LIFELINES - The Year of the Nurse Continues There is no slowing down during a pandemic - College of Nursing | MUSC
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LIFELINES 2021 The Year of the Nurse Continues There is no slowing down during a pandemic nursing.musc.edu
COLLEGE OF NURSING A publication of the
Medical University of South Carolina
College of Nursing
PROUD TO BE A NURSE
It does not seem so long ago when nurses
PHILOSOPHY VISION
LIFELINES worldwide began to celebrate the Year of the
Nurse and Midwife in January 2020. I remember
Volume XIII, Issue 1 • 2021
The College of Nursing’s philosophy is congruent with that of the Medical The Medical University of South feeling a great sense of pride and gratitude that I
belonged to a profession that engaged in shaping
University of South Carolina and guides the education, research, and practice Carolina College of Nursing will
practice and research and, by extension, patient
of nurses and other health professionals in an interprofessional health sciences be a preeminent leader in nursing
outcomes in ways that transcend not only our
center. This philosophy embodies the concepts of nursing, health, person, education, practice, and research to Executive Editor institutions but also in the discipline of nursing
and environment. The faculty believe that the discipline of nursing is both an improve the culture of health and Linda S. Weglicki,
itself.
Dean, College of Nursing
art and a science focusing on the optimization of health and holistic wellbeing quality of life. Now, as we begin 2021, I still feel this sentiment
across diverse populations within global communities. Our core values guide Editor more poignantly than I could ever imagine
the integration of education, scholarship, and inquiry to advance knowledge Beth Khan
nearly one year ago. In the earliest days of this
and practice framed by a collaborative interprofessional model of care. Photographer unprecedented pandemic, I recall moments when
Josh Goodwin nurses were hailed as heroes. I thought, "We are
not heroes. This is what nurses do every day, and
Contributors
Sharon Bond this is what nurses have always done."
MISSION Debbie Chatman Bryant However, over these past many months,
Leslie Cantu the overwhelming stories of nurses and their
Bryce Donovan
actions, as they faced daily new challenges of the
In an interprofessional environment that is respectful, inclusive, transformative, innovative, and sensitive Lisa DuBois
Carrie Cormack coronavirus, have been nothing less than heroic.
to a changing fiscal climate, the College of Nursing is committed to promoting health through: Catherine Durham Nurses have been and continue to lead the way
• Providing evidence-based nursing education Theresa Kelechi
through this pandemic. Their unending stamina, resilience, empathy, and gentle
Sharon Kozachik
• Generating, translating and disseminating scientific knowledge care can be seen at the bedside, in community health settings, in public health
Anahita Modaresi
• Leading excellence in practice Caroline Wright and educational environments, in clinics, and in the "war rooms" of hospitals and
health care systems.
In this issue of Lifelines, we reflect on 2020 and share stories marked not just by
CORE VALUES
one but by two historic parallel evolving crises: the worldwide COVID-19 health
PUBLISHED BY and economic pandemic and racial injustices occurring throughout the United
States. Both terrible and traumatic events highlighted the college's struggles as it
sought new and innovative approaches to meet its tripartite mission of education,
INTEGRITY research, and patient care. Last year's events also pushed us to find ways to combat
• Demonstrate honesty, ethics and moral strength in every aspect of personal and professional life structural racism and remain true to our core values that embrace inclusivity,
• Ensure equity and fairness equity, integrity, diversity, respect, and an environment of belonging.
• Uphold organization standards of conduct, policies, and procedures College of Nursing
Over the past 12 months, I witnessed so many people doing extraordinary
99 Jonathan Lucas Street
Charleston, SC 29425 and innovative things. Our faculty, staff, students, college alumni and friends,
INNOVATION nursing.musc.edu and community partners demonstrated tremendous flexibility, strength, and
• Advance the profession of nursing through research, practice, scholarship and life-long learning compassion as they stepped up in so many different ways. The magnitude of their
• Seek and embrace new and bold opportunities to ensure fiscal responsibility while ensuring the college’s HAVE FEEDBACK?
support and response to mitigate risk and transcend new ways of living, engaging,
growth potential during stable, as well as, unstable financial climates SEND COMMENTS TO:
teaching, learning, and protecting, required adaptability, imagination, and grace.
The MUSC College of Nursing, no matter what, will continue to exercise our
IMPACT Lifelines Editor thoughtful and forward-thinking approach and pause when we need to navigate
MUSC College of Nursing the multifaceted challenges which have transformed many of the ways we carry
• Shape and re-envision the nursing profession by providing cutting edge education and experiential learning
99 Jonathan Lucas St., MSC 160 out our mission and priorities.
opportunities
Charleston, SC 29425-1600 Alumni and friends, I encourage you to stay connected, share your stories, and
• Act intentionally to achieve significant and influential outcomes for our global society khane@musc.edu remain safe and well throughout 2021!
• Transform health care through collaborative leadership, policy, and advocacy
INCLUSIVITY POSTMASTER: Send corrections to Lifelines, MUSC
College of Nursing, 99 Jonathan Lucas St., MSC 160,
• Embrace and promote diversity Charleston, SC 29425-1600. © Copyright 2021 by
the Medical University of South Carolina College of
• Celebrate individual talents and strengths Nursing. All rights reserved. No part of this publication
Linda S. Weglicki, Ph.D., R.N.
Dean and professor
• Create and promote an environment of belonging where people feel empowered, respected, and valued can be reproduced without permission from the Medical
University of South Carolina College of Nursing. Medical University of South Carolina College of Nursing
FEATURES
YEAR OF THE NURSE GAINS NEW MEANING ...............................4
HISTORY OF THE NURSE MIDWIFERY PROGRAM .....................10
ACADEMICS - Jumping in feet first......................................................... 12
• Pivoting in a pandemic............................................................................ 12
• Palliative Care Initiative............................................................................13
RESEARCH - Keeping in touch during a pandemic................................ 14
• What About the Caregivers?................................................................. 14
PRACTICE - Re-envisioning faculty practice during COVID-19.......... 16
• Meeting the moment.............................................................................. 16
DEPARTMENTS
THE DEAN'S DESK...................................................................................... 1
DIVERSITY & INCLUSION....................................................................... 18
AROUND THE COLLEGE.......................................................................20
FACULTY & STAFF NEWS.......................................................................24
STUDENT SPOTLIGHT............................................................................28
ALUMNI CONNECTIONS.......................................................................36
MAKING A DIFFERENCE.........................................................................38
2 LIFELINES 2021
Year of Nurse gains
new meaning during
the pandemic
T
he World Health Organization (WHO) designated 2020 as the "Year of the Nurse & Midwife"
well before the COVID-19 pandemic disrupted our lives. As days and weeks turned into
months, the important role that nurses have in difficult health care crises like these become
so pronounced and valued. But how fitting that the designation is today. No one would have
predicted the same year Florence Nightingale would have celebrated her 200th birthday; we would
also witness a health care crisis like none other in modern times.
Nightingale's pioneering efforts more than 167 years ago led to health care reforms and models
used today. She established standards for sanitation, identified the value of data to inform care,
and decreased mortality associated with preventable diseases - all of which are foundational to
limiting the spread of disease. All were important then and just as important today as we address
the many health challenges of the COVID-19 pandemic.
These unprecedented times have challenged many nurses, especially those serving on the front
lines. Countless nurses have sacrificed their own mental and physical health, as well as time with
their family, and sadly, some have lost their lives while putting others before themselves. Nurses
understand there’s an element of danger to their job, especially when dealing with a virus that
scientists are still trying to figure out.
In the pages that follow, you will read about two nurses who served on the front lines in New
York City in March and April 2020. Both are graduates of the college, but who are at different
points in their nursing careers. Caroline Wright, a 2018 BSN graduate, is a critical care nurse
Interviews conducted by Lisa Dubois in Charleston and felt the calling to take her skills to where they could be best used at the time.
Catherine Durham is a 2012 DNP graduate with 21 years of nursing experience. She is the
and Anahita Modaresi in May 2020 assistant dean of the DNP program and a captain in the U.S. Navy Reserves.
have been edited for space and clarity. Both nurses are heroes, as are the countless others who have and continue to rise to the
occasion by serving and caring for others during times of adversity.
4 LIFELINES 2021 2021 LIFELINES 5
In their own words... “ I am used to times in the ICU before
COVID where loved ones gather and share a
I
n April, Caroline Wright, BSN ‘18, an ICU nurse at MUSC Health, volunteered to serve in the COVID-19
beautiful, bittersweet moment. Here death is
unit of Long Island Jewish Medical Center, New Hyde Park, NY, the U.S. epicenter of the pandemic at the
time. Wright describes the importance of teamwork and the need to improvise, given limited resources
cold, lonely and tragic so I held their hands
in health care crisis situations. Wright notes the important role she took on for ICU patients during this time and told them they are loved."
– that of support as a surrogate family member, because loved ones could not be present during the final mo-
ments of life. Her view from the frontlines is heartbreaking and unfiltered. Yet, she feels valued and believes
she has skills to do what others can't.
patients were on four or five, making outcomes. However, I had a mother who care functions to support us. It was a
it difficult to get them off of the drips. had just given birth. She was COVID huge relief to have that assistance and
Weaning them off the vents was extremely positive and intubated, so I was prepared support. They were all very well qualified
hard. for things to end tragically. Two weeks and trained and were so amazing about
later, we took the tube out and the mom jumping in and knowing what needed to
What do you think would be helpful in survived. It was phenomenal. Later, she be done and doing it. Another thing we
terms of training nurses? was able to FaceTime with her baby. I can't did was prone patients (turn face down).
Teaching flexibility. In New York, we didn't imagine what she went through - to give They used PACU nurses to create a pron-
have all the resources and supplies that birth and be away from her baby. It was ing team so when the physician wanted a
were needed or that I was accustomed pretty amazing. We tried to keep these patient proned you would call and a group
to using. I learned to make do with what I moments fresh in our memories to help of five PACU nurses would arrive. Just
had and repurpose things. I learned how us push through and visualize the happy having those type of resources to eliminate
to stretch things beyond its typical usage endings. some of the stress was huge.
and to use my best judgment and assess The things we learned in textbooks
the situation. Physicians stressed that, Was your nursing training helpful? can only take you so far in these difficult
When you first walked into the Long converted areas like the PACU and the new medications and I was not used to too. Physicians really valued our opinions What could have helped you prepare events. I had to apply the basic principles
Island Jewish Medical Center, were you cath lab into an ICU to meet the demand administering them. Since I was a new because they knew that we spent the most for this? we learned in order to problem solve and
prepared for what you saw? of so many who were so ill. It was so insane. employee, I was constantly asking people time with the patients. They encouraged I don’t know how you can really prepare for figure out a different solution. It wasn’t only
You know, I wasn't prepared for the reality I had no idea and honestly, if people saw questions about how things are done. us to speak up when we saw something something like this during a pandemic, but what I learned in nursing school that had
of the situation. I had this idea in my head what I witnessed every day while I was I'd ask, "What's the protocol for this and unusual or if any major changes were one thing that stood out for me was the to be adjusted, but even things I learned as
but when I walked into that unit, I was in there, they would not be leaving their that?" The response usually sounded like, needed for our patients. The role of the teamwork. Maybe that could be strength- an ICU nurse, I had to do differently. But
complete shock. At the time, at MUSC homes or worried about wearing a mask. “Well, it used to be this, but now just do nurse was different. I felt the physicians ened back home? I'm usually someone what remained constant was reaching back
Health, we had two COVID positive pa- your best.” Many hospital policies had to really valued us. who tries to do everything myself, but in to the basics of what I learned in school
tients in the entire hospital. When I arrived What was the difference between your be modified or changed just to allow us these types of situations you really have like the principles of ABC airway breathing
in New York, I walked into this big room ICU experience in Charleston and your more time at the bedside with the patient. Did you have any moments when you to use the resources you’ve been given, circulation. The basics don’t change. This is
with over 60 COVID positive patients. experience in a COVID unit in NYC? thought this is why I do this? and support from others. For example, as what we train for. This is that moment. It's
The beds were on top of one another and Everything I learned went out the How was the management of the I was starting to question all this. These I was gowned up and in an isolation room, a once-in-a-lifetime thing. Everything we
just a foot or two apart. Patients were on window because it was a completely patient is different? patients were the sickest of the sick and I couldn't go in and out, so I had to reach read about in the textbook combined with
ventilators and all alone. No family mem- different situation. You had to adjust Since I was in a COVID unit, all the unfortunately the success rate with taking out for help. I made signs of what was basic skills we are able to adapt and put to
bers were present. Some patients were on and be flexible. The management was patients had respiratory issues, so the patients off a ventilator and extubating needed that could be read through the good use.
9 or 10 drips at a time. I was in shock. I will different than how you would typically way we managed them was different. For them was not very high. Many ended up window by another nurse who was charting
honestly never forget that moment. I knew manage an ICU patient. I couldn’t get example, we would lay patients on their being re-intubated, so we didn't get to see outside the ICU.
it was going to be bad, but I had no idea. caught up on things which we typically stomach to help improve oxygenation. a lot of the positive side for those we cared Nurses from other areas in the hospital
It was overwhelming, and to think that was focused on, such as charting. Of course, These patients also required a lot more for. Patients don't get discharged from served as resource nurses. It worked great
just one unit. The rest of the hospital was we charted the important vitals, but the sedation than typical ICU patients. the ICU. Before that happens, the patient because trained nurses could innovate.
converted into multiple other makeshift hospital management knew our priority Normally, we would have a patient on one goes to a step-down unit, consequently They would draw all of our labs, turn our
COVID ICUs. It took creativity, as they was the patient. Also, there were a lot of or two sedation meds. These COVID the ICU nurses do not see a lot of positive patients and do many of direct nursing
6 LIFELINES 2021 2021 LIFELINES 7
personnel and was open to taking more med-surg nurses.
U
nder military orders, Cathy Durham, DNP '12, APRN, FNP-C, arrived in
We also implemented a team nursing model where we paired
New York on March 6 to meet her team of 121 nurses from around the an ICU nurse with an OR nurse. The pair could take three patients
United States who were deployed to New York City, the coronavirus instead of just two. The OR nurse also operated as a "runner" to
U.S. epicenter at that time. Three days prior, Durham was tagged to provide get supplies for the ICU nurse. At each site, we tried to match and
leverage our assets as best we could. We managed expectations
a leadership role on a mission to bring help and hope to thousands of New
and understood what each hospital needed. We continued with site
Yorkers. Durham is a Captain in the U.S. Navy Reserves and a senior nurse
visits and checked back at sites where we embedded our people
executive for Operational Health Support Unit Jacksonville that to see how they were doing. By the end of April, we had 217 nurses
encompasses 133 reserve nurses from South Carolina, Georgia, and physicians embedded in seven sites.
Florida, and Puerto Rico. She joined the team in NYC to provide As a senior nurse executive, when I wasn't doing administrative
duties at the command center in a hotel, I rotated to a different Dr. Cathy Durham (left) with College of Nursing alumna, Sadie Treleven, BSN,
senior nurse leadership for a group of nurses mobilized from R.N., at Harlem Hospital in May 2020.
clinical site every two days. I worked the bedside in ICUs with one
all over the United States. Military leadership felt medical of the nurses on my team. I haven't been an ICU nurse in 21 years,
assistance was critically needed in 11 hospitals across the city so many things changed, but I was there to serve the ICU nurse. If create systems to support that work such as team nursing and to
swamped with COVID positive patients. Durham and her team they needed something, I was going to get it. support people working outside their specialty. One team member
At the bedside, there's an opportunity to mentor and counsel. stated, “we have two jobs here; be kind and be flexible” and that
answered their call to duty.
Very few ICU patients in the hardest hit hospitals are being phase was repeated many times.
discharged so some days were notably hard, and it was important to If all health care professionals, nurses, in particular, could go
me to offer support to those nurses. back to our foundational roots and think about how you assess a
What was your reaction when you first arrived in New York members into a COVID hospital, but we were really honest with
patient. What are the basic principles of pathophysiology? Then
and realized the severity of the situation? them and managed their expectations. Our nurses and physicians
What made this situation more difficult than other high- we can come from a place of being flexible and kind to each other
Before I was deployed, I remember thinking 40,000 ventilators was handled this situation with such grace.
pressured situations you've encountered? and work as a team to address the patient's needs and put aside
an overreaction because we live in the United States. How could A month later, Elmhurst was no longer hemorrhaging and
The racial and economic health disparities in this country were what we think is our assigned role. We're all health care providers on
this be necessary? We were all a little wary because we didn't know almost back to baseline in regard to their numbers. Elmhurst has
evident in the patient population that I saw in New York. Many the same side. I think we need to frame our education around that
what the situation was going to look like. Sure, we saw images on an incredible staff. They smiled when they met us and engaged
of the patients needed to work to provide for their families, which understanding.
television, but was it really out of control? in conversation. Even though they had to compartmentalize their
prevented them from coming into the hospital until they were really I know there were some legal questions around this line of
The first hospital we went to was Bellevue, the oldest hospital in stress, they were very thoughtful in our discussions. All of the
sick. Also, many of the patients didn't have primary care providers thinking. Am I going to be sued if I have to be a med-surg nurse
the U.S. It was full of incredibly sick patients. They had expanded hospitals I worked in had an incredibly resilient group of people.
that were managing their symptoms early on. because I'm really an OR nurse? Am I going to be sued for working
their ICU services, but they weren't bursting at the seams. It wasn't Some of the Elmurst staff got emotional when we first walked
Another hard thing had to do with the patient's family since they outside of my scope of practice? I'm one nurse to 15 patients.
hemorrhaging. They were busy, and they just needed a few more inside in uniform. A few days later, when we went back to check-in,
were not able to come inside the hospital. Families were not able It's supposed to be one to eight, so I'm not going to be able to
nurses. the CEO pulled us aside to tell us he had received lots of emails
to see how rapidly their loved one was declining. This made it very do all these things that I was told to do. We have to educate
The second site we went to was Elmhurst Hospital. I was with from staff. He said the thing that resonated most for him was the
tough to have conversations with family members about end-of- students on what it means to respond in an emergency and the
two physicians and another nurse to perform a needs assessment. messages like, "when we saw the people in uniform coming in, it
life care. Family members were and still are having to make tough ethical requirements. The American Nursing Association and the
From our first encounter with the hospital's nursing supervisor, we was the first day that we felt safe." That was pretty humbling.
decisions about life-saving measures very quickly. American Medical Association have statements on the ethical
knew things were different there. In my 25-year career, I've never
We used tablets to help engage family members via FaceTime responsibilities in an emergency and a pandemic. So, we need to
seen that many patients in an emergency department and they What was your role while in NYC?
so that they could see their loved ones, work with the health care emphasize these ethical responsibilities in our education.
were all COVID positive. The gurneys were three deep against the For the first five days, along with my physician counterpart, I
team to make decisions on their health, and at times be with them Being a nurse in a pandemic begins with understanding the
walls and into the hallways. was to call hospitals and create a needs assessment. From the
in their last moments, but it was hard for both the families and the public health aspect, but also knowing how to be a team player. We
As a nurse, I'm used to providing comfort for sick patients, yet I Department of Health and Human Services (HHS), we knew
staff. We had some psychiatric mental health providers on our team may not need a labor and delivery nurse during a viral pandemic,
found it challenging to convey empathy with only my eyes because which hospitals had the highest volume of ventilated patients and
to help both patient families, patients and staff and augment the but you're still trained as a nurse, so let's leverage your skills and
the N95 mask covered half my face. I could see the look of fear the greatest need. We told the chief nursing officers and chief
native hospital resources. educational preparation and maximize them in this pandemic
in their eyes. Their panic-stricken eyes were so hard to see. My medical officers that we were ready to embed a team into their
setting.
physician colleague said that the patients' faces reminded him of hospital system if they needed us.
As a nurse educator and someone who was on the frontlines, This was an incredible experience, and I was really proud to be
photos of prisoners in concentration camps during World War II. We performed needs assessments at five hospitals within
what do you think is a critical need in nursing education? there. I'm proud to be in nursing. I'm humbled by being part of a
The faces in that emergency department will never leave my mind 48 hours. One thing we looked for was adequate staffing. For
From an educational standpoint, a critical need is to incorporate profession that is adaptable and is incredibly resilient. I will forever
and my heart. example, one site did not want any med-surg nurses because they
more public health into our education. Take a look at how nurses be grateful to have witnessed the many nurses I worked with who
When the four of us walked out of the hospital, we didn't speak. had too many. But they were in dire need of ICU nurses and critical
engage in public health aspects and how we can manage that. possess these attributes. I think if you don't look at this as glass-half-
We were still digesting what we saw. When we returned to the care nurses because their ventilated patients had grown by 400%
During this emergency, both physician and nurse were asked to full and take the wins from it, you lose out.
command center, we had a decision to make about which providers in two days. We were able to get them the type of nurses they
work on teams outside their comfort zone. It was important to
to send to these hospitals. There's a risk of sending our team needed from our pool. Another site had the right mix of nursing
8 LIFELINES 2021 2021 LIFELINES 9
strong education program could prepare nurses as midwives
and supported the philosophy promoted by the American
College of Nurse-Midwives (ACNM).
Initially, it was necessary to establish a family-centered,
comprehensive service to provide patient care in outpatient
and hospital settings. A successful nurse-midwifery practice
By Sharon Bond, Ph.D. '09, MSN '92, CNM '83, FACNM was essential for future student education. In 1971, Carmella
Associate professor, retired 2014 Cavero, CNM, fellow of the American College of Nurse-
Midwives (FACNM) and then ACNM president, was recruited
by Curtis to plan and direct the service. Cavero quickly
recruited other certified nurse-midwives to the College of
Nursing. Within 18 months, the CNMs managed a busy
practice, providing family planning services and care to
pregnant women at multiple outlying clinics with oversight
and collaboration from the Department of Obstetrics & Original MUSC College of Nursing Nurse-Midwifery faculty (photo circa
1973): Bottom row, left to right: Harriet Simpson, Carmela Cavera, and Norma
Gynecology. Once this viable service was evident, it became
Pacenta. Top row, left to right: Margaret Ann Corbett, E. Jean Martin, and
time to advance the education program. Anne Malley.
In 1974, a certificate program was implemented, followed
Celebrating Midwives
by a master's degree in nursing curriculum in the maternal- program and practice grew and contributed to improving the
child track five years later. state's perinatal statistics.
Nurse-midwifery practice, especially in outlying rural Indeed, low income, uninsured women cared for by
clinics, was not without its challenges. Since advanced nurse-midwives birthed substantially fewer low birthweight
practice nurses did not yet have prescribing authority, CNMs babies. Between 1979 and 1980, the rate of low birthweight
found it necessary to track down physicians at the hospital babies in South Carolina was 8.9%. During that time, MUSC
A brief history of the Nurse-Midwifery Education Program at
to sign prescriptions. Paper prescriptions for antibiotics and midwives completed 13,250 prenatal visits and 1,102 births,
other medications were then forwarded to patients by postal reducing the rate of low birthweight infants born to women
the MUSC College of Nursing from 1973 to 2009 mail. Fortunately, health departments were able to dispense
prenatal vitamins and treat certain infections.
in their care by almost half (4.8%).
Pope Francis credits a nurse with having saved his life
By Sharon Bond, Ph.D., CNM, FACNM In 1977, Helen Varney Burst, CNM, FACNM, a graduate when he was just 20 years old. He said, "A great woman, brave
of Yale University, became director of the nurse-midwifery too, to the point of arguing with the doctors." He suggested
F
or 138 years, the MUSC College of Nursing has Many grand midwives acquired their knowledge about program at MUSC. The college was fortunate to have Burst that "midwives might have the most noble of all professions."¹
achieved exceptional milestones educating trailblazing birthing at the Penn Center in Beaufort, South Carolina, and on board. Not only was she the president of the ACNM, I think he might be right.
nurses who serve the health care needs of families, some county health departments. Maude E. Callen, certified but in 1978 she released the first edition of her textbook, “The College of Nursing honors and celebrates the
communities and populations; nurses who change what's nurse-midwife (CNM) and graduate of Tuskegee University, Varney's Midwifery, regarded as the gold standard for nurse- pioneers, leaders, and graduates of MUSC CON Nurse-
possible through nursing care. One milestone worthy of a taught at the Penn Center from 1944 to 1964, and assisted midwifery education in the United States. Cavero and Varney Midwifery education program. They have been a critical
look back is the history of the nurse-midwifery educational more than 800 women in giving birth in Berkeley County. are pioneers and living legends to midwives everywhere. part of history and improving the health of so many South
program, from 1973 through 2009. Each year, Callen taught six-week initial training courses and Faced with budget shortfalls in 1981 and a need to turn out Carolinians,” said Dean Linda S. Weglicki.
In mid-20th century South Carolina, the outlook for a two-week refresher course to grand midwives. Callen is more BSN-prepared nurses in the face of a critical shortage,
1. Hattrup KN. Pope: Midwives might have the most noble
women giving birth, especially in rural areas, was bleak. a well-recognized hero in South Carolina and the recipient Curtis realized she might be forced to discontinue the nurse- of all professions. Aleteia. January 21, 2020. https://aleteia.
Many families lived in extremes of poverty, lacked plumbing, of many awards, including an honorary degree from the midwifery program. The tenacious nurse-midwifery faculty org/2020/01/21/pope-midwives-might-have-the-most-noble-
of-all-professions. Accessed January 29, 2020.
electricity and access to health services. Perinatal statistics Medical University. Her work was tenderly portrayed in W. and students sought to protect their program. They won the
at the time depicted a sad state of health for women, ranking Eugene Smith's photo essay published in a 1951 issue of Life support of Lowcountry state legislators, specifically Rembert
South Carolina as having the third-highest rate of maternal Magazine. Dennis, Arthur Ravenel, Dewey Wise and W. Paul Cantrell.
Acknowledgements:
Brooke Fox, MUSC University archivist, Elizabeth Bear, Ph.D.,
and infant mortality in the United States. By 1970, the MUSC College of Nursing and the MUSC These representatives understood the impact of nurse-
CNM, FACNM, Marjorie McManus, CNM, E. Jean Martin,
During these years, especially in the Lowcountry, many Department of Obstetrics & Gynecology began exploring midwives on the health of mothers in their districts and
CNM, Carmela Cavero, CNM, FACNM, Charleston Post &
women received care by the "granny," or grand midwives, the feasibility of bringing a certified nurse-midwife (CNM) persuaded the state Legislature to finance the program for Courier
women whose faith, experience and wisdom called upon education program to the Medical University. Lawrence another two years. The South Carolina March of Dimes was
them to give compassionate assistance to women birthing Hester, M.D., then chair of the Department of Obstetrics also an invaluable supporter of nurse-midwifery education. Sharon Bond, Ph.D., CNM, FACNM, retired in 2014 as an
at home during a time when hospital care was unaffordable. & Gynecology, recognized that using registered nurses in It was the vision and foresight of Lawrence Hester, associate professor in the MUSC College of Nursing. She
In 1950, about 100 grand midwives licensed by the South an expanded role was necessary to meet the demand for M.D., Curtis and Henry Heins, an MUSC obstetrician and graduated from the College of Nursing's nurse midwifery
Carolina Department of Health and Environmental Control services and improve perinatal statistics. Marcia Curtis, gynecologist, who championed for nurse-midwifery in program in 1983, master's program in 1992 and Ph.D. program
(DHEC) assisted in 15,799 births registered in South Carolina. Ed.D., then dean of the College of Nursing, understood that a South Carolina. Through their leadership, the academic in 2009.
10 LIFELINES 2021 2021 LIFELINES 11
ACADEMICS
Jumping in feet first PIVOTING IN A PANDEMIC Undergraduate faculty who were
unaccustomed to online instruction
academic programs is commendable,"
said Felesia Bowen, Ph.D., DNP, APRN,
Teams worked in the workplace, they
began using it with enrolled students
As a Mid-Westerner, I grew up believing the saying, “If were propelled into a world of distance FAAN, assistant dean of undergraduate and prospects to create and keep open
March comes in like a lion, it will go out like a lamb.”
How the College of Nursing came education by mid-March. With the programs. "The entire college com- lines of communication. Additionally,
COVID-19 has forever changed that saying for me; March together to ensure student success outstanding support of the college's munity has been so supportive of our Student Services designed an online
technology team and faculty already students." orientation for new ABSN students, host
2020 started relatively normal and ended with escalating
familiar with online teaching, these Staff also became adept at many frequent student-faculty townhalls,
uncertainty due to the novel
COVID-19 pandemic. The N urses continue to demonstrate time and again
why the nursing profession is consistently rated by
Americans as among the most honest and ethical among
educators became pros at web platforms
such as Collaborate, Panopto, and
online tools they had never used before.
For example, the Student Services
and continually update FAQ's on the
college's website. Even when changes
impact of the COIVD-19
TurnitIn. Faculty quickly learned that team began to use Microsoft Teams, were occurring daily, keeping students
Gallup's list of professions. This belief has continued to be
pandemic affected the with some minor adjustments, such a communication and collaboration informed was critical in alleviating
true throughout the COVID-19 pandemic, as news stories
MUSC College of Nursing as providing students with a weekly platform that offers a variety of ways any anxiety regarding their education
reported and honored nurses serving on the frontlines in
last spring, when the university overview, students could achieve to communicate, such as chat, video during this unprecedented time. The
cities across the United States. It is a phenomenal time to
instituted a modified course objectives a week at a time. meetings, and file collaboration tools, college continues to be committed to
be a nurse, and perhaps it is why the college is seeing a
operations directives. While continuing interest in those seeking a nursing career.
"The collaborative process in which as a way to synchronously connect taking bold steps to create an inclusive
challenging, our faculty quickly Due to the economic downturn and possible finan-
faculty and students worked together with other team members other than and quality nursing education model fit
responded as we transitioned cial issues facing incoming student applicants, it was
to ensure the ongoing success of our the traditional email system. Since for the future.
face-to-face courses in our expected that applicants and admitted students would be
accelerated BSN program
to online delivery with
forced to either defer enrollment or even withdraw from
fall 2020 classes. However, after the country saw how
PALLIATIVE CARE INITIATIVE
the goal of keeping our students progressing towards an
W
essential nurses' contributions are to the health care sys- hen the World Health Organization designated 2020
on-time graduation. For example, Dr. Berry Anderson, tem, the College of Nursing saw no slow down or waning the International Year of the Nurse and Midwife, nurses
associate professor, incorporated peer-to-peer education by interest in the number of outstanding applicants to our rejoiced for the recognition yet had no inkling of how prophetic
undergraduate or graduate programs. In fact, the college
forming small student discussion groups using Blackboard that designation would soon be. Nurses on the frontlines of the
enrolled more students last fall than it did previously in
Collaborate, a comprehensive online learning tool. He COVID-19 pandemic endlessly provide care and comfort to patients,
fall 2019, which was a record-breaking year as the col- connecting patients with their families through video chats and
then brought the entire class into a single virtual session to
lege's largest incoming class. FaceTime, and bolster one another's spirits while navigating the
engage in richer discussions. Dr. Shannon D’Alton, instructor,
Witnessing the resolve, strength, resilience, and brav- myriad health care challenges faced during this unpredictable time.
and Dr. Melanie Cason, assistant professor and simulation ery of nurses who have been committed to providing In addition to the many contributions made by nurses to promote
program director, implemented interactive virtual clinical care on the front lines throughout the coronavirus crisis a culture of health, the pandemic highlighted ways to improve the
learning experiences. These activities allowed students to seems to be inspiring people to want to pursue a career in health care experience for patients and their families.
complete a case study, meet in small groups to discuss case nursing. For colleges of nursing and students enrolled in One thing that has been glaringly apparent over the past
specifics and ancillary course content, and come together as nursing programs during a pandemic brings a unique set few months is equitable access to palliative care. Underserved
a larger clinical group to engage in a clinical case debriefing of challenges, including different ways of learning such populations are among the most severely impacted by COVID-19
session. The esprit de corps and can-do attitudes of our as active engagement in an online learning environment and have a disproportionately higher number of COVID positive diagnoses and associated deaths. Access to palliative care
faculty, staff, and students make me proud to be a member as well as the ongoing difficulties in access to clinical ensures that a sufficient number of educated clinicians, who are prepared to address the palliative care needs of patients and
of the MUSC College of Nursing family. experiences so that students continue to receive required families, is not only available but are met. A recent study by the S.C. Palliative Care and Quality of Life Study Committee found
direct patient care opportunities. that nearly 54% of South Carolinians who died in 2018 would likely have been eligible for palliative care.
Sharon Kozachik, Ph.D., R.N., FAAN In March 2020, the college developed a contingency Years before the pandemic spread around the globe, the college began planning a new program that would prepare advanced
Interim Associate Dean for Academics plan that had faculty reimagining new education models practice nurses to specialize in care for people with serious illnesses. The college felt it was hugely important that advanced
for their educational programs. With the assistance of the practice nurses could obtain expertise and gain a deeper understanding of the physical, psychological, spiritual and social
Sharon Kozachik, Ph.D., R.N., FAAN, joined the college in Nursing Center for Technology team, BSN faculty and needs of patients and families who are living with chronic and serious illnesses.
March 2020 as an associate professor to teach in the doctoral students quickly transitioned from in-person classes to Through a generous gift from the David R. and Margaret Clare Foundation, the College of Nursing developed a Post-master's
online courses. Fortunately, the college has many years
programs. Before moving to Charleston, she was an associate Doctor of Nursing Practice (DNP) in Lifespan Palliative Care program that began enrolling students in fall 2020. A first of its
of experience in delivering quality education in a virtual
professor at Johns Hopkins University School of Nursing, one kind program in the U.S., this doctoral-level palliative care track will meet the growing palliative care needs locally, nationally,
world. Actually, the College of Nursing was one of the and globally by increasing the number of advanced practice nurses it puts into the workforce.
of her alma maters. Kozachik was named the Interim Associ-
first nursing schools in the country to offer web-based "We are preparing advanced practice nurses who will provide evidence-based and compassionate care across the health
ate Dean for Academics in June 2020 when Gigi Smith, Ph.D.,
nursing education to meet students' changing learning continuum, from the point of diagnosis of a serious or life-limiting condition through supportive end-of-life care," said Carrie
R.N., was selected to serve as associate provost for MUSC’s needs when its Ph.D. program went online in 2003. Over Cormack, DNP, APRN, lead faculty for palliative care education in the College of Nursing.
Education Innovation and Student Life effective July 1, 2020. the years, the DNP and RN to BSN programs evolved into This program could not have come at a better time. Amid so much suffering due to the pandemic, palliative care nurses have
To read more about Dr. Kozachik, please see page 24. an innovative online format. Before the novel COVID-19 been given an incredible opportunity to help and serve others while giving patients and family members an added layer of
pandemic, all of MUSC's nursing courses were online, support that they so badly need these days.
except for the accelerated BSN program.
12 LIFELINES 2021 2021 LIFELINES 13
RESEARCH
Keeping in touch during a Shannon Phillips, Ph.D., R.N., and
Leigh Ridings, Ph.D., both received
pandemic a K23 Mentored Patient-Oriented
Research Career Development Award to
The new normal has touched every individual in a different and
individually study the unique needs of
unique way, and that holds true for our researchers and research
caregivers of children, adolescents, and
participants engaged in several studies being conducted at the College young adults.
of Nursing. Keeping in touch was imperative to make sure research Phillips, a former pediatric critical
trials would continue to run smoothly and researchers could uphold care nurse and associate professor,
the responsibilities inherent in research that involves human subjects. recognizes the helplessness families
Protecting the safety of both the study experience when faced with caring
participants and team members directly for children with a complex medical
involved in data collection was one of
our major priorities. The College of
WHAT ABOUT THE condition. Her research focuses on
adolescents and young adults with
Nursing Office of Research was vigilant CAREGIVERS? sickle cell disease and their families. She
received her award from the National
in keeping up with new regulations that
were coming in daily from key university Researchers tackle caregiver Institute of Nursing Research (NINR) to
and federal officials such as the National stress in high tech ways develop an intervention using mobile
health technology (mHealth) that helps
Institutes of Health. It was important
adolescents and young adults up to
to pass this information along to our
I
magine you awaken each morning, be adolescent about how best to self- According to Ridings, 40% of
the age of 18 transition to take care of
researchers, and to problem solve any anticipating your day will be occupied with themselves.
manage pain. That way, the adolescent caregivers develop a mental health
challenges they faced in the transition caring for someone who is unable to care for could now problem-solve and take better concern in response to their child's
One of the most challenging aspects
care of himself. injury. This correlates with their child's
from face-to face data collection themself. Perhaps it is your 28 year-old-son of this transition period, which until
Finally, some caregivers used the app emotional recovery following the
procedures, to the new online formats. with a new spinal cord injury or your spouse this time, has had a high involvement
who has Parkinson's disease, or maybe it's your to teach others outside of the parent- traumatic event.
For example, all of our study teams adapted to using virtual of caregivers (parents, grandparents,
elderly neighbor who depends on you to shop child dyad, particularly grandparents, "Unfortunately, there are very limited
platforms to maintain contact with study team members and their study even siblings), is the caregiver's ability
for groceries and drive her to her physician. about the disease. The app was seen resources for caregivers who often face
participants. Initially, these communications through constant barrages of to make the transition while facilitating
as a useful technology to help children sometimes lengthy hospitalizations,
Whatever your situation, your day will often be their child to self-care.
emails were overwhelming and difficult to keep up with. However, after take care of their sickle cell disease and changes in employment, and other
filled with stress and anxiety. Phillips notes that this process is
a conversation with Dr. Martina Mueller, the concept of Lunch Breaks The day-to-day caregiving stresses contribute reduced caregiving stress by assisting stressors," said Ridings.
much more complicated in children
emerged. Lunch Breaks created a forum in which CON researchers and to the high emotional, physical, and financial caregivers in feeling empowered to The technology Ridings developed
with complex conditions like sickle cell
study team members could keep in touch via an online forum during a tolls affecting the quality of life of the 65 support their child better. enhances coping skills and provides
disease. During her earlier studies, she
weekly informal chat held Fridays at noon. These well attended chats, million individuals who provide unpaid care Ridings, a clinical psychologist and information on how to talk to children
developed an application (app) with
allowed us to discuss national and MUSC research updates, new available and services for loved ones. These family Julie Kantor, M.D., that aimed to help
assistant professor, is the most recent after the injury and what to expect,
resources, and how to navigate challenges that would suddenly arise. members, friends, neighbors, and community caregivers and children monitor their
recipient of a K23 reward, of more than primarily focusing on keeping things
One significant outcome was the development of a COVID impact advocates offer more than $470 billion annually $740,000 from the Eunice Kennedy normal immediately following the injury.
condition, recognize early symptoms
Shriver National Institute of Child Health The intervention starts quickly while
questionnaire. With input from several researchers and study team in unpaid services such as feeding, bathing, that predicted a pain crisis, and
and Human Development (NICHD), to in the hospital and helps parents cope
members, we created a questionnaire to standardize information across shopping, preparing meals, laundering clothes, improve communication with the
and transporting individuals who cannot care study a scalable mHealth resource to through the first 30 days of recovery.
our studies. The influence of factors such as access to medical or mental health care team. They soon realized
for themselves. Many also provide complex facilitate behavioral and emotional Ridings will work towards tailoring
health care and food, reduction of income or lost jobs, or increased caregivers were struggling to assist
medical and nursing tasks. More than half of recovery after pediatric traumatic injury. the intervention, providing a more
responsibilities caring for loved ones are factors known to affect health their older children towards achieving
Anguish is a word often used by personalized approach to meet the
caregivers report they do not have a choice about independence and were experiencing
and potentially, study results. This team effort has resulted in a data caregivers of 300,000 children who unique demands of each caregiving
performing these caregiving tasks. The burden is worrisome stress about their children.
repository available through the Office of Research for use in future trials enormous. sustain a sudden traumatic injury from situation, and help caregivers manage
The app, with input from children
and may help explain the impact of COVID-19 on current and future It is no surprise that some of our researchers animal bites or car accidents in the U.S. during an extremely stressful time to
and parents, helped parents see how
study results. in the College of Nursing understand these each year. In Riding's study, caregivers improve emotional health recovery.
their adolescents were managing and
As we move forward, the success of our community research at the challenges with many acting as a caregiver at are aged 18 years and over and consider The College of Nursing is proud of
improved communication through
CON can be summarized by our motto: We are keeping in touch. one or more times in their lives. Over 75% of the app. One caregiver believed this
themselves the primary caregiver of this exciting work that will advance
the currently funded studies conducted by the an injured child. Her intervention is caregiving science and improve
communication helped bring down her
designed to address highly prevalent caregiver quality of life.
Teresa Kelechi, Ph.D., R.N., FAAN College of Nursing faculty involve caregivers. stress level as well as her child's. Another
traumatic stress disorder and depression
Associate Dean for Research Two, in particular, stand out, and both are parent was so pleased with the ability
principal investigators and scholar scientists. in caregivers and children.
to read information with his soon-to-
14 LIFELINES 2021 2021 LIFELINES 15
PRACTICE
Re-envisioning faculty MEETING THE MOMENT
practice during COVID-19
COVID-19 pushed our health care
The uncertainty and disruption brought on by the coronavirus
systems into reinventing care delivery
have not escaped higher education institutions. Colleges and
models to accommodate patients as we
universities are forced to reckon with the reality of not only the
short, but likely the long-term reality of faculty, students, and staff's
never thought it could.
inability to return to our brick-and-mortar buildings and “normal”
class schedules until COVID-19
I
n the wake of COVID-19, telehealth technologies
vaccinations are widely distributed. and the remote delivery of care have played es-
For health care institutions and sential roles in today's health care. By eliminating
physical boundaries and using virtual care-instead,
the nursing profession, that concern
providers are able to drill deeper into the services
is even more pronounced. Faculty
they provide to their patients, specifically at-risk
competencies in the clinical setting
populations.
and our students' training in the
Due to the pandemic, mental health experts
practical application of clinical skills believe many children are in this at-risk category.
are foundational. The College of Isolation, contact restrictions, and stress due to
Nursing and faculty practices are the economic shutdown have inflicted a shift
not immune to this unpredictability to children and young adults' psychosocial As a way to offer comprehensive health right where kids other recreational activities. One 11-year-old patient confided,
due to many challenges of the environment. Psychiatric mental health are, the College of Nursing partnered with the health center "sometimes I feel like there is no reason to get up in the
COVID-19 pandemic. A key providers had to adjust their practices to quickly last year to establish a mental health program. Joy Lauerer, morning."
question became how to alleviate accommodate shelter-in-place orders so that DNP, APRN, PMHCNS-BC, an associate professor and a This experience also serves as a learning tool for our
the anxiety and face the unknown with more confidence? patients were not left ‘in the wind’ when mental skilled mental health practitioner, was a champion of this MUSC DNP students. Before COVID, DNP students in the
The mission of faculty practice partnerships is to create health services were needed most. initiative. psychiatric mental health nurse practitioner track worked in
According to the U.S. Department of Health Prior to COVID, the program used telehealth technology the school clinic. They prepared children and parents for the
opportunities for faculty members to maintain clinical competence,
and Human Services, one in five children and during school hours to address a child’s mental health and telehealth visits and worked closely with Lauerer to conduct
fulfill certification requirements, and share expertise with other
adolescents experience a mental health problem behavioral needs. Orienting children to telehealth visits comprehensive assessments and psychotherapy. This pre-
health care providers and students beyond the classroom’s
during their school years. Examples include stress, proved simple because they are familiar with technology and COVID experience aided our DNP students to quickly transi-
learning environment. These interprofessional partnerships with
anxiety, bullying, family problems, depression, are comfortable communicating virtually. However, when tion to the use of telehealth as others struggled to provide
hospitals and community-based agencies support the education a learning disability, and alcohol or substance COVID began to spread, the school closed in early March. this important care.
and development of a well-trained nursing workforce to meet abuse, and serious behavioral concerns, such as This put therapy and services on pause for many who relied Telehealth technology has turned the home quarantine
the primary, acute, chronic, and transitional care needs of our self-injury and suicide, all of which are on the on this clinic. and stay-at-home orders into an opportunity to see a glimpse
community both locally and globally. rise. According to the Centers for Disease Control Knowing that these visits could easily be replicated at of a child’s home life and environment for some mental
When faced with challenges, as nurses and interprofessional and the National Institute of Health, children and home, MUSC providers could continue with visits using a health experts. The virtual telehealth visits allow the provider
care teams, we rise to meet them. In health and health care, nurses teens who visited emergency rooms for suicidal virtual telemedicine platform called Doxy.me. By connecting to see the home environment so they can fully appreciate
are extraordinary influential leaders who negotiate the moment thoughts and suicide attempts doubled between through Doxy.me using computers, Lauerer is able to the family's ecology and work dynamically within the family
and expand our boundaries to lead through change. History has 2007 and 2015. However, the availability and connect virtually by inviting parents via text messages to system to affect change.
taught us - those who refuse to evolve dies. The coronavirus' access to mental health services for at-risk youth, join the visit. This program is an example of how we continue to
particularly during these unprecedented times, are "Using telehealth demonstrates that the mental health expand, transform, and innovate to meet the needs of
unprecedented and unpredictable situation has presented us with
at critical capacity. community is there to assist families with the support many our faculty, students, and most especially the vulnerable
an opportunity of a lifetime that we can either meet with a glass
families need during these unsettling times," Lauerer said. populations in the community we serve. Vulnerable, at-risk
half empty or glass half full attitude. We in the College of Nursing
Pilot Program Initially, the emotional responses of children to COVID-19 populations already face significant social determinants of
choose the latter. As faculty leaders we are, as we have over these
But there is hope. In 2016, MUSC Children's was one of both anxiety and fear associated with not fully health disadvantages to include the lack of private or public
past several months and will continue to do so, determined to Health opened a first-of-its-kind medical clinic at understanding what it meant to quarantined. The lack of transportation, service inequity, and unaffordability, to
expand our boundaries, seek innovative solutions, and lead changes Meeting Street Elementary at Brentwood in North a structured schedule and the comfort of interacting with name a few. When faced with uncertainly and disruption,
as we never have before. Charleston that offers parents the convenience peers and teachers proved stressful for many children. As our faculty and students are meeting the challenge with
of an on-site clinic. The school-based health the uncertainty of the COVID impact persisted, children this innovative product as well as expanding nursing
Debbie Chatman Bryant, DNP, R.N., FAAN center has a full-time nurse practitioner who can and families reported problems of disengaging from online professional practice across the health system to connect
Associate Dean for Practice diagnose conditions, order x-rays and lab work and gaming, decreased physical activity, and difficulty sleeping. clinical, professional, and care delivery services.
write prescriptions, as well as a pediatrician who Lauerer found that many children were also experiencing
sees patients once a week. a profound loss from a lack of peer support, interaction, and
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