Our Nurse of the Week, Clinical Nurse Specialist Lois M. Stallings-Welden, DNP, began her career as a nurse’s aide and at age 70, her pursuit of nursing excellence is still inspiring younger generations. This month, the nurse-leader, researcher, and educator was tapped by her alma mater, the University of Southern Indiana, for their 2021 Distinguished Nursing Alumni Award in honor of her influential – and ongoing – contributions as a mentor, clinician, and role model.
“Lois is an outstanding mentor for nursing staff at all levels, sharing knowledge and critical thinking skills in a calm, compassionate and easily approachable manner,” wrote one of her award nominators. “She educates on the importance of using nursing research and evidence to support practice changes to improve nursing care and patient outcomes. She is a nurse who exhibits passion for the nursing profession by being a role model and encouraging others to strive to improve and develop themselves.”
“I will not hire 16-year-olds because they are not dependable!”
Welden, one of seven children, was born in Indianapolis and raised on a farm in north central Indiana. When she was only 15 years old, she applied to work as a nurse aide at Clinton County Hospital in Frankfort, Indiana, with the intent to earn tuition and room and board money while attending a Christian high school and college that was a few hours from home. When she was denied employment because of her age, she returned three months later at the age of 16 to speak to the Director of Nursing, who abruptly said, “I will not hire 16-year-olds because they are not dependable!” Welden immediately reached out to her teachers and others to obtain letters of recommendation, and she continued to regularly call on the DON to give her the letters as they came in. “She finally gave up and hired me, saying (while pointing her finger at me) that she would train me herself!” said Welden. “She was an old Army nurse whose uniform was heavily starched, and she had a stern, no-nonsense look that was quite intimidating, but I refused to be diverted. I was determined to show her I was dependable.”
This young farm girl with no prior nursing experience embraced the various tasks she was given at the hospital which set the stage for her future career. “While working as a nurse aid there, I realized the joy of caring for patients and that I could be instrumental in alleviating their pain and providing comfort,” she said. “Growing up, I thought I wanted to be a missionary, but with my exposure working as a nurse aide, I knew I wanted to be a nurse.”
In 1979, when her four sons were age 7 and under, she made the decision to begin the nursing program at the University of Evansville while working full-time as a nurse aide at Deaconess Hospital, Evansville. “The hospital made a difference in my life,” she said, recalling the tuition support offered by Deaconess to earn her associate degree in nursing. “They believed in their employees and believed in me. After I graduated from UE, I had other job offers, but I felt like I had something to give back to Deaconess, so I started working as a staff nurse in the cardiac intensive care unit there. Deaconess has also been supportive of the other nursing degrees (bachelor, master’s and doctorate) I have earned.”
“They knew I had high standards.”
Throughout her career at Deaconess, Stallings-Welden has held the titles of assistant head nurse and department director, and today, at age 70, she still currently works full time in nursing leadership as a clinical nurse specialist in the Deaconess Magnet Program and Employee Education Department.
She has also served as adjunct faculty at the University of Southern Indiana since 2015, teaching online Clinical Synthesis and Nursing Informatics over the years.
Welden credits USI faculty for her decision to become a nurse manager. “They knew I had high standards,” she said. “One day, I was walking on campus with two of my instructors, and one of them said, ‘Look at your hands. Imagine if you could influence 80 to 100 nurses to give the same care that you do?’ I had four kids … I wasn’t interested in the manager job, but what they said got me thinking. I’ve been fortunate to hold positions to influence nurses to provide excellence in nursing care, use evidence-based practice and be involved in research.”
Each year, the USI Nursing Alumni Society recognizes a graduate who has made outstanding achievements in a career or public service. For more information about the USI Nursing Alumni Society, visit the society’s web page.
After studying neuroscience and immunohistochemistry at UCLA, Starks apparently realized that she was a definite Type N and decided to become a nurse. Already bursting at the seams with undergraduate degrees, she flew to the East Coast to pursue her studies in nursing. In New York, she went for an accelerated bachelor’s degree program for non-nurses (APNN) at the University of Rochester School of Nursing. Upon graduation, Strong Memorial Hospital snapped her up before she had a chance to go west again and installed her in the adult operating room, where she now works as a skilled vascular surgery nurse and preceptor.
However, Starks does not spend all of her time lollygagging about the OR or burying her nose in a textbook; she wants to effect change and has already created a place for herself among the new generation of upcoming nurse leaders. She is an active member in her local National Black Nurses Association chapter, the Rochester Black Nurses Association (RBNA), a founding member of the local chapter, and the chapter’s first vice president.
But that isn’t all. Stark is paying it forward as the founder and chair of the RBNA mentoring program in partnership with the URSON’s APNN program, where she and other Black nurses mentor nursing students of color. In true Type N fashion, she also manages to make time to participate as a member of the NPA’s Diversity, Equity and Inclusion committee.
After she earns her degree, Starks plans to work as an FNP in primary care. Her passion is caring for those with chronic diseases, especially African American patients. She plans to continue her advocacy for Black patients and students through her continued work in RBNA and other organizations and mentoring programs.
Unlike many students during the pandemic, Starks has been very fortunate with regard to clinicals, and told a reporter that “Luckily, within my program, they didn’t stop us from doing any type of clinical rotation or any type of classes.” In her acceptance speech, the charismatic FNP-to-be graciously thanked everyone who made the award possible and declared her dedication to helping to further NPs’ scope of practice in New York State.
To see an interview with Starks at a local Rochester station, click here. Her acceptance speech is below.
*There are two NPA winners, actually, and we congratulate the Region 7 winner Margaret O’Donnell, DNP, FNP-BC, ANP-BC, FAANP, who will have a post of her own shortly.
If you’re a nurse who loves poring over research, or feels passionate about bringing evidence to the bedside, then doctoral nursing just might be your perfect career path.
Of course, earning a doctorate takes significant time and effort. But because nurses are always engaging in continuing education, “I don’t think the idea of doctoral nursing is so foreign to a nurse,” says Stephen Ferrara, DNP, FNP, interim executive director of Jonas Nursing and Veterans Healthcare, a program that provides scholarship funding for nurses who are attaining a doctoral degree. Earning a doctorate in nursing allows a nurse to engage in such activities as research, apply for grant funding, teach, or enter into clinical leadership in an academic medical center, Ferrera says. It provides “lots of opportunities to take this newfound knowledge and really use it to impact the way that we’re caring for patients and ultimately to improve patient outcomes.”
As you may know, nurses can earn two types of doctorates. One is the classic doctor of philosophy (PhD) degree, and the other is the doctor of nursing practice (DNP). As of 2019, 37,852 employed nurses had earned a doctoral degree, according to one estimate.
Those who earn a PhD “are generally going to work on generating new knowledge, new research within the field,” Ferrara says. In contrast, the DNP degree “is really translating the knowledge that exists, or the evidence that exists, and applying it to clinical practice. So we think of the PhDs as generating new knowledge, whereas the DNPs are taking that new knowledge and applying it into clinical practice,” Ferrara says. He notes that the DNP has existed for roughly 15 years. (As editor-in-chief of the Journal of Doctoral Nursing Practice, Dr. Ferrara has considerable expertise on the topic of DNPs and their impact. The journal will publish its 15th volume in 2022).
You’ll likely need to invest two to four years to earn a PhD or DNP, depending on the program and whether your program is full or part time, notes Ferrara. PhD programs require a dissertation, while DNP programs require a final or “capstone” project. “The DNPs tend to be a little bit more streamlined in time, whereas the PhD programs are a little bit longer, just due to the nature of generating new research” and the challenges that may come along with that, Ferrara notes.
Doctoral nurses, Ferrara notes, can make an impact on systemic issues in healthcare. “We need evidence-based solutions that are easily deployed and constantly reviewed and garnering additional evidence so that we can truly design health systems that are patient-centric, that are not ones where clinical staff are burning out as a result of it. We are largely not present in those boardrooms and making those decisions that truly impact patient care and that’s where the doctoral nurse really can shine and really can escalate the conversation and offer meaningful intervention.”
Four impact areas
For its part, Jonas Nursing and Veterans Healthcare, which is part of Jonas Philanthropies, is designed to assist high-potential doctoral nursing scholars through scholarship funding as well as providing the expertise of subject matter experts. Celebrating its 15th anniversary in 2021, the program has invested more than $27 million in 1,400 nurse scholars in all 50 states, according to a press release.
In August, it announced its 2021-2023 scholar cohort of 76 doctoral nursing scholars in 49 nursing schools. Some 50 of these are PhD candidates and 26 are DNP candidates. Over half of this cohort will be representative of Black, Indigenous and other communities of color.
The program, notes, Ferrara, is founded on four impact areas: environmental health; mental health; veterans health; and vision health. Jonas scholars need to work primarily in one of those areas.
Jonas works closely with specific nursing schools to select the Jonas scholars. “It is actually through the recommendation of the faculty members that the students are encouraged to apply to the program,” says Ferrara. Applicants already have to be enrolled in a doctoral program. A Jonas scholar will be provided a total scholarship of $30,000 over two years.
For the first time, the 2021-2023 cohort will have the support of a group of subject matter experts to guide them in each area of expertise, according to the press release. “These subject matter experts will serve as a mentor, a guide, and a resource for the next generation of nurse scholars who are shaping the future of healthcare in this country,” says Lendri Purcell, vice president of Jonas Philanthropies, in the release.
Family and community
Besides the physical opportunity for doctoral students, the Jonas program brings a “family and community” component as well, says Pamela Wall, PhD, PMHNP, FAANP, who became a Jonas scholar in 2010 as a doctoral student at the University of Pennsylvania. Jonas currently is a clinical associate professor at the University of New Hampshire, teaching as a member of the psychiatric nurse practitioner faculty.
Wall notes that the Jonas scholars represent a diverse group that are “changing our health and leadership outcomes in the United States and globally.” A Jonas scholar directory provides a look at activities of the scholars.
“We are a family community of scholars that starts with your work in your doctoral program, but it extends beyond that. They have been a part of my community and my rhetoric and my family” since 2010, she notes. “It extends well beyond just the monetary component that Jonas brings to the table.”
Nurse of the Week Abigail Matos-Pagán, DNP entered a bright-blue house in Mayagüez, Puerto Rico earlier this summer and was met by Beatriz Gastón, who quietly led the way to her mother’s small room. Matos-Pagán had come to provide a Covid-19 vaccine for Wildelma Gastón, 88, whose arthritis and other health concerns confine her to bed.
Wildelma Gastón asked for her rosary to be placed on her chest and motioned to her “good arm,” where Matos-Pagán injected a first dose of the Moderna vaccine. The Gastón household, made up of five family members, breathed a collective sigh of relief. Though the vaccine had been available for months, Wildelma had been unable to reach a vaccination site. According to the Centers for Disease Control and Prevention’s COVID Data Tracker, Puerto Rico’s vaccination rate in March was one of the lowest among U.S. states and territories despite receiving more than 1.3 million vaccine doses. The rollout highlighted disparities in access to medical services, and the challenges of tracking and reaching remote citizens, such as Wildelma.
With each trip to school or work, family members worried about bringing the virus into their home and the threat to Wildelma’s life. Matos-Pagán also vaccinated two of Beatriz’s children, who are students at the University of Puerto Rico-Mayaqüez, during her visit.
“We have been waiting a long time for this moment,” Beatriz Gastón said as she hugged Matos-Pagán goodbye, expressing gratitude for the home visit. To her, the vaccine is more than protection from the coronavirus — it clears the way for the family to be together with her mother.
To Matos-Pagán, it is her latest calling. The nurse practitioner, who has guided relief efforts after hurricanes and earthquakes in Puerto Rico and elsewhere, has made it her mission in the U.S. territory to vaccinate as many people as possible against covid. Some residents of Mayagüez, a city on the western shore of the main island, candidly call her “The Vaccination Queen” and show up at her home asking for help in getting a shot.
According to The New York Times’ case tracker, as of Friday, Puerto Rico has had more than 182,000 covid cases and at least 2,594 deaths. About 57% of the population is fully vaccinated, but many of the unvaccinated are hard to reach because they live in remote mountainous communities or have chronic illnesses that leave them homebound. Matos-Pagán has vaccinated around 1,800 people in Puerto Rico so far, including 1,000 who have chronic illnesses or are bedridden.
In the pandemic’s early days, Carmen Blas’ health declined, and she began using a wheelchair. Blas, 78, was confined to her home, on the third story of an apartment building, which kept her safe from contracting covid, but later she couldn’t find transportation to a vaccination site. In June, her two children, Lisette and Raymond, visited from Wisconsin to help and immediately called the public health officials to get Blas inoculated.
“I usually come back every year and this was the longest I’ve ever been away. It was especially hard as my mother’s health worsened, and I worried I might never see her again,” said Raymond, who planned to extend his visit for as long as he was needed.
Matos-Pagán came to Blas’ home in Aguadilla, Puerto Rico, to give her the vaccine. The family cheered the moment the vaccination was over.
“It’s been really special to have intimate moments in someone’s home during vaccinations. You can tell how much it means to their entire family,” Matos-Pagán said afterward.
Mobilizing during a crisis is nothing new for Matos-Pagán. In the aftermath of Hurricane Maria, which cut off water and electricity to the entire island and claimed more than 3,000 lives, Matos-Pagán conducted initial community assessments in Puerto Rico’s remotest and hardest-hit cities. Flooding and debris made many roads inaccessible, blocking these communities from basic needs such as food, water, prescription medications and transportation. Then, after a series of earthquakes in 2020 rocked the island, leaving even more people without housing or in substandard structures, Matos-Pagán organized local nurse practitioners to provide community health care. They supplied at-risk populations with their medicines when pharmacies closed, and teams set up mobile medical tents near overcrowded hospitals.
“I’m hyper and busy in my daily life, but when there is a crisis, I am calm and still. Grounded. I feel like I’m where I belong,” she said.
Matos-Pagán was born in New York City. She became interested in medicine after watching nurses support her mother, who died of complications from an aneurysm when Matos-Pagán was 9. Her mother’s death taught her “nothing was permanent,” she said, which has inspired her to act when disaster strikes and support people through personal tragedy and loss.
Matos-Pagán returned to Puerto Rico to study nursing and later earned a master’s degree and a doctorate at the University of Puerto Rico-Mayagüez. Through her work, she holds various titles: first commander of the Puerto Rican Disaster Response Team, and director and founder of the Coalition of Nurses for Communities in Disaster.
Her experiences managing medical professionals and resources during hurricanes have taken her to locations across the U.S. Atlantic coast and the Caribbean. During the covid pandemic, she was recruited to assist in triage leadership for an ICU floor short on resources in El Paso, Texas, and a hard-hit senior living facility in Maryland.
“Not everyone is built for this. It’s really sad, depressing work,” Matos-Pagán said. “But even when there are mass casualties, you can still save lives and get people’s basic needs met. I’ve seen communities come together in the most incredible ways. It’s a challenge, but that’s what keeps me going.”
And, even as she is rapidly trying to get more covid shots into the arms of Puerto Ricans, Matos-Pagán is preparing for the next crisis. Hurricane season officially began in June, and she will be on disaster-ready duty until the end of November.
As Nurse of the Week Charlotte Thrall, DNP, FNP-C, CNE, FAANP sat anxiously waiting in the emergency room at Mayo Clinic for news of her husband’s condition after a pickleball accident left him unconscious and unresponsive, her mind spun with uncertainty. Then, among the health care workers that began to fill the room, her eyes settled on a familiar face.
It was her former nursing student, Lexy Richards. Lexy was now a neurosurgery NP for the Mayo team treating Dr. Thrall’s husband.
Their unexpected reunion was bittersweet but welcome, and the following morning, Richards was at Billy Thrall’s bedside, reviewing imaging and lab work, answering whatever questions they had and doing everything in her power to make sure Billy and Charlotte, whom Richards had known since she was a student at Arizona State University’s Edson College of Nursing and Health Innovation, were taken care of.
“It was so humbling to be in a position where someone who taught you everything you know and who you respect to the highest degree is now in a position of vulnerability,” Richards said.
Fortunately, Billy did not require surgery. But having Richards to reach out to during his recovery was invaluable to Charlotte.
“Those first eight weeks of recovery were particularly difficult, and she was … I don’t even have the words,” Charlotte said.
Now, nearly 20 weeks out from the accident, Billy is making good progress. And Charlotte and Richards are still frequently in touch — though not always concerning Billy.
A clinical assistant professor and coordinator of the Family Nurse Practitioner program at Edson College, Charlotte first met Richards as her professor. Equally impressed by each other, they quickly developed a mentor-mentee relationship, with Richards serving on the leadership team for HopeFest, an annual community health care event Charlotte and her husband launched in 2012, and Charlotte writing a letter of recommendation for Richards’ application to medical school to become a neurosurgeon, mere months before Billy’s accident.
Richards received word that her application had been accepted while Billy was still recovering in the hospital. She’ll begin attending the TCU and UNTHSC School of Medicine in Fort Worth, Texas, this summer.
“Charlotte and her husband are exceptional people, and she has been hugely supportive of my career,” Richards said. “Even on a personal level, she was so supportive when my husband deployed to the military. My depth of gratitude to her will always be tremendous for all the ways she has shaped my life. It has been a gift for me to be able, in some small way, to help her and her husband through this experience.”
Charlotte and Billy met in Paris in 1984 on a service trip when she was 19 and he was 21. They’ve been married for almost 33 years now, and during that time, they have become well known for their various community outreach efforts in the Phoenix area, where Charlotte works as a nurse and Billy works as a nonprofit consultant.
It was around 2009 when Charlotte realized she wanted to be able to practice clinically in an independent manner, in order to better serve her community. So she enrolled in Edson College’s Doctor of Nursing Practice program and graduated in 2012. She began teaching for the college as an adjunct faculty member in 2013, then became coordinator of the Family Nurse Practitioner program in 2017.
While teaching in the program, Charlotte also served as a mentor to another student, Jonathan Helman. Like Richards, Helman served on the HopeFest leadership team and was moved by Charlotte’s example of care and compassion, both for her students and for the community.
“She’s one of those people you realize pretty quickly is a special individual,” he said.
Helman now teaches at Edson College himself, sometimes alongside Charlotte. He also works in a field very similar to Richards’ — neurology. And when it came time for Billy to transition from recovering at the hospital to recovering at home, Helman was more than willing to provide consult.
“When I heard what happened, I immediately wanted to give back, I suppose almost as a way to repay her for the incredible influence she’s had on my life,” he said. “I’m not just blowing smoke, I quite often think about the type of provider she is and try to emulate that in my everyday practice. She is one of most empathetic people I know. … She has touched so many lives, either directly as a practitioner and through her outreach efforts, or indirectly as a professor who is teaching students who will eventually go out and serve the community, too.”
Former classmates who have remained good friends, Helman and Richards frequently consult with one another about patients because of their closely related specialties. This time around, it was for the benefit of someone for whom they care deeply.
Despite the reason for this, their most recent collaboration, Charlotte feels grateful to have been able to observe them in action.
“They were a gift to us,” she said. “I would never have anticipated having to rely so much on former students to guide us through such a difficult medical situation, but I knew the kind of students they were, I knew how prepared they were and how well they had done, and I knew I could really trust them.
“There were moments I thought that I could actually see them utilizing some of the things that I had taught them, like motivational interviewing or compassionate care, and in my mind, I thought, ‘I need to tell them later what a good job they’re doing.’ I was just so grateful for them, and it really encouraged me and reminded me that what we do when we train people to be clinicians is really, really important. And there’s a reason why we want to do a good job. There’s a reason why the program is challenging. There’s a reason why we are so careful about who we select to be in the program. Because it matters every day to patients like my husband and the hundreds of others out there.”.
When patients present with a specific type of heart attack (non-ST elevation acute coronary syndrome) or chest pain related to coronary heart disease (unstable angina), they often undergo several tests—many being invasive—and then they may be sent to other facilities for even more procedures.
It’s time-consuming, it can be confusing to the patient, it can be stressful on the patient’s body, and when combined, can lead them to abandon care.
Sarah Slone, DNP, MSN, FNP-BC, CCRN began to address this problem from an implementation science standpoint in her Doctor of Nursing Practice (DNP) project. She aimed to streamline the process of existing care options from acute symptom presentation in the hospital to discharge.
But ultimately that raised a new question:
Can we determine best practices for when patients need catheterization (an invasive procedure) so that we can establish a standardized approach and identify barriers to care that may exist?
“Any invasive procedure carries risk,” Sarah says. “There are non-invasive options like stress tests, information that can be gleaned from a patient’s presentation and previous lab work, and newer options with CT scanners.”
Now she’s pursuing the question from a discovery science standpoint. Her Ph.D. research examines “care pathways” from acute symptom presentation to various methods of invasive and non-invasive testing, to establish best practices for when patients are most in need of these procedures.
From Implementation to Discovery
Sarah Slone graduated from the DNP Executive Track in May 2019, then started the Ph.D. in August 2020. She is in a new Johns Hopkins School of Nursing program that offers an alternative pathway to Ph.D. for nurses who have earned a DNP. Students can transfer credits and earn their Ph.D. in about three years compared to about five years.
The DNP Executive Track is online with on-site immersions, but Ph.D. students must live in Baltimore. So Sarah moved from South Carolina to Baltimore, alone, at the height of the COVID-19 pandemic.
She considered delaying her start but didn’t want to let the time go to waste. And even before the move, the family living situation was complicated.
“My husband is an interventional cardiologist who works in a hospital. At the beginning of the pandemic, we had to decide if we wanted to live together since he would be at risk of being exposed. Our son is in college, but he returned home because of COVID. He decided that he wanted to remain in the house as well,” Slone says.
Now in her second semester, Sarah reflects that the Ph.D. is not harder, but different than the DNP.
“The DNP enriched my perspective as a nurse scientist, but I learned that questions arise from evidence-based practice, and I needed a Ph.D. to explore that further.”
—SARAH SLONE, DNP, MSN, FNP-BC, CCRN
“I’ve already grown a lot in terms of research,” she continues. “I came in with a specific idea of what I wanted to do and was able to develop my research project with my mentors into something not just fundable, but something that can grow into a wider program of research.” Sarah’s DNP mentor was Dr. Deborah Baker, Senior Vice President for Nursing of Johns Hopkins Health System and her Ph.D. mentors are Dr. Cheryl Dennison Himmelfarb and Dr. Kelly Gleason.
Sarah recommends that, if you are considering a Ph.D. and have a DNP, define your research questions early. “The sooner you can do it, the better you can align assignments, so they build and benefit you throughout the program.”
A Passion for Research
Sarah always had a passion for research—from working as a research assistant in a plant pathology lab in high school to initially studying biochemistry in college. She took some time off from undergrad to have a family and later decided to pursue a BSN. Upon graduation, she worked as an ICU nurse for five years, then became a family nurse practitioner, followed by work in general and trauma surgery. She discovered a passion for cardiovascular care when the 36-hour shifts in trauma surgery became too much (especially with a young family!) and the cardiovascular service was hiring.
“It’s fascinating,” Sarah says. “Cardiovascular disease remains the number one cause of morbidity and mortality in the United States. There’s so much opportunity to improve the lives of patients.”