Fairfield Graduates Forge New Paths as Healthcare Evolves.

Fairfield Graduates Forge New Paths as Healthcare Evolves.

Healthcare is evolving at a lightning pace and nurses are at the forefront of that evolution, in a range of leadership roles that defy the old assumptions about what defines a nursing career. And as one of the best schools in the country, the Marion Peckham Egan School of Nursing and Health Studies is in the vanguard, developing this new breed of practitioner.

Today, more than three million nurses comprise the largest sector of the health care labor force. They can be found all across the health care spectrum — in advanced care practice, policy making, business, program development, legal consulting, informatics and change management —revolutionizing healthcare while meeting the needs of an increasingly diverse population.

Professor and Dean of the Egan School, Meredith Wallace Kazer, PhD, APRN, FAAN, reflected on how nursing as a profession has changed since she entered the field. “For years nurses have been encouraged to work more collaboratively with physicians and other members of the health care team. The vision has been there for a long time but now we’re really starting to realize it,” she said. “And I think that positions Fairfield nurses to be leaders in many health care areas.”

This surge in nursing is reflected in the growth of the Egan School overall.

When Dr. Kazer joined the University there were approximately 12 members of the nursing faculty. Today there are 31. There were about 300 students in 2003, compared to 700 students today. “We have been on a constant growth trajectory not only in the growth of number of students and faculty, but also in our national reputation,” Dr. Kazer said.

Already, Fairfield nursing graduates are in a range of leadership positions far beyond the careers they imagined when they took their first nursing class.

The growing field of palliative care

The World Health Organization defines palliative care “as an approach that improves the quality of life of patients and their families facing the problem associated with life-threatening illness through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual.”

As a palliative care coordinator and clinician for the Palliative Care Consultation Team at the VA Connecticut Healthcare System, West Haven Campus, Fairfield alumna Tracy Shamas BSN ’92, MSN ’96 evaluates patients for admission to Heroes Harbor, which houses the hospice and palliative care patients.

She is also responsible for the administrative aspects of the palliative care service and sees veterans with life-limiting illnesses on the inpatient hospital units and outpatient clinics, to help maximize symptom management and facilitate goals of care discussions.

Shamas’ idea of nursing was being a staff nurse and she never imagined that she would pursue a master’s program. As an undergraduate in nursing she worked at the VA Connecticut Healthcare System, West Haven Campus. Once she completed her master’s, Shamas returned to the nursing home as an APRN in geriatrics.

In 2006, Shamas had the opportunity to work in palliative care where she found her niche. “It took me 10 years or more to get there and while I have always loved geriatrics, palliative care is where I am meant to be.”

Shamas’ experiences in an ICU and in geriatrics have given her perspective on costly and aggressive late-in-life interventions. “We have to be doing this better. We can’t change their disease, where death will still occur, but the way that we are going about it is completely wrong.”

Targeted funds from Congress to improve end-of-life care for veterans across the nation put the VA ahead of the curve in recognizing the need for excellence in palliative care. Shamas has since seen the West Haven program skyrocket from treating one to two patients per month when she started, to more than 500 patients a year.

While Shamas predicts it will be another 20 years before palliative care evolves into a “true subspecialty, like cardiology, where doctors and nurses have a basic comfort level and skill set for taking care of people who are facing life limiting illnesses,” she noted its progressive evolution. “We didn’t have a program to speak of 10 years ago and now it’s had an impact on hundreds if not thousands of veterans and their families.”

The Kanarek Center for Palliative Care Nursing Education, which will be housed in the Egan School of Nursing and Health Studies, is scheduled to open fall 2017, and will position Fairfield as a leader in this field.

The business of health care

As a partner in L1 Health, an international investment company, Meghan FitzGerald BSN ’95, MPH, DrPh, looks at investing in and growing companies in the health sector and refers to her work as the “ultimate dream job.”

Prior to joining L1 Health, Dr. FitzGerald was the executive vice president of Strategy and Health Policy at Cardinal Health, a global integrated healthcare products and services company that ranks among the top 25 in the Fortune 500.

When she encounters other nurses in the business world, Dr. FitzGerald said, “it’s like a badge that says I understand you’re going to be interested in patients because of your training. Some of the best leaders that I have met in this space have had a nursing background.”

According to Dr. FitzGerald, nurses are now in many different business roles because the emphasis across the healthcare spectrum is on treating the patient throughout the process of illness and recovery. That means following patients from the hospital to back home, and maintaining their health in the most efficient cost setting. This takes both nursing knowledge and business sense.

One of Dr. FitzGerald’s first jobs after she graduated from Fairfield was on a Tohono O’odham tribe reservation in Arizona as a dialysis nurse. She managed three clinics and got her first taste of the business side of health care. Dr. FitzGerald has always loved data, trends and population health and that led her to pursue a master’s of public health at Columbia University, followed by a doctorate of public health at NY Medical College.

Dr. FitzGerald is also an associate professor of strategy and health policy at Columbia University where she currently teaches “The Business of Healthcare.” The course offers students “live labs” and real world experience, such as visiting Saatchi & Saatchi to learn about healthcare advertising campaigns or doing mock CNBC interviews. Each exercise and class is meant to simulate what life would be like in a Fortune 500 health care company through the lens of a CEO or a chief strategy officer.

“This ability to make a difference is really easy when you have a nursing degree,” she said. “Your opportunities are infinite. But it starts with this inherent desire to help those in need and make things better.”

Commitment to life-long learning

When Patricia Dykes ’86, PhD, MA, RN, FAAN, FACMI, received her BSN from Fairfield, she was well-prepared for her clinical role and she envisioned that she would soon be pursuing her master’s degree. “At Fairfield, the message was nursing is a profession and we must have a commitment to life-long learning. It was instilled in us.” Dr. Dykes went on to earn a master’s in nursing from NYU and was the first nursing informatics doctoral graduate from Columbia University School of Nursing.

After earning her master’s degree, Dr. Dykes worked as a clinical specialist in orthopedics and surgery. At the time, healthcare systems were trying to become more efficient — better able to predict the clinical pathways that each patient should follow to ensure quality care while reducing costs. In those days, clinical pathways were paper-based.

Figuring out a predictive model for these pathways was going to require computer systems and clinical decision support. To better prepare herself to address this challenge, Dr. Dykes pursued her doctorate in nursing and biomedical informatics, the study of biomedical sciences and information sciences.

Dr. Dykes is now a senior nurse scientist and program director for research in the Center for Patient Safety Research and Practice and program director in the Center for Nursing Excellence at Brigham & Women’s Hospital, and an associate professor at Harvard Medical School. She was an early innovator in the development of clinical decision support, integrating clinical pathways into electronic health records and using technology to champion patient engagement.

As part of her program of informatics and patient safety research, Dr. Dykes tackled one of the biggest challenges hospitals face—patient falls. She was principal investigator and worked with teams at various hospitals to develop strategies for fall prevention as part of a Robert Wood Johnson Foundation-funded research project. Through this research, Dr. Dykes and her team developed Fall TIPS (Tailoring Interventions for Patient Safety), a computerized clinical decision support algorithm that guides nurses in completing a fall risk assessment, developing a fall prevention plan, and communicating the patient’s personalized plan to the hospital staff and the patient’s family.

Dr. Dykes said, “We found that we reduced falls by 25 percent and results were published in JAMA in 2010.”

Partners Health Care, NY Presbyterian Health Care System and Montefiore Health Care System have all integrated Fall TIPS into their electronic medical record systems.

It’s all about the culture

The nursing path of Catherine Santarsiero RN, BSN’92, MSN, APRN, has wound through the medical surgical unit, urgent care, women’s health and primary care areas, the post-partum unit and the emergency department.

A love of mentoring and teaching was cultivated through nursing faculty roles at San Diego State and Quinnipiac University and led to her current position as a leadership organization development (LOD) specialist with Hartford HealthCare (HHC).

As an LOD specialist, Santarsiero teaches leadership development from a strategic perspective—to physicians, physician assistants and nurse practitioners at HHC, in a program that focuses on core competencies like communication, knowledge of health care and emotional intelligence. She is the only clinician on the team.

“It’s all about the culture,” Santarsiero explained. “There are so many changes in healthcare right now, it’s about how people adapt to those changes and incorporate leadership behaviors into their daily lives.” Santarsiero’s role at Hartford HealthCare, which is composed of five hospitals, is about helping providers develop strong leadership skills and partnering with many of the executive leaders at Hartford HealthCare.

This relatively new focus in healthcare leadership development is gaining traction. The Harvard Business Review recently reported, “The emphasis on patient-centered care and efficiency in the delivery of clinical outcomes means that physicians are now being prepared for leadership.” For Santarsiero, who is passionate about her work, it all goes back to the patient. “Ultimately, my goal is to bring this work back to patients by working through providers so they can be better leaders, so they can be better with their colleagues and with their patients.”

“Be in the moment, be authentic, be humanistic, model high performance, be curious versus judgmental, be accountable, have courageous conversations, spend at least half your time developing others,” she said of the culture she is working to build.

The rigor and professionalism of Fairfield’s nursing program stand out when Santarsiero looks back on her undergraduate education and where it has taken her. “The rigor of the program gave me the respect for self-discipline and hard work. I think when you can say you’re a graduate of Fairfield University nursing, it gives you pride. It gives you credibility.”