Faculty Spotlight: Mary Donnelly

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.

Faculty Spotlight: Angela Banks

During our conversation, Angela Banks, Associate Professor in the School of Nursing and Health Professions, shared her passion for patients and her research in cardiovascular disease. We discussed her Fulbright experience in Jordan, bringing stories of her patients into the classroom, and running her first marathon.

Angela Banks

 

How did you first become interested in research?

At a very young age, I knew that I wanted to become a registered nurse. I enjoyed taking care of people that were sick, and whenever my family members became ill, I embraced the idea of helping them get better. I have a PhD in the Philosophy of Nursing.

While I was completing my PhD at UCSF, we had to select a particular area of interest, and I chose cardiovascular disease. I became quite interested in this area because I had a couple of family members who died prematurely as a result of cardiovascular disease.

How did you decide to come to USF?

The USF Nursing Program has a wonderful reputation in the community, and it’s highly respected throughout the state of California. I heard about USF long before I decided to come here. It was my first and only choice. I decided that after I graduated I wanted to work at this university, and it was also the only place where I interviewed. I’ve been here for 11 years and experienced many challenges, but overall I really enjoy teaching and the wonderful opportunities it has to offer.

How do you bring your research into the classroom?

Well I teach pharmacology and pathophysiology, so the heart is a fundamental aspect of my research. When I talk about the heart, I also share my research findings with my students. I want my students to be informed and understand the importance of cardiovascular disease and become advocates for their family members and themselves should they become diagnosed with cardiovascular disease.

Is there something in particular about working with the students and the program at USF that keeps you motivated?

Because of my many years working in the intensive care unit and also the emergency room, I have had an opportunity to bring those life experiences to the classroom. It brings the classroom alive. Students remember the stories that I tell them, the stories about my patients—how I advocated for my patients, how I advocated for their family members, and how they can do the same thing. I always say to them, you are the next generation of nurses. I’m just happy that I’m able to play a significant role in making you an excellent nurse. So when you graduate from this university you will have the necessary skills to care for people in the clinical setting or the community. One of these days you may have the opportunity to take care of me, or my loved ones and I want you to be well prepared for that responsibility.

What are the questions you’ve been thinking about recently?

I’m interested in cardiovascular disease and its impact on the female population. There are a lot of people that might not be aware of the fact that cardiovascular disease is the number one killer of all women. It’s actually the number one killer of all Americans—men and women—but it really does impact the female population considerably more. With my dissertation, I was specifically concerned about the African American population because, even though all women as well as men in the US are impacted by this disease, it has a significantly higher consequence on the African American population. I wanted to better understand why people wait to go to the hospital when they experience signs and symptoms associated with heart disease.

What leads to these delays and disproportionate impact?

From my research, when African Americans experience cardiac signs and symptoms, they wait to see if the symptoms will disappear. Many of them are wondering if these signs and symptoms are associated with something that’s not cardiac in origin. Several people experience denial, and believe that their signs and symptoms are related to something less serious, especially the female population because women do not necessarily experience cardiac symptoms in the same way that men do. Many healthcare providers, especially male physicians are reluctant to diagnose women with cardiovascular disease even though they present to the emergency room with the classic signs and symptoms. Physicians tend to attribute the symptoms that women are having to a condition that’s less serious compared to men experiencing the same symptoms when they arrive at the hospital.

You spent some time doing research in Jordan. What brought you to the Middle East?

I was in Jordan as a Fulbright Scholar, and it was a wonderful experience. I wanted to visit a place where the language, the religion, and the culture were very different from my own, so I specifically selected Jordan. I had a lot of fear associated with the Middle East, and if you listen to the media, most people would be frightened to travel to the Middle East. I wanted to branch out to a different part of the world, and it was one of the best decisions that I have ever made for my personal and intellectual growth.

How did your research collaborations work?

At the Jordan University of Science and Technology, you really needed to be fluent in Arabic in order to conduct research, and Arabic is a very difficult language to learn. So I collaborated with professors who spoke fluent English. For instance, there was a professor who was doing some interesting work on diabetes, which is a major risk factor for cardiovascular disease, so we worked together and were successful in publishing a manuscript.

The professors also had their graduate students collect data, and then together we would analyze the data and write up the analyses. There was a tremendous amount of collaboration across disciplines, which is something I haven’t had the opportunity to do at USF. I would love to have the opportunity to work with professors across disciplines at USF, because we can learn from each other and disseminate the information to a broader audience.

I look forward to the opportunity of collaborating with my colleagues here at USF, specifically individuals who have an interest in how culture, and racial prejudice intersect with my area of research. I am currently working on a project dealing with culture, and oppression in the African American population who is suffering with heart failure.

How has your research impacted you individually?

I’m very conscious about my health, and I’m very much aware of the risk factors that will increase the chances of me developing heart disease—I try to eat a balanced diet and exercise as often as I can.

In Jordan, I actually ran my very first marathon for my students at the university. It was never my plan to run a marathon, but the whole purpose was to raise money for my students because in the Middle East students rarely have the funds to purchase books. They will usually purchase one book and make copies for all of their classmates, so I wanted to assist my students in paying tuition and buying books. Even though I didn’t raise a lot of money, all the money was donated to the university, and my students and colleagues were impressed. I encouraged people to run with me, but very few people in the Middle East run. Most people in the Middle East who run marathons are foreigners from other countries, the US being one of them.

I decided because I’m getting older and it’s such a burden on your body—that constant jarring when you’re running—so I decided to take up swimming. So now I swim because that’s the type of exercise that I can actually do for the rest of my life.

It seems like you’re always working on this goal of learning more, focusing on the community, and disseminating the information. Do you have a large goal for your research?

It’s a work in progress. If we can just get people to the hospital when they experience signs and symptoms associated with cardiovascular disease, that would be phenomenal because so many people, not just African American but also individuals from other ethnic groups, delay in getting to the hospital. When it comes to the cardiac muscle, time is very important because the longer you wait, the more damage you actually do to the heart muscle. If someone is aware of this knowledge about cardiovascular disease, it places them in a much better position to advocate for themselves and their family members.

How do you inform people about your research?

I’ve tried to reach the African American community, and educate women in general. In April, I spoke to a group of over 250 women about heart disease and shared the classic signs and symptoms. It is so important that they advocate for themselves if they go to the doctor, and if they feel like they might be experiencing symptoms associated with cardiovascular disease. It is important to get the physician to listen to them and not dismiss their concerns. A lot of it is education, but I’ve also found that even with educating people, it may not necessarily change behavior. So we still have a lot of work to do.