Author Archives: Susan Hassmiller

The Man in the Red Cross Blanket

May 17, 2017, 9:00 AM, Posted by Susan Hassmiller

In this personal essay, Sue Hassmiller shares how an ICU nurse helped her face the most difficult milestone of her life—and discover a deeper meaning of a Culture of Health.

Editor’s note: In September 2016, Bob Hassmiller, beloved husband of our own Sue Hassmiller, our senior adviser for nursing, was involved in a bicycle accident that left him critically injured and ultimately took his life. We asked Sue to share her story—and she very graciously agreed—because we believe that a Culture of Health is possible even when people are at their very sickest. She tells us how.

My life is separated into two time periods: Before my husband’s accident—and after.

Bob and I were married for 37 years, and he was, in every aspect, my best friend. While I traveled frequently for work—work I am very passionate about—Bob was the person I came home to, my bedrock, my backstop and my biggest fan. We knew each other as only two married people who have been together for so long can. And we relied on each other for our very different strengths.

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Why School Nurses Are the Ticket to Healthier Communities

May 11, 2016, 9:37 AM, Posted by Susan Hassmiller

A visit to Mt. Pleasant High School in Wilmington, Delaware, highlights the critical role that school nurses play in fostering healthier kids and communities.

Robin Wallin, DNP, RN, first became concerned about the unmet dental needs of children attending the Alexandria City Public Schools in 2000 when one of the school nurses she supervised participated in a multidisciplinary evaluation for a kindergarten boy named José who could not sit still in class.

Upon examining his mouth, the nurse discovered gaping black holes where teeth should have been. She helped find an oral surgeon willing to treat José—who came from a low-income family without health insurance—free of charge. As it turned out, once José’s teeth were treated he no longer struggled with sitting still in class.

This experience led Wallin—who was then the Health Services Coordinator for the Alexandria City Public Schools in Alexandria, Virginia, and now serves as the director of health services at Parkway Schools in the Greater St. Louis area—to wonder if other kids like José struggled with school due to underlying oral health problems.

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Expanding Opportunities for Rural Communities to Get Quality Care

Jun 9, 2015, 4:58 PM, Posted by Susan Hassmiller

Initiatives like the Future of Nursing and Project ECHO are expanding opportunities for more communities to get quality health care and lead healthier lives regardless of ZIP code.

I read recently in The New York Times about Murlene Osburn, a cattle rancher and psychiatric nurse, who will finally be able to start seeing patients now that Nebraska has passed legislation enabling advanced practice nurses to practice without a doctor’s oversight.

Osburn earned her graduate degree to become a psychiatric nurse after becoming convinced of the need in her rural community, but she found it impossible to practice. That’s because a state law requiring advanced practice nurses to have a doctor’s approval before they performed tasks—tasks they were certified to do. The closest psychiatrist was seven hours away by car (thus the need for a psychiatric nurse), and he wanted to charge her $500 a month. She got discouraged and set aside her dream of helping her community.

I lived in Nebraska for seven years, and I know firsthand that many rural communities lack adequate health services. As a public health nurse supervisor responsible for the entire state, I regularly traveled to small, isolated communities. Some of these communities did not have a physician or dentist, let alone a psychiatric nurse. People are forced to drive long distances to attain care, and they often delay necessary medical treatment as a result—putting them at risk of becoming even sicker, with more complex medical conditions.

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Calling All Nurses to Address Health Disparities

Jan 16, 2015, 10:11 AM, Posted by Susan Hassmiller

I spent the 2014 holiday season reading a book by Sarah Wildman called Paper Love. She describes how she, as a journalist, examined the fate of her Jewish predecessors, including her grandfather and his long lost love. I selected the book because my father was a Jew of Polish descent.

Wildman describes the horrific atrocities bestowed upon the Jews. Of course I knew of the Holocaust growing up, but as I get older, the connections between past and present seem to be more important. While I don’t know of any relative who was personally affected or killed, someone in my extended family very likely was. I pondered my own existence and how it may have depended on a relative escaping Europe and immigrating to the United States to escape the death camps. It is unspeakable how one man’s view of what is mainstream or normal sent so many others to their death.

I am not naive enough to believe that prejudice is a curse of the past. Stark data on health disparities continue to mount. The Centers for Disease Control and Prevention report on Health Disparities and Inequalities (2013) found that mortality rates from chronic illness, premature births, suicide, auto accidents, and drugs were all higher for certain minority populations.

But I believe passionately that nurses and other health professionals can be part of the solution to addressing these disparities. Nurses are privileged to enter into the lives of others in a very intimate way, and that means lives that are, more often than not, very different than our own.

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The Top Five Issues for Nursing in 2015

Dec 3, 2014, 9:00 AM, Posted by Susan Hassmiller

Susan B. Hassmiller, PhD, RN, FAAN, directs the Future of Nursing: Campaign for Actionwhich is implementing recommendations from that report. Hassmiller also is senior adviser for nursing for the Robert Wood Johnson Foundation.

In 2013, the Institute of Medicine released a report, U.S. Health in International Perspective: Shorter Lives, Poorer Health, that compared the United States with 16 other affluent nations. The United States ranked last or near last on nine key indicators:  infant mortality and low birth weight; injuries and homicides; teenage pregnancies and sexually transmitted infections; prevalence of HIV and AIDS; drug-related deaths; obesity and diabetes; heart disease; chronic lung disease; and disability. This is despite the fact that we spend significantly more on health care than any other nation.

I believe there are five ways nurses can contribute to improving these conditions in 2015. 

Nurses Can Help Us Build a Culture of Health

In a Culture of Health, the goal is to keep everyone as healthy as possible.  That means promoting health is as important as treating illness. Unless everyone in the country joins this effort, we will remain at the bottom of the list of healthiest nations. “Everyone” means all health care workers, business owners, urban planners, teachers, farmers and others, including consumers themselves.  Nurses especially understand wellness and prevention, and have a special role to play in building a Culture of Health. 

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Celebrating Four Years of Nurses Leading Change to Advance Health

Oct 6, 2014, 9:00 AM, Posted by Susan Hassmiller

Susan B. Hassmiller, PhD, RN, FAAN, directs the Future of Nursing: Campaign for Action, which is implementing recommendations from that report. Hassmiller also is senior adviser for nursing for the Robert Wood Johnson Foundation.

This week marks the fourth anniversary of The Future of Nursing: Leading Change, Advancing Health, the landmark Institute of Medicine (IOM) report that galvanized the nursing field and partners to participate in health system transformation. Nurses nationwide are heeding the report’s call to prepare for leadership roles at the national, state and community levels. Why?  Simply put, nurses coordinate and provide care across every setting, and they can represent the voices of patients, their families and communities. Nurses are the reality check on committees and in boardrooms.

The Future of Nursing: Campaign for Action, a national initiative led by the Robert Wood Johnson Foundation (RWJF) and AARP to implement recommendations from the future of nursing report, is promoting nursing leadership—and I’m thrilled by our progress.

To date, Action Coalitions report that 268 nurses have been appointed to boards. Virginia has implemented an innovative program to recognize outstanding nurse leaders under age 40, and several other states including Arkansas, Nebraska and Tennessee are offering similar programs. New Jersey has set a goal of placing a nurse leader on every hospital board. Texas has partnered with the Texas Healthcare Trustees to provide its nurses with governance and leadership education to prepare them for board leadership. Even better, other states are fostering nursing leadership by adopting these best practices.

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Bringing the Caring Touch to Leadership Tables

May 9, 2014, 12:00 PM, Posted by Susan Hassmiller

I flew to Florida years ago to be with my father at the end of his life. He lay in a hospital bed, at times conscious of the family members gathered at his side and other times unaware of his loved ones surrounding him. I watched a nurse I didn’t know lean over and kiss his forehead.

At another hospital bed years later, I watched a nurse comfort my daughter as she labored to bring my first granddaughter into the world. “You’ll be okay,” she whispered to my daughter, giving her a hug.

The end of life and the beginning of life, marked by a compassionate nurse keeping vigil and offering comfort.  In the midst of machines, a nurse provides a human touch and caring to patients and their family members.

The essence of caring is what first attracted me to the nursing profession. Now, more than 35 years later, the essence of caring still propels me in my work as the director of the Future of Nursing: Campaign for Action, a joint initiative of RWJF and AARP to transform health through nursing. One of the Campaign’s major focus areas is promoting nursing leadership. 

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Developing New Partners: The Future of Nursing Scholars Program

Mar 31, 2014, 9:43 AM, Posted by Susan Hassmiller

Susan B. Hassmiller, PhD, RN, FAAN, is co-director of the Future of Nursing Scholars Program and senior adviser for nursing for the Robert Wood Johnson Foundation (RWJF). The Future of Nursing Scholars program’s call for proposals will close on April 15. It is open to schools of nursing with research-focused PhD programs. The schools that receive awards will select the scholars to support.

I started my nursing career at a community college. It was a terrific experience that left me as prepared as I could be for my beginning staff nurse role. I quickly discovered that I wanted and needed to know more, however, so I returned to school. Over the next several years, I earned a PhD in nursing administration and health policy. It was difficult but incredibly rewarding and has led to a career I could never have imagined when I started out, including serving as a faculty member at the University of Nebraska and George Mason University. That experience has made me want to “pay it forward”—to pay homage to the nurses who mentored and encouraged me on my journey.

Serving as co-director of the Future of Nursing Scholars program is part of my personal mission to help other nurses who want to follow the same path. It also is a big part of RWJF’s extraordinary, long-term support for the nursing profession, which advances the Foundation’s mission to improve health and health care, and build a culture of health in this country.   

Supporting nurses seeking PhD degrees is tremendously important. Because nurses have vast experience working directly with patients and families, we are positioned to help make care safer, more accessible, and higher quality. In particular, PhD-prepared nurse scientists and researchers are in a unique position to identify solutions that make a real difference to patients and families. But, as the Institute of Medicine (IOM) noted in its landmark report, The Future of Nursing: Leading Change, Advancing Health, the country will need many more PhD-prepared nurses in coming years.

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Leading in a Collaborative Environment: A Top 10 List for Getting There

Oct 14, 2013, 9:00 AM, Posted by Susan Hassmiller

Susan B. Hassmiller, PhD, RN, FAAN, is senior adviser for nursing at the Robert Wood Johnson Foundation, and director of the Future of Nursing: Campaign for Action. Three years ago, the Institute of Medicine issued Future of Nursing: Leading Change, Advancing Health, which supports “efforts to cultivate and promote leaders within the nursing profession—from the front lines of care to the boardroom.” The goal, the report says, is that nurses be full partners, with physicians and other health professionals, in redesigning health care in the United States.

The only way to achieve a healthier future for everyone in this country is to work collaboratively toward that goal. Leading in a collaborative environment takes very special skills. To find effective leaders, we must consider the skills, talents, and experience of everyone who aspires to leadership, regardless of their profession.

In fact, there is no evidence pointing to a single profession as having all requisite leadership skills to get our population to a healthier state. It is truly about the skills, talents, and experience of the whole team, and everyone on the team should be considered a potential leader.

The Institute of Medicine (IOM) report, The Future of Nursing: Leading Change, Advancing Health states that all professions should be equal partners in leading health and health care efforts in this country to assure access, affordability, quality, and a healthier future for all. The IOM committee members who shaped that report made extremely thoughtful recommendations on leadership.

Below, I add my own take, based on experience, about what it takes to lead in a collaborative environment.

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Bold Solutions, Not Tired Turf Battles

Jul 1, 2013, 9:19 AM, Posted by Susan Hassmiller

On Thursday, New York Times blogger Pauline Chen, MD, took a fresh look at the disagreements over the services that advanced practice registered nurses should be authorized to provide, reporting on a primary care meeting at which a doctor dared to raise “the unmentionable” topic with his colleagues. The room, she reports, erupted into discord and chaos.

The same divide was documented in a survey reported by the New England Journal of Medicine in May.  It is a terrible shame.  What we need, now more than ever, is open and reasoned conversation within and between health care fields about the best way to provide high quality care and improve our population’s health.

These are challenging times for our health care system. Millions of Americans are about to gain insurance through the Affordable Care Act. Our population is getting older and living with more chronic illnesses. And we have an urgent need to promote prevention, improve quality, and contain costs.

There is no question that we need more physicians and more primary care physicians in particular. There is no question that physicians should treat the sickest patients and those with the most complex health problems.  But there also is no question that we need nurse practitioners to be able to practice to the full extent of their education and training.

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