School of Nursing and Health Professions Mary Donnelly lived all of the world before she started working at the University of San Francisco. During our conversation, we discussed how working and living abroad informed her nursing and practice and how she approaches collaboration in research.

Mary Donnelly

How did you first start in the field of nursing?

When I was in high school and beginning to think about college and talked about my goals with my parents who were both public school educators, and they gave me a choice—this was back in the ‘60s—I could be a nurse or I could be a teacher. Trying as a teenager to find my own unique way, I chose to study nursing, in Villanova, Philadelphia, where I completed my undergraduate degree in nursing. While an undergraduate student, I became aware of the social factors, which created barriers to access to care. From that moment, I became aware of health disparities I wanted to be part of the solutions to increase access to healthcare.  I worked with the Panthers and the Medical Committee for Human Rights. We provided sickle cell testing at health fairs in Philadelphia, PA and provided acute care and health promotion interventions to antiwar and anti-segregation demonstrators along the East Coast.   I wanted to learn how health care could be utilized and provided beyond the walls of hospitals and clinics and I wanted to respond to the health concerns and needs of social activists working in urban areas.

I moved back to upstate New York soon after graduating from Villanova to work at a Community Health Center in Lackawanna. I worked with community health workers and made home visits to a unique population of Bethlehem Steel workers from around the world. Our Health Center treated people from Yemen, Puerto Rico, Mexico as well as Southern African Americans who had all come for the hope of better wages. I went back to school, attending State University of New York at Rochester while working. I graduated as an adult nurse practitioner, and became the first adult nurse practitioner in Erie County. I was still on a quest to learn how best to provide community health so I entered the School of Public Health at Johns Hopkins University to get my Masters of Public Health. My life has provided opportunities that were often unexpected.  After marrying a Navy officer, I had the opportunity to learn about health care in Europe and Asia. I worked in Japan and Italy, and with the National Health Service in London. When my husband retired, we came back to the United States in 2005, and I continued my nurse practitioner practice and teaching at Johns Hopkins University School of Nursing.

How did working and living abroad inform your nursing and your practice?

Japan was so different, and I had to learn the language and culture to be successful. I was providing occupational health services through the Department of Defense, and many of my patients were Japanese. One of my patients did not pass the hearing test, so I could no longer qualify him to drive a forklift in the shipyard. A hearing deficit could be potentially harmful when driving. Soon after, all of his co-workers came to my office and said, “He’s got to work; what can we do?” I said that he needed a hearing aid, and while wearing the hearing aid, if he passed the hearing test, he could work. His work team bought him a hearing aid and brought him back to take the hearing test. It was a group effort. They cared for each other, worked together, and supported each other. This incident was crucial to my understanding of Japanese culture. Keeping the team together was important to achieve work goals.  Each individual of that group was supported by the group’s efforts.

How do you approach interdisciplinary research?

Healthcare is so complex that we cannot live and work in silos, and we really need to reach out to all stakeholders involved in the provision of high- performing systems. Microsystem analysis utilizes a failure mode effect and analysis (FMEA) for potential risk analysis. I see FMEA as a reasonable and evidence-based approach to teach our students and to identify areas of research. We owe a debt a gratitude to W. Edwards Deming, an American statistician who is credited with the rise of Japan as a manufacturing nation, and with the invention of Total Quality Management (TQM). Deming went to Japan just after the War to help set up a census of the Japanese population. While he was there, he taught ‘statistical process control’ to Japanese engineers – a set of techniques, which allowed them to manufacture high-quality goods without expensive machinery. Deming insisted that we create a work culture, which would create a constancy of purpose towards improvement. This means we do not wait for failure or an error but analyze where potential benefits or efficiencies could occur.  I believe this campus is unique because it fosters partnerships across disciplines. Here, I have the opportunity to work with someone in the School of Education, and we are able to collaborate on research.

What brought you to USF?

The USF is a perfect place for collaboration. For example, I needed help looking at reliability, so I approached a colleague and asked, “Will you help me with those statistics?” I also like to work in groups. Writing group members may motivate each other while providing various skills and qualities. Personally, I am not terribly interested in writing alone. I might have a good statistician or I might know a person who is a good editor and we can learn from one another, at least that is what I am trying to establish here. We can continually help each other to produce research.

When I came to interview, there was a discussion on the similarities between Malcolm X philosophy and Jesuit philosophy, so I knew this was the place for me. I was also concerned about diversity, and my daughter-in-law’s aunt went to school here. She’s from Afghanistan, and they left because of the Taliban. I asked, “How were you treated? How did you feel when you were accepted?” She gave me good answers and she highly recommended coming to USF.

What are your different research interests?

I look at primary care topics, which are of interest to primary care providers, and provide up to date standards and case studies for application. I published a few articles last year on hyperparathyroidism—and one on the use of certain antibiotics and the relationship to Achilles tendon ruptures. Fluoroquinolone is a very common class of antibiotics and with certain populations there’s an increased risk of Achilles tendon ruptures.

I’ve been commissioned by the American Journal of Nursing to write about hypertension and to discuss the best approaches to treatment of hypertension. One of the newer items we need to consider is motivational interviewing because hypertension can be addressed by motivating people to change their lifestyles, which are associated with risk factors. I talk about treatment standards, which are pretty well established, and how are we approach the patient and how we can help patients toward better outcomes. Motivational interviewing is evidence-based and there’s a lot of research indicating that this is an effective communication technique has the potential to effect changes in patients’ behaviors.

How do you bring your research into your teaching?

Teaching, writing, and working with our nursing clinical groups keeps us on our toes, and healthcare as a profession continues to change. Our population changes, and in primary care, we’re at the front line treating anything that our patients come in with. I try to teach my students that we need to look at our practices and at the evidence to support them. Motivational interviewing is supported by research. It takes a lot of time to learn it, and it’s hard in a busy primary care practice to develop those skills when you might only be given fifteen minutes to interview a patient and provide some intervention.

What are you thinking about with your research interests now?

I did my doctoral work on decision-making. One of my interests is looking at how we communicate whether it’s with a student, patient, peer, or other professionals. I’m looking at better ways to engage students in learning. I recently had an article published about the use of VoiceThread in graduate education, which uses audio or video to engage students with each other’s work. This method can help our profession because as a provider of care, you need to discuss cases in front of people. You need to be able to analyze and be clear and succinct. Our graduate students come from a variety of backgrounds—they can be in management, they might have been in the Arts and Sciences—so they bring a range of gifts. We’ve seen that these videotaped discussions increases engagement and the desire to learn, and also, it brings more confidence.