Catherine Gilliss, Helene Fund Health Trust professor of nursing and dean of the School of Nursing, is Duke Medicine’s first vice chancellor for nursing affairs. She graduated with a bachelor’s in nursing from Duke in 1971 and assumed presidency of the American Academy of Nursing last November. The Chronicle’s Shaoli Chaudhuri reports.
The Chronicle: You’re the first Duke alumna in 75 years to be Dean of the School of Nursing. How do you think your experiences with Duke will and have already contributed to your tenure as president of the American Academy of Nursing?
Catherine Gilliss: The reason that I came back to Duke after many, many years is that Duke has a particular governing structure that brings nursing education much closer to nursing service. Since I’ve been here, I’ve been exposed to and have come to understand much better the problems of service delivery than I ever understood before in my various academic appointments.
The Academy’s mission involves using knowledge in service to policy development, for nursing care and health care. And so my experience at Duke, particularly understanding how we deliver care and what our issues are in an academic health center, I think will inform my understanding of the issues that we’ll be advancing at the academy.
TC: You’re certainly making progress in education and research but given the health care debate and the uncertainty of its future, what role do you think you, the academy and Duke will have in its future?
CG: The situation right now is unstable for those who were left-leaning and hoped for more public service for meeting the needs of 45 million uninsured people—that probably won’t happen. But there are still some important issues on the table.
I am at Duke, but... speaking on behalf of the academy, we’re in the process of working on a strategic plan right now, we know that the issues we want to work on—whether the health reform agenda changes or not—involve quality and safety, issues that nurses are very much in a position to control or alter.
We want to work on issues of information technology, meaningful use, making sure that nurses who are managing patient care have the opportunity to participate in designing and improving the systems of data collection and data use that will improve patient care.
And right now we’re also very involved in working to advance the utilization of all nurses at their fullest scope of practice. It’s the case that particular advanced practice nurses, midwives, nurse practitioners, clinical nurse specialists, even sometimes nurse anesthetists are not permitted to use the full set of skills for which they’re licensed and then licensing varies from state to state across the country.
The academy would really like to be able to advance an agenda... that would remove the regulatory barriers across the country, state by state, so we’re working with folks to try to figure out what the right strategy is to be able to do that.
TC: Why did you think it was important to help initiate a nursing Ph.D. program here?
CG: The Duke School of Nursing was, at the time that we launched it, the highest ranking U.S. News & World Report program in the country that didn’t have a Ph.D. program.... We had pretty successful entry-level, lower-level programs but we didn’t have programs to do science in nursing.
Most people can’t even imagine what science is like in nursing or what the questions are that nurses would explore because the public image is portrayed pretty inaccurately on shows like “Scrubs”.... In “ER,” the fabulous Julianna Margulies character who was a very good nurse moves on and goes to [medical] school. It sort of reinforces the sense that if you’re smart enough, you want to be a doctor and not be a nurse.
There’s a lot of intellectual activity in nursing.... We felt at Duke that it was very important, given the interdisciplinary nature of the campus and the pressing questions in the field, that we organize and implement a Ph.D. program so that we could prepare scientists for academic nursing roles.
There’s a very significant shortage of nurses in the country, world-wide actually. This is because there’s a significant shortage of faculty members, and we believe we’re contributing to the preparation—its not a big program—but we’re participating in preparing people to be teachers in nursing and scientists in nursing.
TC: What do you think the future has in store for the nursing profession?
CG: You know, this has been a time of great hope, the last year, because there were assumptions that health care could sort of rationalize team delivery of health care and I still have that hope.
I think where we can document that safe and quality care is still delivered, there should be some task shifting from physicians to advanced practice nurses, from advanced practice nurses to registered nurses and frankly from registered nurses to people who have limited licensure and in some cases have no licensure.
There are models of care that we believe we could help design to implement that would be community-embedded. [They] would reach people that find it hard to travel to get the care they need.... There’s no reason why we shouldn’t be sort of tipping this over and going out to people where they need us and we can do that with less expensive providers.... Many people don’t need a sophisticated level of medical background to meet their basic health needs.
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