Leadership seems to be a hot topic these days. We are often hearing such phrases as “lead where you stand” or “lead by example.” Leadership has been the focus of a number of programs here at MUSC and the waterfall of books related to it continues to cascade down the steep cliffs of the organizational literature. Add to that the numerous leadership conferences that pepper the continuing education landscape and you simply can’t escape!

All of this makes me wonder whether true leadership can be learned and does everyone even need to be a leader? Quite honestly I remain skeptical because in my own experience, I have known people who have read all the books and taken all the courses but still lack true leadership skills. So too, I think there is a need for followers as much as leaders—and that those individuals who can alternate those roles may represent the best of all worlds. So I have a different take on leadership. I think that a true leader plays to one’s strengths and uses them to promote the aspirations of one’s group—whether it is the family, community or workplace. This view acknowledges that not everyone is visionary, good at conflict resolution or successful in crafting strategic plans. But everyone is good at something and those traits can be developed and enhanced. At the end of the day I believe that leadership can be learned, but not necessarily by randomly reading a book or sitting in on an occasional lecture. These are most often superficial and not geared to you and your unique set of traits. Leadership styles vary and so do people. My idea of learning leadership starts with an honest self-assessment of your particular strengths and limitations. Next, identify your personal and professional goals and what new things you need to master in order to achieve them. Then carefully hone in on specific resources that will help you grow, including most importantly, a good leadership role model who will mentor you by giving you specific, challenging and regular feedback about your emerging leadership skills. This, more than anything, will help you learn both by imitation and by real life experiences. Analysis, practice, and feedback will help shape your learnings and mold new behaviors that will position you well to be a true leader today and your many tomorrows….Gail

INSIde Are leaders born or made?By Dean Gail Stuart, PhD, RN, FAAN

VoLUMe 9 | JUNe | 2012

eCONnectionsMedICAL UNIVerSITy of SoUTh CAroLINA

CoLLeGe of NUrSING

Published by:Medical university of south Carolina College of Nursing

send inquiries to:beth KhanMusC College of Nursing99 Jonathan lucas st., MsC 160Charleston, sC 29425

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MusC Nurses Change Lives!

College News ...........................p. 2

CaleNdar of eveNts ................p. 3

offiCe of aCademiCs ...............p. 4

offiCe of researCh .................p. 5

offiCe of praCtiCe .............. p. 6-8

College News

JUNe 2012 eCONnections2

NCSBN launches new campaign The National Council of State Boards of Nursing (NCSBN®) has launched a new educational campaign that introduces consum-ers to the fact that boards of nursing (BoNs) in the U.S. license advanced practice registered nurses (APrNs) as part of their mis-sion of protecting the public. The campaign is designed to explain that BoNs are working toward the goal of more APrN licensure uniformity across the country to continue to keep the public safe as health care reform advances. forming the centerpiece of this new campaign is a 30-second television spot that was produced in conjunction with the CBS Community Partnership Program. This commercial is currently air-ing in New york, Ny; Chicago, IL; Philadelphia, PA; detroit, MI; Tampa, fL; St. Louis, Mo; Indianapolis, IN; Louisville, Ky; New orleans, LA; Charleston, SC; and Jackson, MS on CBS owned and affiliated stations. The spots air within each market during shows such as: The early Show, dr. Phil, the CBS Local early News, entertainment Tonight, and the CBS Local Late News. The spot will also have occasional rotation into prime time program-ming. filmed at University of Illinois at Chicago College of Nursing, the commercial familiarizes consumers with the fact that APrNs are an integral part of the health care team and a vital component in providing more access to care. Patients are safely cared for because BoNs oversee APrN practice. The commercial can be viewed online at https://www.ncsbn.org/2732.htm. Additionally, consumers will find a wealth of resourc-es about APrNs, boards of nursing and contacting a board of nursing at www.ncsbn.org.

Page honored with leadership awardMUSC Vice President for Academic Affairs and Provost dr. Mark Sothmann presented the University excellence pillar award to Carolyn Page, director of student services at the Col-lege of Nursing. The award was presented on April 20 at the MUSC excellence University Leadership development Institute. Carolyn is the “front door” to all those interacting with the College and she truly exemplifies MUSC excellence by the amazing job she does each day. She has been a valued employee at the College since 1992, having previously served as an administrative assistant for a center director and a former CoN dean. In 2002, she became the director of student services and through her consistent, expert leadership and management, student services has become the “hub” of the College. The award was created to recognize exceptional perfor-mance and leadership at MUSC and is awarded to an indi-vidual who has advanced the principles of MUSC excellence by living its values while achieving results.

Former CON dean passes awayfaith Jefferson hohloch passed away May 12, 2012. In 1979, she assumed the position of associate dean of the College of Nursing and then interim dean from 1984 to 1986. She was

a strong proponent of advanced practice nursing and graduate education in nursing. She brought a keen intellect for analysis and the steps in research methodology which was reflected in the large number of master degree and doctoral candidates whom she mentored. She transferred to the MUSC College of Medi-

cine where she worked in geriatrics from 1986 to 1991. over the years she was seen as a superb editor and collaborated on innumerable articles, journals and texts. A donation from the College of Nursing recognition fund was made in her honor to the 125 Anniversary Scholarship fund.

on May 25, Carlos

lopez became a dad for the second time. Carlos, his wife, Lisa and big brother, diego welcomed emilio Andres Lopez into the world weighing 8 pounds, 3 ounces and measuring 21 inches. Congratulations to the entire Lopez family!

Welcome to the world, Emilio!

June8 fridayMini Orientation for incoming ACC BSN Students1 p.m.CoN 220

July4 wedNesdayIndependence DayCoN closed

9-12 moNday-thursdayPhD Residency Week

25-26 wedNesday-thursdayDNP Immersions for new students

10 tuesdayVisiting Professor: Marion Broome, PhD, RN, FAAN“The Nurse Scientist in Translational Science”9 - 10 a.m.location tBdCoN 220

25 wedNesdayJanelle Othersen Visiting Professor: Vicki Lachman, PhD, APRN, MBE, FAAN4:30 - 5:30 p.m.storm eye institute auditorium

Calendar of eveNts

CONgRAtuLAtIONS 2012

College of Nursinggraduates!

3eCONnections JUNe 2012

Awards for Excellence presented at convocationThe College of Nursing’s spring convocation was held May 17 at The Cathedral of St. Luke and St Paul. Several recognitions and awards were presented. Congratulations to all!

fIrST hoNor GrAdUATeS - BSN ProGrAMrebecca allshouse, Moly augustine, Kim leslie

fIrST hoNor GrAdUATeS - MSN ProGrAMantonia Corrigan, Cameo green

fIrST hoNor GrAdUATeS - dNP ProGrAMelizabeth davenport, Cathleen durham, Cassie Frazier,

tiffany Phillips, Meredith Wood

JoSePhINe A. foGLe AWArd tom rudisill

rUTh JACQUI SKUdLAreK AWArdveronica ramos

oUTSTANdING BSN STUdeNT AWArdandrew stufflebean

faculty were recognized for their support of students and outstanding teaching skills.

GoLdeN LAMP AWArdteresa atz

oUTSTANdING CLINICAL fACULTy AWArdKathy neely

oUTSTANdING BSN fACULTy AWArdtiffany Williams

oUTSTANdING GrAdUATe fACULTy AWArdgigi smith

oUTSTANdING Phd fACULTy AWArdCarolyn Jenkins

Immunizations, appointments available onlineMUSC’s division of education and Student Life is now offering a new online service to MUSC students. Students can access a copy of their immunizations and make appointments. Simply visit https://lifeNet.musc.edu and sign in using your MUSC net Id and password. In the future, Student health Services will not routinely print out copies of immunizations once all student information is loaded in the electronic medical records.

office of aCadeMICs

eCONnections feBrUAry 2012 JUNe 2012 eCONnections4

Kudos to our graduates...Julius o. Kehinde, Phd (class of 2011), who currently has a post-doctoral fellowship at the University of Utah, was chosen for the very competitive National Institute on Aging Summer Institute on Aging research. Julius will spend 10 days in a retreat with scientific leaders in the field of aging and rising stars in the field.

Melissa b. aselage, Phd (class of 2011) was selected as a 2012-14 John A. hartford foundation Claire M. fagin fellow. This two-year post-doctoral fellowship is for $120,000; her primary mentor will be elaine J.

amella, Phd, rn, Faan, along with a team led by ruth Anderson, Phd, rN, fAAN at duke University where Melissa is a tenure-track assistant professor.

...and studentsCurrent Phd student Mary Kathryn naccarato, Msn,

rn, CCns, Cen received the “Best Performer”award from the University of Phoenix, South florida campus. Mary teaches online for the University of Phoenix. The award is determined by administrative faculty review-ing professor performance and student feedback.

l to R: Tiffany Williams, Outstanding bsN Faculty Award recipient and Teresa Atz,

Golden lamp Award recipient.

Andrew stufflebean, 2012 Outstanding bsN student

Congratulations to robin evans Matutina for successfully defending her dissertation titled,

“Introduction to dissertation: educational Interventions to Improve the Perception of Nursing as a future Career Choice among Middle School

Students” on April 27. her advisor was Teresa Kelechi Phd, GCNS-BC, CWCN, fAAN

Funded grantsPamela Holtzclaw Williams, Jd, Phd, rn submitted her eLSI Pilot and feasibility grant application titled, “Mea-suring and comparing social impact of AATd” to the Alpha-1 foundation and was approved in the amount of $40,000. The long range objective of this pilot project is to establish an academic-community based participatory research partnership to serve as a platform for sustain-ing a future program of intervention focused research addressing social implications of living with alpha-1 anti-trypsin deficiency (AATd), using instrumentation adapted in this study to measure and show that the genetic and/or low prevalence components of AATd are independent, quantifiable variables that influence measureable levels of illness impact.

nancy d. duffy, dnP, rn, Cen, Cne received funding from the robert Wood Johnson foundation (rWJf) New Ca-reers in Nursing. This program supports scholarships for students seeking accelerated baccalaureate or master’s degrees in nursing as the most efficient way to increase the numbers of nurses within the profession while simul-taneously increasing the diversity in nursing. The College is expected to increase student enrollment capacity in its accelerated program and the number of students from disadvantaged backgrounds that enroll and graduate from the program. The CoN will receive 15 scholarships for BSN students who may use their funds to pay tuition, academic fees or as a subsidy for living expenses to reduce their financial burden while in school.

gail W. stuart, Phd, rn and robin l. bissinger, Phd,

aPrn, nnP-bC received funding from the BlueCross BlueShield of South Carolina foundation for the ap-plication titled “expanding the Pipeline of Primary Care Nurse Practitioners in SC” in the amount of $250,000. The purpose of this application is to sustain and grow the dNP program, which educates primary care nurse practitioners critically needed in South Carolina.

Charlene Pope, Phd, MPH and her team of co-investiga-tors have received funding by the VA Quality enhance-ment research Program (QUerI) for the continuation of her telehealth research. The project, rrP 12-229, is titled, “Communication skills training for heart fail-ure self-management in telehealth,” and will receive $99,700 for one year.

office of researCH

5eCONnections JUNe 2012

Publications & presentationsPUBLICATIoNS:> Acierno, r., rheingold, A., Amstadter, A., Kurent, J., amella, e., resnick, h., Muzzy, W., Lejuez, C. (2012). Behavioral activation and therapeutic exposure for bereavement in older adults. American Journal hospice and Palliative Care. 29(1), 13-25.

> Wagner, J. l., smith, g., ferguson P. (2012). Self-efficacy for sei-zure management and youth depressive symptoms: Caregiver and youth perspectives. Seizure. 21, 334-39.

> Johnson, V.A., Powell-young, y.M., Torres, e.r., spruill, I.J. (2011). A systematic review of strategies that increase the recruitment and retention of African American adults in genetic and genomic studies. ABNf Journal. 22(4), 84-8.

> stuart, g. (2012). Community mental health nursing: the long road home. Indian Journal of Psychiatric Nursing, 3(1), 40-44.

> Kennedy, s. (2012). Polymyalgia rheumatica and giant cell arteritis: An in-depth look at diagnosis and treatment. The Journal of the American Academy of Nurse Practitioners, 24(5), 277-285.

PoSTer PreSeNTATIoNS:> Pope, C. “Unpacking the black box of telehealth communication patterns in heart failure self-management.” American heart Association (AhA) Scientific Sessions of the Council on Quality of Care and outcomes research in Cardiovascular disease and Stroke (Q-Cor). Atlanta, GA, May 2012.

> devandry, s., amella, e., andrews, J., Kelechi, t., Ford, M. “Viewing cancer trial recruitment of African Americans (AAs) through social cognitive theory. oncology Nursing Society Annual Congress. New orleans, LA, May 2012.

> Matutina, r., Kelechi, t., Mueller, M., Jenkins, C., Johnson, J. “educational interventions for middle school students to improve the perception of nursing as a future career choice.” 2012 roper St. francis healthcare Nursing research Conference. Charleston, SC. April 2012.

> Matutina, r., Kelechi, t., Mueller, M., Jenkins, C., Johnson, J. “educational interventions for middle school students to improve the perception of nursing as a future career choice. MUSC Nurses Week Poster fair. Charleston, SC. May 2012. (out of 24 entries this poster won first place in the research division.)

office of PraCtICe

HHI Scholars visit migrant campon May 15, the new hispanic health Initiatives (hhI) Scholars (cohort 12) visited a migrant camp on Johns Island to learn more about the social determinants that affect migrant workers’ health. from the camp, the students went to the east Coast Migrant early head Start Center, one of the many sites the group will be working at this summer as part of their clinical experiences for Population focused Nursing. Afterwards, the students traveled to a farm on Wadmalaw Island to pick strawberries in order to gain a small amount of

perspective of life as a migrant worker. The students wore long sleeve shirts and pants and picked as many quality strawberries as they could without talking for 15 minutes. This gave the students an opportunity to experience and reflect in the work of migrant workers that many people may take for granted. Throughout the summer semester, the scholars will have many opportunities in to learn about the hispanic population in rural and urban areas of Charleston and also focus on

health disparities in the area. The scholars will also visit another migrant camp during the semester to provide educational information and health screenings. for questions about the hhI Scholar program, contact Anna Tecklenburg at tecklenb@musc.edu.

6 JUNe 2012 eCONnections

“ The task of leadership is not

to put greatness into people, but

to elicit it, for the greatness

is there already.”

- John Buchan

“

PASOsromina McCandless, MPH and Judith rundbaken of PA-Sos spent a busy May planning outreach and conducting community-based health education about intimate partner violence. Lesson participants included men and women enrolled in eSoL classes (english for speakers of other languages) on Johns Island, and were well received. romina also facilitated a cultural competency activity for the hhI Scholars to help students understand how to improve health services to underserved populations. PASos is a program that helps both the Latino com-munity and health care providers work together to promote strong and healthy families.

Kudos to our facultyelaine amella, Phd, rn, Faan has been invited to serve as an inter-national expert member for the National Medical research Council (NMrC) in Singapore. elaine will be assisting in the peer review of the various NMrC grants and programs for two years.

robin bissinger, Phd, aPrn, nnP-bC and Charlene Pope, Phd, rn,

MPH, CnM were both accepted to the American Academy of Nurs-ing. They will be inducted as fellows in october. details to follow.

Charlene Pope, Phd, rn, MPH, CnM has been invited by Cathy rick, chief nursing officer for the department of Veterans Affairs (VA), to join the VA’s Nursing research Advisory Group (NrAG).

gigi smith, Ms, aPrn, CPnP, PC has received the 2012 SC Council of deans and directors of Nursing Scholarship.

smithPopebissingerAmella

If you’ve read this column over the past several months you already know that 64 percent of health care is consumed by 10 percent of the population. In this 10 percent are patients who have chronic health conditions, such as coronary artery disease and diabetes, often accompanied by complications that require hospitalization. Because of the complexity of their illnesses, these groups of frequent health care consumers require a higher level and cost of care. What’s going on in south Carolina?

The prevalence of diabetes among SC’s population is 9.5 percent or 400,000 to 450,000 people. In 2007, 70 percent of the diabetic population also had hypertension, while 65 percent had high cholesterol. over 100,000 hospital discharges within one year listed dia-betes as the primary or secondary diagnosis, leading to a cost of approximately $2.8 billion. heart disease accounted for over 57,000 hospitalizations during 2010 with a total health care cost of more than $2.86 billion. In that same year, stroke accounted for nearly 15,000 hospitalizations costing the state $560 million. Approximately one in four people in SC are uninsured. Unfortunately, many of these people also have greater health disparities and data suggests that taxpayers pay about two-thirds of their health care costs through government subsidy. It is also reasonable to conclude that many of their hospitalizations could have been averted if earlier intervention had been initiated in managed primary care. With the rising rate of obesity in the population (by some estimates as high as 65 percent), the future for SC’s health and economic welfare looks bleak.

solutions?

Many studies have analyzed diverse models of care that can improve outcomes for patients with chronic disease. In one such study1, Wayne Katon, Md and his colleagues investigate principles that redistribute health care by changing the roles of providers working in collaboration and created an evidenced-based approach to manage health care problems more effectively. Based on their research, they advocate a model that acknowledges that different people need different levels of care. finding the best level of care for each patient is the result of monitoring patient outcomes and moving the patients from lower to higher levels of care as needed. This model uses multiple providers in an organized stepwise manner, thus keeping costs down and optimizing the use of each provider based on patient need. By reorganizing the roles of specialists, primary care physicians, and nurse practitioners (NPs), a four stepwise model has been proposed by Glasgow where uncomplicated patients receive least costly care. In model trials, nurses provide Step 1 Care that includes screening, patient education, and comprehensive preventive care. In Step 2 Care, nurse practitioners provide diagnosis, medication management, lifestyle change education, and close monitoring. The NP and patient together focus on specific problems with targeted goals and jointly develop a specific plan of action. The NP also provides support and problem solving to optimize self-management, close monitoring of adherence, and outcomes. In Step 3 Care, the NP facilitates appointments to see the primary care physician for patients with adverse outcomes or side effects. Lastly, Step 4 Care is a referral to a specialist for patients with adverse outcomes despite Level 3 care, or for those with higher initial levels of complexity. The programs reviewed were quite diverse with some using primarily telephone-based intervention. These programs, which use a stepwise approach and innovative utilization of nurses, nurse prac-titioners and/or allied health professionals, were found to significantly improve outcomes and patient symptoms, reduce hospitalizations, and divert visits to the emergency room. These programs also produced fewer days absent from work and school. Using this model, the findings were consistent for patients with diabetes, asthma, and congestive heart failure. The high utilization of nurses and nurse practitio-ners resulted in lowered costs compared to usual care. These studies show that allocating more resources to educating patients, improv-ing provider accessibility by telephone, and offering care in local clinics for minor relapses results in better disease control.

Can NP’s lower health care costs? By Carole Bennett, PhD, APRN, BC, PMH, CNS

office of PraCtICe: Policy UPdate

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(Continued on page 8)

Can NP’s lower health care costs? (Continued from page 7)

office of PraCtICe: Policy UPdate

8 JUNe 2012 eCONnections

In 2006, the Nurse Practitioner healthcare foundation, a think tank for nurse practitioner innovation, published the white paper, “Nurse Practitioner Services in retail Locations.” In it this group advocates for small nurse practitioner run clinics to be made available in both ur-ban and rural settings, such as grocery or pharmacy chains. They contend that barriers to care including difficulty getting an appointment, lengthy travel distances to care settings, long and unpredictable waits, and limited hours and days of service could be reduced or eliminat-ed by this model. It is easy to imagine these clinics located in pharmacies and grocery stores in rural settings across SC, utilizing protocols in a stepwise model as described, serving people in their home community, intervening early in a disease episode, and monitoring them from the local grocery store or pharmacy - a familiar and accessible community setting. These clinics would give the nurse practitioner the opportunity as a local triage point to manage patients at Step 2 or send them on to Step 3 providers in larger hubs.

Currently, Minute Clinic has opened walk-in clinics in SC in CVS pharmacies located in Charleston, Greenville-Spartanburg, and Colum-bia. These clinics are staffed by nurse practitioners who provide easy access to care. however, because of the existing barriers to the scope of prac-tice for NPs in SC, the clinics have not been able to expand beyond these metropolitan areas. In order for this model to be implemented and improve care for high consumers of health care, NPs must be allowed to practice full scope without the current restraint of distance and mandated supervision. If NPs could function without restraint, then they could be

located in grocery and pharmacy chains across South Carolina and engaged in improving health care for all South Carolinians. It is time for South Carolina to fully utilize the strengths of the NP in offering full access to care for our citizens. only then will NPs be able to make a full economic impact in managing patients in their home community, intervening early in the disease process, and significantly lowering the cost of chronic disease in high consumers of health care in South Carolina.

1Katon, Wayne, et.al. (2001). rethinking practitioner roles in chronic illness: the specialist, primary care physicians, and the practice nurse. General hospital Psychiatry, 23(3), 138-144.

emmanuel, e. J. (2012). Where are the health care savings? JAMA, 307(1), 39-40.

“diabetes by the numbers: South Carolina.” American Podiatric Medical Association, release date 2010. www.apma.org

www.minuteclinic.com/SC/SC-Coast/Charleston.aspx

“Nurse Practitioner Services in retail Locations,” Nurse Practitioner healthcare foundation, release date April 17, 2006. www.nphealthcarefoundation.org

“State of the heart: heart disease in South Carolina,” department of health and environment Control, release date November 2011. www.scdhec.gov