“The future of nursing and health care is unknown, and the COVID-19 pandemic has brought a newfound urgency for us to work together to find solutions to both long-standing issues and new challenges,” said Bettencourt. “Starting now, we step forward with a renewed sense of purpose, a commitment to action and a focus on a better tomorrow.”
Bettencourt is an assistant professor in Penn Nursing’s Department of Family and Community Health. As an educator, researcher and pediatric clinical nurse specialist, her focus is on achieving the best possible outcomes for acutely and critically ill children. Her current research involves evaluating factors influencing the research-to-practice gap in critical care settings and testing implementation strategies targeting the interprofessional team to improve evidence-based care. She was recently a postdoctoral fellow at the University of Michigan, where she was appointed to the National Clinician Scholars Program and received advanced training in implementation science. Previously, she was responsible for ensuring high-quality nursing care and optimal outcomes for burn, trauma and pediatric patients as a clinical nurse specialist at Regions Hospital in St. Paul, Minnesota, and at UF Health Shands Children’s Hospital in Gainesville, Florida.
Bettencourt’s extensive volunteer service with AACN includes board liaison, NTI Program Planning Committee (2021), AACN – AACN Certification Corporation Nominating Committee, (2020-2021), community moderator, online AACN Peer Support Community Development Team (2020) and board liaison, Chapter Advisory Team (2019-2020).
Her additional affiliations include the American Burn Association and Sigma. In addition to presenting at the National Teaching Institute & Critical Care Exposition (NTI), she has led sessions at several other conferences, including the American Burn Association’s annual meeting. Bettencourt’s publications are in the areas of implementation science, nursing and patient safety, nurse staffing and work environments, burn critical care and pediatric delirium.
Bettencourt earned a Bachelor of Science in exercise science from the University of Florida, an accelerated Bachelor of Science in Nursing from the University of North Carolina at Chapel Hill, and a Master of Science in Nursing from Johns Hopkins University, Baltimore. She earned a PhD from the University of Pennsylvania and a Master of Science in health care research at the University of Michigan.
Before she assumed the role as president, Bettencourt served a one-year term as president-elect. Before that, she completed a three-year term as a director from July 1, 2018, through June 30, 2021, and a one-year term as treasurer from July 1, 2019, through June 30, 2020.
For more than 50 years, the AACN has been dedicated to acute and critical care nursing excellence. The organization’s vision is to create a healthcare system driven by the needs of patients and their families in which acute and critical care nurses make their optimal contribution. AACN is the world’s largest specialty nursing organization, with more than 130,000 members and over 200 chapters in the United States.
In the Covid era, we often hear (and can’t help but understand) that older nurses, resources exhausted by their pandemic ordeal, are retiring early. Nurse of the Week Mercedes “Mercy” Kallal, RN, however, has been a nurse for over half a century now and at 83 years old she just isn’t ready to hand in her stethoscope. She tried once, about a dozen years ago, but even after working the Covid-19 frontlines—in her 80s, mind—there’s no evidence that Kallal might be running out of steam.
By now, it’s hard to imagine the post-anesthesia care unit (PACU) at New Jersey’s Jefferson Washington Township without the diminutive RN (Mercy is barely five feet tall). Fortunately, Kallal finds her work so meaningful that she’s in no hurry to hang a “Gone Fishing” sign on her door. “As long as I am mentally and physically able, I would love to dedicate my remaining life to taking care of patients … and help[ing] people,” she told the Philadelphia Inquirer. The Daisy Award winning RN seems to thrive on helping staff as well as patients; she’s the first person they call when someone needs a holiday or evening off, and the hospital even lauds her willingness to “help… younger co-workers balance life and work.” Jefferson Washington VP of Operations Autum Shingler-Nace happily describes Mercy as “A nurse’s nurse.”.
“What the heck is this? I was supposed to become a nun.”
This does not mean that Kallal is an ascetic lady-with-a-lamp who lives only for her patients. She has been a widow for years, but always has plenty to do. When off duty, she loves to travel, hit some casinos, and watch horse races. To wind down, she works in her garden.
Nonetheless, nursing truly is the life calling of this small gambler. In fact, Mercy’s husband entered her life as one of her patients.
After Arthur Kallan was discharged from the hospital, the feisty little nurse who had cared for him loomed large in his mind. Initially, when her former patient began to call and said that he missed her, Mercy was nonplussed, to say the least. The devout Roman Catholic recalled, “I thought, ‘What the heck is this? I’m supposed to become a nun.’ But we started dating.” In fact, the match worked out so well that she acquired her fondness for horse races from her patient-turned-spouse.
Kallal’s nursing career began in the Philippines, where she graduated from nursing school, and ventured to the United States in 1969. When she and a few fellow grads landed in Philadelphia, the newly arrived nurse says, “They put me in charge of 32 patients, and when I asked why, they said it was because I had a big mouth… I didn’t know the idiomatic expression, so I took it literally.”
After that, the nurse gravitated to Newark. Apparently, her mouth was not quite the right size yet for New Jersey (there is a checkpoint when one enters the state), so before long Mercy returned to Philly and picked up a range of nursing experience, including a VA hospital, a nun-managed nursing home, and finally, the heart transplant unit at Temple University, where she settled for two and a half decades.
“We keep thinking she’ll slow down a bit, but she keeps picking up more shifts.”
As she completed her 25th year at Temple, though, Mercy decided that she had had enough and DID retire… for a bit less than a year.
It was a delight to indulge in nearly 11 months of travel, but her savings began to dwindle, and now in her 50s, she still had an overabundance of energy and nursing beckoned to her once more. Widowed and living alone with no immediate family in the US, she took stock and thought it was time to work again “before I become a pauper,” and besides, “I live[d] by myself now. How much can you clean?”
By this point in her life, Kallal’s mouth must have been just the right size for NJ and the hospital now operating as Jefferson Washington Township was a mere 5-minute drive from her home (another reason she’s everyone’s go-to when someone needs to be covered). Into her 70s by then, Mercy began by taking things slowly and worked part-time, but that didn’t last for long. As a PACU co-worker told the Inquirer, “We keep thinking she’ll slow down a bit, but she keeps picking up more shifts.”
Patients, Mercy is not here for your careless risks
Since then, in addition to becoming known for her willingness to cover shifts whenever possible, Kallal is the unofficial PACU Health Martinet. She does not hold back when patients are disruptive, abusive, or take dangerous risks, and co-workers have been known to shamelessly throw particularly difficult charges on their Mercy. Her view: “I’m very strict and I explain to the patient that this is the way it has to be. You have to listen to your nurse.” But she adds, “And before they leave, they give me a hug and a kiss.” The kind-but-firm Philippine-born RN also meets any misguided obstinacy over masking or vaccination head-on—or something like that: ”I tried to explain getting vaccinated to one patient and she just looked at me like I had two heads. But at least I did my job as a nurse.”
To read the full story—and see more pithy Mercy quotes—click here.
The $125 million donation by Leonard A. Lauder, Chairman Emeritus of The Estee Lauder Companies, to create this first-of-its-kind, tuition-free Program is the largest gift ever to an American nursing school. Mr. Lauder is a Penn alumnus. The gift comes at a time when the COVID-19 pandemic has magnified the nation’s acute shortage of primary care providers, and persisting inequities in access to quality healthcare.
“This is the most timely and consequential gift not only for our university but for our country. It is unprecedented in its potential to address America’s most critical need of providing primary health care to all who currently lack it by investing in nurses,” said former Penn President Amy Gutmann.
“Growing the number of nurse practitioners who are prepared and committed to working in underserved areas is the most practical and inspiring way to ensuring a healthier country. I am grateful and honored that Leonard would make this gift to Penn Nursing, and thrilled to know that it will have an immediate impact that will last far into the future.”
Nurse practitioners are leaders on the front lines of care, a role never more important as Americans confront a primary healthcare shortage in their communities. With their advanced clinical training and graduate education, nurse practitioners have the knowledge and skill to supervise and manage critical aspects of care in a decision-making capacity, from patient diagnosis, to ordering and interpreting tests, to prescribing medication. Nurse practitioners deliver high-quality primary care to people of all ages, such as treating common illnesses, managing chronic conditions, and providing preventive care that helps patients stay healthy.
Nurse practitioners are also able to take on key leadership roles, from managing and operating walk-in or community clinics to leading interdisciplinary teams within health systems. The new Program will better the lives of patients and communities most in need, while providing a pathway for the many nurses interested in advanced education who may not otherwise have the means to pursue it.
Structure: Leonard A. Lauder Community Care Nurse Practitioner Fellows will enroll full-time in a two-year, rigorous Primary Care Nurse Practitioner Program at Penn Nursing.
Community Practice: Fellows will complete at least 50 percent of their clinical education at community partner sites in the greater Philadelphia area that provide direct patient care, an invaluable experience that will prepare Fellows to meet the complex needs of patients and families throughout their careers. Every Fellow will be expected to commit to practice or service in an underserved community for two years after graduation.
Recruitment: Penn Nursing will select 10 Fellows to begin classes this fall, growing the program enrollment through 2026 when it will reach its annual target enrollment of 40 Fellows, continuing in perpetuity. By 2027, the program will have enrolled 140 excellent nurse practitioner students. Fellows will need to show a demonstrated commitment to working in underserved neighborhoods, where they are needed most, and to promoting health equity.
Tuition: All participants in the program will enter the workforce free of graduate school debt, receiving student aid to cover their tuition and fees and thereby eliminating any potential financial barriers for nurses and others who wish to enroll. Fellows with greater financial need will also receive stipends to help with living expenses.
Program Leadership: Penn Nursing will name the first endowed Leonard A. Lauder Community Care Nurse Practitioner Professor, who will oversee curriculum innovation, support of community sites, and program implementation.
Penn Community Partnership: Penn Nursing will provide support for select community partner sites to support the clinical education of Fellows while providing professional development and networking opportunities and access to School and University resources.
“Penn Nursing has a long history of advancing science, promoting equity, practice excellence, and preparing leaders. That’s why Mr. Lauder’s gift is so meaningful. The synergy between Penn Nursing and the Program will improve the health of underserved patients and families, by uniquely preparing primary care nurse practitioners, who will work with them in their communities. The sustained investment in the education and careers of primary care nurse practitioners and communities is unprecedented. We are excited by the opportunity to lead this important Program and to extend its impact beyond Penn Nursing,” says Penn Nursing Dean Antonia Villarruel. “We are deeply grateful to Mr. Lauder for recognizing and investing in this critical need, and for partnering with us in this ambitious endeavor.”
NPs are “key” to health care in underserved communities
Stephen P. Fera, Executive Vice President of Independence Blue Cross, which is one of the community partners that will be involved in the new initiative, noted that nurse practitioners are key to improving individual and community care. Said Fera: “Bolstering the nurse practitioner workforce is a means to improve access to care and strengthen the health care safety net provided by health centers. This is a key priority of the Independence Blue Cross Foundation and our partnership with Penn Nursing has been synergistic in efforts to prepare nurses to work in community-based settings. The Program will build and strengthen our individual and collective efforts toward improving the health and well-being of communities.”
“Now more than ever, the country needs greater and more equitable access to quality primary care—and highly-skilled nurse practitioners are the key to making that happen,” said Leonard A. Lauder. “The program will ensure that more Americans receive the essential health care services that everyone deserves, and I’m so pleased to be working with Penn Nursing on this initiative. I look forward to welcoming our first class of future nurse practitioners this fall. I know their expertise will be matched only by their commitment to serving our communities.”
The American Association of Nurse Anesthesiology (AANA) is presenting the Pennsylvania Association of Nurse Anesthetists (PANA) with the Excellence in State Government Relations Advocacy Award at its Mid-Year Assembly in Washington, D.C. this week.
The Excellence in State Government Relations Advocacy Award, established in 2016, is presented annually to a state association based on the quality of its efforts in the state legislative or regulatory arena for the nurse anesthesiology profession. The recipient is chosen by the AANA Government Relations Committee.
In 2021, the PANA successfully lobbied for a law that includes formal title recognition for Certified Registered Nurse Anesthetists (CRNAs) in statute for the first time, clarifies the CRNA relationship with physicians and dentists, and allows for CRNAs to work with podiatrists.
“The pandemic raised awareness of the critical roles that CRNAs play in healthcare settings and how some state policies prevented CRNAs from practicing to the fullest extent of their education and training at precisely the time they were most needed,” PANA President Lew Bennett, DNP, CRNA, said. “We are honored to be recognized by the AANA for our achievements.”
To increase the flexibility of healthcare resources, Pennsylvania Governor Tom Wolf waived physician supervision during the pandemic. PANA used this opportunity to build relationships with legislators to support title recognition legislation.
“The relationships PANA developed with the governor and legislators will benefit CRNAs for years to come,” Bennett said. “Thank you to the many Pennsylvania CRNAs who laid the foundation for this effort, and those who will continue to fight to protect CRNA practice in the future.”
In addition, PANA developed relationships with a coalition of nursing, rural health, and other groups, including Americans for Prosperity, the Pennsylvania Farm Bureau, and the National Guard, all of which validated and reinforced PANA’s message to legislators.
As advanced practice nurses, CRNAs are members of one of the most trusted professions according to Gallup. CRNAs provide anesthesia care across all settings and in all patient populations and are the primary anesthesia providers in rural and underserved areas and on the battlefield in forward surgical teams.
During the COVID-19 pandemic, nurse anesthetists across the country have been essential in addressing the deadliest part of the disease in addition to providing top-of-the-line anesthesia care. They have served as experts in airway management, hemodynamic monitoring, management of patients on ventilators, and overall management of critically ill patients.
As 2021 nears its end and we prepare for pinning and graduation ceremonies, our Nurse of the Week is a classic American story about starting from nothing, working hard (and smart), and refusing to give up the pursuit of your dream.
The student marshal who leads her fellow grads in the procession to commencement represents the best of the student body. Selected on the basis of outstanding academic achievement and contributions to student life, the student marshal is often someone who excels even as they overcome obstacles that can bring many to a crashing halt. At Penn State’s Ross and Carol Nese College of Nursing, the fall 2021 graduation ceremony is being led by Aleksandra Williams, who will soon have the letters “BSN” after her name.
Not long ago, the Schuylkill campus student was a near-penniless, non-English-speaking immigrant from Ukraine. Williams came to the United States by herself when she was only 19 years old with one suitcase and $500. She began working as a housekeeper, building her new life, and learning an entirely foreign language. As she progressed through her life in America, Williams knew she wanted to pursue a new and more meaningful career path.
“My mother is a nurse and used to work long shifts at the children’s hospital in Ukraine. She had been raising me by herself and used to take me to work with her because there was nobody to watch after me,” said Williams. “I saw how my mother took care of the children and I thought of her as my hero.”
After meeting her husband in the U.S. and having a healthy baby boy together, Williams and her husband welcomed their second child. Unfortunately, their second child fell ill, and after many visits with nurses and doctors, recently died.
Her dream of becoming a nurse lived on, though, and she simply could not stop excelling. In 2017, Wiliams received the SEDCO Scholarship for Workplace and Adult Education. A year later—as the Schuylkill Campus student with the highest GPA—she earned the 2018 President’s Freshman Award. Apparently, in 2019 the school temporarily ran out of awards. After they replenished their supply, Williams bounced back in 2020 when she won the Lehigh Valley Hospital-Schuylkill Medical Staff Award to the Class of 2020 Valedictorian. Now, Penn has tapped the young mom to be Student Marshal for their 2021 BSN class.
“Aleksandra is such a bright and caring student; she sets high standards for herself and her peers. She has successfully balanced academic, personal, and professional life while completing her BSN and we are so thrilled that she is exploring graduate program options. I sincerely look forward to watching Aleksandra grow as a nurse and her contributions to our profession.” said Marianne Adam, Penn State Ross and Carol Nese College of Nursing program coordinator and professor at the Penn State Schuylkill and academic advisor to Williams.
Williams will accept her diploma on behalf of the college during the University-wide commencement on Dec. 18, in the Bryce Jordan Center. After the daughter of Ukrainian nurse Tatiana Zhukova receives her BSN, she plans to work toward an MSN and DNP at the Penn State Ross and Carol Nese College of Nursing.
Despite the collection of previous awards and honors, Williams has not become jaded. She was surprised and delighted to be chosen as the college’s 2021 marshal: “I could not believe what I was reading,” the future MSN and DNP claimed. “I had to re-read the email several times. For me to be selected as a student marshal is very important and I am beyond honored.” Congratulations, Aleksandra! It takes a massive amount of work, determination, and discipline to become a model of nursing excellence before you even receive your BSN. No pressure :)!
Jennifer Grubb, our Nurse of the Week, is a military veteran who is now deploying her hard-earned experience to help others as a nurse.
The PA native started her career in 2003 at the age of 20, when she served in Afghanistan at the height of the post-9/11 military action. Grubb was a combat lifesaver and worked security details in a place where saving lives was often impossible, and no one could afford to feel secure. She saw comrades die in attacks, witnessed the wretched collateral damage suffered by civilian adults and children, and picked her way through minefields.
Like so many soldiers, she struggled as her psyche attempted to process things that most people are not meant to process. In an interview with her hometown Pennsylvania newspaper, The Daily Local, she recalled, “I saw so many gruesome sights. I just hated where I was and decided my best route was just to feel nothing… I started writing less, I started calling less, I started eating less.” Finally, after Grubb had lost 80 pounds during her quest to seal off the horror of war, the Army medevacked her back to the US with an honorable discharge. Then, again like so many other soldiers, she found that even 7000 miles somehow failed to provide a safe distance from the war. As she describes it, “you don’t fit in in your own life anymore. I was always looking over my shoulder. The slightest thing made me jump.”
The nightmares were so intense that they seemed to taint her waking hours, so she tried her best to avoid sleeping and numbed the trauma with drugs. Eventually, she slid to one of those make-or-break low points: “I was just going to use drugs until it killed me. I had one moment where I had a glimmer of hope, and I prayed to God to save me. Two hours later, I was pulled over and arrested for possession of crack cocaine.”
Things began to arc upward when the court allowed her to enter a drug program, and Grubb’s new therapist diagnosed her with PTSD. “I wasn’t Jenn anymore; I was PTSD, with all of my symptoms, and allowing it to really consume my entire life.” With the help of her therapist, though, and treatment at her local VA medical center, she says, “I started to smile more. And the nightmares became a little less. And not every social situation I was in made me jump out of my skin. And I just tried to stay sober, just one day at a time.”
In 2015, Grubb’s life asserted itself as being on an upward swing when she was invited to a women’s vet breakfast with then-first lady Michelle Obama and Jill Biden. During the gathering, Obama noted, “So much of your rise had to do with that reaching out and realizing that there are so many folks out there that are ready to just take your hand.” Grubb realized she was in an ideal position to help other vets sidestep the pitfalls of the self-reliant military ethos and the notion that “we can do anything by ourselves, and I don’t need your help.” She adds, “And there’s such a stigma attached to reaching out.”
As the urge to serve and help others is part of her nature, the recovering vet soon sought ways to do that. While PTSD is chronic – Grubb will always do her best to avoid crowds and can only tolerate sitting in an auto passenger seat if her trusted husband is driving – the treatment allowed her to acclimate. “PTSD is not hopeless,” she says. “There are ways to make it a part of you rather than have it define you.” Once she felt that her demons were tightly reined in, Grubb became an LPN, then a director of patient services at an SUD treatment facility. When the latter’s lack of resources had her teetering on the edge of burnout, she then found a position at the VA center where she first received help herself, the Coatesville VA Medical Center.
Now, the LPN, Almost-BSN is caring for fellow vets and helping them navigate their own trauma ordeals. The military connection is powerful. “These guys and these gals, they’re my brothers; they’re my sisters. There’s a closeness and a bond even with strangers that I can’t really explain to the rest of the population. There’s a level of trust that comes with it.” Deciding that she had a calling to pursue, Grubb earned a BA in Psychology, then entered Immaculata College’s accelerated BSN program, where she will graduate in 2022.
Becoming a nurse came naturally to Grubb. She was moved by the nurses who cared for her when her daughter was born, and realized, “When I left the service, I missed being in service to people.” Today, she’s finishing her BSN program and working as a communications specialist at the Coatesville VA, where “I’m good at my job because of the personal connection I have to it. With the veteran population, they want other veterans to be their caregivers. They want people who really get it.”
For more details about Jennifer Grubb, see the excellent Daily Local article here.