Chapter 20: Activities as Chief Nursing Officer; Creating a New Academic Department of Nursing; The Future of Nursing at MD Anderson
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Description
Dr. Summers talks about her activities as Chief Nursing Officer (CNO) and Chair of the Department of Nursing, and offers her views on the futures of the Department and Division of Nursing.
She first talks about her appointment to the position of CNO in 2003 and sketches her main activities to develop patient care, the Professional Practice Model, the Clinical Nurse Advancement Program and the Nursing Practice Congress. She ensured that MD Anderson has Ph.D..
Next Dr. Summers explains a legacy she feels she is building faculty hires in a new Department of Nursing to create an academic Department of Nursing equivalent in status to other departments. She observes that the creation of the Department of Nursing was not controversial. She offers her views on the future of the Department of Nursing.
Identifier
SummersB_03_20140429_C20
Publication Date
4-29-2014
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, April 29, 2014
Topics Covered
The Interview Subject's Story - The AdministratorThe Administrator The Leader Building/Transforming the Institution Contributions to MD Anderson MD Anderson in the Future
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:
And since my appointment as the chief nursing officer, I really view my role as carrying on the legacy of excellent chief nursing officers and I’m here to ensure that we are providing our nurses with the support and resources necessary to give excellent care to our patients. So the things that I have endeavored to focus on include taking the Professional Development Model developed under Dr. Crossley’s leadership and convening a group to revisit that Professional Development Model, because it had been in place for probably twelve years, maybe more, and refining it based on our experience. So that now has evolved into the Clinical Nurse Advancement Program, still taking the novice-to-expert concept but applying it very differently and now saying that there are basic role expectations for any professional registered nurse, and along the continuum, there are additional aspects of your professional practice that we expect to see evolving. The Clinical Nurse Advancement Program also put a stake in the ground and stated that every nurse will be required to have professional board certification by the time they have five years of clinical practice experience, which has not been noncontroversial. It has caused quite a little kerfuffle, because we were saying our nurses all have to be board-certified. And we’ve now moved past the kerfuffle and it is now accepted as that is the way it is, nurses have to be board-certified, because we need to be able to demonstrate to our patients and families that we have nursing professionals who are practicing at the highest level, and that is demonstrated by getting your board certification. We also really worked on the Nursing Professional Practice Model, which I just finished explaining to you. We took the nursing governance structure, which when I became chief nurse was something called a council structure, where there were a number of different councils—a Research Council, Education Council, Practice Council—which had been somewhat effective but was limited in its ability to engage the frontline nurses in decision-making in a meaningful way. So there were individuals who volunteered for the councils and they made the decisions, but it wasn’t truly representative of the large body of nurses. So, again, I convened a team and charged them with coming up with a new model for our Nursing Professional Practice, and that team created our Shared Governance Model called Nursing Practice Congress, which it’s been in place six years, I think, now, and is a fairly novel structure in that the Nursing Practice Congress is made up of nurses and interprofessional team members who are elected by their peers to serve. We talked about that.
Tacey Ann Rosolowski, PhD:
You talked about that last time, yeah.
Barbara Summers, PhD:
So that was a significant point of evolution for practice. I’ve also worked to really formalize our nursing workforce and development programs so that we could ensure that we have a pipeline of clinical nurses, advanced practice nurses, and nursing leaders for the future, and that’s been an effort that I have had under way for probably the last eight years, and we continue to refine that. But it’s been very, very successful. We probably have somewhere in the neighborhood of fifty to sixty doctorally prepared nurses in the institution right now, and we continue to have literally hundreds of nurses enrolled in academic graduate programs annually, as well as we’ve done a really nice job of developing and refining our new graduate residency program so that we now hire a hundred to two hundred new graduate nurses every year, put them through a residency program, and that’s been quite beneficial to the nurses and to the organization.
Tacey Ann Rosolowski, PhD:
You had wanted to address the issue of hires, too, faculty hires.
Barbara Summers, PhD:
Mm-hmm. That was really—you know, people tell me, “Well, that will be one of your legacies,” is that we were able to—I don’t want to say “advocate.” How about I was able to build on the professional history of nursing here at MD Anderson and the accomplishments of all the people who preceded me, and leverage a window of opportunity that presented itself to formally create a department, academic Department of Nursing within the organization that is equivalent to the other academic departments, whether it’s an academic Department of Neurosurgery or an academic Department of Psychiatry or an academic Department of Thoracic Cardiovascular Surgery. We have a Department of Nursing.
Tacey Ann Rosolowski, PhD:
Just so I understand the administrative structure, where does the department sit vis-à-vis the division?
Barbara Summers, PhD:
The department resides within the division. Just as the Department of Neurosurgery and the Department of Thoracic Surgery reside within the Division of Surgery, the Department of Nursing resides within Division of Nursing. The key for the establishment of the department academic structure is that that’s the framework necessary to appoint nurses to be members of the faculty at MD Anderson, and our physicians here are all faculty members, and they may have a component of education in their roles because we have fellows or residents here, but were not faculty like you would see in a School of Medicine or a School of Nursing. Yet the nursing faculty here within our Department of Nursing must demonstrate that they are making contributions in the areas of innovation and research, in service to the institution, in education of doctoral students or graduate students, and then in their area practice, whether it’s clinical practice or administrative practice.
Tacey Ann Rosolowski, PhD:
What was your strategy or rationale for fleshing out the hires within the department, this new department?
Barbara Summers, PhD:
Well, really the purpose behind pursuing the establishment of the Department of Nursing is that we were having an increasing number of nurses pursuing doctoral studies here who had a passion for and an interest in becoming nurse scientists and conducting investigation using the same robust scientific method that physicians use, and to be having the same recognition as faculty members that the physicians have. So the establishment of the Department of Nursing allowed us to formally recognize we have doctorally prepared nurses who have the capacity to engage in original science, who can design and conduct their own studies, who do publish professionally, present professionally, who do participate in education and mentoring of doctoral students and graduate-level students, and who demonstrate expertise in their area of practice, whether they’re an advanced practice nurse or a nurse leader in an administrative position. So that’s been really great.
Tacey Ann Rosolowski, PhD:
Was establishing a Department of Nursing controversial?
Barbara Summers, PhD:
You know, interestingly, at the time it was not controversial, and the feedback that I got most often was, “I don’t know why we didn’t do this before.” So as I presented the rationale to the various groups that had to approve the establishment of a new department, I never had anyone say, “Oh, well, this doesn’t make any sense.” I had people say, “Well, why didn’t we do this earlier?” So that tells me that it was time, that people understood that there is legitimacy to the role of a nurse as an investigator in science and that that nurses can, in fact, sit at the table as a faculty member along with other faculty. So we did that, and I think I had my faculty appointment four years ago and started building the department, so I’m the chair of the department and I have the rank of professor, and we have four faculty in our department with some additional positions to fill over the coming years.
Tacey Ann Rosolowski, PhD:
And what was the decision-making process for making those hires? Who are those four faculty members?
Barbara Summers, PhD:
Well, the four faculty members are Dr. Joyce Dains and Dr. Anecita Fadol, F-a-d-o-l, and Dr. Robert Massey. And then I have a position under recruitment right now, so I can’t give you a name for that. But each of them has a different area of focus. Dr. Massey is also a director of clinical nursing, with responsibility for our inpatient surgical units, and his program of research is in the area of postoperative recovery from abdominal surgery and pain management. Dr. Fadol is a nurse practitioner with specialty in cardiology and her area of research focuses on individuals who develop cancer treatment-related heart failure. And Dr. Dains is an advanced practice nurse who practices in cancer prevention, and she’s also the director of our Advanced Practice Nursing Program. Her area of focus and research has been in the development of the advanced practice nurse workforce as well as development of tools to support advanced practice nurses in the community to effectively conduct cancer screening. So the process of getting these individuals appointed to faculty positions is the same as any other faculty position here, which is the application had to be submitted to the Clinical Faculty Review Committee and was reviewed by that committee and had to be approved by that committee. So there were not less stringent requirements for nurses to be appointed faculty members. The requirements are identical for nurses or other physicians or other doctoral clinicians like clinical psychologists. Everybody has to meet the faculty criteria. And I’m actually very pleased. The faculty have done very well. We are at a point where in their appointment they’ve been in their positions for three years, and we are now getting ready to complete their progress review, which occurs midway between the appointment and the six-year appointment they get reappointed. So the purpose of the three-year progress review is to get unbiased feedback from other faculty members that will help us in the continuing development and strengthening of our individual faculty members. And as we’re going through their accomplishments, I’m just very delighted for them, because they’ve done very, very well.
Tacey Ann Rosolowski, PhD:
It sounds like really a key landmark in the Division of Nursing to have that department.
Barbara Summers, PhD:
Absolutely, have that department. It legitimizes the presence of nurses as clinical caregivers, as educators, and as scientists.
Tacey Ann Rosolowski, PhD:
Now, you’ve mentioned the nurse scientist a number of times. Is there more that you’d like to talk about with that particular role? When you said “nurse scientist,” I thought, of course, of physician scientist. Those are two parallel tracks.
Barbara Summers, PhD:
Well, you know, we use the term “physician scientist” here in kind of an unusual thing. We call people a physician scientist if they spend 80 percent of their time in a laboratory doing research and then 20 percent of their time in clinical practice. The term “nurse scientist” is generally used in the profession of nursing to describe doctorally prepared nurses who are engaged in the design and conduct of original research. So it’s not a designation of a percent effort in research. It’s a designation of education, a degree, as well as the capacity to engage in original research.
Tacey Ann Rosolowski, PhD:
Now, what’s your future vision for the department? You’re at the three-year mark now. What do you foresee in terms of an efflorescence?
Barbara Summers, PhD:
Well, I have supported our faculty in submitting numerous grant applications. As the monies from the NIH are shrinking, of course, the application process is far more competitive. So we have successfully competed for some foundation funding, but we have yet to get a big NIH grant. We need to get that done. One of my challenges is that I have multiple roles, and when an individual has multiple roles, it’s entirely possible to be highly competent in many roles, but in my case, my competence as a department chair is limited when it comes to the procurement of grant funding. And that’s not to say that the other department chairs in the organization are superstars in getting NIH funding, because they’re not, but we are such a small department and my area of focus has been in research and administration and as an administrative leader, so I’m not an academician who has great expertise in developing the research portfolio of our faculty. So I have been able to identify mentors for our faculty to help them, but I really want to see us hire a department chair who is not me, and I want us to bring in a department chair who has an established track record of grant funding, who is recognized as an effective nurse scientist and who can come in and take the department, and I will happily hand it to them and say, “Please take this and develop it to the next level.”
Tacey Ann Rosolowski, PhD:
What’s the timeline for getting a new department chair?
Barbara Summers, PhD:
Oh, I don’t know what the timeline is for that, you know. As we had our change in leadership structure, I had had a commitment to move forward to hire a chair, and then financial exigencies presented themselves and there were holds put on recruiting, even for people who had just been recruited into leadership positions and given commitments for packages to hire faculty. They were not allowed to hire faculty. So my desire to bring a chair into my department is not a high priority, although I’m going to surface that again with my executive vice president bosses, the provost and the physician-in-chief. Because I’m very good at what I do, but even I have limitations. (laughs) Even I have limitations, and I feel that if I want to act in the best interest of the department and in the best interest of building the academic capacity of our faculty in our department, I need someone who has more expertise than I have.
Recommended Citation
Summers, Barbara PhD and Rosolowski, Tacey A. PhD, "Chapter 20: Activities as Chief Nursing Officer; Creating a New Academic Department of Nursing; The Future of Nursing at MD Anderson" (2014). Interview Chapters. 1257.
https://openworks.mdanderson.org/mchv_interviewchapters/1257
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