Former Head of HHS Has Nurses in Her Heart

    • October 11, 2010

She's a professor of political science, a former government leader and a university president, a few times over. Yet Donna Shalala—the head of the U.S. Department of Health and Human Services under President Clinton—finds time for yet another of her professional passions: nursing.

Shalala has no formal training as a nurse, but she has become one of the profession’s best friends and strongest advocates.

Shalala’s latest effort on behalf of nursing is her work as chair of the Committee on the Robert Wood Johnson Foundation (RWJF) Initiative on the Future of Nursing, at the Institute of Medicine (IOM). The two-year effort was designed to find solutions to the continuing challenges facing the nursing profession and to build upon nursing-based solutions to improve quality and transform the way Americans receive health care.

The committee organized technical workshops and public forums to discuss key issues that address a range of system changes, including innovative ways to improve health care quality and address the health care workforce shortage that continues to threaten the availability and quality of care in the United States.

On October 5, 2010, the IOM issued a transformational report on the future of nursing that included a set of bold national recommendations and a blueprint for action on nursing, including changes in public and institutional policies at the federal, state and local levels.

Now president of the University of Miami in Florida, Shalala made time in her busy schedule to chair the committee because she saw it as a unique opportunity to explore the profession’s potential to improve care as the nation overhauls its health care system. “For nursing, this report represents an opportunity to take a giant step, not a small step” in improving the quality of care at a critical time in our history, she said. “It’s an idea whose time has come.”

Linda Burnes Bolton, Dr.P.H., M.P.H., M.S.N., vice president for nursing and the chief nursing officer and director of nursing research at Cedars-Sinai Medical Center in Los Angeles, served as the committee’s vice chair. “Linda was critical in educating all of us” about the real-world conditions of nursing, Shalala said. Read a profile of Burns Bolton.

Shalala hopes that the report will encourage health professionals to rethink ways to organize the health care workforce and to join together to improve the system. “I hope it will be… seen as an opportunity to move forward and get over the competition between people in the workforce, and understand that we’re all in this together.”

Born in Cleveland, Shalala earned a bachelor’s degree in history from Western College for Women in Ohio and a doctorate from the Maxwell School of Citizenship and Public Affairs at Syracuse University. After graduating, she became a political science professor and a leading scholar on the political economy of state and local governments.

Nurse Leaders Educated Shalala about Nurses’ Unique Role in Health Care

In 1980, when she became president of Hunter College, the largest college in the City University of New York system, she began to turn her attention to the important—and often overlooked—role that nurses play in the delivery of quality care.

As head of Hunter College, later as chancellor of the University of Wisconsin at Madison, and then as president of the University of Miami in Florida, Shalala learned about the largely untapped potential nurses have to transform health care. All three institutions, she said, have “outstanding nursing schools and exceptional faculty and deans who taught me about the important role nurses—the largest group of health care professionals—play in our health care system.”

Shalala took those lessons to heart when President Clinton asked her to head up the U.S. Department of Health and Human Services (HHS) in 1993. During her tenure there, nurses were appointed to top positions inside and outside of the department, Shalala said. Most notable among them was Shirley Chater, Ph.D., R.N., a nurse executive who headed up the Social Security Administration during Clinton’s first term. Read her profile.

On June 14, 1993, Shalala implemented the National Institutes of Health Revitalization Act, transforming the National Center of Nursing Research into the National Institute of Nursing Research.

“We put nurses on every panel we could to make sure nurses were seen as a senior member of the teams,” Shalala said. “And then we paid attention to education and training, making sure we weren’t making decisions that didn’t involve nursing.”

After a record two full terms as HHS Secretary, Shalala became president of the University of Miami, a position she holds today. And even though she no longer serves in an official health care capacity, she continues to dedicate her time to improving health and health care—with a particular focus on nursing.

A Fellow of the American Academy of Nursing, Shalala recently stepped down as chair of the Advisory Council of the Raise the Voice Campaign, funded by the Robert Wood Johnson Foundation, which is a project of the American Academy of Nursing (AAN). Raise the Voice seeks nurse-led and nurse-designed solutions to health care challenges.

And although her work as chair of the study committee on nursing’s future is coming to an end, Shalala remains committed to improving health care. To do that, she plans to continue to work on behalf of nurses. “I see no way we can improve outcomes in health care without a significant role for nurses,” she says.