Leading Adult/Community Educators

Petra responded to group #1 and 3

Petra Davison

Erin Rusher

EDAC 631

February 24, 2014

Leading Adult/Community Educator

Ball State University

            When one says the word Nurse Educator, most people immediately think of Florence Nightingale or Margret Sanger. These two nurses and the work they did are very important within the field of Nursing.  They completed work within the field during a time when nurses were considered to be nothing more than tasks performers.  They paved the way for future women nurse educators and leaders.  Loretta C. Ford and Shirley Sears Chater were women who benefitted from the early work that their predecessors laid as a foundation.  Both Loretta and Shirley were able to obtain advanced degrees and use this knowledge and experiences to benefit not only minority women but also the nursing profession by fighting for the nurses right to be more than just a task performer and a critical partner in the healthcare industry.

Loretta C. Ford

Background

Loretta C. Ford, RN, EdD, PNP, FAAN, FAANP, is an educator is many different aspects. Loretta not only was a public health nurse but also, according to Hobart and William Smith College, ” dean and professor emerita at the University of Rochester Schthe Founding Dean of the University Of Rochester School Of Nursing” (https://www.hws.edu/about/blackwell/ford.aspx).  But perhaps her most important role within the field of nursing was her role in realizing that nurses are not just task performers but as a knowledge worker.  It was because of this knowledge and experience, that Loretta has been credited as the mother of the Nurse Practitioner movement.

Profile

            Some of Loretta’s earliest influences came from teachers.  She was an avid reader and wanted to be a teacher when she was younger.  She was unable to afford the tuition to the teacher’s college but her sister-in-law suggested she consider nursing school.  Although Loretta was not particularly interested in nursing, she was interested in getting an education and enrolled in the nursing program at Middlesex General Hospital in New Brunswick, New Jersey.  This was a much more affordable option and her father borrowed $100 dollars to cover the cost of tuition.  Loretta wasn’t 18 years of age at this point, the minimum age to enter the nursing program.  While waiting for entry, she worked as a nurse’s aide, lived with the nursing students, and read all the nursing books  and so started ahead of her class (Houser & Player, 2004).

            In 1941, Loretta graduated from the nursing program and went to work for a local visiting nurse service.  She was engaged to a Navy pharmacist during this time and in 1942 received notice that her fiancée had died during a WWII battle (Houser & Player, 2004).  Loretta decided that she wanted to contribute to the war in his honor so joined the Army Air Force where she became first lieutenant.  Loretta found the experience to be highly rewarding and was stationed for the majority of her service in Miami, Florida.  This opportunity provided her with a strong sense of discipline and teamwork which served her well throughout her career (Houser & Player, 2004). 

            When her tour of duty was finished in 1946, Loretta took advantage of the GI Bill and went to the University of Colorado at Boulder to pursue a baccalaureate degree in Nursing.   The University of Colorado at Boulder was one of the few schools that offered a certificate in public health nursing at the baccalaureate level.   Although Loretta was not initially interested in nursing, by this time, she realized nursing was her calling and in particular the prevention of illness embodied in the public health model (Houser & Player, 2004).  Between 1946 and when she entered the Masters of Science in nursing (MSN) program at the University of Colorado at Boulder in 1949, she met and married her husband, Bill Ford.  During her time in graduate school, Loretta felt she began to expand intellectually and began to see the nurse as a knowledge worker rather than a performer of tasks (Houser & Player, 2004). 

Perspectives

Loretta spent 12 years as a public health care nurse, supervisor, and director. It was during her time as a public health care nurse that she learned that the health of the residents in some Colorado communities depended upon competent health nurses.  This was due to the fact that there were two kinds of well-child clinics in rural Colorado.  One was a well-child health operation that was physician attended and the other was an intermittent well-child health nursing clinic run by nurses without physicians in attendance (Houser & Player, 2004).  Loretta concluded that it was because of the nurses’ abilities to run these clinics that nurses were under-utilized.  She realized that if they could run clinics, their knowledge, skills, and competencies were logically much broader than was allowed in practice and ideas for how nurses could become integral to healthcare solutions (Houser & Player, 2004). 

            The early 1960s in the United States were a time of political and social unrest.  The Vietnam War was on-going, and the nation’s fabric was being torn by the extensive loss of life and diversion of U.S. dollars to a war that appeared to many to be hopeless.  Poverty was a major social issue and access to healthcare services was a significant concern for many people.  Educational preparation and distribution of physicians were heavily weighted toward specialty care, creating a shortage of generalists who were needed to meet community demands (Houser & Player, 2004).  Since WWII had demonstrated the value of nurses to the world, nurses themselves were seeking autonomy and independence in practice.  Healthcare in America was experiencing a crisis that presented an opportunity to introduce an expanded role for nurses (Houser & Player, 2004).  Loretta was very clear in stating that the nurse practitioner movement was not created to meet a deficit of physician services.  In fact, she stated “There was no reason in the world that I, as a nurse educator, should make up for medical deficiencies.  That is the physician’s responsibility, not nursing’s” (Houser & Player, 2004); however the physician shortage did create an optimal environment for changes in nursing (p. 6). 

            While co-serving on the dean search committee for the school of nursing at the University of Colorado Medical Center in Denver, Loretta and Dr. Henry Kemp began a dialog about advancing the practice of public health nurses for the pediatric population.  Dr. Kemp suggested Loretta contact a pediatrician colleague named Dr. Silver (Houser & Player, 2004). 

Contributions

In 1965, after months of discussion and collaboration, Dr. Silvers and Loretta fashioned the pediatric nurse practitioner model.  According to the National Women’s Hall of Fame, the model combined clinical care research to teach nurses to factor in the social, psychological, environmental, and economic situation of patients when developing café plans (https://www.greatwomen.org/women-of-the-hall/search-the-hall/details/2/243-Ford).  “Silver and Ford integrated the traditional roles of the nurse with advanced medical training and the community outreach mission of a public health official. The Nurse Practitioner would provide care and patient education previously offered only through doctors” (Evitta, 2004).  The model was designed so that the nurse could be extensions of the patient, not physicians.  It was designed as a different kind of service driven by the nursing process from a holistic perspective (Houser & Player, 2004).  Loretta and Dr. Silver surveyed rural public health nurses to determine what they needed to know in order to perform in an advanced practice role.  Nurses were saying that the advanced practice nurse should be clinically competent, capable of practicing independently and autonomously in any setting, and able to work as a partner with physicians (Houser & Player, 2004). The role was initially restricted to public health nurses and was originally named the Public Health Nurse Pediatric Nurse Practitioner but later the name was shortened to Pediatric Nurse Practitioner (PNP) (Houser & Player, 2004). 

            Loretta and Dr. Silver decided to pursue a demonstration project to test the viability of the Pediatric Nurse Practitioner model.  The program was to be taught by physicians and nurses with an intensive four months theory and practice classroom component followed by and eight month supervised practice clinical rotation.  Loretta and Dr. Silver obtained a small grant from the University Of Colorado School Of Medicine to begin the Pediatric Nurse Practitioner project.  They decided to test their model with one nurse (Houser & Player, 2004). 

            Loretta was concerned about creating a curriculum that would meet academic standards in order that the graduates could be credentialed.  Loretta was also adamant that the students who were going to take the risk with the new expanded role not be exploited.  She was going to assure the validity of the education by upholding admission standards, academic requirements, and accreditation criteria (Houser & Player, 2004).  In 1966, the first class of nurse practitioner students included6 students.  Although they all did not have a master’s degree, they were all academically and experientially qualified for graduate school (Houser & Player, 2004).

Impact

            Loretta felt it was her duty to create life-ling knowledge workers rather than technicians.  She believed it was important to create critical thinkers who could determine and solve the problems inherent in providing quality care in the ever changing healthcare system.  This meant teaching students how to learn, how to evaluate, and how to process (Houser & Player, 2004).  As the program grew in popularity, so did the challenges.  The nurse practitioner program went against the grain of the School of Nursing at the University of Colorado.  She struggled to convince her nurse colleagues that the use of stethoscopes, otoscopes, opthalmoscopes, and critical thinking did not erase the nursing perspective (Houser & Player, 2004). 

            Dr. Silver had encouraged Loretta to publish the concepts and findings and within months she was traveling the nation disseminating the nurse practitioner message.  Loretta discovered that the nurse practitioner movement was being embraced by the military, Veterans Administration, and even physicians; however, nurses, nurse faculty, and nursing organizations were slow to even acknowledge the new advanced practice role. It took a long time for nurses in all capacities to accept the role as a nursing role.  It wasn’t until the role was accepted into academics that the nurse practitioners were recognized by many of their nursing colleagues (Houser & Player, 2004).

Implications

            The early years of the nurse practitioner leadership were a difficult period for Loretta.  She was isolated by criticism and uncertainty of how the practitioners would perform long term with expansion.  It would have been easy to give up because the scope of the project seemed daunting and barriers to success seemed plentiful.  Loretta’s defense of the nurse practitioner role were the evidence and data collected that supported the successes of the nurses.  In the first 20 years, there were more than 1,000 publications by a variety of researchers supporting positive nurse practitioner outcomes including the fact that patients love the nurse practitioner model of care (Houser & Player, 2004).

            Thanks in large part to Loretta’s efforts, there are more than 140,000 nurse practitioners working in the United States today. Many can prescribe and diagnose as doctors can, but their nursing background emphasizes health promotion and patient empowerment (Landau, 2011).

Shirley Sears Chater

Background

            Shirley Sears Chater, RN, PhD, FAAN, grew up in a small town in eastern Pennsylvania that was filled with the deeply conservative Amish culture and influences that so often instill strong values and a deep sense of community into those raise there (Houser & Player, 2004).  These strong influences have been Shirley’s guiding light throughout her leadership career.  She was the first woman nurse president at Texas Woman’s University; the first woman assistant vice chancellor at the University of California; and the first woman nurse commissioner of the Social Security Administration for the United States with the responsibility of 62,000 employees.  However, she never lost sight for those simple values of cooperative leadership and respect for others (Houser & Player, 2004).

Profile

            Shirley was born in 1932 and at an early age demonstrated the leadership traits typical of a firstborn child, such as being the first to respond, the first to step forward, and the one who set the standards for the siblings.  Her father was a blue-collar worker, and her mother was a homemaker.  Neither parent had more than an eight­-grade education; however, they were very supportive of Shirley’s aspirations (Houser & Player, 2004).

            Shirley received a full scholarship from the University Of Pennsylvania Hospital School Of Nursing.  Shirley did not struggle to succeed in the three year diploma program.  In fact, she earned the Florence Nightingale award.  Upon graduation, Shirley was offered a full time teaching position that enabled her to complete a Bachelor of Science in Nursing at the University of Pennsylvania.  Upon finishing the baccalaureate degree, she applied to and was accepted by the American Nurse Association to participate in an international exchange program.  She chose to go to London, England for one year, with all expenses paid (Houser & Player, 2004). 

            Shirley came back to the United States and worked for a couple of years as a faculty member in order to earn enough money to get a master’s degree.  She applied to the University of California at San Francisco where they were developing a department of social and behavioral sciences program and this coincided with her interest (Houser & Player, 2004).  She completed her master’s degree and within a short amount of time, started a doctoral degree.  In 1964, she was the 64^th nurse in the United States with a doctoral degree after which she accepted an assistant professor position at UCSF’s School of Nursing (Houser & Player, 2004). 

            Shirley’s administrative leadership opportunities at UCSF campus were numerous as she rose from assistant professor within the School of Nursing to assistant vice chancellor.  Shirley was nominated by her peers for the vice chancellor position when the position became available.  Shirley withdrew her nomination when she learned she was a final candidate.  She believed that it was not likely she would be chosen since the campus has had never had anyone in the chancellor position other than a physician since the 1800s (Houser & Player, 2004).

            The new chancellor asked Shirley to remain in her position, but she declined and took advantage of the sabbatical leave she had never used.  She took her sabbatical in Washington, D. C to work with the American Council on Education (ACE).  She wanted to expand her view of higher education in general and examine other institutions of learning.  In the past, she has been on several ACE commissions, so she was eagerly accepted.  Not only did she have one year working in Washington, D.C. but she extended her leave of absence from the university in order to serve another year with the council (Houser & Player, 2004). 

            It was during her second year in Washington, D.C. when Shirley learned she was nominated for the presidency of Texas Woman’s University (TWU).  Shirley was the eighth president of TWU, from 1986-1993 (https://www.twu.edu/downloads/library/77-86.pdf).  Shirley enjoyed her time at TWU so much that she would probably still be there for the remainder of her career had she not received a call to interview in Washington, D.C. for the position of commissioner for the Social Security Administration.  Shirley had been recommended for the position by several individuals that new of her leadership abilities.  Shirley made it clear that she had no in depth knowledge of social security, but the administration was seeking leadership. In 1993, she became commissioner of the Social Security Administration (Houser & Player, 2004). 

Perspectives

            Even though Shirley’s family was not Amish, she loved the close-knit Amish community where she grew up and where she worshipped.  Her aspirations, however, were not for settling down in her hometown.  She knew that someday she wanted to leave and experience the rest of the world. This desire became pressing after her family attended a Mennonite worship service when she was very young.  At this worship service women were segregated from the men, with the women on one side of the church and the men on the other side.  Not only was she upset that the family could not sit together, but the purpose for the segregation did not make sense to her. Perhaps the roots of her sense of injustice were fed there and aspects of her career would be dedicated to serving women and minorities (Houser & Player, 2004).

Contributions

            Shirley envisioned opportunities for expansion and growth at TWU, and accomplished this through a number of new start-up programs.  Increasing diversity on campus was an important area of focus. “We worked very hard to put into place not just a recruitment process that would bring minority women to the campus, but we also worked hard to create a climate for success on the campus” (Houser & Player, 2004, p.33).  Shirley selected a strong team who put several programs in place to honor different ethnic groups.  For instance, TWU institute tutorial system, whereby students had extra faculty attention if needed.  Pre-registration was done before students arrived on campus to allow for a smooth transition back to campus, and university-wide programs were offered to include both students and their families (https://www.twu.edu/downloads/library/77-86.pdf).

            In addition, young girls were encouraged to become interested in math and science through the use of summer camps sponsored by TWU.  Another program enabled single mothers to bring their children to live on campus for four to five years; while the mothers worked part-time jobs and held scholarships through school, the campus became the home for them and their children. 

Impact

            The single mothers’ program became so popular that even today there is a waiting list. De Madras De Madras, from mother to mother, is another thriving program that Shirley is most proud of.  This program was offered through the School of Nursing Houston Center.  It enabled pregnant Hispanic women to receive prenatal care from other Hispanic women who had gone through an educational program supervised by the School of Nursing.  Eventually, this program grew to be so large a separate house was purchased and its own board of directors was formed (Houser & Player, 2004).  

Implications

            Because of Shirley’s early exposure to gender inequalities, she took that experience and used it to the advantage of minorities and women within the educational system.  She helped develop programs that have become so popular that they have lasted even past her presidency at TWU and have benefitted hundreds of minority and women students.  Even with all the leadership opportunities and degrees Shirley has had during her lifetime, being an educator has been one of her most precious.  “Being president of a very special university was the highlight of my career” (Houser & Player, 2004, p. 33).

Summary of Leading Adult Educators: Loretta C. Ford and Shirley Sears Chater

Educator	Loretta C. Ford	Shirley Sears Chater
Time Period	1949 to Present	1932 to Present
Background	Public Health Nurse Nurse Practitioner Model Co-founder Professor	Nurse First nurse president at Texas Woman’s University; the first woman assistant vice chancellor at the University of California; and the first woman nurse commissioner of the Social Security Administration for the United States
Profile	Wanted to be a teacher but couldn’t afford the tuition. Went into a nursing program, which was more affordable. After WWII, she went to University of Colorado at Boulder and earned her BSN and graduate degrees.  Began working in Public Health	RN PhD FAAN Assistant Professor Assistant Vice Chancellor ACE council member President of TWU SSA Commissioner
Perspectives	Well-being children clinics in rural Colorado was run without physicians present gave rise to Loretta realizing that nurses are knowledge workers and not performers of tasks	Injustices for minorities and women
Contributions	C0-founded the nurse practitioner model with Dr. Silver	Bringing minority women to campus Climate for success Tutorial system Pre-registration University wide program offered to student and families Living/job/scholarship opportunity for women and family De Madres De Madres program
Impact	Published data and findings and nurse practitioner model gained acceptance but slowly	Programs that have been so popular and successful that they are still in existence today
Implications	More than 140,000 nurse practitioners work in the US today	Provided opportunities for minority women to be successful with educational pursuits and these still exist today

References

Evitts, E., (2004). RX: Nurse Practitioners. John Hopkins Nursing Magazine, Spring 2004. Retrieved February 17, 2014, from http://magazine.nursing.jhu.edu/2011/08/rx-nurse-practitioners/

Landau, E. (2011, October 1). Nurse Practitioners were “Lone Rangers”, founder says. CNN. Retrieved February 17, 2017 from http://www.cnn.com/2011/09/30/health/living-well/loretta-ford-nurse-practitioner/

Houser, B., & Player, K. (2004) Pivotal Moments in Nursing. Indianapolis, IN: Sigma Theta Tau International.