News

Alumnus Spotlight: Major Pedro Oblea, PhD, RN

Feb. 14, 2018
Jason Gelt

US Army Nurse Scientist and UA College of Nursing Alumnus Receives Funding to Study LGBTQ Military Service Member Experience

An active duty military officer for nearly 15 years, Major Pedro Oblea, PhD, RN, completed his PhD at the UA College of Nursing in December 2014. A nurse scientist keenly interested in the domestic situations of active duty service members, his dissertation examined the effects of short-term separation on the behavioral health of military wives. His research into issues like depression, stress, social support, and marital relationships led to his latest study, Exploring LGBTQ Military Service Members Stressors and Lived Experiences. Thanks to a two-year $200,000 grant from TriService Nursing Research Program (TSNRP), he and his team are about to embark on a groundbreaking investigation into the experiences and challenges impacting the health and readiness of Lesbian, Gay, Bisexual, Transgender, Queer (LGBTQ) military service members.

What is the main question of your investigation?

My overall goal is to understand lived experiences, associated stressors and social support impacting the health and readiness of the LGBTQ military service members. Initially, I intended to examine the lived experiences and stressors of same-sex couples in the military. But since that population is relatively small, I decided to broaden the study to include the experiences and stress factors faced by the LGBTQ military community.

What makes this study particularly unique?

There are a lot of studies about the difficulty the LGBTQ in the civilian population has in accessing health care, but this is the first study of its kind with the military. Data was hard to access until the repeal of Don’t Ask, Don’t Tell in 2011. With the military recognizing LGBTQ and same-sex couples, for the first time, it was an opportunity to register as couples for our healthcare insurance. Before Don’t Ask Don’t Tell, same-sex couples weren’t part of the conversation. Now, the partner actually gets a dependent military ID. It’s a big deal that they can access healthcare.

How will this project build better futures?

My hope is that this study will be the basis for the future creation of military health care policy to take care of LGBTQ in the military. The results will guide or help the military policymakers to improve health care policies that will affect the LGBTQ population because the LGBTQ population has special needs. Based on the literature, they often suffer from stigma. They don’t want to access help. They’ve been subjected to prejudicial treatment, and often have a lot of stress and emotional problems from when they were coming out. This study might impact the degree of stress this population faces in the future.

Jason S Gelt
jasongelt@email.arizona.edu
520-626-2742

Student Spotlight: Richard Coenen

Feb. 1, 2018
Jason Gelt

Fourth-year Masters of Science for Entry to the Profession of Nursing (MEPN), from Tucson, AZ

Why did you decide to pursue a nursing degree?

As a former United States Marine and Police Officer, I have always had a passion to serve and help others. I was discouraged with police work because I felt it was a very reactive approach to helping the community. For me, nursing is an opportunity to make a difference in the lives of patients through education and actively involving them in the plan of care. This career not only allows me to help others in a tertiary care setting, but I can be involved in implementing primary prevention strategies through health promotion. Nursing is a profession that deals with people and requires true compassion. I am passionate about working with patients and helping them navigate through their complex healthcare needs.

What drew you to the UA College of Nursing?

As a former graduate from the University of Arizona, Eller Business College with a bachelor’s degree in Public Administration, I have always been a Wildcat at heart. I love the UA because of its dynamic and innovative teaching strategies with a research focus. Specifically, when I researched the UA College of Nursing I knew it was where I wanted to be. The Master of Entry to the Profession of Nursing was a great fit for me as a husband, father and prior graduate. I felt the school was innovative, challenging and invested in the students. I immediately could tell upon observation that the instructors were passionate about student success. I really liked the physical environment of this school and was excited about the emphasis placed on critical thinking within the program.

What features of your program are you especially passionate about?

I am extremely passionate about the focus placed on independent and critical thinking within a fast-paced and challenging environment. I feel like I have learned so much and gained the most out of a nursing program because of the high expectations placed upon students. Within a clinical setting, we are not just observers of care, but are expected to manage care beside the primary nurse. This program has challenged and prepared me for this amazing career.

Please share your favorite memory from your time at the CON.

One of my favorite memories was conducting a role-playing scenario on Therapeutic Communication within one of our early nursing courses. It was a great moment with close friends to share a hard laugh and learn in a non-stressful environment. I also have a lot of great memories within the clinical setting. I enjoyed working with patients, great instructors, and nurse mentors.

How do you intend to Build Better Futures?

I intend to build better futures by not only helping one critical care patient at a time, but making a difference at a hospital and community level. I plan to be involved in developing hospital and local healthcare policy. I hope to use my foundational education in research and evidence-based practice to make quality improvement initiatives within nursing. I believe there is a need for more advanced nurses within the hospital setting to make effective changes. I would like to be a role-model and mentor for other nurses and students to encourage evidence-based nursing and patient advocacy.

Outside of the profession, I hope to be a role-model for my three children. I want them to learn that it is important to care for others and utilize their education to help change the world. I am appreciative of those who have helped me achieve an education in nursing, so I can support my family and provide a better future.

$1.9M Federal Grant Helps UA College of Nursing Expand, Diversify Nursing Workforce

Jan. 30, 2018
Jason Gelt

Thanks to the four-year diversity grant, the college will expand its support of students from backgrounds that are underrepresented in nursing in Arizona.

Jan. 30, 2018

TUCSON, Ariz. – The University of Arizona College of Nursing has received a four-year, $1.9 million grant to support students from diverse backgrounds, with the goal of increasing diversity in the nursing workforce.

The Health Resources and Services Administration diversity grant (No. D19HP30859-01-00), administered through the HRSA Nursing Workforce Diversity program, will fund the Arizona Nursing Inclusive Excellence scholars project, which supports students admitted to the college from disadvantaged backgrounds that are underrepresented in health care and nursing.

The nursing workforce remains predominantly white, with other ethno-racial groups underrepresented in the profession.

"As an institution of higher learning, discovery and service, it is critical that the University of Arizona is a community that accepts and encourages a diversity of thought, heritage and tradition," said UA President Robert C. Robbins. "We are incredibly grateful for the enhanced opportunities this grant will enable for students of underserved populations, which will ultimately contribute to better access to health care education and clinical care for all the people of our state."  

Full-time, pre-professional nursing, Bachelor of Science in nursing and doctoral students who are Native American, Hispanic/Latino, first-generation college attendees or from a rural or U.S.-Mexico border community may qualify to become ANIE scholars. As scholars, they gain access to financial support and academic enrichment services, such as mentoring, coaching, individual and group tutoring, professional skills development and peer networking. As part of the ANIE project, college faculty members are designing a holistic admissions process in concert with the American Association of Colleges of Nursing.

"As a college of nursing at a land-grant university, we have an obligation to create a workforce that is representative of and reflects the communities we serve," says ANIE Project Director Mary Koithan, PhD, CNS-BC, FAAN, associate dean for student support and community engagement at the College of Nursing. "The ANIE program is focused on improving access to nursing educational opportunities by reducing the barriers and improving the success of our Native American, Hispanic/Latino, first-generation college and rural/border students."

In addition to Dr. Koithan, the ANIE project team includes Michelle Kahn-John, PhD, RN, PMHNP-BC, GNP, ANIE co-director for scholar enrichment; Cheryl Lacasse, PhD, RN, OCN, ANIE co-director for community partner outreach; and Linda Perez, M Admin, RN, ANIE living/learning coach.

ANIE scholars who join the project include:

  • Voyager scholars, who are first-year, first-semester, pre-professional nursing students enrolled at the UA who have access to programs aimed at their successful completion of pre-nursing studies to optimize their admission to the college's two-year professional BSN educational program;
  • Vanguard scholars, who once enrolled in the BSN degree program, have access to academic enrichment and mentoring to ensure their successful BSN completion and readiness to attain RN licensure; and
  • Pinnacle scholars, who are working toward Doctor of Nursing Practice or a PhD in nursing, who have access to programs that work to ensure their success in graduating and finding employment in advanced practice or as faculty members.

In addition, a Career Advance Transition supportive program will be developed to recruit and enroll more registered nurses with community college associate nursing degrees into the UA College of Nursing degree programs. 

“The project seeks to progressively strengthen and transform the college's culture of `inclusive excellence’ while supporting the personal and professional success of underrepresented nursing students,” Dr. Koithan said. “Providing new opportunities for these students not only furthers the college's 60-year mission to build better futures, but ensures the nursing workforce will diversify to reflect the needs of disadvantaged Arizona populations,” she added.

With the nation's third-largest population of American Indians and a Hispanic/Latino population of nearly 31 percent, Arizona is an ideal state in which to implement this program. The ANIE project will work to expand the diversity of the nursing workforce to meet the state's needs, project officials say.

Contact: Jason Gelt, UA College of Nursing, jasongelt@email.arizona.edu, 520-626-2742

Student Spotlight: Megan Quinn

Jan. 11, 2018
Jason Gelt

Megan Quinn

Third-year PhD student; from Phoenix

Why did you decide to pursue a nursing degree?

I have always felt a calling to help and heal, and I felt that nursing provided me with an opportunity to provide compassionate care and to help ease suffering. 

What drew you to the UA College of Nursing?

When looking for a place to pursue my PhD studies, I heard great things about the faculty at the UA CON and how well the program prepares its students to be high performing nurse scientists. I have found both of these rumors to be true! 

What features of your program are you especially passionate about?

I love the camaraderie and support I have found in the faculty at the CON. I have received amazing mentorship through relationships with my advisor and other faculty members, and have been able to work with them closely by taking research assistant positions and independent study courses. I also appreciate the flexibility of the program, which has allowed me to pursue a graduate certificate at another institution to help me achieve my career goals.

Share your favorite memory from your time at the CON.

The best memories I have from the program are from spending time with my cohort colleagues at RISE and at WIN conferences. Spending time with my classmates helped me feel like a part of the community and helped us build better teams for our later work together.

How do you intend to Build Better Futures?

I am interested in improving outcomes for babies and families dealing with serious illness in the neonatal intensive care unit. I have taken care of babies at the bedside for several years and have been moved by the suffering I have seen. I hope my work will help advance the use of palliative care in the neonatal intensive care environment so that families can feel comforted and supported in the decisions they make about their baby’s care.

Newsletter: 2018 Issue 1

Jan. 11, 2018

$50K Gift to UA College of Nursing Professor Will Aid Investigation of Compassion Meditation Technique

Dec. 20, 2017
Jason Gelt

The estate of bestselling integrative health author, educator and cancer survivor, Jack Challem, has awarded a $50,000 gift to University of Arizona College of Nursing Assistant Professor Thaddeus Pace, PhD.

The funds will support Dr. Pace’s research, including an upcoming pilot study using Cognitively-Based Compassion Training® in cancer survivors and their friends and family.

“Jack’s focus was on immunity and inflammation processes,” said the estate’s executor, Sally Dodds, PhD, who first became aware of Dr. Pace’s research when she was an associate professor at the UA College of Medicine Tucson. “And since Dr. Pace investigates inflammatory immune responses to stress, his work is a perfect fit.”

The donation will help Dr. Pace apply a specific compassion meditation technique called CBCT® to assess its effects to ease the onset of stress in home caregivers as well as patients coping with cancer. CBCT® (Cognitively Based Compassion Training), works to cultivate compassion to reduce stress, build resiliency, improve relationships and foster human value in the self and others.

“Dr. Pace has been a wonderful asset to our college and his work is an obvious fit with the goals and values of Jack Challem's estate" ~ Dr. Joan Shaver, Dean, UA College of Nursing 

Dubbed compassion meditation, in previous studies, the therapy already has proven effective in dampening the body’s response to stress in healthy young adults. “We’ve taken initial work on how compassion meditation may be good for modifying stress activation and have examined indicators of its stress-reduction effect in foster-care children with trauma histories,” said Dr. Pace, who theorizes the therapy also may prove useful in the cancer-survivorship arena. “The biological underpinnings of the quality-of-life impairments that happen in cancer survivors likely involve similar stress components.”

Thanks to prior research by Dr. Pace’s UA collaborators, Terry Badger, PhD, RN, professor, College of Nursing, Department of Psychiatry and member of the UA Cancer Center, and Chris Segrin, PhD, professor, UA College of Social and Behavioral Science, UA College of Agriculture and Life Sciences, it is evident that a complex social bonding occurs between cancer survivors and their home caregivers (family or close friends).

Studies involving prostate and breast cancer survivors revealed when the patient’s mood was down, their caregiver’s mood tended to be down, and vice versa. Based on this interplay, Dr. Pace plans to offer a multi-week CBCT® program to both parties, promoting more tranquil moods in tough social situations, and also promoting a calmer overall outlook. “If we can elevate the mental outlook on one or both parties, both are likely to show a positive effect,” Dr. Pace said.

Dr. Pace, who also is assistant professor of psychiatry and psychology, hopes that new research underway in his laboratory will build solid scientific evidence to support an integrative wellness strategy for breast cancer survivors and their close family members and friends. In the study, participants will learn to adapt their mind-body state through instructor-guided meditation sessions and be expected to practice at home. Any change in depression, anxiety, stress and social interactions will provide insights into the body’s mental and physical responses to the therapy and help provide feedback to improve wellbeing.

“Dr. Pace has been a wonderful asset to our college and his work is an obvious fit with the goals and values of Jack Challem’s estate,” said College of Nursing Dean Joan Shaver, PhD, RN. “One of our distinctive research strengths relates to cancer prevention and survivorship and the use of integrative approaches. Our faculty collaborate in this quest with our other UA health professions colleagues, particularly as co-members of the Arizona Cancer Center. These philanthropic gifts accelerate our ability to move important research forward.”

The Healing Power of Technology: Nursing Students Spread the Word about UA College of Nursing Telehealth Research

Dec. 12, 2017
Jason Gelt

In early October, four students from the Doctor of Nursing Practice (DNP) program at the University of Arizona College of Nursing presented their research posters at the third annual Telemedicine & Telehealth Service Providers Showcase in Phoenix. Hosted by the UA’s Arizona Telemedicine Program, the conference is focused on building partnerships to bring high-quality telehealth services directly into hospitals, clinics, private practices and patients’ homes.

Kimberly Denise Shea , PhD, RN, CHPN

Nearly 400 attendees browsed an array of telehealth specialty services and supporting technologies and discussed the latest trends in applications of clinical telehealth. Associate Clinical Professor, Dr. Kimberly Shea, PhD, RN, CHPN, who accompanied the students to the showcase and serves as their doctoral committee chair, said, “It’s a national convention, and people come from all over the country. It’s a great way to give students terrific experience and shine a spotlight on the impressive work that students are doing in our doctoral programs, in the field of nursing and health informatics in general and more specifically telehealth.” 

Melissa Koon, MSN, APRN, FNP-BC, NP-C, third-year Dual-Degree DNP/PhD student
Project: A Best Practice Assessment Protocol for Mobile Technology Home

Tell us about your telehealth project.

We realized that technology could enable us to see more people in the home – especially those living in rural areas – than we could in person, so we’re working on bringing telehealth to palliative and hospice patients. The goal is to use telehealth to help people avoid having to go to hospitals or clinics. Typically, if you are a patient in hospice and need access to care, generally for distressing symptoms, you contact on-call staff and it may take a nurse an hour or two to arrive at your door. Using a telehealth strategy (an iPad for example) for the initial call, a nurse can immediately see what’s going on and coach toward a start on treatment or completely treat the distress. We asked our panel of experts, the hospice staff at Casa De La Luz, to help us develop a protocol by rating the most important activities occurring during home visits. We used the information to make the iPad visit protocol closely resemble the home visit, making sure the visits are appropriately structured and make good use of a limited amount of time.

How will your project impact patient care and education?

Compared to the usual approach, we expect that this telehealth enhancement will lead to relieving symptoms in a more timely fashion. It will also avert nurse burnout by allowing nurse case managers more flexibility in time management. In the realm of education, we hope to guide future nurses in how to do assessments and physical examinations by tablet visualization versus in-person, but still convey that personal human touch that comes with a visit. We’re already using telehealth strategies for many aspects of healthcare delivery, but not yet hospice and palliative care. We need to make this a formal part of our education programs because this is the way of the future.

John Lee Conway, RN, MSN, Ed., third-year online Dual Degree Doctor of Nursing Practice student.
Project: Telemonitoring: Utilizing Persuasive Technology to Improve Client Engagement

Tell us about your telehealth project.

I have a very personal interest in this field because it was the process of telemonitoring that identified anomalies in my mom’s heartbeat and led to early cardiac surgery. She was in and out of the hospital in record time and sent home with monitoring equipment.  However, she didn’t use it all appropriately. That led me to the question: What enablers would most motivate patients to monitor themselves and regularly report accurate healthcare data to their healthcare providers? The answer, I believe, lies in persuasive technology. My intention is to study the use of computers to test what would persuade patients to provide information to their healthcare providers on a regular basis. Improved, consistent and accurate health-related communication between the patient and provider would improve health and well-being outcomes and could be implemented at a distance. 

How are you helping to build better futures with your research?

My project is meant to expand healthcare capacity for managing chronic health care issues in the home, so the growing patient population of people with chronic conditions can be managed without repeat visits to hospitals or urgent care.  By managing health care using online strategies, we’re changing the face of how patient care occurs.

(L-R) Brooke Finley and Dr. Kimberly SheaBrooke Finley, BSN, RN-BC, third-year Dual Degree Doctor of Nursing Practice/ PhD student.
Project: Opting In: Exploring Veterans’ Satisfaction and Perceptions of Telecardiology

Tell us about your telehealth project

It started with my interest in using information technology like teleconferencing to transmit video or auditory signals between people. I was working for the VA as a cardiology research assistant while I was in nursing school and one of our cardiologists was really curious as to how patients were doing in their telemedicine clinics. So I designed this study when I was entering my PhD program to examine the satisfaction ratings of veterans using telecardiology versus those who came into the VA in person. The first part of my survey asked, ‘Would you recommend telecardiology to a friend or family member?’ and overall the veterans thought it was great: they would recommend it, they got really good care, and they could see the same provider team every time. Most of the time, they saved hundreds of miles driving.

What makes your project unique and innovative?

Telehealth has been around for a while, but there really hasn’t been a lot of superb research on it as a healthcare delivery modality. A lot of the studies do not include advanced methodology or well-controlled quantitative investigation. My intent is to design better quality studies in telehealth to provide evidence that telehealth use should be expanded. It can save a lot of money and it helps the providers have a better quality of life too, because they’re not commuting all the time. I believe that’s really a win-win for lots of people and is cost effective.

John Paulo Batucan Bautista, BSN, RN, AGACNP, third-year online Doctor of Nursing Practice student
Project: TeleICU Nurse-Directed Low Tidal Volume Ventilator Rounds

Tell us about your telehealth project.

I work for Banner’s TeleICU, whereby a central command station is linked to a number of intensive care units (ICUs) across Banner hospitals and we provide extra oversight and expertise to support the on-site staff. As part of quality assurance for patients using a mechanical ventilator to assist with breathing, we regularly examine reports of best practices for low tidal volume ventilation, which in seriously ill patients protects against the developing or worsening lung tissue injury.  When I looked at a series of quarterly reports of data across ICUs, I noticed that we were not consistently hitting the ideal benchmarks.  The use of this protective ventilation technique requires advanced knowledge of ventilator management.  My intent was to create a way using TeleICU technology to make sure every patient in every ICU gets the exact same quality of care. 

What makes this project particularly unique and innovative?

I’m using telehealth technology to remotely monitor patients in ways to help free up bedside nurses so they don’t have to worry about making sure that patients are on proper low tidal volume ventilation.

Student Spotlight: D. Anthony Tolentino

Dec. 5, 2017
Jason Gelt

D. Anthony Tolentino

Second-year PhD student; from California

Why did you decide to pursue a nursing degree?

I envy nurses that knew from the start that they wanted to be a nurse through some life experiences, a calling or an epiphany. My story is a bit odd as I was going to school to be a clinical lab scientist, but during the last semester of my first year I suddenly decided to switch to nursing. Ultimately, pursuing a career in nursing has been one of the best accidental decisions in my life. After being a nurse for 11 years, I have grown to fully appreciate what we do, the contributions we make, the love, dedication, and passion we bring daily despite the challenges, and the difference we make to our patients, families, communities and to each other. 

What drew you to the UA College of Nursing?

Drs. Sheila Gephart and Jane Carrington's area of research drew me to the college and the school's substantive area in Informatics. When I started searching for PhD schools, I wanted a curriculum that not only offered me the opportunity to learn about nursing science, but also had a substantive focus in informatics. After reviewing the biographies of both Drs. Gephart and Carrington, I knew I had to learn from them. In addition, the very accomplished faculty members with diverse expertise in research and practice, a highly-ranked nursing program, and research opportunities sealed the deal. Plus, the flexibility and rigor of the program drew me to apply at UA.

Tell us what it is about nursing informatics that you find so appealing?

Nursing informatics gives me the opportunity to make a difference in our patients' lives indirectly by implementing, supporting, and optimizing multifaceted health technology activities related to patient care.  The utilization of nursing science, computer science and information science to manage data and transform it to knowledge and to support nurses and other clinicians makes this specialty very appealing to me. The fact that informatics has a multiplier effect, that is, whatever I do as an informaticist can touch not just one patient, but many patients is very powerful. I can advocate for patients in a different level and contribute to the growing profession of healthcare informatics.  

What features of your program are you especially passionate about?

I appreciate the dedication of the faculty and administration knowing that they are genuine in seeing us succeed as future nurse scientists. When the program director, Dr. Anne Rosenfeld, knows each PhD student by name, that signals that she and the rest of UA staff are here for good reasons and are dedicated to nurturing the students to be the best nurse scientists. I am also very excited to learn from the best informaticians. As a working nurse informaticist who is not formally trained, I'm able to bring what I'm learning to my organization. In fact, I'm in the inaugural Nursing Research Fellowship at Dignity Health, and a big part of being selected is due to being a PhD student at the UA CON. 

Share your favorite memory from your time at the CON.

It's only been a year, but I already have many great memories at the CON -- ranging from forming strong and lasting bonds with my cohort and being a research assistant for Dr. Gephart, to going to conferences to present, network or connect. My favorite memory so far is volunteering at American Medical Informatics Association (AMIA) conference in Chicago last November, and winning the AMIA #Why Informatics video contest where I had the opportunity to showcase why Informatics can be boundless and can redefine the possible and the impossible.  The prize? I get to attend the conference in Washington, DC this November - for free! 

How do you intend to Build Better Futures?

Dr. Rosenfeld once asked us how we see ourselves in the future as nurse scientists. She asked us to think big and be boundless. This made me think why I pursued a PhD. I see my journey as a future nurse scientist as an opportunity to be a caregiver and a researcher to improve health outcomes. We are all in healthcare and nursing for a reason. Although my research focus is in technology, I still believe in the power of human touch. As nurses, we have the opportunity to be with our patients in their most vulnerable times. Technology may be gradually taking over our lives, and it may seem that the more we get connected the more we lose the human connection. To build a better future, I would like to find the appropriate balance of the use of technology with patient care. My vision is a future where we can provide high tech care with a human touch. The ultimate goal is to make it easy for our nurses to do the right thing for our patients. 

Are you funded by a scholarship?

I'm a recipient of the Nursing Scholarship Endowment for this year from the College of Nursing. I also work as a graduate research assistant for Dr. Gephart's NEC-Zero Project. 

There's a Mobile App For That! Enhancing Prospective Memory Through Technology

Dec. 4, 2017

Taking one’s medications as they were prescribed is essential to managing disease but sometimes a challenge in adults undergoing age-related or other kinds of memory changes.  Using theory and evidence specifically about prospective memory (remembering to do something you intend to do), University of Arizona College of Nursing Professor, Dr. Kathie Insel, is striving to assure that older adults are helped to take their medications as prescribed.  Having learned that cognitive functions called executive function and working memory (associated with successful prospective memory) also affect remembering to take medications, in prior work, Dr. Insel tested the behavioral intervention designed to support prospective memory and improve remembering to take medications. Applying the results of her prior research, which has been years in development, she and her team are now debuting a mobile app that could have wide-reaching implications for helping older adults in general and others who experience certain brain changes as a consequence of illness and/or treatment, e.g., treatment with chemotherapy sometimes referred to as “chemo brain”.

Dr. Insel and her colleagues, Dr. Jeannie Lee from the UA College of Pharmacy, Drs. Wendy Rogers and Dan Morrow from the University of Illinois, Dr. Gil Einstein of Furman University and Dr. Tracy Mitzner of Georgia Institute of Technology, are working with local Tucson company Ephibian to design and execute an app for smartphones that translates the essence of Dr. Insel’s behavioral intervention into consistent daily reminder support and more. The overall intent is to make self-management of chronic conditions easier and more successful, thus promoting continued independent living for as long as possible among older adults.

Kathleen C Insel , PhD, RN

“In the world of cognitive psychology, study after study has demonstrated differences between younger and older people and the way they process information and remember” says Dr. Insel, pointing to the two types of memory, retrospective memory (remembering something you did) and prospective memory (remembering to do something you intend to do). “My work is addressed to new terrain. To date, little attention has been focused on translating what is known about prospective memory into specific supportive strategies that can be put in the hands of patients and  therefore enhance older adults’ capacity for self-management.”

Now, thanks to a $275,000 National Institute of Health (NIH) R21 research grant, Dr. Insel and her colleagues will transform the behavioral intervention to a smartphone application (app) and test its influence on medication-taking by patients grappling with high blood pressure. “People think older adults don’t use smartphones, but there’s a generational change going on whereby older adults are more tech savvy than ever before. Furthermore, we are seeing that people are looking for apps to help with remembering to take medications. So there’s definitely a need.”

Evidence shows that as few as 50% of patients take medications as prescribed and the picture is worse when people are managing long-term illnesses such as high blood pressure as compared to short-lived illnesses such as a time-limited infection.  Dr. Insel’s multi-disciplinary team has designed their MEDSReM (Medication Education, Decision Support, Reminding and Monitoring System) to have all the features the name implies. Dr. Jeannie Lee as pharmacist expert is instrumental in guiding the medication decision support, such as what to do if you forgot to take it when you intended to take it.

“This technology is a promotion of health as well as a treatment of illness,” says Dr. Insel. “The current effort is focused on those with hypertension. Uncontrolled high blood pressure is the primary cause of stroke and a cause of heart disease, retinal and kidney damage hence taking medication as intended is important. We can make a huge impact in helping people effortlessly manage their condition, stay healthier and live independently longer.”

Ambassador of Integrative Health: Dr. Deborah Williams Weaves Integrative Care Techniques into Local Assisted Living Facility

Nov. 30, 2017
Jason Gelt

Her experience as a fellow in the University of Arizona College of Nursing’s inaugural 2016-2017 Integrative Nursing Faculty Fellowship (INFF), has uniquely positioned faculty member Deborah Williams, PhD, MPH, RN, to advance the College’s commitment to the science, theory and practice of integrative health. As the liaison between the College of Nursing and The Hacienda at the River, the latest assisted living community in the Watermark Retirement group, she has helped incorporate various integrative health interventions into the community’s care, including yoga, massage therapy, meditation, aromatherapy, reflexology, healing touch, acupressure and acupuncture. Under Dr. Williams’ supervision, the partnership between the College and The Hacienda creates a unique environment where nurse faculty can practice and nurse students can learn person-centered and relationship-based care that inspires optimal health and wellbeing.

The Hacienda at the River

What did you learn from the INFF?

The INFF taught me that it is acceptable to teach these integrative interventions to nursing students. To be brave and introduce new ideas in the classroom and in the clinical setting. In our fast-paced society, we need to care for people in a way that allows nurses to have the time to really listen to them and find out what works for them. People respond differently and we can advocate for their chosen interventions. Integrative nursing is a process which is centered on the person and the relationship we create with each other. The impact on health outcomes and wellbeing is remarkable.

What changes have you seen in students since you incorporated these techniques into your teaching?

Recently, I heard from a graduate who told me about a job interview she had at a hospital. She wanted to say thank you because in her interview she talked about how she had learned the integrative nursing approach that I introduced in the medical/surgical and psychiatric mental health clinical rotations. She felt like that knowledge set her apart from the other candidates and she ended up getting the job. When I began teaching the integrative approach to managing symptoms, I started to see students thinking beyond prescribed medications and offering things like guided imagery and breathing techniques instead of Tylenol. And interestingly, their care plans started to reflect these interventions, choosing less invasive treatments.

Tell us more about the integrative techniques you’ve incorporated into your work?

Each fellow chose two modalities to focus on and I chose relaxation response and music. Music does wonders. At The Hacienda, I see its effectiveness in terms of behavior changes and happiness in assisted living and memory care residents. I have been writing policies and protocols for many of the integrative interventions. Our administrative team starts the day together with Qi Gong, a meditative quote, or centering. I am in the process of bringing to The Hacienda integrative practitioners from the community for a full repertoire of integrative services.  

One of the six principles of integrative care focuses on the health and wellbeing of caregivers as well as those they serve. What is particularly important about self-care for nurses?

In nursing you are used to taking care of other people. I remember very well being a nursing student. There was no down time. You have academic work you need to do and on top of it you are in clinical, taking care of people and learning and then you are going back to the books again, reading about what it was you saw in practice. It’s this constant back and forth and it’s easy to forget to take care of yourself, but if you are not in top form it is hard to fully focus on the needs of your patients. In clinical post conferences sometimes I have my students do a brief meditation or I’d ask them about their weekend plans, and I would encourage the students to take time -- even if it’s just an hour – to give themselves a break. And then I would check back with them and find out what they did as a way of keeping them accountable.

Tell us about some of the other integrative health activities you supervise at The Hacienda.

We have a Zen Down hour every day of the week. Every day focuses on a different topic such as mindfulness, gratitude, and wellbeing. Recently, I introduced mindfulness and we had an engaging 45-minute conversation. We used clementines in an exercise. It was all about being mindful, so we talked about the texture, the flavor, being present in the moment – it was just a really neat conversation and exercise together. That probably is my greatest challenge right now in training caregivers: You’ve got to become comfortable and not afraid to try new things.