Poised for Preeminence A Living Legend 'Quite an Achievement' A Shift in Paradigms People of Note

Nursing School aims for top tier research status year of strategic review and planning for Emory's Robert W. Woodruff Health Sciences Center culminated last December in the approval by the Center's board of directors of a group of initiatives aimed at upgrading Emory's capabilities and facilities in research, education, and clinical care. The School of Nursing will be a key beneficiary, as the approval gives the green light to the construction of a new nursing school building along the Clifton Corridor, a larger space that will allow the school to move forward with plans to increase its research base and establish a doctoral program. The result of this strong internal push for growth in the nursing school, says Dean Dyanne D. Affonso, is to position the school for preeminence in the 21st century. "Our stated goal in the strategic plan is for the Nell Hodgson Woodruff School of Nursing to move in accord with the Woodruff Health Sciences Center in its march to the top tier," she says. "Expanding our curriculum and our physical space will allow us to attract the top-notch students and senior research faculty who will help us achieve that goal. This is a truly exciting time for nursing at Emory." Benchmark studies comparing the School of Nursing to top institutions revealed that Emory ranks low in terms of net square feet of available research space and percentage of senior faculty on staff. Nursing research, however, is in the early stages of development; the NIH developed a nursing research institute only ten years ago, and few nursing doctoral programs have existed for more than 25 years. Still, Emory intends to join this upper tier, says Dean Affonso, and has the financial resources and institutional support to do so. Other components of the strategic plan will address needs in the schools of Medicine and Public Health, as well as The Emory Clinic, Emory Hospitals, and the other various arms of Emory Healthcare. The planning was initiated by Dr. Michael Johns, director of the Health Sciences Center, and is being carried out through the cooperative efforts of the deans and Emory Healthcare executives. Dr. Johns notes the review process identified a core of excellent, highly productive faculty researchers, but at the same time an apparent lack of a critical mass in regard to investigators in several key areas and a shortage of quality laboratory space on campus. The research planning committees made strong recommendations for strengthening Health Sciences Center capabilities in these areas. With plans for the nursing school in place and with the medical and public health schools undertaking a review and strengthening their educational programs, Dr. Johns suggests that health sciences is well positioned to develop new models of cross-disciplinary research, teaching, and other activities. "These are substantial first steps we are taking together in a monumental process to define our leadership role into the next century," he says.

Dr. Michael Johns, director of the Woodruff Health Sciences Center, initiated a strategic plan to stimulate research growth in Emory's schools of public health, medicine, and nursing.

---

Mary Woody receives nursing's most prestigious honor n unwavering belief in the ability of nurses to serve the complex needs of patients gave Mary Woody, MA, FAAN, the courage to carve out pioneering roles for the nursing profession. Her focus on patients was so strong that she never hesitated to advocate for changes that would improve their care. Her respected career as nursing leader, patient advocate, and professional innovator was honored last November, when she accepted her profession's highest honor, the American Academy of Nursing's "Living Legend Award." "Mary Woody is an example of nursing excellence," says School of Nursing Dean Dyanne D. Affonso. "She exemplifies our aspirations in patient care and nursing administration." Woody's nursing career began in the late 1940s when the delivery of health care was on the threshold of tremendous change. She first came to Emory University Hospital and the School of Nursing in 1956, where she was a model administrator, problem-solver, coach, and facilitator. Her leadership led to major patient-care improvements, including patient's education about their medicine and the implementation of the revolutionary principle that every patient admitted shall have an RN responsible for his or her care. In 1968 Woody was named director of nursing at Grady Memorial Hospital, where she worked with physicians and administrators to create innovative programs of care, including a diabetes day care program using nurse practitioners, a nurse-midwifery service, specialized nurse-run clinics, and a patient education program. She was a seminal influence on coronary care and intensive care nursing in the South. As nursing care became more specialized, she was one of the first nurse administrators to seek out advanced practice nurses. Her creativity, her rich encouragement of nurses, and her willingness to take risks allowed her to forge new roles for nurses in the interest of improved patient care. Both Emory and Grady hospitals gained a national profile for their pioneering use of clinical nurse specialists and nurse practitioners during Woody's tenure. In 1973 she was selected as a charter fellow of the American Academy of Nursing. After 23 years in nursing administration at Emory and Grady, Woody became founding dean at Auburn University's School of Nursing, launching the school in a record two years from her appointment to full accreditation. She returned to Emory in 1984 as director of nursing at Emory University Hospital and associate dean of the School of Nursing, establishing additional roles for nurses in transplantation medicine, pain, and incontinence management. In 1992 she served as interim dean of the nursing school. In more than 25 years of national volunteer leadership, Woody helped negotiate understanding among nurses, physicians, and administrators. She continues to advocate for greater authority and autonomy for nurses. "Mary always cuts through to what is right," Eleanor Lambertsen, former dean of nursing at Columbia University, said in a tribute upon Woody's retirement from Emory in 1993. "She doesn't have to think about the 'ethical' thing to do. She doesn't think about what ought to be done. She thinks about what is right for the patient."

Mary Woody has been recognized as one of 50 "Georgia Women Pioneers in Health Care." At a March 10 reception, nurses, midwives, doctors, and other distinguished health care professionals and advocates were honored for their contributions--past and present--to health care, as part of the state's observance of Women's History Month.

---

Young researcher receives two major research awards ssistant Professor of Adult and Elder Health Laura Porter Kimble, RN, PhD, has received two major grants to study patients' perceptions of chronic anginal chest pain. One of those is a $349,000 "First Award" from the National Institutes of Health, National Institute of Nursing Research. The other is a $20,000 grant from the American Heart Association. "Receiving these two grants is quite an achievement for a young researcher," says Sandra Dunbar, RN, DSN, professor of Adult and Elder Health and a co-investigator of the study. Last fall, Kimble and her team began enrolling patients in the NIH study, a five-year project called DAD (Daily Angina Diary), which follows 150 men and 150 women experiencing anginal chest pain. The patients are asked to record daily notes, over a six-month period, about their pain. The study will focus on the multidimensional nature of chest pain, including physical sensations as well as emotional and behavioral responses. More than six million Americans have chronic angina, but little is known about patients' day-to-day experience of living with chest pain, Kimble says. The information gathered could help raise awareness among health care providers, says Dunbar. "Many simply don't understand what the chest pain experience is like for their patients," she says. On August 1, Kimble began enrolling 75 men and 75 women for the one-year American Heart Association study. "I am focusing on people taking sublingual nitroglycerin, whether they take it according to guidelines given them," she says. "It has been suggested that many people do not. The findings will help us know more about how patients make decisions about chest pain symptoms."

Dr. Laura Porter Kimble

---

Dunbar delivers Great Teacher Lecture rofessor of Adult and Elder Health Nursing Sandra Dunbar, RN, DSN, delivered an Emory Great Teacher Lecture last fall, in which she suggested that new technologies call for a shift in health care paradigms. For years, Dunbar has worked with patients who either have experienced sudden cardiac arrest or have been diagnosed with an irregular heart rhythm. As a nurse and researcher, she has observed patients and their families using ICDs (internal cardioverter defibrillators) to treat their ventricular arrhythmias. While some patients adapt well to the lifestyle changes required by ICDs, others seem to self-restrict activity and have significant emotional distress. A team at Emory led by Dunbar and colleagues from five hospitals across the country examined those differences, using a stress and coping model as a framework. Their data showed that patients' coping behaviors and interpretation of the meaning of their illness were the strongest predictors of emotional outcome. The more out of control they felt, and the more they avoided dealing with the illness and its treatment, the greater the negative emotions. The researchers identified the need to reframe disease self-management so that patients are taught how to know what can be controlled and what cannot, to anticipate and manage symptoms, to access information, and to learn coping behaviors. Traditionally, this type of patient education was the role of professional nurses in the hospital setting. But as lengths of stay have decreased, so has access to professional nurses, making it nearly impossible to tell ICD patients and their families all they need to know under such limitations. As managed health care systems evolve and become more sophisticated, Dunbar believes there will be a greater need to foster patient and family self-care and to document emotional and functional outcomes of care. Patient recovery, she says, can be improved in cost-effective ways by integrating the interdisciplinary professional talents available and by targeting those at greatest risk for adverse response to their health care.

Dr. Sandra Dunbar

---

Bavier and Johns join the School of Nursing wo key administrators joined the School of Nursing last spring--Anne R. Bavier, 73MN, special assistant to the dean, and Alan D. Johns, administrator for finance and operations. Since last fall, Bavier also has acted as director of development and alumni relations for the school. Before coming to Emory, Bavier had just completed an appointment as deputy director of the Office of Research on Women's Health, Office of the Director, National Institutes of Health. Prior to that, she created the position of coordinator for women's health at the Agency for Health Care Policy and Research. Bavier first entered the government at the National Cancer Institute, where she created the nursing research extramural programs and was program director for the Community Clinical Oncology Program. She served for eight years as associate professor and coordinator of the oncology specialty at Yale University School of Nursing. Bavier has been recognized with numerous awards: the Sigma Theta Tau International Founder's Award for Creativity; Agency for Health Care Policy and Research Administrators' Award of Excellence for Outstanding Contributions; the Public Health Service Chief Nurse Officer Award; election into the American Academy of Nursing; and, most recently, the NIH Director's Award. She has received the distinguished alumni awards from both Duke University School of Nursing, where she completed her undergraduate work, and Emory's Nell Hodgson Woodruff School of Nursing. Alan Johns had previously served as chief fiscal officer for academic affairs in the Office of the Provost at the University of North Florida. A native Floridian, Johns earned his bachelor of science degree in business administration from the University of Florida and his master's in public administration from the University of North Florida, where he also began doctoral studies. "Joining the Emory community was an easy decision for me," he says. "The faculty, staff, and administration of the nursing school, the Woodruff Health Sciences Center, and the university represent what I believe to be the best in higher education in the nation."

Anne Bavier, special assistant to the Dean, also has responsibilities for fund-raising and alumni relations. Alan Johns, administrator for finance and operations.