Terrance Keenan Nursing Leadership

Lecture: National Student Nurses Association

53rd Annual Convention

Linda Thompson Adams, DrPH, RN, FAAN

Dean and Professor
Oakland University School of Nursing
Rochester, Michigan

Citation: Thompson Adams, L., (March, 2006). Keynotes of Note: Terrance Keenan Nursing
Leadership Lecture: "Pathway to Leadership." Online Journal of Issues in Nursing. Available:
www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/Columns
/KeynotesofNote/TerranceKeenanLecture.aspx

Author Note: This presentation was supported in part by the Robert Wood Johnson Executive
Nurse Fellows – Terrance Keenan Leadership Association

How wonderful it is that nobody need wait a single moment before beginning to improve the
world.
~ Anne Frank

From the beginning, nurses have been at the center of our history supporting
civil rights and women’s rights and caring for those in need -- focusing on the
vulnerable and needy in our society. You, as tomorrow’s leaders, will be
taking the steps to lead the changes in the entire health system. Margaret
Mead said, "Never doubt that a small group of committed citizens can change
the world. Indeed, it is the only thing that ever has" (Wikiquote, n.d., c). And
if there is a group of committed citizens that can make the changes necessary,
I believe they’re in this room right now. That is why I am so excited about the
opportunity to speak with all of you -- tomorrow’s leaders and changers of the
world.

I take pride that I am able to speak to the nurses of the future who are learning how to protect the
health of our nation through high caliber research into killers like heart disease, cancer, stroke,
HIV/AIDS, substance abuse, and violence. I take pride in the fact that you all are caring
professionals reaching out to the poor and to people with limited access to health care. I take
pride in the fact that you all are caring human beings uplifting the lives of others. I tell all my
students to have pride in being a nurse. PRIDE in the Oakland University School of Nursing is a
part of our core values. It means:
P = Professionalism: caring, commitment and service
R = Respect
I = Integrity
D = Diversity: inclusiveness, social and intellectual
E = Excellence: innovation, education, research & practice

You, nurses, are the living messages to a future that I may never see. Thank you for who you are
and what you do. Look around at this group of life changers. Already, you’ve done so much in
the lives of patients and their families: treating someone’s grandmother with the compassion and
respect you would give your own grandmother; ensuring that a father will be around to walk his
daughter down the aisle; implementing procedures and policies in your department to save the
hospital money. You all deserve credit for that and to be appreciated. Now, give yourself a round
of applause. You deserve it! YOU deserve it because YOU are the people who have the power to
be leaders. You have the power to make history.

Changing the World One Step at a Time

I can see that you’re thinking, "I’m not ready to step up and take over the mantle of leadership."
"Lead what?" "I don’t know how to be a leader!" The truth is, no one is ever READY to be a
leader. Triumphant leaders like Harry Truman, Florence Nightingale, Helen Keller and Harriet
Tubman never set out to make history. Even Martin Luther King, Jr. claimed he wasn’t ready. He
never intended to become a controversial leader. He just felt that "someone had to do it." He saw
the need for change and stepped up. He started with one small step (Wolfson & Moynihan,
2003). The stepping stones to success are not planned. You have to seize the opportunity, and
you all have the ability to take the one small step to leadership.

Leaders don’t need a fancy upbringing or to come from wealth. In fact, many great leaders
came from humble beginnings. Earlier this year, we lost one of the greatest leaders in our
history: Pope John Paul. He was born in Poland to an administrative officer in the Polish army
and a schoolteacher, and grew up to become the first non-Italian pope in 455 years. And if that
weren’t enough of an accomplishment, he was credited with Leaders don't need a fancy
freeing his native Poland, which set into effect the collapse of upbringing or to come from
Soviet Communism. He spread a message of peace as he traveled wealth ... many great leaders came
throughout the world. Two years after becoming the new pontiff, from humble beginnings.
his life was threatened in an assassination attempt, which left him with serious wounds. Later, he
publicly forgave the man who tried to take his life. In his later years, Parkinson’s disease
progressed as did crippling knee and hip injuries. But he never gave up his mission. He never
gave up his goal for peace. He wanted to bridge the gap between religions, and he gained the
respect of many people including Muslims and Jews (Christenson, 1999).

A Personal Journey: The First Step

Pope John Paul was not given any tools or magic potion to make the strides he made. He had the
spirit and determination to take the steps needed to get where he wanted to go. Although I’m
certainly not the Pope, I did come up from the bottom. I didn’t have a fancy upbringing or wealth
of any kind. In fact, my life began in the inner-city of Detroit, Michigan where my mother was
on welfare and my oldest sister became a teen mom. My other sister chose to live her life as a
heroin addict and prostitute, and was gunned down in the street and killed. For three years, I
lived in foster care as my mother struggled to get her life together. I watched poverty and
helplessness tear apart my family. It frightened me, but it also motivated me. I knew the life I
DIDN’T want and I turned to education as my way out.

As a high school student, I wanted to be an engineer or a lawyer. But it was the Dean of Wayne
State University’s College of Nursing in Detroit who called and offered me a scholarship. At the
time, no one in my immediate family had ever completed high school. College was never even
considered. I was a poor kid with no money for any kind of college. After reviewing my high
school scores, however, Dean Faville at Wayne State University saw that I had an aptitude for
math and science; she knew I had potential.

It was my former foster mother who said, "Since these people are offering you a scholarship;
why not go to nursing school and after that, you can get whatever kind of degree you want."
Little did I know that nursing was where I would stay! I began to see that nursing was about
more than needles and bedpans. I saw people doing all kinds of jobs. I saw nursing
administrators and mangers, department heads and teachers, researchers and community health
nurses. So after nursing school, I went on to earn my BSN and MSN at Wayne State’s College of
Nursing. Then I completed my masters and doctorate education at the Johns Hopkins University,
Bloomberg School of Public Health. I saw my dream of a career in engineering and law
transformed into a passion for nursing. I have a passion for building community health programs
like engineers build systems and a passion for defending life like lawyers defend our concept of
justice.

People Who Influenced My Steps

During my lifetime, I watched successful men and women. I ... I watched successful men and
women. I watched how they spoke,
watched how they spoke, how they carried themselves, how they how they carried themselves, how
negotiated with colleagues, and what they did to impact society they negotiated with colleagues ...
and make social change. In addition, there were four individuals
who were particularly

The first major influence in my life, I mentioned briefly before, is my foster mother. She also
instilled in me what I describe in my research as the five C’s of healthy children: competence,
confidence, character, connections and compassion.

The next major influence in my life was the Director of Nursing at Henry Ford Hospital in
Michigan who encouraged me to believe in myself. She told me that being born into poverty
didn’t mean I had to stay there. She also taught me to speak up and let my voice be heard. I saw
the sacrifices she experienced to achieve her role as Director which I vowed to emulate.

And I can’t forget Professor Joyce Fitzpatrick at Wayne State. She is still a friend to this day. Dr.
Fitzpatrick was the former Dean of Nursing at Case Western Reserve in Cleveland, Ohio and it
was she who taught me nursing research as well as the importance of precision in my writing.
And finally, I want to mention the chair of my department in graduate school, Don Cornely.
Sadly, he passed away last year. He was the one who gave me the job at Johns Hopkins and
taught me how to write grants and really encouraged me to get involved with the juvenile justice
system.

Here they were--people who broke through the stereotypes to make a difference. I knew that if
they could do it--I could do it.

Discovering Advocacy and Politics

When I went to John Hopkins University in Maryland, I discovered advocacy and politics. This
was my calling. I’d always been interested in helping children; now, here was a way I could
make an impact. While doing my dissertation work in the mid I was both shocked and appalled
1980s, I conducted a study of 8th graders in two rural counties in when [the superintendent] said
Maryland. There was one group of about 30 surveys that I there was nothing that could be
couldn’t analyze from the written responses, so I needed to do done for [these African American
some additional investigation. All 30 surveys were from 15, 16 8th grade boys].
and 17 year old African American males who were still in 8th grade with 13 year olds. I
remember asking the school superintendent what was going to happen to these boys. I was both
shocked and appalled when he said there was nothing that could be done for them. They would
probably end up either in juvenile homes or incarcerated.

It was then that I really discovered the interplay of politics and policy. For most of the last 25
years, I’ve focused on issues related to the health of children and families. I found out how to
make policy work for the good. During my research, I found that that a large number of youth
who were incarcerated were minorities AND, many of those who were incarcerated were
children with mental health disorders.

Fortified with this information, I was then able to help Congress look at this disparity of the
incarcerated. I was able to ensure that the detention facilities were required to give mental health
screenings of every child AND develop separate treatment protocols for boys and girls. Can you
believe they didn’t have that before?

I then became involved politically on mayoral campaigns, governor’s campaigns, and

presidential campaigns. I kept learning more and more, which prepared me for the steps that
came next. I served as the Director of Medicine and Safety for the Mayor of Baltimore and
Secretary for Children, Youth, and Families for the State of Maryland.

As the Director Medicine and Safety, I implemented the first blood borne pathogen standards for
first responders, police officers, EMT, firefighters, etc. as well as ensured the city complied with
the American’s With Disabilities Act. These steps led the governor to appoint me as secretary, a
position where I also could make a difference. I was responsible for getting the first funding for
the Head Start programs in the state by training Head Start workers and parents on the
importance of politics and advocacy. I trained ordinary citizens to lobby, and we were able to get
dedicated funding for services to pre-school children.
I was able to make these changes NOT because I am special or any different than any of you. All
I did was take that first step. And a second step. Then a third step. Each step led me to the next
step. I didn’t have to search. The steps found me. "Changers of the world" don’t know what the
outcome of their steps will be. But you have to begin somewhere. You don’t change the world
with your intentions, but with YOURSELF.

Nurses Have An Essential Role To Play In Health Policy

Nurses have been in the forefront of progressive social movements in the past. I encourage
everyone in this room to continue to play that essential role in American life – especially in the
area of health policy. It is so wonderful that health professionals are learning to save lives in
universities all over the country, but outside those walls, people are dying. The causes are many.
The major killers are cancer, cardiovascular disease, and diabetes as well as handgun violence
and HIV/AIDS.

Outside those beautiful buildings, people just like us are

struggling to survive. Too many of these people – a Let the history of our time say it
was nurses who were among the
disproportionate number – are people of color. They are dying first to hear the call and
within earshot of your university or school. Let the history of our RESPOND.
time say that it was nurses who opened up the windows of
America so that everyone could hear the cries for help. Let the history of our time say that it was
nurses who were among the first to hear the call and RESPOND.

People all over this country would be better off if nurses like you could make our national health
policy. The nurses who work in the central cities and depressed rural areas of America
UNDERSTAND. Where the health of our people is concerned, we have no time to waste. Where
public health is concerned, there is no time to waste.

Here’s how you can do it -- how you can become an advocate of change. Just think as nurses do
– in terms of the human body.

Use Your Mind

You will have to use your mind more than the rest of your body. Believe in yourself. You are
unique in your talents. You were given gifts that no one else has. Find those gifts--those
strengths--and use them.

Strengthen your mind. Be prepared so you can seize the opportunity when it arises. Read, stay
current on events and join professional organizations or political forums. Before Martin Luther
King Jr. ever spoke at a rally or attempted to make social change, he read. He studied the works
of Ghandi and was moved by his solution of non-violent reform. So when it came time for King
to take his step toward leadership, much of his foundation had been laid. He was able to create a
vision; a dream which became a reality through his efforts (Wolfson & Moynihan, 2003).

Use Your Eyes

Create your vision. (Ostrow, n.d.) What is your ultimate goal? It doesn’t matter so much HOW
you get there, but you have to know where you want to end up. Do you want to change a certain
policy? Do you want to help lower the infant mortality rate in your city by creating an education
plan for expectant mothers? Do you want to improve the conditions of patients at your hospital?
Do you want to become a mentor for nursing students? This is what you want to think about: one
of the greatest lessons I’ve learned is to know yourself. Know what you like and what you don’t
like. Your career is so much more than a job; when you’re doing something you love you will
put everything you can into your career.

Use Your Heart

Great leaders have heart. Change seldom is used for selfish Great leaders have heart. Change
reasons---rather it is used for the good of the people. Leaders seldom is used for selfish
have good character. Good character means they are ethical and reasons---rather it is used for the
moral. Leaders are sympathetic to others and take care of the good of the people.
vulnerable. Leaders like Isabella Van Wagener. Here’s her story:

Nursing during the Civil War included little of the medical science taught today. The courage,
dedication and compassion of the nurses however, were the same. Many wounded Union solders
– lying between death and life -- found their way back from the front lines to army hospitals in
Washington DC. A large number of these wounded soldiers could thank two remarkable Black
women for the care they received in 1864. No doubt the soldiers did not realize who these nurses
were or the pivotal roles these two women had played in this nation’s war with itself. I want you
to know who these nurses were because they changed the America in which we live for the
better.

The first was Isabella Van Wagener. Isabella was born a slave in upstate New York. After New
York abolished slavery in 1827, with the help of Quaker friends Isabella waged a court battle
with the help of Quaker friends to recover her small son who had been sold illegally into slavery
in the South. (We should never forget how slavery tore African American families apart.) About
1829, Isabella relocated to New York City with her two youngest children, where she supported
herself through domestic employment for the next 14 years. Then, in 1843, at the age of 46,
Isabella followed an internal spiritual calling to "travel up and down the land."

She sang, preached and debated at camp meetings, in churches and on village streets, exhorting
her listeners to accept the biblical message of God’s goodness and the brotherhood of man. It
was about this time that Isabella Van Wagener adopted the name by which history would
remember her forever ... Sojourner Truth (Internet Modern History Sourcebook, n.d.).

Most of you may be familiar with the strength and force of character this 19th century evangelist
and Civil War army nurse brought to the struggles for civil rights – what she gave to the cause of
African Americans and all American women. These are character traits that we in the African
American community see in our women every day.

Let me share with you what Sojourner Truth said to a man who challenged the natural
capabilities of women during an 1851 Akron, Ohio women’s convention:
"AIN’T I A WOMAN"

Well children, where there is so much racket there must be something out of kilter. I think that
‘twixt the negroes of the South and the women at the North, all talking about rights, the white
men will be in a fix pretty soon. But what’s all this here talking about?

That man over there says that women need to be helped into carriages, and lifted over ditches
and to have the best place everywhere. Nobody ever helps me into carriages or over mud puddles
or gives me any best place! And ain’t I a Woman? Look at me! Look at my arm! I have ploughed
and planted and gathered into barns, and no man could head me! And ain’t I a woman? I could
work as much and eat as much as a man – when I could get it – and bear the lash as well! And
ain’t I a woman? I have born thirteen children, and seen most all sold off to slavery, and when I
cried out with my mother’s grief, none but Jesus heard me! And ain’t I a woman?

Then they talk about this thing in the head; what’s this they call it [member of the audience
whispers, "intellect"]. That’s it honey. What’s that got to do with women’s rights or negroes’
rights? If my cup won’t hold but a pint and yours holds a quart, wouldn’t you be mean not to let
me have my little half measure full?

Then that little man in black there, he says women can’t have as much rights as men, ‘cause
Christ wasn’t a woman! Where did your Christ come from? Where did your Christ come from?
From God and a woman! Man had nothing to do with Him.

If the first woman God ever made was strong enough to turn the world upside down all alone,
these women together ought to be able to turn it back and get I right side up again! And now they
is asking to do it, the men better let them! (Internet Modern History Sourcebook, n.d.)

These are the 1851 words of Sojourner Truth, who 13 years later would be nursing the wounds of
Union soldiers in the Washington, DC army hospitals during the Civil War. They are words that
could have been uttered by almost every nurse (and African American mother) I know today.

If we had nurses who would lay it on the line like this to the It's time for more nurses to
SOJOURN to Washington and tell
United States Congress, we would have a Patient’s Bill of Rights
the TRUTH about what is
and universal health insurance legislation on the President’s desk happening to the American health
ready for his signature within two weeks! It’s time for more system.
nurses to SOJOURN to Washington and tell the TRUTH about
what is happening to the American health care system.

Ok, we’re still using our HEART. Are you with me? When you hit a road block, find strength
in the adversity.

I’m going to use another example from history: Mary Seacole. In the mid 1800’s, she wanted to
be sent as an army nurse to the Crimean war. She went to England to meet with the war office,
but being a poor, African American woman, she was refused even an interview. But she did
NOT back down. She did NOT say, "Oh well, I tried. What can I do?" Instead, she funded her
own trip to Crimea where she set up a mess hall and comfortable quarters for sick and
convalescing officers. She became a hero to these men who referred to her as "Mother Seacole."
When she returned to England, with no money and in poor health, the press praised her and
money was raised for her through the grand military festival. She was awarded the Crimean
Medal, the French Legion of Honor and a Turkish Medal. Despite all the prejudices, she was
able to establish herself as a pioneer in nursing (BBC, n.d.).

And, one more example in history of a nurse who used her heart is Harriet Ross. Harriet was a
younger black nurse who served with Sojourner Truth in the Washington DC hospitals during the
Civil War. Her parents had been brought to Maryland from the Ashanti tribe of West Africa to be
slaves on the Brodas plantation. In 1847, Harriet learned that she would be sold to the South and
escaped the plantation to freedom in Pennsylvania. Harriet Ross – who is best, remembered by
her married name – can you guess? Yes, Harriet Tubman. She became known as the Moses of
her people.

Harriet loved being free. She loved it so much that she wanted to help other slaves to be free. Her
first journey back into the South was to a church near Baltimore where she rescued her sister and
her sister’s two children. During the next years, Harriet Tubman would make at least 15 more
dangerous journeys into the South and lead at least 200 people to freedom.

Capture would have meant death, but Harriet was a master in

planning the strategy of each of her escape operations. She Capture would have meant death,
but Harriet was a master in
missed no detail. She planned for food, clothing, train tickets and planning the strategy of each of
forged passes. She even included sedatives for crying babies. As her escape operations.
a result, she never lost a single passenger on the Underground
Railroad. With the outbreak of the Civil War, Harriet Tubman’s service included nursing, but she
also served as a scout and spy for the Union Army.

Despite all her efforts for the war, Harriet Tubman received no veteran’s benefits of her own.
Rather than being bitter, however, she maintained an interest in the welfare of others throughout
her life. She raised money for schools, former slaves and destitute children even though she was
near destitution herself. She assisted the sick and the disabled. She passed away in 1913 in the
Harriet Tubman Home for Aged and Indigent Colored People that she, herself, had helped
establish (The Harriet Tubman Historical Society, n.d.)

As nurses, we share Harriet Tubman’s compassion and capacity for planning as well as
Sojourner Truth and Mary Seacole’s determination and self-reliance. These women used their
instinct- what their gut told them to do. This brings me to my next point.

Use Your Gut

Deep down, I know that you get a nagging feeling inside when something is not right. That’s part
of being a nurse, but it’s also part of being a leader. Recognize when you get that feeling and
think about what you can do to set it right.

Believe in yourself. Leaders are not fearless, but they believe in themselves and have just enough
strength to move forward. Everyone is afraid of risk--but don’t be afraid to try things that involve
taking a risk. Even the biggest achievers in history had to wrestle with fear. Perhaps we could
learn from Abraham Lincoln who said, "The probability that we may fail in the struggle ought
not to deter us from the support of a cause we believe to be just" (Abraham Lincoln Research
Site, n.d.) Or from Mickey Mouse’s creator, Walt Disney who said, "All our dreams can come
true if we have the courage to pursue them" (Wikiquote, n.d., a). These quotes show that even
the greatest leaders knew fear--just like you and me.

Be optimistic. If you believe you will succeed--you will succeed. Maybe not the way you
thought you would, but you will succeed. Don’t get caught up in what others tell you that you
can or can not do. You have a vision. You have strength. You have your talents. Be optimistic
(Ostrow, n.d.).

Use Your Hands

Reach out for help. You need others to help. You can’t do it alone. Collective action is better
than individual action. Learn how to build and maintain relationships. A lot of opportunities I
enjoyed were through my own efforts, but there were many others that came to me through
people I met along the way. I always asked them a lot of questions, respected their authority, and
looked upon them as mentors. These are the people who remembered my passion and my
potential and recommended me for various positions.

And network – shake a lot of hands. Everyone can be a potential friend. Keep people involved
in life. You may need them for help, advice, and a favor, and they may need you too. Get
involved in professional organizations.

Use Your Feet

Move forward. Take the next step. Again, take risks. Don’t be You have to learn how to negotiate
afraid to try things that involve taking a risk. Christopher with people and manage conflict
Columbus took a risk. Mother Teresa took a risk. You take risks with people who may not think the
every day in your dealing with patients and disease. Risks are same way that you do.
just a part of leadership and are nothing you should fear.

Once you step up and start talking, people will see you. Some might think you are a threat.
That’s ok. Take it as a compliment. They are more afraid of your strength and power than you
should be of what they might say about you. BUT ... have diplomacy. Whatever it is you want to
achieve in the nursing profession, you have to learn diplomacy. You have to learn how to
negotiate with people and manage conflict with people who may not think the same way that you
do. Everyone is not going to like you, but there’s more than one way to get to the same place.

Use Your Mouth

Be an excellent communicator. What you have to say IS important. Whether it is written or

verbal, you need to be able to communicate with others. Communication is one of the clearest
strategies for making healthcare improvements. You have to be able to present a clear picture of
what needs to happen, in order for people to think you are credible and to gain their support. Not
everyone is a born communicator but there are ways to develop that skill. You have to read a lot
and write things down. I take a lot of notes; I’m a collector of thoughts. In communication or any
area where you have a weakness, take an extra class or get someone to coach you.

Think Like An Entrepreneur

This is difficult in light of the history of nursing. Nursing began as a service field over 100 years
ago with nuns and military nurses. Even today, despite the strides that have been made in nurse
leadership, many people are not aware of what nurses do for them.

A nurse in Michigan told a story about a patient she had. As with many nurses, she was
responsible for this man’s plan of action and worked with the
family to create one. She asked many questions about the man’s There is a direct correlation
between a patient living and dying
lifestyle and ended with, if they had any questions, to give her a and the care he received by the
call. The mother of the patient said to her, "You are so good! nurse.
You should be a doctor!" And the nurse asked why. The woman
responded, "Well you took the time to ask all kinds of questions, you worked with us on a plan
for his health, and you gave us your number to call you." And the nurse laughed and said,
"That’s called being a nurse!"

Today, the nurse’s role has changed drastically. There is a direct correlation between a patient
living and dying and the care he received by the nurse. That is a lot of power to wield. In a
January 31, 2005, article in US News and World Report (Levine & Marek, 2005) confirmed what
so many nurses already know. Many of the country’s 2 million nurses are taking on jobs that at
one time only doctors could do. They’re bringing in new ideas and philosophies geared toward
health promotion and case management. The stereotypes of nurses being followers are being
broken every day.

Take the Step

This talk on leadership is named for a leader in philanthropy who particularly saw the
importance of training nurses to be leaders. Terrance Keenan worked for the Robert Johnson
Wood Foundation where he wrote over 950 grants to people who had the passion to start their
own agencies of change and nurse training.

During this time, he not only helped these groups financially, but supported their programs with
his guidance and knowledge. Programs ALL over the country, from San Francisco to Seattle, to
New Jersey--everywhere there was a need, Terrance was there. He helped start groups like
Grandparents who Care, Faith in Action; he supported research that benefited children, programs
that helped mentor adolescents, school-based health centers, training for nurses, chronic disease
management and assistance for families in distress. He believed that families, their neighbors,
and their communities were the building blocks of social change.

Find Your Passion

Ralph Nader said, "I start with the premise that the function of leadership is to produce more
leaders, not more followers" (Wikipedia, n.d.). This is how Terrance Keenan operated. He knew
that he couldn’t single-handedly help a nation of children and their families, but by producing
other great leaders, he could. His first step was recognizing his passion. He was often asked if he
thought his programs would work. He’d just shrug and say, "I don’t know. But we have to try."

The next big change begins with you. Nurses have often been in
the forefront of progressive social change. I encourage you to Why are these people dying in
such large numbers in a country
continue this essential role in American life. Don’t know where with as much wealth as the United
to start? Start with your passion. What drives you? Think of all States?
the reasons people are dying. Cancer, cardiovascular disease,
diabetes, HIV/AIDS. Where the health of our people is concerned, we have no time to waste.

What issue of disparity makes you most angry or energized? Is it the fact that the United States
ranks 24th among industrialized nations in the infant mortality rate? Is it the fact the United
States ranks lower in health status because of limited access to health care by minority
populations?. The fact that SIDS accounts for about 10% of all infant deaths in the first year of
life? Is it that the juvenile detention facilities are filled with poor, misdiagnosed children? Poor
Americans are struggling to gain the same level of health care that other Americans enjoy. The
causes of the health disparities we confront today are complex, but we know the appalling cost in
human lives. People of color in America get sick MORE OFTEN and DIE SOONER than other
Americans. Why are these people dying in such large numbers in a country with as much wealth
as the United States?

Do you see the disparity in your hospital? In your clinic? In your school? In your city? Start
there.

Maureen Tippen’s Passion

Maureen Tippen is a nurse in Michigan who uses her mind, her eyes, her heart, her gut, her
hands, her feet and her mouth. She, like most nurses, is humble and doesn’t think of herself as a
leader. But this past spring she was honored at an awards dinner that we have every year.

This award’s dinner honors eight of Michigan’s top nurses. Maureen was nominated by her peers
because of her work in helping international patients as well as exposing nursing students to
transcultural nursing. She developed an elective course called "International Nursing" which
includes a voluntary mission trip to the Dominican Republic.

When her gut told her to go to the Dominican Republic 10 years ago, she used her own resources
to pay for the trip. She has been going ever since. Students can elect to go on the trip, which will
help them to increase their sensitivity to diverse cultures. In addition, the trip heightens their
awareness of the needs of underserved impoverished populations.

Maureen even arranged to bring a young boy to the United States to have his club feet (or as he
called them, his ‘backward feet’), operated on. She has been able to touch the lives of hundreds
of real people and real families over the years. Did she know 10 years ago that she would create
a legacy? Of course not. She started with one step. She believed in herself. She took care of the
vulnerable. She was prepared. She had a vision. She took a risk. She was optimistic. She was her
own advocate. She communicated well. She networked. She made friends. She got involved.
What’s YOUR passion?

You have what it takes to make a difference -- whether it is to a small group of people or in
major social reform. Don’t let doubt get in the way. What is your passion?

Nurses Have to Step Up

Health care today is in a real crisis. We have untapped insight

into problems and solutions, and the only way we are going to be If we band together as the leaders
we are, there can be no stopping
heard is through advocacy and action. Nurses represent the the greatness that can come.
largest single group of people in health care. If we band together
as the leaders we are, there can be no stopping the greatness that can come.

There is never going to be enough money in health care or in any community to take care of
every problem. So choices have to be made. If you’re not there sharing the best solutions, you’re
missing an opportunity to affect change. Nurses have to become much more engaged and
involved and use their collective voice. Doctors do it; people in other professions do it. And we
need to do it.

I commend the efforts that nurses have made to reach out to the medical communities. We must
continue to reach out to our churches and street corners. Too many people are dying before their
time and too many others no longer experience the quality of life they deserve. I firmly believe
that we can put a stop to this appalling devastation, but it will require our concerted efforts as
well as the efforts of our communities. It’s time for the nursing profession to take an even
stronger position of leadership in implementing that choice.

One of the most famous nurses of all time, Florence Nightingale, said, "Unless we are making
progress in our nursing every year, every month, every week, take my word for it we are not
going back" (Rivett, 1998). So take that step forward to leadership.

THE AUTHOR

Linda S. Thompson Adams, DrPH, RN, FAAN

Linda S. Thompson Adams, DrPH, RN, FAAN, is Dean and Professor of the School of Nursing
at Oakland University. Prior to joining Oakland University she was the Associate Dean for
Policy, Planning & Workforce Development at the University of Maryland School of Nursing
and served concurrently as Director of the Center for Community Partnerships for Children and
Families. Previous to that post, Governor Parris Glendening of Maryland appointed her as
Special Secretary of the Governor’s Office of Children, Youth and Families. She served as
Director of the City of Baltimore’s Office of Occupational Medicine and Safety—a Cabinet-level
position under Mayor Kurt Schmoke. In addition, she has held administrative and teaching
positions at the University of Maryland, The Johns Hopkins University, Coppin State College,
and Hampton University in Virginia.

Dr. Thompson Adams has spent the majority of her career promoting policies and programs to
improve the quality of life of vulnerable populations. Her research on the determinants of risky
behaviors among youth documented the need for collaborative strategies for healthy child
development. Her strategy to create partnerships with academic institutions, government, and
community-based organizations to promote healthy children was designed in her role as Special
Secretary for Children, Youth, and Families. As such, she was the Chief Policy Advisor to the
Governor on all matters related to children and youth, managing an interagency budget of over
$350 million.