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Dean guides nursing education into millennium by Cindy Abole Public Relations As Gail Stuart steps into her leadership role as dean of the College of Nursing, she sees it as a time of both promise and opportunity. “The college has grown and is well-positioned,” said Stuart, R.N., Ph.D., who was appointed to nursing’s top position this past July. “It’s clear that Dean Keefe (Maureen Keefe, R.N., Ph.D., former nursing dean) left a great legacy—including the initiation of the college’s own doctoral program, many “Caring for the Community” programs, and an innovative accelerated baccalaureate program of study.” From Stuart’s point of view, the college has scaled one set of peaks, and she assumes her leadership role with her eyes poised and focused on conquering an even taller and more challenging set of mountains.  Unlike the analogous climbing obstacles of boulders or sheets of ice, Stuart is challenged to manage one of the state’s most respected nursing programs at a time of shrinking fiscal budgets, retiring faculty, the need to merge innovative educational technology with traditional practices, as well as the enormous crisis of the nation’s nursing shortage.  Despite all of these obstacles, she remains upbeat and optimistic.  An energetic innovator and scientist, Stuart always looks ahead to new methods and fresh ideas. “I believe that one should try new approaches to old problems and be open to evaluating them; if something doesn’t work, then at least we’ve learned more than if we didn’t try any solution at all,” Stuart said, emphasizing the need to keep the school growing, stimulated and energized. So far, she and the college have already benefitted from the preliminary work of the 2002 MUSC Strategic Plan, a campus wide program that Stuart co-chairs with associate provost Tom Higerd, Ph.D. She and her nursing colleagues were able to apply the same process and focus in defining the College of Nursing’s goals and strategic actions that will direct future efforts.  A model program For more than 120 years, MUSC’s nursing program has been at the forefront of educating professional nurses, and it maintains a competitiveness with some of the country’s top nursing programs through innovative teaching and dynamic practices. The Charleston campus maintains various nursing programs including the accelerated BSN, master's programs in nine specialty areas, and the nursing doctoral program. Since 1981, the college has successfully partnered with Francis Marion University-Florence campus to provide both traditional BSN, and RN to BSN degree programs for people in the upstate. Improvements in programs and increased research funding enhanced by the nursing doctoral program will allow the college to contribute to the national nursing agenda, especially in focused areas like aging and health disparities, predicts Stuart. “Based upon our unique S.C. population and its needs, we’re poised to become a national leader in the nursing field,” Stuart said. “It’s a nice way of featuring our accomplishments and successful community partnerships to help move nursing’s national agenda forward.” “I am looking forward to working with Dr. Stuart in her new role as dean of the College of Nursing,” said MUSC President Ray Greenberg, M.D., Ph.D. “Having worked with her in the universitywide strategic planning effort, I was impressed with her ability to collaborate with a broad range of individuals on campus. I am sure that she will bring these same skills to the College of Nursing as she works with the faculty, staff, students and alumni to chart their future direction.” Adding to this, John Raymond, M.D., interim vice president for Academic Affairs and Provost, commented that “Gail has really hit the ground running.” A recommitment to academics and education Part of Stuart’s agenda as dean is to manage a list of core priorities. Topping these is a recommitment to academics and education. “It’s so easy in an academic environment to get pulled away into other important areas like research and practice initiatives such that we lose focus of the big picture and what we’re all about, which is the education of nurses throughout our state and region,” Stuart said. “Yet we must keep our eye on the academic mission, especially with today ’s nursing shortage.” The nation’s shortage of an estimated 126,000 registered nurses began in the 1980s when cutbacks in Medicare and other resources led to a reduction of the nursing workforce. Despite today’s staffing shortage, new research and evidence highlight the importance of both adequate numbers and greater education of nurses as having a direct impact on quality patient care.  Specifically, one recent national study found that nurses who achieve higher levels of education, a BSN or higher, have better patient outcomes.  Within South Carolina, the need for continual nursing education is real. The national recommendation is that 66 percent of a state’s professional nurses should have completed their baccalaureate degrees. In sharp contrast, about 66 percent of S.C. nurses possess only an associate degree in nursing. This has a major impact on the quality of health care received by the citizens of the state.  “There is an equal emphasis on nurses working towards completing their master's and doctorate in nursing,” Stuart said. “This is needed in order to supply our state and country with the next generation of nurse educators. All of this fits within the college’s grand teaching mission.” One of Stuart’s strengths as dean is her ability to bring many outside contacts to her position. An honors graduate of Georgetown University’s nursing program, Stuart received her master’s in psychiatric nursing from the University of Maryland, and her doctorate in behavioral sciences from Johns Hopkins University in 1985. She was recognized by Johns Hopkins for writing the outstanding doctoral dissertation. Her 17-year career at MUSC has allowed her to focus on psychiatric and mental health nursing, teaching students on all levels. She was also the College of Nursing’s first director of the doctoral program.  As former associate director of the university’s Center for Health Care Research, she became involved in interdisciplinary research activities with scientists and investigators across campus.  She was also the administrator at the Institute of Psychiatry managing the full spectrum of psychiatric care programs. Stuart’s academic contacts and further collaborations within the nursing profession, the university, national committees, groups, research study sections and international appointments offer much potential and opportunity to her position, the college and the broader university community.  Cultivating nursing research Another one of her priorities is to increase the college’s level of nursing research through grants and extramural funding. The nursing faculty have developed its research goals and objectives to coincide with the university’s Strategic Plan themes of healthy youth, healthy aging and reducing health disparities as part of the institution’s overall focus. “Academic doctoral programs thrive on the quality of their faculty’s research,” Stuart said. “Our focus on health disparities and provision of care is a very important topic within our state. Our programs in maternal health, parent-child nursing and gerontologic care are strong and nationally recognized. To this I would like to add more interdisciplinary research, which I believe is the way of the future. ”  In an effort to inspire and open doors to collaboration, the college will organize and host new research seminars and visiting lecture programs to provide valuable interaction among faculty, students and invited guests. On Oct. 28, the college will host its first distinguished leader in nursing lecture series. The program will feature National League of Nursing past president and distinguished professor Jean Watson, R.N., Ph.D., of the University of Colorado Health Science’s Center.  The college is actively recruiting for two key positions: a new associate dean of research replacing retiring associate dean Barbara Haight, R.N., Ph.D., and holder of the Ann Darlington Edwards Endowed Chair. To Stuart, both are critical to maintaining the school’s growing research perspective.  Also sharing Stuart’s list of core priorities is the school’s focus on teaching strategies using new technologies. Stuart’s leadership in creating web-based courses is based on today’s changing academic world and technology. As she notes, “offering an online nursing program is one of the innovative methods the college can use to reach nurses in every part of the state.” The school hopes to begin offering its RN to BSN program exclusively online in fall 2003. Handling the nursing shortage South Carolina’s nursing shortage has resulted in positive gains for MUSC’s nursing program. According to Stuart, the shortage has attracted many qualified people into the field—creating a diverse workforce.  Much of the college’s emphasis has been focused on student services, recruitment, and development issues in order to attract the best and brightest, as well as a more diverse group of qualified nursing applicants. Stuart is fascinated by the variety of today’s mix of nursing students—most possessing prior degrees and showing a combination of educational and life experiences that enriches the program. For example, about 80 percent of the students entering the accelerated program this fall have a previous college degree. In addition, the school’s mix of minority nursing students is credible—about 20 percent of all undergraduate, graduate and doctoral degree students. Males make up 10 percent, which is equal to the national norm.  Stuart would like to see improved recruiting strategies aimed beyond high school and the state’s historic black colleges such as those targeted to specific professions including emergency medical staff and other medical-related personnel. She will work hard to advocate and increase the number of nursing scholarships, an important recruitment incentive as the program competes with top students who are considering other nursing schools.  “We’re doing a good job attracting students,” Stuart said. “The question is what can we do to educate more nurses in the state. That’s the frustration.”  Classes are currently at capacity and accrediting guidelines require maintaining an 8-to-1 student/faculty ratio. Aside from lack of classroom space, the school’s “Catch-22” dilemma focuses on the school’s inability to educate additional nursing students without increasing the number of faculty. Thus, the program is unable to recruit faculty without increased funding for faculty positions. “Although there is a national need to quickly educate more nurses, many programs lack the appropriate resources to meet those needs,” Stuart said.  To Stuart, the problem is really not so complicated, citing the government’s immediate response of diverting funds in order to support the military, bioterrorism and homeland security issues since Sept. 11. She believes a similar strategy will be necessary to adequately address the crisis of the nursing shortage. “The shortage does impact health care in that it limits the system’s ability to provide safe, high quality care,” Stuart said. “Finding ways to establish funding on a state-federal budget level is one clear way we can truly impact the state and the nation’s nursing shortage. Another strategy is for hospitals, which are in dire need of nurses, to enter collaborative arrangements with the College of Nursing to allow for an increase in student enrollment.” Moving forward As the College of Nursing continues to move forward and outward, it is also reclaiming its long and distinguished nursing history. For years, nursing alumni have amassed a collection of historical objects and materials that Stuart wants to proudly display on the second floor of the college. She also wants to bring new and important traditions back to the school. Traditions such as the nurse capping ceremony have always been an important symbol reflective of the nursing profession.  In a modern effort to welcome nursing students into the profession, the college held its first stethoscope ceremony on Sept. 11 at St. Luke’s Chapel. Stuart asked faculty to bring in their caps from when they graduated to be displayed. She discussed the transition from capping to the stethoscope ceremony. The ceremony, which provided an opportunity to bring together MUSC's nursing community, was co-sponsored by clinical nurses from MUHA. “We’ve arrived at a time of focus, a time to bear down and scan our horizon, and a time to think in new creative ways,” Stuart said. “The blending of all of these elements along with a good dose of hard work will ensure our success.”         Catalyst Online is published weekly, updated as needed and improved from time to time by the MUSC Office of Public Relations for the faculty, employees and students of the Medical University of South Carolina. Catalyst Online editor, Kim Draughn, can be reached at 792-4107 or by email, catalyst@musc.edu. Editorial copy can be submitted to Catalyst Online and to The Catalyst in print by fax, 792-6723, or by email to petersnd@musc.edu or catalyst@musc.edu. To place an ad in The Catalyst hardcopy, call Community Press at 849-1778.