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Chief nurse found success via introspection The following articles are the last in a series dedicated to National Women’s History Month and this year’s theme, “Generations of Women Moving History Forward,” which seeks to recognize the wisdom and tenacity of generations of women who have come before and those who will follow in celebrating the equality, courage, determination and steadfastness of women in American culture. by Heather Woolwine Public Relations Marilyn Schaffner's rise to one of MUSC’s most critical nursing positions has been a journey fraught with personal doubt, success, near-defeat, and drive to stay the course.   The hospital administrator for clinical services and chief nursing executive for the MUSC Medical Center is a complex blend of compassion, tenacity, and spirit, and the resulting formula demonstrates to all women in health care what is possible when you set your heart to it.   Dr. Marilyn Schaffner   One of three children raised by a strong single mother in Springfield, Ill., Schaffner, Ph.D., R.N., grew up poor. Her father left when she was 2, and her mother did the best she could.   “I went to a grade school where it was very clear who had money and who didn’t. I remember children making fun of our clothes. We would have mission drives at the school where people would bring in their old things to give away, and the school administrators called our family down to look through them, because they knew we were in need. So we would wear the things that other children had thrown away, and they would make fun of us. It was tough, but I know that it made me stronger,” Schaffner said.   Schaffner said everything changed when her mother encouraged her to go to an all-girls’ high school across town. The students wore uniforms and no one had to know her history. Schaffner blossomed as a young woman with many new and exciting experiences. For the first time, she fit in. “But as a result of my coming out, we’ll say, I really didn’t pay attention to my school work so I was mainly a B and C student when I could have been doing much better,” she said. “I had a social life now, and I didn’t want school to interfere with that. I hate to admit this, but I never read a book during high school. It was always Cliff’s Notes. I just skidded through.”   A pivotal moment came when a friend suggested the two 16-year-olds take a nursing assistant course so they might make some extra money. After two summers working as a nursing assistant in a local hospital and in a nursing home during the school year, the school counselor asked Schaffner what she wanted to do after high school. “I said, ‘Well, I’ve been working as a nursing assistant so maybe I’ll be a nurse.’ I really enjoyed it and knew I must be pretty good when I got to work on the orthopaedic floor at the hospital, because they only let good workers go there. I applied to St. John’s (School of Nursing, Springfield, Ill.), which at time was the oldest Catholic diploma nursing school in the country,” Schaffner said. “I was so confident; I thought it would be a piece of cake. So, when the rejection letter came, I was crushed. Ms. Larson (school counselor) went to St. John’s and advocated on my behalf and I got in. I was admitted on probation and had to maintain a B average for the first semester.”   With no real study habits, the girl who had always crammed the night before tests found herself challenged to demonstrate her best, with little room for mistakes. “I knew I had to get it together, and quick,” she said.   And get it together she did. Schaffner worked for almost a decade after receiving her nursing diploma before deciding to continue her education with a bachelor’s degree in nursing. She was initially rejected for acceptance into the program at Sangamon State University in Springfield. Schaffner set about proving her academic aptitude by taking three courses designated by the school. Schaffner graduated with her husband the same day he received his master’s in business degree in 1985. “I seem to go back to school about every 10 years, so the next time it was while I was working at Duke (University, Durham, N.C.) and I wanted to go for my master’s,” she said. “My entrance exam score was one point off from being accepted. I was published by then, and had gotten my bachelor’s with high honors. So I took it again, and was one point off, again.”   Some people would have given up by that point. Taking the test for a third time, Schaffner passed. She completed her master’s degree with one of the highest GPAs in her class. But it’s not as if her academic development was the only thing going for Schaffner. She was a devoted wife and also became mother to an adopted daughter Kelsie. “Kelsie was 2 and I was working part-time in gastroenterology endoscopy three days a week at St. Johns so I could spend time with her. My husband's new job led us to relocate in Durham, N.C.,” Schaffner said. She recalled interviewing at Duke University Medical Center. “Chris Roback, my nurse manager, said she thought I was management material and hired me as assistant nurse manager to work along side her… when we heard that Dr. (Peter) Cotton was coming to town, we were told to give him his own area within our unit. This caused a major uproar with the nursing staff, so I put together an education plan, and we made it work. Two months later, Chris told me that Dr. Cotton was looking for a nurse manager for his GI unit. She saw potential in me and helped me develop and practice interview questions, and she role-played with me. I guess it worked because I got the job.”   As a new nurse manager, Schaffner found herself in a small nightmare. Her unit had a large turnover rate and her staff was disgruntled about several issues. “I couldn’t figure out what I was doing wrong. We went on a retreat and I basically said to them, ‘Help!’ They said, ‘You don’t even say hello when you come in the morning.’ That spoke volumes to me. My mind was in the job, but my heart truly wasn’t. I was coming in with 1,000 things on my mind and wasn’t even showing my staff the basic respect of saying hello or good morning,” she said. “Not long after that I read an article that suggested you put three pennies in your pocket and transfer them from one pocket to another when you gave out a genuine compliment or positive feedback to a staff member. At the end of the first day, none of my pennies had moved. I was thinking positively about people, but I wasn’t verbalizing it. This is what MUSC Excellence is really about and that’s why I’m such a big supporter of it here. You have to provide recognition and positive feedback where it’s deserved.”   Another reality check came in the form of a public scolding during a large staff meeting with Duke physicians. “They said I was coming across as disrespectful to residents and fellows, physicians and other staff members. That meeting was very painful, and probably was not the right forum to discuss those things with me, but it forced me to take a look at myself and how I would use cynical comments disguised as humor to communicate with people,” Schaffner recalled. “I found out those comments were hurtful, and it really opened my eyes because the last thing I ever wanted to do was to hurt people.”   As Schaffner found her preferred means of working with her staff, she said that she never felt a glass ceiling. “I was always ready to try new things. People would say, ‘oh we don’t have a policy for that,’ and I’d say, ‘Then let’s write one.’ I was also very fortunate to come into contact with Peter (Cotton) because working with him has afforded me so many opportunities,” she said. “He was a great mentor and advised me to choose a particular patient focus in GI. That led to my expertise in that area and thus speaking engagements  and travels to Hong Kong, Austria, China, Australia and Saudi Arabia.” When Cotton took a job at MUSC in 1995, he asked Schaffner to come along as clinical director of the MUSC Digestive Disease Center. Schaffner jumped on a professional roller coaster that swiftly enhanced and added to her nursing career. In less than a year she was also the clinical director of  DDC's medicine and oncology.   In 2000, Schaffner was attending a conference in Chicago when she received a message that her boss, the chief nursing executive, was looking for her. “I thought one of two things, either someone had died or she was leaving for her to make a call like that. When we connected, she expressed her thoughts on my taking her position. I just remember an acute sense of disbelief that she had so much confidence in me. I just couldn’t believe that she thought I could do her job.”   While humbled, Schaffner was excited and approached her interim post as chief nursing executive with gusto. After a honeymoon period during the first few months, Schaffner began having doubts. “My husband and I carpool to work, and one day he picked me up and asked how my day was and I just let go. I was incredibly frustrated. In this job, every day, every hour, you get hit with really big lows and really amazing highs. It’s an emotional roller coaster. I realized that if I continued on in the same way that it would break my spirit, so a huge objective for me from that moment on was to keep an even keel. I still have my moments, but I’ve wised up enough to take things as they come.” Schaffner has been officially in her position since 2001.   During her tenure, Schaffner learned that she had breast cancer (1999). Treating it like any other challenge was important to her. “Maybe it wasn’t a little rock to go around, maybe it was a big boulder, but once I realized that I was going to have to let go and let the situation control me, and that was OK and part of the deal, I could get on with it,” she said. “I had a 65 percent survival rate with metastasis to lymph nodes. I’m now an eight-year survivor and I believe there’s a reason I’m still around. I suppose God’s not done with me yet.”   A member of many nursing societies and organizations, with approximately 70 publications and several noteworthy awards, including the South Carolina Palmetto Gold Award for excellence in nursing practice and commitment to the profession of nursing, Schaffner has achieved a level of success the likes of which she said she never imagined. Since her tenure as chief nursing executive began, she has worked hard to incorporate the thoughts and planning of her staff into her leadership style with the MUSC Nurse Alliance and through forums like Moments with Marilyn.   When it came time to apply for the doctorate in nursing program at MUSC, Schaffner was understandably nervous. After all, she knew standardized testing was not her thing. Fortunately for her, the College of Nursing saw potential in Schaffner, highlighted by high marks during her higher education career, good interviews, her numerous publications, and her presentation record throughout the world. With all of that, a score on the entrance exam slightly below what they wanted was not going to deter her acceptance.   She successfully defended her dissertation in December, and will walk in May. In June, Schaffner and husband, Jim, will celebrate their 35th wedding anniversary. “He’s incredible,” she said. “I have a great support system with him and Kelsie, and it has been important to be with someone who’s not challenged by my success. He even jokes about it, saying, ‘Dr. and Mr. Schaffner.’”   A balance between professional and personal life has always been a priority for Schaffner, and at home she cultivates a love of gourmet cooking and tending to her garden. Every Thursday she spends time with her mother for mother-daughter dinners out or to attend special events. She knows how to step back and take time for herself. “I don’t take my computer with me when we travel. I’ve found that you might leave what you think is a two foot pile of stuff on your desk on Friday, and then you come back Monday and realize that it’s only five inches. Your perspective changes when you’ve had a chance to rejuvenate.”   Schaffner’s advice for women seeking leadership positions in health care seems simple, but sometimes the simplest advice is the best. “Follow your dream and always advance your education. Never consider any barrier a permanent one, because many things that we perceive as barriers are not real and sometimes we put them there ourselves. I never thought I would be where I am today, and I think it’s because I just kept going.” Psychologist urges women to face fears by Heather Woolwine Public Relations Darlene Shaw, Ph.D., has created an ambiance within her office setting that is much like her personality. Warm, comfortable, and genuine, it comes as no surprise that with this woman and in this environment, many students and patients find it easy to open up about what troubles them most.   Dr. Darlene Shaw As the executive director of Student Health and Wellness, vice chair for education and director of medical student education for Psychiatry and Behavioral Sciences, and a full professor, Shaw wears many hats. No matter which one she has on at any given time, those who know her have come to trust her gentle and sincere nature in guiding them to make healthy life decisions.   Born and raised in a tiny rural community in Ohio, Shaw is the first generation college graduate in her family. In what she described as a great place to grow up, but not one to live in, Shaw’s early mentoring experiences were limited to teachers she encountered during her primary education and her mother. She never felt marginalized by her gender. “I’ve been incredibly fortunate in that I didn’t have or see any barriers to my development,” she said. “I went to college at Ohio University and fell in love with my psychology 101 course. While I was working on my undergraduate research project, a woman named Abby Silver said I should go to graduate school. I just loved, and still do, learning about psychology, but it hadn’t even occurred to me to go beyond where I already was, I hadn’t dared to dream that big. Being from a small town meant that I wasn’t aware of the options out there or what my capabilities might be. It was much more difficult to get into graduate school as a woman at that time than it is now. You needed to have better credentials than the majority of men who were getting in, but once you were in, you were fine.”   Four years after earning her bachelor’s degree in 1970, Shaw received her doctorate in clinical psychology, also from Ohio University. An internship opportunity at MUSC brought her south. With a dual appointment at MUSC and as a clinical psychologist on the staff at the Veteran’s Administration hospital, Shaw was content. But after a decade on campus, others saw her potential and began engaging her in other activities. It was during this time that Shaw recalled the influence of several mentors on campus, including Layton McCurdy, M.D., (former Psychiatry chairman and Dean Emeritus of the College of Medicine) and Dean Kilpatrick, Ph.D., Psychiatry Distinguished Professor, the man who opened the door to Shaw’s medical student education career path. “He said something like, ‘Why don’t you just join our committee,’” she said with a laugh. As her heart and mind became more enamored with teaching medical students and working issues related to student education in general at MUSC, Shaw left the VA’s staff in 1988. With a promotion to associate professor, Shaw began counseling and psychology services for students as “an office of one.” The rest, the old adage goes, is history. From 1988 until 2003, she served in her new capacities, as well a 10 year stint as the associate dean for student life in the College of Medicine and reaching full professor in 2000.     “One thing that I feel like I did well and that I encourage all of our students to do early in their careers is to negotiate your path so that you are keeping your options open,” she said. “Do some teaching, some research, and find something you love to do and do it well. You have to follow that passion and foster it. Another important bit of advice goes along with the saying, ‘Location, location, location.’ In this case, it’s mentor, mentor, mentor. I think that is true for any career path. If you have a good mentor, then you’ll get all of his or her cast-offs, meaning that opportunities arise from getting the chance to work with a particular person, and that person doesn’t have to be at your home institution. And you don’t have to have just one; you can have different ones for different aspects of your career or life.”     As the executive director for Student Health and Wellness, Shaw has the overall responsibility for student health services and the Wellness Center. As director of Counseling and Psychological Services, she administers and coordinates the provision of services to the entire MUSC student body. She supervises and instructs psychology interns, psychology post-doctoral fellows, medical students and psychiatry residents, as well as developing curricula and evaluation methods and administering all psychiatry courses for medical students. And as if all of that wasn’t enough to fill her time, she has other responsibilities related to her appointment as vice-chair for education for Psychiatry and Behavioral Sciences. A member of 11 professional and scientific societies, the recipient of more than 20 honors and awards (including several Golden Apple Teaching Awards), and the primary or co-author of more than 60 publications, Shaw said she was especially proud of becoming a member of the inaugural class of the Executive Leadership in Academic Medicine program. “It was a huge honor to be involved with this group of very accomplished women from around the country,” she said.     While Shaw noted that things have changed for the better when it comes to women in academic medicine, she still feels that women are underrepresented in terms of tenure and full professorships. “I hope that women professionals today are more confident and self-assured. In my generation, we weren’t particularly confident—we were thankful for being there instead of knowing we should be there. Young women today seem more confident about stretching their wings and staying aware of new opportunities. The important thing is not letting your fear get in the way of success,” Shaw said. “Women have a tendency to be nurturers and say yes to too many things, because they are afraid to say no or hurt someone’s feelings. If you become involved in too many things, have too many responsibilities, or become accountable to too many people, you can actually hinder your efforts to excel in one particular area. I work closely with students and see their struggles between professional and personal life, as well as how much the financial burdens weigh on them, all the time.”   With a special spot in her heart for students coming from underprivileged or underserved areas who desire to be the first generation of college graduates in their families, Shaw is a generous supporter of higher education scholarships at MUSC and other institutions. In her time away from MUSC, she and her husband enjoy traveling and real estate investment.  Friday, March 30, 2007 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 catalyst@musc.edu. 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