A Caring Legacy

Success stories abound at Florida Atlantic University, but few are as inspiring as that of the Christine E. Lynn College of Nursing, which is celebrating its 40th anniversary this year.

From its humble beginning in 1979, as a program serving an initial student body of 10 registered nurses seeking a bachelor of science in nursing degree, the college has grown to an enrollment of more than 1,100 students pursuing undergraduate and graduate degrees on the Boca Raton, Davie and Harbor Branch campuses. Even more impressive is the role the college has played in founding and developing a caring model of nursing practice.

The caring philosophy provides a holistic framework and set of values that focus on the human relationship between nurse and patient. This defining characteristic has long been at the heart of the college’s educational, research and community outreach activities.

This year, U.S. News and World Report ranked the college’s online graduate nursing program No. 23 nationwide — and No. 1 in Florida.

Throughout its history, the college has received sustaining support from philanthropist Christine E. Lynn, whose generous $10 million gift in 2001 funded construction of its state-of-the-art headquarters facility on the Boca Raton campus.

The college has identified four key areas of research:

This anniversary year provides an opportunity to take a look at selected research initiatives in each of the four categories, including notable work that began earlier in the college’s history and recently funded new projects.

Healthy Aging Across the Lifespan

Then: The 2001 opening of the Louis and Anne Green Memory and Wellness Center, Boca Raton campus, capped years of pioneering research on memory disorders of older adults conducted by Ruth Tappen, Ed.D. Tappen was the center’s founding director, overseeing development into a vital community resource, offering an array of services to individuals with Alzheimer’s disease and other memory disorders, and providing support to their caregivers. Tappen, Christine E. Lynn Eminent Scholar, continues to make major contributions to enhance quality of life for older adults. Among other accomplishments, she has worked to reduce rehospitalization of nursing home residents, producing a valuable decision guide that is disseminated across eight states. Tappen’s textbook “Advanced Nursing Research: From Theory to Practice” won the 2018 Book of the Year Award from the American Journal of Nursing.

Now: Lisa Kirk Wiese, Ph.D., an assistant professor, is focused on addressing the healthcare needs of rural populations, with special emphasis on reaching out to older individuals and their families who face a high risk for Alzheimer’s disease. She is leading a study on the effectiveness of home-based cognitive screening, with follow-up dementia-specific assessments and provider referrals by gerontological nurse practitioners. Wiese’s work builds upon the strong foundation established with Tappen, Christine Williams, DNSc, professor and director of the Ph.D., program; and David Newman, Ph.D., associate professor and statistician, both from the College of Nursing, in designing the Basic Knowledge of Alzheimer’s Disease survey for use in underserved populations. Wiese has presented this assessment tool to organizations, including the International Association of Geriatrics and Gerontology, Alzheimer’s Association and National Rural Health Association. It is also available in the Journal of Aging and Mental Health in her article titled “An Updated Measure for Investigating Basic Knowledge of Alzheimer’s Disease in Underserved Rural Settings.” Her research focuses on early dementia detection and management in underserved settings, thereby delaying costly institutionalization.

Healthy Equity

Then: John Lowe, Ph.D., a Native American tribal member and one of only 23 doctoral-prepared Native American nurses nationwide, devoted years to developing effective approaches to addressing drug and alcohol use among Native American/Alaska Native youth and young adults. In 2014, as faculty of the College of Nursing, he received a National Institutes of Health grant to design, conduct and evaluate an intervention program for Native American youth based on the traditional Talking Circle concept. The study utilized a web-based internet program to bring together sixth-graders from tribal communities in Minnesota, Oklahoma and North Carolina during virtual intervention sessions, with the aim of increasing participants’ sense of self-worth and cultural identity while decreasing their substance use. The success of the Talking Circle approach led the U.S. Department of Justice to name it a promising evidence-based program for the promotion of well-being among Native American and indigenous youth. Through this and other research, Lowe is having a positive impact on indigenous populations worldwide. Lowe went on to become the founding and current executive director of the Center for Indigenous Nursing Research for Health Equity at Florida State University.

Now: Tarsha Jones, Ph.D., an assistant professor, received a DAISY Foundation grant to understand the needs of minority women with breast cancer risk, particularly black and Hispanic women. She also received a National Cancer Institute grant through Columbia University to promote diversity in health- related research. Black women in the U.S. are more likely than white women to get early-onset breast cancer before age 50, and twice as likely to be diagnosed with triple-negative breast cancer, an aggressive form of the disease associated with a BRCA1 gene mutation. They also have a 39 percent higher mortality rate. Jones also works with Hispanic women, who also suffer disproportionately from breast cancer. Both minority groups would benefit from genetic testing, but research findings indicate that this important risk assessment is underutilized in these populations. Jones is studying barriers to genetic testing of minority women who receive care in community health centers, with the goal of promoting increased use of genetic testing to identify individuals and families at risk for hereditary breast cancer. In her work with Columbia University, she studied more than 1,000 diverse young breast cancer patients diagnosed at age 50 and under to examine frequency and predictors of BRCA1/2 genetic testing among this group.

Holistic Health

Then: In 2011, researchers at FAU launched an examination of the effectiveness of Kristine Lee’s Sit 'N' Fit Chair Yoga program on reducing pain and increasing physical function in older adults with osteoarthritis. Led by Ruth McCaffrey, Ph.D., DNP, professor emeritus of the College of Nursing, and JuYoung Park, associate professor in the Phyllis and Harvey Sandler School of Social Work, the results were encouraging, culminating in a National Institutes of Health grant in 2013 to continue the study through a randomized controlled trial. The researchers randomly assigned 131 older adults with osteoarthritis to either participate in the Sit 'N' Fit Chair Yoga or a health education program and 112 completed the interventions and the data collection after interventions. As reported in the Journal of the American Geriatrics Society, the chair yoga group showed a greater reduction in pain and pain interference with normal life activities. Another benefit is reduction of pharmacological treatment, which can have adverse effects. Chair yoga holds promise to improve the quality of life for millions of older Americans suffering from lower- extremity osteoarthritis.

Now: The healing effect that the company of dogs can have upon sick and injured people has been recognized for centuries. Increasing understanding of that healing bond is at the heart of an initiative called Canines Providing Assistance to Wounded Warriors (C-PAWW), led by Cheryl A. Krause-Parello, Ph.D., a professor in the College of Nursing. Tragically, each year, about 7,300 military veterans suffering from post-traumatic stress disorder (PTSD), depression and other health, emotional and physical concerns, die by suicide. Krause-Parello and Erika Friedmann, Ph.D., of the University of Maryland, are working under a grant from the National Institutes of Health on a study using stress biomarkers to measure the effectiveness of a service dog training program for veterans with PTSD. Positive results could support changes in public policy, including allowing the classification of service dogs as reimbursable medical expenses for veterans with PTSD. Krause-Parello was recently named an Edge Runner by the American Academy of Nursing in recognition of her pioneering work in the field of anthrozoology, the scholarly investigation of the human-animal bond.

Transforming Health Care Environments

Then: It has been well documented that challenges such as increasing demands on the workforce, inadequate staffing and lack of an appropriately prepared workforce result in a healthcare system that fails to embody essential values held dear by those who choose to be members of helping professions. A 2004 research project conducted by Anne Boykin, Ph.D., professor emeritus; Susan Bulfin, Ph.D., associate professor and DNP director of practice teaching tracking both of the College of Nursing; John Baldwin, Ph,D., professor of biological sciences in the Charles E. Schmidt College of Science, and Rebecca Southern in the emergency department at Boca Raton Regional Hospital focused on transforming care from object-centered to person-centered. This transformation required a commitment to intentionally focus on creating a caring-based value system. The Dance of Caring Persons, a key concept in the Nursing as Caring Theory, was used to ground the evolution of an innovative practice model. This model, unlike the more traditional bureaucratic structure, envisions a circle of dancers in which all persons are valued, respected and supported in their roles without the encumbrances of power, authority and positional importance restricting their unique contributions to the dance. Through a commitment to live the value of caring, significant changes occurred and patient satisfaction significantly increased.

Now: Doctors, nurses, pharmacists, social workers and other professionals all interact with hospitalized patients, but communication among them has historically been spotty at best. Both Terry Eggenberger, Ph.D., associate professor; and Kathryn Keller, Ph.D., professor, launched an interprofessional initiative to create a team-based approach to hospital care that could become standard practice nationwide. A project undertaken at Boca Raton Regional Hospital in 2015 focused on establishing a system for facilitating communication among the various healthcare providers during patient rounds, with the aim of promoting collaborative care and improving patient outcomes. Eggenberger and Keller, advanced master trainers for Team STEPPS (Team Strategies to Enhance Performance and Patient Safety), have incorporated these evidence-based communication tools and techniques in a variety of education and practice settings. As the complexity of care needs increase and the focus shifts to value-based care, the need for interprofessional collaboration becomes increasingly important.

Future: FAU recently named Safiya George, Ph.D., as the new dean of the Christine E. Lynn College of Nursing. She is only the third dean to be appointed in the college’s 40-year history. “I have a passion for people, holistic health, caring and nursing science and I believe that I can contribute to and further support the impressive initiatives and programs at the college and across the campus,” George said. “I already have grown to love Florida Atlantic University and the Christine E. Lynn College of Nursing, especially the caring philosophy that transcends and represents everything about the college.”