Nurses Leading with Care to Create a Pathway for the Future and Leave a Legacy to Follow
This month we celebrate National Nurses Week (May 6-12) and honor nurses who are paving the way for future leaders.
Teamwork Makes The Dream Work
The impact of Mary’s Center, a Washington, DC- based Community Health Center on its community reflects the leadership and dedication of its staff, which features a robust and effective team of nurse leaders.
Dara Koppelman, Chief Nursing Officer, was drawn to the many nurse leadership opportunities available at Mary’s Center, where she joined in 2012 as a Nurse Manager at a clinic site. As a member of senior leadership, Dara participates in meetings with internal leadership and nursing teams, while contributing to practice guidelines, policy implementation and program development.
“I think people don’t realize all of the awesome things you can do as a community health nurse,” she says. “It is such a dynamic role. I get to be involved in so many different things as a nurse leader in community health. I’m not limited to working with only nurses. I get to help build new sites, create new programs, and inform how operations can work within a clinical setting, among other things.”
Describing the many roles nurses serve at Mary’s Center, Dara shares, “Over the years, as we have grown as an organization, we have been able to expand the nursing team as well. We have phone triage nurses, clinical nurse coordinators, and nurse managers in the health centers. We also have an amazing nursing leadership team of 3 nursing directors who oversee the health centers, nursing programs and education, and care coordination.”
Dara’s colleagues and clients (or participants, as Mary’s Center calls them) bring her the most joy in her role, she says. “It’s such a privilege to work in a place that respects their staff and provides opportunities for growth and development to them, along with increasing access to high-quality care for people who may otherwise find it hard to get any care at all.”
High-quality care delivery is a key component of Mary’s Center’s mission statement and a day-to-day goal for Director of Care Coordination Leah Shoval. Leah joined Mary’s Center to work on the Healthy Start program, a home visiting program supporting families and mothers through pregnancy and the first two years of the child’s life. In her current role, Leah works with the health center’s telemedicine program, which ensures delivery of high-quality care for clients experiencing challenges, such as mobility and transportation costs.
“One of the real beauties of our telemedicine program is that they get the same kind of care from their own providers over the most innovative of platforms that we have in medicine,” she says. “They’re really getting, in a sense, ‘concierge medicine.’ So to support that and provide access to that — and to see that in the numbers, in terms of health outcomes — is pretty spectacular.”
The Healthy Start and telehealth programs are among many of the nurse-led programs and services offered by Mary’s Center. Director of Nursing Education and Programs Ingrid Andersson develops and implements nurse-related programs, and is currently an instructor and advisor to Mary’s Center’s Briya Medical Assistant Training Program.
Ingrid started at Mary’s Center as a Clinical Nurse Coordinator before transitioning into a Nurse Educator. In her current role, Ingrid is able to “be privy to the bigger picture of what we do at Mary’s Center,” while also getting to “provide some direct patient care through telemedicine and triage.” In evaluating the programs and teams she supervises, Ingrid works with the DC Department of Health, the Uniform Data System (UDS) and other external organizations for evaluation measures with program and patient outcomes.
The Social Change Model developed and practiced by Mary’s Center represents an integrated approach to holistic care delivery, and its impact relies on effective community empowerment and collaboration. Siomara Segovia, a nurse manager at Mary’s Center, shares that as a nurse she has always wanted to have a partnership with the clients she serves.
“What drew me to Mary’s Center was the use of the Social Change Model and how we didn’t just look to provide for the medical needs of the patient but also the educational and workforce development needs of the community,” she says. “So as a nurse, I’m grateful to be able to provide care to someone not just in a moment of crisis but over a continuum of time.”
As a nurse manager, Siomara has both clinical and administrative duties. “Typically, my day consists of regularly checking in with staff to ensure everyone is doing okay in their flow, jumping in to help as needed, and seeing patients via nursing visits. As the nurse manager, I also have administrative tasks that I tackle daily such as schedule changes, inventory checks, leadership meetings, and supervision of staff.”
Megan Bailey, also a nurse manager at the health center, adds that she manages “clinical workflow, determining provider assignments, or medication and supply inventory,” while she also “meets with patients who have scheduled nursing visits, responds to rapid responses, and works closely alongside the providers to offer additional nursing support.” For Megan, “working in a Community Health Center allowed me to combine my nursing experience, while using public health measures to positively affect population outcomes.”
Nurse Manager Angelica Centeno shares this passion for public health nursing. She adds, “I think there is a big misconception, especially prevalent in nursing programs, that hospital nursing is the only legitimate way that you can get quality experience. There are so many other spaces that you can practice nursing that are valuable, worthy and as important as hospital nursing.”
For people interested in community health nursing, Angelica shares the following advice: “Do your research and follow your gut. You have to practice a lot of initiative and drive to seek out those opportunities in settings you are interested in, because they may not be as clear.”
NACHC’s Year of the Nurse initiative celebrates nurses in community health centers who “lead with care.” Katie Williams, a home visiting nurse for the Healthy Start program, shares how the nursing profession at Mary’s Center leads with care by serving as a “liaison between the participants and their prescribed care.”
“In home visiting, with Healthy Start, we’ve had the ability to meet people where they are, in a setting where they are comfortable, and ask them, ‘what is your goal?’ ‘What do you want to do?’ You’re really focusing on what the participant’s needs are.”
Katie started at Mary’s Center in 2015 to work in clinic management, and then joined the Home Visiting team, where she visits participating families and provides health education, childhood developmental assessments and referrals for care.
In describing common misconceptions about her role as a community health nurse, Katie shares, “I think that it’s very easy for the public to think that nurses are in the hospital, and they are wearing scrubs and they are delivering medications and changing dressing. But I don’t wear scrubs at work, and I don’t deliver medication, and just to see the opportunity for that knowledge to be applied in a different setting, and also a setting that is more cost-effective, a setting that addresses people where they are.”
The Next Generation of Nurses in Primary Care
As in all areas of nursing, there is increasing demand for community health nurses, particularly in medically underserved and low-income communities. Therefore, it is essential to recruit and secure a primary care workforce that meets the needs of community health centers and their patients.
NACHC asked a second-year graduate student about why she is interested in community health nursing.
“I’m Clare and I am a second-year graduate student pursuing my Master’s in Clinical Nurse Leadership at Georgetown University. I became interested in the nursing profession during my time as an undergraduate at Fordham University, where I majored in Biology and minored in Political Science. I felt particularly drawn to nursing because it seemed to combine my interests in health promotion, public advocacy and policy. During this time, several work experiences as a medical student observer and as a legislative intern helped me better visualize how a career in nursing would allow me to address challenges in health care delivery while helping others live their healthiest and most fulfilling lives.
I’m excited by community and public health nursing for this reason — I can better address system-level barriers and facilitators in improving the lives of communities and individuals. I’m also passionate about the nursing profession serving others in leadership spaces beyond the clinical setting.
Throughout my program of study at Georgetown, my excitement for these nursing opportunities has grown as I’ve been able to work with clients across varying settings in the DC metro region. I’m excited by the work of community health centers in nursing advocacy and policy development, and I look forward to the lasting impact of the Year of the Nurse campaign in promoting connectivity among community health nurses.”
Train the Trainer: Transforming the LGBTQ Culture Outside the Clinic Walls
Cecilia (Cec) Hardacker, MSN, RN, CNL
Director of Education, Research and Advocacy
Howard Brown Health
Cec Hardacker, RN, MSN, CNL is committed to improving the health care system’s ability to provide affirming care to the lesbian, gay, bisexual, transgender and queer (LGBTQ) community. She has worked at Howard Brown Health, an LGBTQ FQHC in Chicago, for nine years, serving as the Director of Education since 2015 and developing a curriculum to teach nurses and other health care workers about LGBTQ elders.
Her Howard Brown Health colleagues say that Cec dramatically benefits their community, their agency, and the nursing profession. Cec responds to the needs of the LGBTQ community by developing educational curricula to address gaps in health care providers’ knowledge and skills. In addition to developing the Health Education About LGBTQ Elders curriculum, Cec was instrumental in developing Howard Brown Health’s Gender Appropriate Language training. This is an interactive training designed to equip healthcare professionals with the skills to communicate respectfully with transgender and gender non-binary patients. Cec and other Howard Brown Health staff developed this training because they recognized that being misgendered – being referred to with the wrong gendered language, including greetings, names, and pronouns – can adversely impact transgender and gender non-binary patients’ health outcomes.
While Cec’s passion is to improve the health and well-being of our community, her work also serves to advance the mission of Howard Brown Health. Howard Brown Health exists to eliminate the disparities in health care experienced by LGBTQ people. Cec understands that this mission can only be fully fulfilled by transforming the culture outside of the clinic’s walls. Cec does this by bringing education to organizations all over the country, with the goal of helping each new organization become safer and more affirming for the LGBTQ community. In her time at Howard Brown Health, Cec has provided education to over 90 agencies in at least 16 different states.
Cec also founded Howard Brown Health’s Midwest LGBTQ Health Symposium, a conference that brings together over 450 researchers, health care and social services professionals to improve the health of LGBTQ people across the life course. Cec is dedicated to improving the field of nursing by making sure that nurses receive the training and education they need to provide affirming care to the LGBTQ community.
As a nurse herself, Cec understands both the key role nurses play in eliminating health disparities and the lack of nursing education on LGBTQ-specific health issues. Cec is working to address this gap by designing LGBTQ health education curricula for nurses and facilitating these trainings in health centers, nursing homes, home health agencies, and nursing schools. Furthermore, Cec disseminates what she has learned about the benefits of providing LGBTQ cultural competency training to nursing professionals by publishing in nursing journals and speaking at nursing conferences.
Cec was the lead editor of Transgender and Gender Non-Conforming Health and Aging, a textbook for health care and research professionals interested in learning how to better support transgender and gender non-conforming individuals as they age.
Her contributions have had a profound impact and have helped hundreds of health care professionals provide better health care for the LGBTQ patients and communities they serve. “I am most satisfied when the professionals at the end of the long day of training tell me they never understood what their patient’s lives were like and now are looking at them with compassion and empathy,” Cec said.
With appreciation to Ray Marie, Kelly Ducheny, Andie Baker and Diane Pascal.
Mother Teresa Meets Rambo
Joanne Cochran, RN, MSN, PhD
Franklin County, PA
Joanne Cochran had a vision. She saw the need for high quality health care for migrant and seasonal farmworkers working in the area and co-founded Keystone Health in Chambersburg, PA, in 1986. What started as a small health center serving around 500 patients is today a thriving health center serving close to 60,000 people across the lifespan and all walks of life, delivers nearly all the babies in the county, is a HRSA Advancing HIT for Quality awardee and is Patient-Centered Medical Home (PCMH) certified. According to Joanne’s colleagues, this is all because of her heart, vision, and leadership.
Joanne’s typical day consists of balancing the day-to-day with leading strategic initiatives. As Joanne puts it, “[nurses] want to do hands on AND change the world.” Joanne does a little bit of everything in her role as CEO: developing staff, hiring and retention, implementing clinical care, maintaining compliance, acting as a main liaison for developing key partners outside the organization, and making sure finances are sound.
What is distinctly unique about her role of CEO is her commitment to be “out there.” Joanne is on many boards, is always trying to develop new processes to improve care and feels that to be a leader at an FQHC, you need to be able to position yourself, communicate well, and provide pertinent services to the community. She and other leaders at Keystone are always looking for new populations to serve.
Joanne started her nursing career in a hospital but was always interested in working with the poor and underserved populations. She started volunteering at a local doctor’s office that provided care to migrant and seasonal farmworkers, which eventually led to the founding of Keystone Health. Joanne credits the longevity of both her career and service at Keystone as “always recruiting people smarter than myself, especially with the business aspects. Without margin, there is no mission”.
Joanne, who has been characterized as a cross between Mother Teresa and Rambo, shared that she often feels more like a mother than a CEO. Joanne leads with care by doing just that—caring. “Nobody cares about how much you know, until they know how much you care,” she said.
This week, Nurses Week, we celebrate all those nurses, like Joanne, who are leading the legacy of service and leaving an indelible impression in their communities.