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Presidential Inspiration
Jimmy Carter visits nursing students

s a young boy, Jimmy
Carter often ate lunch with the nurses at the local hospital in Plains, Georgia. It seemed only natural to Carter, whose mother, Lillian, was a nurse. “I grew up surrounded by nurses,” Carter told students during a recent town hall meeting at the School of Nursing.
     The town hall was one of a series of special events in observation of the nursing school’s Centennial this year. And it was the first time that Carter had visited the nursing school building on Clifton Road. Before the town hall, Carter toured the facility, including the offices of the Lillian Carter Center for International Nursing, which he
dedicated in 2001. At that time, the school honored him as the
center’s first fellow and named him an honorary
nurse.

       Carter’s visit provided students with a special opportunity to hear and talk with a Nobel laureate and former US president. But for the moment, Carter was first and foremost an honorary nurse as he paid tribute to his mother and described The Carter Center’s work. Founded as part of Emory University more than 20 years ago, The Carter Center promotes peace and improves health worldwide through different programs. Among them is the Ethiopia Public Health Training Initiative, directed by Emory nursing professor Joyce Murray to assist educators in developing curricula to train health workers throughout the country.
     Carter attributed his interest in health and serving vulnerable people to “Miss Lillian,” who became a registered nurse in 1923 and a Peace Corps volunteer in India at age 68. “You can see I get emotional about my mama and what she did. I have no doubt you share the same ideals and values,” Carter told the nursing students after reading a poem he wrote about her nursing experience in India. “It was one of the most glorious experiences of her life.”
     During the town hall, Carter answered students’ questions, all of which touched on some aspect of nursing. “There’s no way a human being can separate those values,” Carter told senior Jordan Bell in response to her question about nursing and spirituality. “I don’t see how we can separate that from our daily life . . . in serving people. I had those same feelings as president—alleviating suffering and pain and providing hope for a better life.”
     The former president also turned his attention to matters closer to home as students quizzed him about what they could do to improve nurse retention in Georgia and amend state law to give prescriptive authority to advanced nurse practitioners. Carter pledged to take their concerns to Georgia Gov. Sonny Perdue.
     Just as important, Carter encouraged students to share their talents by serving abroad in countries like Mali, which shares a partnership with The Carter Center and Emory. The 12 million people who inhabit the African nation live on less than $2 a day, which “leaves nothing for health care, education, self-respect, or hope,” Carter said.
     In addition to acquiring the necessary medical and technical skills, nurses must be willing to bridge the growing chasm between rich and poor. “A nurse [must] have the ability to break down that wall and reach out to people who are different,” he said.

—Pam Auchmutey
     
     


 
  Aiding Georgia's Farm Workers
Grant expands health care for underserved

Georgia’s
migrant farm workers are receiving expanded health care through the School of Nursing’s Farm Worker Family Health Program.
     For the past 10 summers, the program has provided two weeks of intensive health services for the workers and their families, in and around Moultrie, Georgia. The program complements year-round services provided by the Ellenton Rural Health Clinic. Thanks to a $20,000 grant from the Georgia Health Foundation (GHF), students have begun additional visits.
     By expanding the program, students are able “to visit Moultrie at different times throughout the year to hold smaller, specific clinics for workers and their families based on needs identified by the Ellenton Clinic and the results of previous assessments,” says program director Dr. Judith Lupo Wold, 81MN. This spring, two Emory nursing students worked in the Ellenton Clinic. One of their tasks was to educate outreach workers on preventive health information for farm workers and their families. Also, GHF funds have been used to purchase medical equipment to support the expansion.
     The Farm Worker Family Health Program has been a model of collaboration involving community members in Colquitt County and faculty and students from Emory’s School of Nursing, Georgia State University (psychology and physical therapy), Clayton State University and College (dental), Kennesaw State University (nursing), and Darton College (dental).
     Other partners include the Colquitt County Health Department, the Colquitt County Board of Education, the Southern Pine Migrant Education Agency, and farm and packing house owners in the area. Churches and community organizations also take part.

—Amy Comeau
 
     
     
     
  Family, Community, Public Health
Freeman holds new professorship

r. Sarah Freeman will remember this year for a special reason. She began 2005 as the first holder of the Betty Tigner Turner Professorship in Nursing.
     Freeman’s new appointment is definitely apropos, given that she directs the Women’s Health Nurse Practitioner and the Women’s Health/Adult Health Nurse Practitioner programs and teaches as a clinical professor in the Department of Family and Community Health Nursing. The Turner Professorship was established to honor excellence in teaching and care in the areas of family, community, and public health. Turner, a 1953 graduate of the nursing school and former president of the Nurses Alumni Association, practiced as a public health nurse with the DeKalb County Health Department in Georgia and with the Martha Jefferson Hospital in Virginia. Her husband, Dr. John Turner Jr., 52C, 55M, retired director of the Division of Otolaryngology at Emory’s School of Medicine, and her three daughters—including Beth Turner Gibson, 76Ox, 78C, a 1981 nursing graduate—established the endowed professorship in her memory.
     “Betty nurtured the careers of countless nurses and served many patients and families through her high-quality standards of care,” says Dean Marla Salmon. “We are deeply honored to have the Turner family’s support for this important professorship in her memory.”
  
     Freeman, a nurse practitioner for more than 20 years, specializes in teaching women’s health, bioethics, and primary care. Highly regarded for the quality and rigor of her teaching (often spiced with her characteristic humor), she has been instrumental in establishing national accreditation for women’s health advanced practice nursing programs. She is a fellow of the American Academy of Nurse Practitioners and maintains a clinical practice in women’s health and chronic disease management.
     “The health of our nation depends greatly on the health of the community and family,” says Freeman. “It is an honor to be named to this position that recognizes the importance of these concepts. I hope that I may provide the same inspired leadership that Ms. Turner did during her career.”

—Amy Comeau

The School of Nursing also has a scholarship named for Turner. Friends, colleagues, and former classmates created the Betty Tigner Turner Scholarship following her death in 1997.
     
     
  Determinants of Global Health
Nursing alumna presents Davis Lecture


icture this: A mother and baby in Uzbekistan, a young boy in Africa, or an elderly woman in Russia. In each case, different factors affect their health and life span. But precisely what are those factors?
     That is the subject of an ongoing study led by Dr. Sue Hegyvary, 66MN, professor and dean emeritus at the University of Washington School of Nursing. Hegyvary presented her findings to date during the 2005 Hugh P. Davis Lecture on “Understanding and Improving Global Health.” The annual lecture, funded through an endowment established by the family and friends of its namesake, brings nationally recognized nursing leaders to Emory.
     Hegyvary’s study, which evaluated demographic, health, financial, and other data from more than 160 countries, illustrated the challenges in comparing information from a wide variety of sources and provided as many opportunities for new questions as it did answers.
     Hegyvary and her team of researchers at the University of Washington devised an explanatory model showing three types of determinants of health outcomes: resources, empowerment (as measured by level of education, for example), and demography. They then used this model to evaluate health outcomes on a global level.
     Early findings indicate that demographics may affect life expectancy and child mortality more significantly than national resources. The United States, for example, lags behind peer countries in these areas.
     While the group found the typical expected variations in life expectancy and child mortality related to the accessible resources of each country, their greatest surprise, she said, was the “importance of demography, which was even more significant than resources in developing countries.” She noted that demography characterizes human populations in a number of ways, such as size, growth, density, distribution, and birth and death rates. Standard demographics may include age, ethnicity, gender, income, education level, and region.
     Hegyvary’s study resulted from questions that nursing students raised during her class on international health. They wanted to know more than what Hegyvary referred to as the “health olympics”—official listings that rank countries based on life expectancy and other factors.
     When Hegyvary and her colleagues embarked on their research, they used data from the World Bank and United Nations agencies. But using and comparing the data proved to be challenging. As Hegyvary noted, the majority of related studies found in scientific literature are based on a few countries. And the way different countries measure data can vary significantly. For example, the United States measures infant mortality based on live heartbeat, whereas in other countries this is measured based on gestational weight or other factors.
     “This is the data that everybody deals with, and it’s the best available in the world,” she said. But it was stymieing nonetheless. “Each time we looked at it, we saw something different.”
    Hegyvary will soon return to Emory. Shortly after her lecture, the university announced that she will receive one of five honorary degrees presented at commencement in May.

—Pam Auchmutey and Amy Comeau
     
     
 
 
Widening the Net

Robert Hoover joined the School of Nursing
as director of the Office of Admission and Student Services this winter, just as the school was gearing up for its Centennial. In his new role, Hoover works with eight staff members, including admissions advisers Katie Kennedy, Andrea Clark, and Angela Kang. All are working to widen the net of prospective students, based on a marketing strategy that builds on Emory’s name recognition and more clearly identifies sources for scholarships and financial aid.
     “We have great resources of funding available for students, and we need to do a better job of communicating what’s available and how they can access those resources,” says Hoover, who previously worked in admissions at Samford University in Alabama. “It’s a partnership, and we want to help as much as we can.”

 
     
     
     
  The Challenges of War
Spencer trains Kurdish nurses in Northern Iraq


ursing professor Linda Spencer knows what war can do to a community. She saw it firsthand while assessing and training Kurdish nurses in war-torn Iraq. Now, following Iraq’s first democratic election in more than 50 years, the nurses she helped train could play a major role in the development of an Iraqi health system.
     In August 2003, just
after the war in Iraq began, Spencer
joined a program sponsored by the Washington Kurdish
  Institute and traveled to hospitals in three villages northeast of Mosul and Kirkuk. While there, she worked to enhance the clinical practice of the Kurdish nurses and helped them develop a continuing education program.
     Spencer’s team assessed the Kurdish nurses’ situation by asking three basic questions: What are the challenges you face? What are your duties? What new skills do you want to learn? The team found a bright, eager group of caregivers who had little organization and inconsistent training and standards.
     “We discovered that there were no specific standards of care, no nursing leadership organization, and no job descriptions. Nurses’ education varied from a six-month program after sixth grade to a three-year college program,” says Spencer, a clinical associate professor in the Department of Family and Community Health Nursing.
       To address the nurses’ needs and ultimately save lives, program participants like Spencer focused on the basics of care—physical assessment and body systems, hand washing and hygiene, CPR training, the Heimlich maneuver, choking and body mechanics, and preventing decubitus ulcers (bedsores). They combined classroom training with hospital
  practicing skills and role-playing in a collegial and supportive atmosphere that provided the Kurdish nurses with skills and empowerment.
     “These nurses are amazing and inspiring,” says Spencer. “I was humbled to see their dedication and determination in providing care for the Kurds in what many Western nurses would consider very bleak conditions. The nurses each have 35 to 40 patients to take care of at a time, many of whom are burn victims or have birth defects, which are both huge problems in northern Iraq.”
     In addition, families must provide most of the nonmedical patient care in hospitals—bringing blankets and sheets for hospital beds and providing meals.
     Even though it has been nearly two years since Spencer traveled to Iraq, the Washington Kurdish Institute continues to send American nurses to support the Kurdish nurses for up to three months at a time. Spencer continues to help with training by keeping in touch via e-mail.
     
  Correction:
In the Winter 2005 issue of Emory Nursing, a news brief (Big Jump: School Lands in Top 20 for NIH Research, page 5) incorrectly stated that Emory and the University of Alabama at Birmingham were the only two nursing schools in the Southeast to rank in the top 20 for research funding from the National Institutes of Health in 2003. The University of North Carolina (UNC) at Chapel Hill is also in the top 20. UNC ranks third in the nation, followed by UAB (17th) and Emory (18th).
   
   
   
   
   
   
   
 
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