Welcome to the Nursing Outlook Blog – “3 Questions” – Timely Interviews with Thought Leaders in Nursing and Health Care Policy

2016 American Academy of Nursing Living Legend – Ann Wolbert Burgess

Nursing leaders of our times are recognized by healthcare professionals and the public for their outstanding contributions not only to our discipline, but to the health of the population. The American Academy of Nursing recognizes its distinguished leaders who have given service over their career to a group of selected individuals known as the American Academy’s “LIVING LEGENDS.” In 2016, these recognized scholars, policy makers, educators, researchers and truly dedicated nurses received this highest honor and addressed the audience with humble thanks and inspired all of us in the room with their living stories. For future nurse leaders who may not have been in the room, we believe that their personal viewpoints about leadership ought to be shared online in their own words. This second interview is with Dr. Ann Wolbert Burgess, Professor of Nursing at Boston College.

Dr. Ann Wolbert Burgess is internationally recognized for her contributions in the assessment and treatment of victims of trauma and abuse. Her research has provided significant insight into the links between child abuse, juvenile delinquency, and the perpetrators of serial offenses. Her public service on numerous national committees and councils for victims of serious trauma, including sexual abuse in a variety of settings, has culminated in work that has been applauded at many levels of government and her courtroom testimony has been described as “groundbreaking.” Her focus that includes elder abuse, cyberstalking, and internet sex crimes has been recognized in forensic science classrooms nationally. At the heart of the work is her compassion for victims and victimization on which she has built a distinguished career, receiving numerous honors and numerous highest awards including the Sigma Theta Tau International Audrey Hepburn Award, the American Nurses’ Association Hildegard Peplau Award, the Sigma Theta Tau International Episteme Laureate Award, and named a 2016 American Academy of Nursing “Living Legend.”

Dr. Burgess’ leadership continues in her active work with other researchers and scholars at the Boston College. One of her two most recent projects is the College Warrior Athlete Initiative Project funded by the Wounded Warrior Project (click here for video). The purpose is to assist our nation’s wounded service men and women transition back into civilian life by partnering with an athlete in active physical exercise and socially supported learning activities. We asked her about the project and advice she might offer aspiring nurse leaders who seek ways to channel personal compassion into meaningful research and scholarship.

We asked her to elaborate on the College Warrior Athlete Initiative Project and her leadership lessons in forensics by answering 3 Questions!

Veronica D. Feeg, PhD, RN, FAAN
Editor/Moderator

We invite commentary that is thoughtful and provocative! Join the online dialogue!

Ann Wolbert Burgess

2016 American Academy of Nursing (AAN) Living Legend

William F. Connell School of Nursing

Boston College

 

 

Question 1. Can you tell us about the Wounded Warrior Athlete Initiative Project and how you found the connection with your own body of work and the victims of military trauma?

The College Warrior Athlete Initiative or what we call in shorthand the Wounded Warriors Program is a nurse led health promotion program for wounded vets. It’s our way of having academic nursing to be a part of the wounded warrior trajectory back to health. There had been some discussion about how we, who are in academic situations, could be helpful. What happened is Ada Sue Henshaw, who was Dean down at the Graduate Nursing Program of the Uniformed Services University of the Health Sciences (USUHS) in Bethesda had taken on a high profile military issue for nursing to take the lead – and it was what is called “military sexual trauma.” And at the time that she contacted me it was getting a lot of press as well as Congressional attention. She knew of my clinical and research work in the area of sexual trauma. So she applied for a budget to fund a visiting professor to come to USUHS, advertised it competitively, I applied! And that’s why I got down to USUHS.

Now once I was down there working with Dean Henshaw, I spent some time with Dr. Sue Sheehy who was on faculty. And interestingly enough Sue had been a military nurse and had spent time working with returning wounded warriors coming into Walter Reed Hospital, which is right down there on the campus. And she had made a very compelling point that once these wounded warriors were discharged back home, there were very few resources, often, for them to continue in any kind of rehab program. Now that’s in more of the rural areas, certainly not in the major cities. But she was kind of pondering that and had been thinking about it, and realized that every small community would have access to a nursing program. That’s one thing that we certainly have done very well is that we have our nursing programs scattered nationwide.

So she thought why not test the nurse led program using the “battle buddy” system. Now, the occupational culture of the Army’s “battle buddy” concept refers to an attitude of support during tough times and had at that time never been applied to veteran health promotion. The big health problem outside of any of the medical or psychiatric diagnoses were nutrition for weight control, and strength decline. These seem to be two of the big problems that wounded warriors were having. So, with Sue, there was a decision to design a program with an athletic department and a nursing department to pair a veteran with a college student athlete for an exercise workout program that would also include wellness classes, and lunch – a nutritious lunch.

Now the next step is that Dean Susan Gennaro here at Boston College was able to offer Dr. Sheehy a visiting scholar position. Sue came up, we wrote a grant, submitted it to the Wounded Warrior Project and was one of three projects to be funded. That’s how it all got started.

We just finished our two-year program. We had a total of 50 veterans between Boston College and we had one satellite site at Norwich University. So we had 38 males and 12 females between the ages of 25 and 54, of seven cohorts. And they lost a total of 232.8 pounds and showed very positive changes in their BMI.

The way I got involved is through the military program and these were veterans who were also victims, if you will, of a war, and it seemed to be kind of a natural fit for me to become involved. And our goal is to extend the program to other nursing programs across the country. It’s very low-cost, highly rewarding, certainly for the wounded warriors, certainly for the students, certainly for the faculty who participate, the University and the community. In all it’s a win-win.

Question 2. What lessons did this project and other work you have done teach about nursing and what nursing can do?

Well I think there are several lessons that we can talk about. One is certainly to identify a high profile issue where nursing can take a leadership role. That, I think is critical. For example, one is the current opiate crisis. I’ve just finished analyzing data from over 300 cases where teens died by suicide. And so what we did was to look at the toxicology findings from the medical examiner’s office that identified the drugs in the teen’s system at death. And that’s important – for all that I’ve looked at the problem, nobody says what are the drugs that kids have in their body when they suicide? That will be from the data – that will be a recommendation for nurses on how to prevent teen suicide where prescription drugs and mental health is involved. So I saw that as an example of a high profile issue where nursing really can take a major role…I send that out for all of nursing!

Now a second high profile issue from my perspective is nursing staff violence, especially in the ER. How are we training or responding to violent patients and visitors? Now I know that many are…as we read some of these incredible cases of shootings…I know they are doing that…but is there anything else we can do? And one experience I’ve had that I would pass on is: I was involved in analyzing, doing a psychological autopsy of a mass shooting in the community of Seattle Washington. And the police chief there convened a panel to analyze the shooting and then publish our report on his website for the community to understand. So that is again another place, when they have one of these horrendous cases, nursing should get in there and suggest this – that the police chief can do such a thing. Out of Seattle, they found that very, very helpful.

And a third area I suggest is the cyber security of health records. Everybody knows that ransomware is hitting hospitals and nurses can be key in the solutions regarding records. I think that would be a huge area.

Now to take the example from their wounded warriors, nursing leaders know of nurses’ expertise and how to find them to consult on an issue. We have that published in our Academy notes. So Dr. Henshaw demonstrated that educators need to have a budget for visiting scholars or professors, whatever they want to call them, and also a budget for funding annual speakers. So that would be something that could be done – it doesn’t just have to be academics it can be in hospitals and so forth. And then have working groups on high profile issues. Then you can find some leadership for nursing. And I think that’s the way we get ourselves out in front and show what nursing leadership is.

So those are just some of the suggestions I had for how did I take the lessons learned from the Wounded Warriors project, as a model if you will, and transpose it to different topics.

Question 3. What is Forensic Nursing and what advice do you have for aspiring nurse leaders and scholars to be able to connect forensics with their specialty leadership goals

Well first of all, as a definition, Forensic Nursing is the interface of Nursing and the Law. So any time that a nursing issue, problem, case, etc. comes into a legal arena, that’s what Forensic Nursing is. So nursing has many areas, in fact, I can’t think of a single area in nursing that doesn’t have a potential legal issue to talk about. For example, the easiest ones are abuse cases, trauma cases, accident cases, they all come into the emergency department. That is the most logical place and that’s where, I think, a lot of Forensic Nursing started. My project did. We saw – Lynda Holmstrom and I – saw all rape victims coming into the emergency room over a one year period, and we took that data – and that’s what really kind of bounced my career into the crime victim arena. But I entered the forensic arena before there was such a title. We didn’t talk about forensic nurses back then. In fact I introduced the term and worked with Virginia Lynch as a pioneer in the field at the 1992 ANA annual meeting in Las Vegas. She was the one that really was the pioneer. And we were able to get that onto the annual meeting. So we date it back there.

But one of the official organizations, what we call the International Association of Forensic Nurses, which is the IAFN, was actually formed in Minnesota with the leadership of Linda Ledray and others. If you go to the Linda Ledray website, her definition is: ”by linking the clinical care with forensic care the result is better outcomes for patients” – and that’s Linda Ledray’s message.

And just to give you an example: One of the cases I helped with – because the US Attorney’s Office here in Boston needed a “forensic nurse” – they called me. And I helped by reviewing over 200 case files of meningitis cases where fungus had been introduced through a compounding center (and that was in Framingham Massachusetts). The US Attorney’s Office was handling it. The first trial just came about and I testified at that trial. But that was the case where it was (a) very unclean compounding center that was somehow…a fungus got into it…you could even see the fungus in the test tube! I mean I don’t know how people administering the steroid wouldn’t have seen it! But at any rate that’s just another example where people died – they needed a forensic nurse to be able to help them legally.

So my suggestion is nursing leaders need to be updated on forensics as it applies to nursing care. Nursing homes and even hospitals are facing a lot of what I call sexual exploitation cases, and nurses in risk management really need to know how to manage them. Two cases I was just called on this week: (1) one involved an ICU nurse taking photos with his iPhone of a patient’s breast and genitalia; (2) another case involved a nurse molesting a patient while under anesthesia and surgery was going on! These cases are publicly recorded on the Internet, so one of the things I try to do when I lecture on this is to give the actual cases – as it’s right there on the Internet for people to read! And we need to know how forensics can play a key role in this.

So those are just some of the cases and a definition of how I see forensic nursing as a potential in every nursing specialty.