Chapter 9: A PhD Program and a Theory of Nursing and Leadership
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Description
In this Chapter, Dr. Summers notes that she was Director of the Department of Nursing at Inova Fairfax Hospitals for about a year when she felt she was losing her ability for sharp thinking. She decided to go back to school for her Ph.D (though she was still working; Ph.D. Health Care Administration, 1995). She talks about the struggle to get back in the habit of reading and synthesizing information. She also re-evaluated the stresses in her life and moved into a lower intensity job as a nurse educator while she was in her graduate program. Dr. Summers then talks about the ideas she encountered in this program: James Burn’s theory of transformational leadership and Jean Watson’s human caring theory. She saw crossovers between the two and ended up writing her dissertation on this subject.
Identifier
SummersB_01_20140123_C09
Publication Date
1-23-2014
Publisher
The Making Cancer History® Voices Oral History Collection, The University of Texas MD Anderson Cancer Center
City
Houston, Texas
Interview Session
Barbara Summers, PhD, Oral History Interview, January 23, 2014
Topics Covered
The Interview Subject's Story - Professional PathProfessional Path Evolution of Career The History of Health Care, Patient Care Overview Definitions, Explanations, Translations Mentoring Leadership Experiences Related to Gender, Race, Ethnicity
Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License.
Disciplines
History of Science, Technology, and Medicine | Oncology | Oral History
Transcript
Barbara Summers, PhD:
Yeah. So I was in that director-level position for, I think, about a year, maybe eighteen months, and I started to feel that I was intellectually getting not sharp—I don’t want to say rusty, but not sharp—that I was spending my days reading memos and responding to memos. It was like all day long reading memos, responding to memos, getting a problem, figuring out how to fix the problem. And I just thought that my ability to really have deep thinking, it was shot. So it was extremely superficial, but if it came to anything where I actually had to give serious thought, I just felt that I had lost that. So I thought, “Well, I think I’m going to go back to school.” So I talked to my husband. He said, “Sure, if you want to do that, it’s great with me.” So I was in my regular position as the director. I enrolled in a Ph.D. program. I was accepted into the program. Of course, they said, “Well, what are you going to focus on for your dissertation?” I’m like, “Who knows? I don’t know. I’m here for the experience. I have no idea what I’m going to study.” And I started in the program as a part-time doctoral student.
Tacey Ann Rosolowski, PhD:
And this was at George Mason again?
Barbara Summers, PhD:
Yes. But the interesting thing is that each time I went back, they had all new faculty, so there were only two faculty that I had experiences with two times during my three tours at George Mason.
Tacey Ann Rosolowski, PhD:
That’s great. So basically a new experience each time.
Barbara Summers, PhD:
A new experience every time, mm-hmm. So I went back to school, and I would carry two courses a semester while I was working full-time, and my first semester back was extraordinarily difficult because I had forgotten how to read scholarly papers. So my first semester included a course in theory, and we were reading these very deep papers. And I remember with horror, I had them all copied and at home, and I sat down and read. And I was highlighting as I was reading, and after I finished reading, I had highlighted like 95 percent of the piece of paper, and I had no recollection of what I had read. I had just completely lost the ability to read for meaning and content. I had become so accustomed to scanning for just a few key points so that I could make a decision and move on. So I had to relearn how to be a student and relearn how to read and to think and to synthesize again, read multiple papers, and synthesize the information from those papers and then be able to write about them and speak about them. So the first semester was tough, but then I got the hang of it, and I moved on to my second semester. And by the time I finished my second semester, I realized that between the demands of school, which were substantial, two evenings a week in class and then all of the out-of-class work, and the demands of work, you know, working fifty or more hours a week—and, oh, by the way, I was married. My husband and I never had children, but I was married, loved my husband very much. I felt that I was failing in all three areas, and I wasn’t happy, because I didn’t think I was giving my best anywhere. And I sat down and thought about it, and I said, “Well, Barbara, you’re the one who made the decision to go to school, no one made you do that, and so if you’re going to be happy, something’s going to have to give. So you could drop out of school. No harm, no foul. Or you could leave the position that you’re in and go into a position that won’t be as demanding and stressful as this administrative position. Because I’m definitely keeping the husband.” (Rosolowski laughs.) So I decided to do that, and I moved into a position as a nurse educator/clinical specialist in the same organization, focused in oncology, and I was able to be a sane person again. It was wonderful. So I was then able to actually enjoy school.
Tacey Ann Rosolowski, PhD:
And did the teaching—because I’m just thinking you gave up the job that had made you feel you were losing your intellectual sharpness anyways, so did teaching help with the learning side as well?
Barbara Summers, PhD:
Well, the development of the staff was very rewarding, so I enjoyed that, but I also would teach a course every semester for the university as well, a graduate-level course. So I enjoyed that. So I felt very challenged and very fulfilled the whole time. And I would have three or four graduate students with me at all times, but I came to have an appreciation for the fact that while I was nearly omnipresent, that no matter what the need was, people could call on me, and I was like the Fix-o-matic, that in the end, that being the Fix-o-matic was disempowering the staff, not empowering them, because they learned how to be helpless. Because why would they figure stuff out for themselves? I could fix it for them. So I had to stop that. And then the other lesson that I learned is that no matter how hard you’re working and how many hours you’re putting in, people don’t appreciate you more because of that. All they do is notice the few times when you’re not there and ask you, “Where were you?” Very hard lesson to learn, very hard lesson to learn, because you can end up feeling very underappreciated when, in fact, if you can step back and look at it through a little bit of an objective lens, you can’t blame people for that. Because how could they possibly know that you’re working twelve hours a day every day? I mean, they only see you for a snippet. The problem is, every snippet that they have, you’re there. Well, that just seems to be coincidence to them. So I learned a lot about—not about working shorter hours, because I still worked terrible hours, but I learned a lot about if you’re going to work long hours, you need to be able to put some boundaries around that. So that was a difficult lesson to learn.
Tacey Ann Rosolowski, PhD:
Tell me about the lessons you were learning in your graduate program. How did your interests evolve?
Barbara Summers, PhD:
Interestingly, in that very first course in theory, I became very interested in leadership theory, and in particular in Burns’ Theory of Transformational Leadership. And then I became exposed to a nursing theory developed by Jean Watson called Human Caring Theory. And as I read about transformational leadership theory and I read about Human Caring Theory, it was just so clear to me that there were tremendous crosswalk between the key concepts of the two.
Tacey Ann Rosolowski, PhD:
And who was the originator of the Human Caring Theory? I missed the name.
Barbara Summers, PhD:
Dr. Jean Watson, W-a-t-s-o-n. And then transformational leadership is James Macgregor Burns. So it was like I was—
Tacey Ann Rosolowski, PhD:
I’m sorry. What were the crossovers that you saw between these two areas?
Barbara Summers, PhD:
Well, that became my dissertation.
Tacey Ann Rosolowski, PhD:
Oh, okay. Neat.
Barbara Summers, PhD:
I mean, I had just never heard about Watson’s Caring Theory before, so it was like a kid in a candy store, because what she described just resonated deeply in my soul. So, you know, I really got into that, I really enjoyed that and enjoyed exploring more about leadership theory because my doctorate is in healthcare administration. And then in my coursework, in my finance course or courses, taught by CFOs from local hospitals, it was really interesting for me to see at a very macro level the economic approach to healthcare. And then in some of our healthcare administration courses, I had one fabulous faculty member, Dr. Hazel Johnson Brown, and she passed away in the last eighteen months, but she was so tremendously influential for me as a leader. She had been a three-star general in the army and had been responsible for leading all of the nurses in the Army Nurse Corps. She had this beautiful deep voice. She was a very tall African American woman, very distinguished, and no nonsense, no nonsense. Hazel was like the best. And she would teach us these little pearls, and some of her pearls—I pass them along now—are things such as, you know, because they were all women in the class, we didn’t have any men in our class, she’d say, “Ladies, now as you’re executives, you have to remember that you can’t do the job for the people who are working for you. You have to cause them to do their own work.” And she said, “And as I have had conversations with many people over the course of my career, you need to remember if you’re doing someone else’s work for them, you have to have this conversation, and you have to say, ‘Right now it’s taking two of us to do your work. That’s one more than we need, and I’m not talking about myself.’” (Rosolowski laughs.) She was so funny, but very strong, very clear, and incredibly compassionate and very encouraging, you know. We would write our papers for the course, and then she would immediately sit down with us and talk to us and say, “Okay, now you need to submit this for publication, and let’s talk about how you’re going to edit so you can submit it for publication.”
Tacey Ann Rosolowski, PhD:
Wow.
Barbara Summers, PhD:
So I just became very, very energized.
Tacey Ann Rosolowski, PhD:
Mm-hmm. And as you’re talking, I’m just thinking, “Wow. This woman’s experience is so different from mine,” because most of the people you’re mentioning are women. So you were in a field where you had female role models and mentors.
Barbara Summers, PhD:
Mm-hmm, I did.
Tacey Ann Rosolowski, PhD:
And so many of us in other fields had zippo, I mean really none. So that must have been really something. I mean, this is an era where women were really moving through ranks.
Barbara Summers, PhD:
It was. It was. And it was interesting, because these were not like mothering mentors. These were tough-as-nails mentors. So, you know, I moved forward in my doctoral studies and continued working as a clinical nurse specialist, and got to the place where I had passed my comprehensive exams and I was admitted to candidacy, and now all I had left was my dissertation. And I had vowed I would never, ever be an ABD person who had done everything but get their dissertation completed, because I had had too much blood, sweat, and tears. So right about this point in time, I was recruited for a position at the National Institutes of Health within their Clinical Center, working with the Nursing Service in the National Cancer Institute intramural program, which means the clinical services on the NIH campus. So I was brought in to be a research nurse specialist for the ambulatory care nurses in the NCI and the inpatient nurses in the NCI. So there were two inpatient units, two clinics from Radiation Oncology involved, and I was brought in very specifically to develop a cancer nursing research program, and it was perfect for me because I was nearly complete with my doctorate. Being a government employee and being in this position offered me scheduling flexibility, so I was able to work four ten-hour days, and that gave me a three-day weekend every week so that I could travel for my data collection for my dissertation, because I traveled up and down the East Coast interviewing nurse executives and getting some quantitative data from surveys administered to staff.
Tacey Ann Rosolowski, PhD:
You had mentioned that your dissertation focused on that overlap between transformational leadership and Human Caring Theory. Could you just give me a snapshot of what that was?
Barbara Summers, PhD:
I came to have the belief that as nurses change roles, they continue to practice nursing and they continue to use nurse caring interventions, but they shift their focus from the patient client to the organization as the client or the team as a client. And I just saw really good consonance in what Burns said about the way leaders interact with others, with the way Watson described the way nurses interact with others.
Tacey Ann Rosolowski, PhD:
Could you just tell me what does Jean Watson say about how nurses interact with others?
Barbara Summers, PhD:
Well, I think—I mean, she’s got a whole book on it.
Tacey Ann Rosolowski, PhD:
Right. (laughs) I know I’m challenging you here.
Barbara Summers, PhD:
Yeah. She would basically say that when nurses are in caring relationship—not a caring relationship, but in caring relationship—with others, that there is a resonance between what she called the geist or the spirit of the nurse and the spirit of the patient, where they join together in this brief moment where the nurse is able to reflect back to the client, the patient, everything that the patient is manifesting, so that the patient can more clearly see for themselves what’s going on, and they can begin the process of self-healing. And that presupposes that nurses come with a very set of clinical skills, that they know how to do a physical assessment, they know how to appropriately administer medications, they can take care of a wound, but it’s this additional joining of the spirit of the patient and the nurse that produces the healing moment.
Tacey Ann Rosolowski, PhD:
It sounds like a very powerful theory.
Barbara Summers, PhD:
But that so resonates with Burns that, you know, leaders, transformational leaders, join with their followers, they join their hearts and minds together. It’s like, wow, it’s the same thing. So that’s what I did. I interviewed nurse executives and I asked them to talk about their nursing practice as nurse leaders and to give me exemplars of the ways that they used caring as a nursing leader. For example, one of the stories was around a nurse executive who had one of her direct reports, a director, who developed cancer, and she talked about the way that as the nurse executive she worked with her team to care for this colleague who had developed cancer, and that included not only caring for her personally, but caring for her team. So it was just so fascinating to hear people talk about the way that they used caring, but they used it as a leader and as an executive. So I then would take the interviews, have them transcribed, and then I would use content analysis in reading through them, and I initially performed just a latent content analysis to see what emerged from it. Because I had identified my biases and I knew what I was going to be looking for, so I kind of wrote those down, put them aside, and then I just looked to see what would emerge. Then I did an intentional or manifest content analysis first using Watson’s Caring Theory and then second using Burns’ Transformational Leadership Theory to see if there was actually evidence of that in there, and I did find that that was the case.
Tacey Ann Rosolowski, PhD:
Interesting, yeah.
Barbara Summers, PhD:
So I was now at NIH, so maybe that’s where we need to stop, because I think—is time up now?
Tacey Ann Rosolowski, PhD:
We were going to go till three.
Barbara Summers, PhD:
Oh, were we?
Tacey Ann Rosolowski, PhD:
But if you need to do things, that’s—
Barbara Summers, PhD:
No, I’m okay. So I can take us up to the point in time when I came here. How about that?
Recommended Citation
Summers, Barbara PhD and Rosolowski, Tacey A. PhD, "Chapter 9: A PhD Program and a Theory of Nursing and Leadership" (2014). Interview Chapters. 1246.
https://openworks.mdanderson.org/mchv_interviewchapters/1246
Conditions Governing Access
Open
