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Q&A with Dean Hurn

In this special digital edition of Panacea, we focus on the COVID-19 pandemic and the multifaceted response from the U-M School of Nursing community. We begin our coverage with a Q&A featuring Dean Patricia D. Hurn to hear her thoughts on the pandemic and how nursing is specially equipped to lead our health care system through this historic public health crisis and beyond. She also takes a closer look at our community’s collaborative efforts to move the U-M School of Nursing’s mission forward in the midst of the pandemic, and explains why she believes nurses are well-positioned to lead anti-racism and social justice efforts within our health care system.

What is your message to nurses across the country, who are on the front lines of patient care in the midst of the COVID-19 pandemic?

Dean Patricia D. HurnA heartfelt thank you for putting their lives on the line every day and sacrificing so much to care for their patients. Nurses, along with other health care professionals, are facing difficult circumstances in almost every clinical setting you can imagine. Their collective response has been nothing short of heroic.

The pandemic has presented a whole new set of complex challenges for our country’s health care system. From supply shortages and capacity issues to patient care for a novel virus, this pandemic is once again highlighting what I have believed for a long time: Nurses will lead the transformation of our health care system. While nurses collaborate with many other professionals in health care, nursing is uniquely positioned to lead a transformation of our current system because we are so close to our patients. The type of day-to-day interaction nurses must have with their patients to provide quality care often leads to questions and subsequent discoveries that will ultimately benefit care for everyone in our health system.

The COVID-19 pandemic has very publicly highlighted some longstanding challenges within our system, including scope of practice, which you can read more about in this magazine, and health inequities. Nurses understand how the health care system should work for patients and how it needs to be transformed. COVID-19 has further exposed health inequities in our country, and nursing can be at the forefront of addressing those problems. Because of the focus on the person and collegiality in nursing, the pandemic may help orient the health care system around how we need to provide prevention as well as meaningful intervention for disease.

How has the School of Nursing been able to continue its mission during the pandemic?

PH: We have a strong foundation at our school thanks to the many groups of engaged people who make up the U-M School of Nursing community. Everyone came together with the idea that focusing on students and patients was paramount to fulfilling our mission as an education and research institution focused on providing health for all through nursing. In the early days of the pandemic the situation was highly fluid and uncertain, but we knew our students had to have the level of education required to earn the degree they were seeking. For most of our graduating class, this meant continuing with hands-on training in clinical settings at the onset of the COVID-19 pandemic. As nursing students, they needed training that wasn’t required of many other students at the university. It wasn’t easy to deliver, especially in a clinical setting, but I think our staff, faculty, clinical preceptors and even parents of our younger students stood and said “We will do what’s necessary” to get them through the clinical piece of their nursing education.

From a clinical care perspective, I think faculty and thousands of alumni really stepped up to do their part. I think the general public sees that as an add-on to our nursing school, but we are remarkably strong not only in clinical research and education but also in the quality and ability of our faculty clinicians who provide care. We saw many examples of people who were able to align their work as patient care clinicians with their commitment to guiding our students through their education.

We also have outstanding relationships with our health care partners, which has allowed us to continue with our educational mission. Aside from producing the next wave of Michigan nurses to work in our health care system, I think having students in a clinical environment brings something truly remarkable to a health care setting when they are learning.

Finally, I’ll say that the university was very careful working with the health professional schools, and the university stood with us to be able to do what we needed to do.

How can nurses take their expertise and support social justice and anti-racism efforts in our country?

PH: It’s important to recognize that nursing grew as a profession while working with and providing care to people who were also seeking social justice — not necessarily working with the most well-off, healthy, fairly treated or well-provisioned in life. Nursing has always had its roots in social justice. I think to fully use our expertise and training to support anti-racism efforts, we (nurses) need to examine ourselves first. We need to make an effort every day to ensure we truly understand the basis of racism and the necessity of anti-racist work. We need to make sure we are not in any way, even in the most subtle way, contributing to or supporting structural racism and the damage it brings to our patients, students and colleagues of color.  

Nurses have historically stood up for patients, so we must continue to use our role as advocates for patients or clients of color. Recently, we watched on video the horrifying killing of yet another African American, George Floyd. We all know this has to stop; we can’t accept any alternative to meaningful change. But we also have decades of data and experiences from African Americans who have engaged with care providers and demonstrated that the health care system doesn’t fully work for them, and they don’t receive the quality and quantity of care that all Americans expect. We need to be hypervigilant in our advocacy for African American patients.