Tell us about your background, schools attended and your family.
I was born in Rockford, Illinois and traveled to New London, Connecticut with my mother as a newborn. My father was a submarine officer and we joined him when I was six weeks old. We lived between Portsmouth and New London until I was 7. At that time my father was retired from the submarine service because of illness.
I received my BSN and MSN from Northern Illinois University, in Maternal/Child Nursing, and my Doctorate of Nursing Science (DNSc), from Rush University. I have always been interested in research and evidenced-based practice. I have received several grants from the Society for Education and Research in Psychiatric Mental Health Nursing (SERPN), Midwest Nursing Research Society and Illinois Department of Public Health.
I have four children who each have their own careers. Michael is a pilot for Jet Blue Airlines, T.J. is a pilot for Continental, Don II recently graduated from Southern Methodist University Law School and Shannon is the director of marketing at Podesta Mattoon. I have five grandchildren, three girls and two boys.
I have previously been employed as an Obstetric and Pediatric Nursing Instructor, Psychiatric Nurse Manager, Case Manager with certifications as Pediatric Advanced Life Support Instructor (PALS), Neonatal Resuscitation Program Instructor (NRP), International Board Certified Lactation Consultant (IBCLC) and a Maternal/Child Clinical Nurse Specialist (CNS). I have been a Director of Professional Development, and Director of Women’s and Children’s Services, before being hired as the Director of Women’s Services at OSF Saint Francis Medical Center.
I developed the first postpartum clinic at OSF Saint Anthony Medical Center during the time women were being discharged from maternity units within 24 hours after delivery. I love to travel so when I was asked to lead international missions to China, Australia and South Africa for the International Scholar Laureate Program between 2002 and 2005, I accepted immediately. I firmly believe the way we will achieve peace in this world is through the understanding of other cultures and I enjoyed facilitating that understanding.
I have received many awards in my life, but there are a few I really cherish: The John Hyel Vincent Award for Excellence in Teaching, the YWCA Alta Hulett Award for Professionals and the Innovation in Women’s Health Special Recognition Award from The Snowmass Institute.
You are Director of Women’s Services. What is included in that position?
This position includes oversight of the Family Birthing Center at OSF Saint Francis, which encompasses the units of Antepartum, Labor and Delivery and Mom/Baby, and supervision of the Maternal-Fetal Diagnostic Center, where high-risk mothers are seen in the office and in the hospital. It also includes oversight of our Centers for Breast Health at our five locations. Women’s Services also includes the Breastfeeding Resource Center, Natural Family Planning Program, Women’s Resource Center, plus the osteoporosis program and several grants.
Who or what influenced your decision to become a nurse?
My father was a World War II naval war hero. He made 12 war patrols of approximately 55 days each in enemy waters. Eleven of these patrols being considered successful, costing the Japanese navy some 42 war craft, including three destroyers, 14 destroyer escorts and one submarine. He received several citations: Gold Submarine Dolphin, two silver stars, two bronze star medals, Presidential unit citation, the Navy unit commendation and individual commendations from Admiral Nimitz and the Secretary of the Navy. He was written about in Run Silent, Run Deep and Submarine. When he became ill it had a profound impact on me. When he died at age 40 of service-related injuries, I was devastated. He was my hero. I wanted to become a nurse to help people.
How has the nursing field changed in the last 5 years? Ten years?
Nursing has become technologically savvy, as has all of healthcare. In the past 5-10 years, the paper chart has evolved into an Electronic Medical Record (EMR). Nurses have learned more about evidenced-based information related to their practice. There is licensure for Advanced Practice Nurses and more standardization of processes in healthcare. There is now benchmarking “for best practice;” however, nurses always strive to provide the very best care possible in their practice. There is more emphasis on quality and safety, and the creation of safety officers and unit safety champions have become commonplace. Joint Commission on Accreditation of HealthCare Organizations (JCAHO) now has safety goals for healthcare institutions.
As an international board certified lactation consultant, I have also seen a greater emphasis on helping mothers to breastfeed their babies. I feel this was a major step in progress for babies. Breast milk has a significant protective effect for healthy babies but even more so for pre-term infants. Necrotizing enterocolitis is a disease that affects the infant gut and breast milk can help prevent it. Nurses and lactation consultants have had an impact on the education of mothers about breastfeeding.
Nursing care in all fields has become more specialized. Because of the shift of much of medical care to outpatient services, those who are admitted to the hospital are much more ill. Caring for these very sick patients has made nursing more complex and demanding.
What trends are you seeing in regards to women’s health issues in the past 10 years? 5 years?
More women in the past 10 years are working, having fewer children and starting families at a later stage in their lives. Baby boomers revolutionized pre-natal care when they were of child-bearing age. Now they have begun to do the same with menopause. They are well-informed women who want to be involved in their healthcare, not just bystanders. They are curious about all forms of alternative healthcare: from bio-identical hormones to the benefits of therapeutic massage, aromatherapy, and acupuncture, just to name a few. There has also been a revitalization and interest in exercise and diet. Women want to know ways to improve their health and prevent disease. There has been a significant interest in yoga, Tai Chi, and other forms of stretching, meditation and relaxation. Community screenings have become common place. Because women represent over 50 percent of the workforce, they need healthcare screenings to be convenient and available. Community screenings at the mall or in the grocery store fit that bill.
What future issues do you believe will become more important to women’s health needs?
I believe heart disease, incontinence and osteoporosis will become more important as women’s health issues because the population is aging. Heart disease is the number one killer of women over 50 and has been since 1908. Many women do not believe they are at risk for sudden cardiac death; hence they do not pay attention to subtle signs and symptoms such as insomnia, fatigue, etc. The fact is that 500,000 women die each year from heart disease (one woman every minute). Heart disease is gender-specific and has different presentations in men and women. The take-home message for women is: be your own heart advocate. Partner with your physician and have your lipids checked annually, just as you have your mammogram. Keeping tabs on your waist is another important point that women sometimes forget. A circumference greater than 35 inches puts you at risk for metabolic syndrome, which is a cluster of symptoms that includes high blood pressure, high insulin levels, excess fat and abnormal cholesterol levels. If you suffer from depression, (more women than men do) you are more likely to get heart disease, probably because you may be more likely to indulge in behaviors as smoking and overeating. Depression can also set off chemical changes that increase blood pressure and make platelets more likely to form a clot. There is already great awareness of breast disease. We must raise awareness of heart disease to that same level.
Osteoporosis is another disease which affects an older population. It is a “silent killer” because it has virtually no symptoms. Calcium intake, as you age, is just as important as it was when you were building bone. Women over age 50 need 1,200 mgs of calcium daily, according to the National Osteoporosis Association. It is important that calcium is taken with Vitamin D, in divided doses of no more than 600 mg at one time, as the body will not absorb more. Women are approximately three times as likely to have a hip fracture as men. Women also need to be screened for osteoporosis just as they need to have their mammogram and have their lipid panel completed annually. Prevention is easier than treating a disease, but in America we are only now coming to that realization, although health promotion and disease prevention have been the mantra in nursing for many years.
Incontinence issues will also become more important as women age. Because leaking, urgency and frequency are embarrassing for many women to discuss, they often do not consult with their physicians until the problem has intensified. It is important to know that there are many treatments and your physician can give you guidance so you can find resolution to the problem, the earlier the better.
You have been a Lamaze childbirth educator for many years. Have the instruction techniques or methods changed through the years? Are women today embracing more natural methods of childbirth?
As a Lamaze fellow since 1991, I can safely state that Lamaze education is a wonderful preparation for childbirth. The best thing about this method is that it has not changed much since it originated and when it has, it’s been for the better. There is a certain portion of the pregnant population that opt for a completely non-medicated birth. Most utilize a combination of methods, including medication. The goal of a Lamaze Childbirth Instructor is to adequately prepare the couple through education which will instill confidence in the couple or the women and to be certain that no matter how the birth is executed, the woman feels successful—there is no right or wrong. The outcome we want is a healthy mom and a healthy baby.
Has the age of first-time mothers affected traditional care of expectant mothers and their newborns?
I do believe that because the age of first-time mothers has increased, it has presented a new and different set of concerns. Many women have opted to have a career and then motherhood at a later date. When women begin childbearing in their mid-to-late-30s some encounter fertility issues. Some are easily treated, some need more attention. When women experience fertility issues and are treated for them, there is a greater chance for multiples. When women are pregnant with multiples, it increases the risk of the pregnancy. There are ways to address the concerns of infertility, natural fertility care being one. Paul Kortz is a fertility care specialist at OSF Saint Francis who provides a natural method of fertility care when other methods have failed.
As more women enter the menopausal years, has the care and/or expectations of women changed in the past 10 years?
As the baby boomers enter menopause the expectations of women have changed. Women are far more informed about their alternatives. The Heart Estrogen Replacement Study I and II and the Women’s Health Initiative studies provided women with information, but still left many questions about estrogen and whether it should or should not be taken. This is very individualized and should be discussed by each woman with her physician. Many women feel good as they enter menopause. They are much more energetic, healthier and full of life than their mothers. A woman who lives into her 50s (on average) can expect to live into her 80s. That is wonderful to look forward to if you are healthy. Women are more likely to be healthy through menopause and beyond, if they take care of themselves in body, mind and spirit.
You have done a lot of work with domestic violence and women. Are nurses trained to assess if a woman might be a victim, but afraid to tell someone?
We have raised awareness around domestic violence (DV) considerably since our DV act was created in 1986. Nurses have always been advocates for patients and DV victims are not different. Since 1992, JCAHO has mandated that there be policies and procedures related to screening for DV. Unfortunately, policies and procedures do not always translate to screening of patients. Nurses are in a great position to screen patients for DV. They have always been patient advocates and they see patients in the healthcare setting. Screening all patients for DV is appropriate. I was a speaker for the statewide Family Violence Coordinating Council and aided in the education of each judicial district in the State of Illinois about DV. The following are two questions that could be used to screen for DV: Has a recent-past or current partner ever caused you to be afraid? Has a recent-past or current partner ever physically hurt you?
From my own and others’ research we know that if healthcare professionals screen for DV the percentage for identification goes from 5-7 percent to 29-30 percent. Time is always one of the stated barriers to screening for DV. However, if shelter advocates are called, time does not have to be a barrier. Medical advocates from the Center for Prevention of Abuse are available to hospitals 24/7/365 days a year. Nurses screen for many risk factors that affect the healthcare of patients. Many nurses are not comfortable screening for DV, but we must become comfortable. We ask very personal questions of patients, i.e. how much do you drink, smoke, etc. We don’t ask these questions to pry into their personal lives, but rather to provide them the best quality care possible. At OSF Saint Francis Medical Center, we have incorporated education about DV into New Employee Orientation. Because victims of DV use healthcare services six times more often than the average person, it is important to educate healthcare providers and workers about it. We are forming an inter-disciplinary team at OSF to deal with adult violence across the Medical Center.
Are instances of domestic violence on the increase, or just being reported more?
I believe DV is being reported more but I also know America is the most violent nation in the world, from a study that was completed by the Center for Disease Control. Because we know this, we need to be diligent in our efforts to screen for DV at every point of service in healthcare. Screening is one way we can decrease morbidity, mortality and, more importantly, decrease the amount of time that children are exposed to DV. When I spoke at the World Conference on Family Violence in Singapore, sponsored by the International YWCA and People to People, I was humbled that they thought I was an expert. Many women risked their lives to come from third world countries to attend.
OSF’s neonatal unit is expanding. Is there a prevailing theory as to why there are more infants born needing intensive care? More multiple births?
We are experiencing a slight upsurge in births. However, the increased need for neonatal intensive care can be traced to the fact that there are now more multiple births and because women are having babies at a later age. All babies are very precious and we want to ensure each one goes home as healthy as possible. Labor and Delivery is expanding the triage area to be able to provide better outpatient care to the women we serve. We can quickly assess our patients and determine if they are in labor or can go home.
Are there any particular healthcare trends experienced by women that are unique to central Illinois?
The good news is that women of central Illinois are much the same as in other parts of the United States. We have the same health problems as other women across the country. The bad news is that breast cancer rates have increased from one in nine to one in seven. We have raised a great deal of awareness on breast health and why it is so important to be certain you have a mammogram. This past summer the National Healthcare Advisory Board visited our Comprehensive Breast Center program and determined that we are one of seven sites in the United States to benchmark. OSF Saint Francis Medical Center Centers for Breast Health have provided information on breast health to local car dealerships in Peoria during the month of October for the first time. We even want to educate women while they are having their car serviced or repaired. This is an effort to further raise awareness around breast health. The research OSF Saint Francis Medical Center Centers for Breast Health and U-Systems are completing is in its second phase. Using the research tool, three cancers have been identified that would have gone undetected.
What would you like our readers to know that has not been asked?
I would like readers to know about the significance of women’s health. It is extremely important to know there are gender-specific differences in the way diseases affect women versus men. Women make 75 percent of healthcare decisions for themselves and their families and make significant choices regarding their selection of healthcare providers and healthcare products. TPW