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Terrance Keenan Nursing Leadership Lecture: National Student Nurses Association 53rd Annual Convention

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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:

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

Linda Thompson AdamsFrom 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 ... many great leaders came from humble beginnings.

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 freeing his native Poland, which set into effect the collapse of Soviet Communism. He spread a message of peace as he traveled throughout the world. Two years after becoming the new pontiff, 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

... I watched successful men and women. I watched how they spoke, how they carried themselves, how they negotiated with colleagues ...

During my lifetime, I watched successful men and women. I watched how they spoke, how they carried themselves, how they negotiated with colleagues, and what they did to impact society 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

I was both shocked and appalled when [the superintendent] said there was nothing that could be done for [these African American 8th grade boys].
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 1980s, I conducted a study of 8th graders in two rural counties in Maryland. There was one group of about 30 surveys that I couldn’t analyze from the written responses, so I needed to do some additional investigation. All 30 surveys were from 15, 16 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.

Let the history of our time say it was nurses who were among the first to hear the call and RESPOND.

Outside those beautiful buildings, people just like us are struggling to survive. Too many of these people – a disproportionate number – are people of color. They are dying within earshot of your university or school. Let the history of our 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 reasons---rather it is used for the good of the people.

Great leaders have heart. Change seldom is used for selfish reasons---rather it is used for the good of the people. Leaders have good character. Good character means they are ethical and moral. Leaders are sympathetic to others and take care of the 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:


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.

It's time for more nurses to SOJOURN to Washington and tell the TRUTH about what is happening to the American health system.
If we had nurses who would lay it on the line like this to the United States Congress, we would have a Patient’s Bill of Rights and universal health insurance legislation on the President’s desk ready for his signature within two weeks! It’s time for more 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.
Capture would have meant death, but Harriet was a master in planning the strategy of each of her escape operations. She missed no detail. She planned for food, clothing, train tickets and forged passes. She even included sedatives for crying babies. As 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

You have to learn how to negotiate with people and manage conflict with people who may not think the same way that you do.
Move forward. Take the next step. Again, take risks. Don’t be afraid to try things that involve taking a risk. Christopher Columbus took a risk. Mother Teresa took a risk. You take risks every day in your dealing with patients and disease. Risks are 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.

There is a direct correlation between a patient living and dying and the care he received by the nurse.
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 lifestyle and ended with, if they had any questions, to give her a call. The mother of the patient said to her, "You are so good! 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."

Why are these people dying in such large numbers in a country with as much wealth as the United States?
The next big change begins with you. Nurses have often been in the forefront of progressive social change. I encourage you to continue this essential role in American life. Don’t know where to start? Start with your passion. What drives you? Think of all 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

If we band together as the leaders we are, there can be no stopping the greatness that can come.

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 heard is through advocacy and action. Nurses represent the 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.


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.


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© 2006 Online Journal of Issues in Nursing
Article published March 2006