bar visitors of any kind, which makes in-person support impossible. McElhanon went into the medical field to protect those close to her, but now she finds herself stuck at arm’s length due to the ongoing pandemic. 

“The nursing profession is needed now more than ever. Nurses are at the patient’s bedside 24/7, when their loved ones cannot be there,” McElhanon said. “The nurse’s presence ensures that the patient is never alone. In addition to their medical expertise, nurses are everything for the patient. They take on the roles of family, friend, advocate and much more.” 

Somehow, McElhanon sees a silver lining amid all the uncertainty. 

“We can’t change anything we did yesterday; we can only be better today,” she said. “Taking a step back and looking at what this experience is going to offer us. One thing is innovation in medicine. Right now, people are pushing in so many avenues for so many different medications and treatments and protocols. Researchers and medical professionals are out there trying everything that they can.” 

Medical professionals are starting to see that they can not only strive to help with the current pandemic, but also pioneer and push new boundaries. 

“Medicine is very foundational. Views and practices remain inside the box,” she said. “This silver lining is teaching us, ‘Let’s never think inside the box. Let’s keep going.’ I think this may benefit us in the long term. We may be able to identify and prevent viruses sooner. We might be able to predict how other viruses, with which we’re already struggling, infect and overtake the body. We might be able to cure some things that we’ve never been able to cure.” 

It’s really hard to try to find sources of optimism and positivity, she admitted. “But honestly, that’s what we need to do right now,” she said. “We will get through this. We can get through this. We just have to stay positive.” 

AUTHOR MENACHEM WECKER

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Accelerated B.S.N. students create COVID-19 prevention video for Costa Ricans

Costa Rica

“I remember being in class and Dr. Karen Dawn asking who spoke Spanish,” said Eva Cruz, an accelerated B.S.N. student in her final semester. “Instinctively, I raised my hand. It turns out I’d volunteered myself to do a project for global health.” 

As the spring 2020 semester wore on amid the COVID-19 pandemic with the university making difficult decisions to ensure programmatic continuity while keeping students safe, many of them were disappointed to learn that all university-related international travel would be suspended. This had implications for Ms. Cruz and her colleague, Victoria Hinson. Both were nearing the end of the Accelerated B.S.N. program and were eager to broaden their nursing horizons in Costa Rica as part of their global initiatives community project requirement. 

Like her colleague, Ms. Hinson was drawn to this opportunity because it offered a great opportunity to strengthen her medical Spanish skills and make a positive impact on an international community during such difficult times. “I was greatly disappointed with the travel restrictions cancelling the Costa Rica study abroad program, but I thought ‘no better way to give back than to work on this project with our in-country partners virtually.’” 

“Our school was partnering with Global Learning in Costa Rica,” said Hannah Hahn, program associate in the Office of Community and Global Initiatives at GW Nursing. “Our two students and I worked with two of their local partners, Asociación por la Sonrisa de los Niños (ASONI) and Children’s Well-Being Foundation’s mobile clinics, to develop educational materials and provide donations of personal protective equipment.” 

This virtual collaboration turned out to be a perfect way to demonstrate the hands-on knowledge and skills that Ms. Hinson and Ms. Cruz had learned throughout the accelerated B.S.N. program, while helping a community in need and discovering how effective they could be making an impact on people’s health and well-being from such a great distance.  

Not knowing about the community and its needs, the students engaged the partners to help shed light who these families were, where they lived and what resources would be most beneficial. “During the conversations, we identified that educational materials could play a significant role in preventing the spread of COVID-19,” said Ms. Hinson. “And, of course, it would need to be virtual,” added Ms. Cruz. 

The team decided to make three educational videos in Spanish for children ages 3-15 about how to prevent COVID-19, how to make masks with used T-shirts and how to wash your hands properly. 

“We created scripts that were edited and amended by our partners,” said Ms. Hinson. “And after this exhaustive prep work, it was satisfying to see them come to life in these videos with the help of GW Nursing’s Community and Global Initiatives team and Online Learning and Instructional Technology team.”  

The students were amazed by the end-product, and thrilled to learn that the videos they had created reached hundreds of Costa Rican children and their families. They were also excited to hear that rising final-semester Accelerated B.S.N. students would use this project as a launching pad for future projects.   

“By choosing to work with our partners to provide informative health videos for Costa Ricans in need, I realized that my nursing skills could transcend internationally,” said Ms. Hinson. “My colleagues and I were encouraged to engage our creativity and think outside the box to see how we could engage children and their families for something bigger than a project. I am thrilled that other students will have this same opportunity, and I am excited to see what products will be created in semesters to come.”  

“Despite the challenges and hard work this virtual global health project was a uniquely fulfilling learning experience,” said Ms. Cruz. 

Watch the COVID-19 prevention videos developed by Ms. Hinson and Ms. Cruz. 

Costa Rica Part 1 – What are the Germs and How to Prevent COVID-19
Costa Rica Part 2 – How to make masks with used t-shirt- No Sewing Needed
Costa Rica Part 3- How to wash your hands properly
Costa Rica Part 3 – How to wash your hands properly (spanish)

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NCSBN Grants Bolster Banner Year for GW Nursing Research

Grad students in Sim lab

Despite the outbreak of COVID-19, which resulted in many sudden changes to the school’s research endeavors, and the university moving to a shared-services model for research administration services, GW Nursing has seen significant increases in its commitment to sponsored research this year. 

As exemplars of the schools heightened focus on research are three grants awarded through the National Council of State Boards of Nursing (NCSBN) totaling more than half a million dollars. 

Jeongyoung Park secured funding for her study titled, “To what extent is the degree of state scope of practice autonomy associated with malpractice lawsuits filed against nurse practitioners (NPs)?” 

“A growing number of states are taking action to expand the roles of NPs—who have the authority to diagnose, treat and prescribe medications,” said Dr. Park. “These states are doing so as a response to emerging health care needs in their communities.”  

Recent changes in delivery and payment policies spurred by health care reform, coupled with a nationwide shortage of primary care physicians, are expected to shift greater responsibility for patient care to NPs. “As NPs continue to expand their autonomy and responsibilities, they may become more vulnerable to malpractice exposures,” Dr. Park said. 

The overall goal of this study is to examine the extent to which the degree of state scope of practice and prescriptive autonomy is associated with malpractice lawsuits filed against NPs. Dr. Park’s study will use a repository of all malpractice claims against licensed health care practitioners in the U.S. It will also tackle several research questions that address the association between NPs’ increased authority and the magnitude of malpractice claims; differences in the types of claims, allegation groups and severity of injury; and other factors associated with the scope of malpractice claims against NPs. 

“As NPs achieve greater autonomy and move into independent practice, it may be necessary to develop additional regulatory standards or processes to better protect the public and promote delivery of high-quality care,” said Dr. Park. “It may also be important to assess efforts to educate NPs regarding their potential exposure to malpractice lawsuits and how best to decrease it.” 

Dr. Angela McNelis was awarded funding for her study titled, “Using Screen-Based Virtual Simulation in Family Nurse Practitioner Education.” 

“Innovations in nursing education are a funding priority for NCSBN and a necessity for schools of nursing across the globe as we collectively and collaboratively create new learning models that ensure quality preparation and sufficient numbers of nurse practitioners,” said Dr. McNelis. 

As demand soars for primary care providers amid the COVID-19 pandemic and physician shortage, NPs are increasingly providing frontline care. At the same time, care delivery to those who are aging, battling chronic health conditions or living in underserved areas continues to be most affected. With NPs consistently demonstrating positive performance comparable to primary care physicians, they can address these needs and the provider gap. Yet, educating enough NPs is a challenge and requires developing and testing novel and pioneering methods for clinical education, such as virtual simulation. 

“Generating a robust evidentiary base for alternative approaches, such as screen-based virtual simulation, is critical for nursing education and regulation,” said Dr. McNelis. “The expansion and acceptance of substituting simulation hours for clinic practice hours in NP education, is dependent, in part, on strong and favorable evidence from rigorous, high quality studies. Findings from our study may support a change in regulations similar to the impact the NCSBN National Simulation Study had in pre-licensure programs.” 

And Dr. Ellen Kurtzman completed the NCSBN triad with her study titled, “Medical Cannabis: Are Nurse Leaders Prepared?” 

As more and more states move to legalize cannabis for medical and recreational use, nurse leaders will face increasing challenges and play greater roles in patients’ access to and use of medical cannabis.  Dr. Kurtzman’s study explores nurse leaders’ attitudes toward, knowledge of and experiences with medical cannabis, as well as their awareness and use of The NCSBN National Nursing Guidelines for Medical Marijuana, which were published in July 2018.   

“While a handful of studies has examined health care clinicians’ attitudes towards and experiences with medical cannabis… none has focused exclusively on nurse leaders,” said Dr. Kurtzman. “Yet, nurse leaders are pivotal because of their responsibilities and accountabilities for maintaining a safe environment and setting the vision for nursing practice in their organizations.”    

The study will examine the perceived barriers to patients’ use of medical cannabis and explore the education and training needs of nurses in the range of settings and organizations in which nurse leaders practice. Given very different state policy environments—to date, 34 jurisdictions have legalized cannabis for medical use and 11 states, plus the District of Columbia, have legalized cannabis for adult, recreational use—this study will also illuminate whether the legal status of the jurisdiction in which a nurse leader practices predicts the level to which he or she is prepared to deal with patients who use medical cannabis.  

“NCSBN has shown tremendous leadership in publishing guidelines for nurses about medical cannabis,” said Dr. Kurtzman. “This study will contribute to our understanding of these guideline’s utilization in the real-world and provide a baseline against which we can gauge changes in nurse leaders’ knowledge and attitudes towards medical cannabis as state-level policy environments shift.”

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Knowledge Sharing in the Age of COVID-19

Just as the emergence of COVID-19 affected many aspects of GW Nursing’s operations, the Center for Health Policy and Media Engagement saw interruptions of our typical lecture series. Knowledge sharing is one of the pillars of the Center for Health Policy and Media Engagement, and we were determined not to let the inability to host in-person events hinder our ability to further that goal. By utilizing technological innovation and the impressive expertise of our faculty, we found our solution.   

In April, amid the height of the shortage of personal protective equipment that was plaguing the U.S. health care system, center Executive Director Y. Tony Yang moderated a webinar titled Masks and PPE: COVID-19 and the Next Pandemic. Utilizing the expertise of Senior Service Professor Diana Mason and a colleague at University of Michigan, Christopher Friese, the center had the opportunity to educate a large and diverse virtual audience on the current state of the coronavirus and personal protective equipment (PPE) shortages. The webinar covered routes of transmission of COVID-19, PPE needed to reduce transmission for both health care workers and the public, reasons for shortages of PPE for health care workers, short-term options for addressing the shortage, and finally, long-term options for preparing for the next pandemic. This partnership of nurse experts was reflected further in the Journal of the American Medical Association (JAMA) forum piece on “Protecting Health Care Workers Against COVID-19—and Being Prepared for Future Pandemics.”  

In May, the center had the opportunity to utilize the expertise of two GW Nursing professors, Joyce Pulcini and Joyce Knestrick. In conjunction with Susan Hassmiller of the Robert Wood Johnson Foundation, Silvia Cassiani with the Pan American Health Organization, and David Stewart of the International Council of Nurses, we brought together this team of global nursing expertise and put on a webinar titled Global Advanced Practice Nursing Leadership in the Era of COVID-19. They spoke on the role of advance practice nurses in the health workforce in the U.S., in different regions across the globe, the role of nursing during COVID-19, and how the pandemic will influence the future of nursing. The speakers of this center-sponsored virtual event are also the authors and editors of the book Advanced Practice Nursing Leadership: A Global Perspective. 

Many of the center’s members are also utilizing their expertise to conduct COVID-19 related research, win grants, and publish think pieces on health during the pandemic. Dr. Yang, for example, has written multiple pieces examining the legality of vaccine mandates and travel restrictions during the pandemic. Ashley Darcy-Mahoney wrote an op-ed weighing the dangers and importance of getting children back to school. Diana Mason has written on the challenges of care and lessons learned.  

It is an understatement to say that the COVID-19 pandemic has presented a lot of hurdles to the way work gets done — including at GW, the center, for nurses and the medical community at large. However, there has been great resilience and incredible adaptation. The Center for Health Policy and Media Engagement was proud to engage our community in new ways during this time, to continue to share timely and critical information, and for the opportunity to showcase the great work and expertise of our quality faculty.  

by HALEY STEPP

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