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

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 first interview is with Dr. Linda Schwartz, Assistant Secretary of Veteran Affairs for Policy and Planning, who received the “2016 Living Legend Civitas Award.”

Dr. Linda Schwartz serves as VA’s principal advisor on all matters of policy, interagency liaison activities and strategic planning to enhance and promise the health of America’s 22 million veterans and their families. She is the former Connecticut Commissioner of Veterans Affairs (2003 – 2014) prior to her Senate Confirmation in 2014. She was a flight nurse and member of the United States Air Force, serving during the Vietnam War and following on Active Duty until 1986.

In her leadership roles, Dr. Schwartz was a strong advocate for issues related to homeless veterans, veteran suicide prevention and women veterans. Among her many awards and honors, she received the National Commendation medal of Vietnam Veterans of America for “Justice, Integrity and Meaningful Achievement”; the Legion of Honor Bronze Medallion from the Chapel of the Four Chaplains; Sigma Theta Tau’ International ARCHON Award “for her leadership and research on the human effects of exposure to Agent Orange.”

In a recent town meeting where she was asked to speak for the VA, Dr. Schwartz gave a response to a journalist known for his aggressive style that changed the tone of the meeting and the negativity in the room. In her poised but passionate response about a particular issue that is near and dear to her heart, she spoke to the audience with her nursing “voice” that said “we’re listening to you” and “this is a new day.” This short video captures that event and teaches nurses about talking to the press, but more importantly, shows how using opportunities to turn to the humanity of our profession can be a skill for nurses who aspire to positions of leadership to develop (click here to view video – courtesy of Elizabeth Leary, doctoral student, Yale University).

As a distinguished leader in nursing today, and with such significant service to country and discipline, we asked her to speak about nurse leaders using opportunities to educate the public about nursing as we face challenges today in health care. For future nursing leaders, we hope to inspire courageous young nurses to find their voices and seek opportunities to make a difference. Here are some of her words of wisdom:

Veronica D. Feeg, PhD, RN, FAAN

Linda Schwartz, DrPH, RN, FAAN 2016 Civitas Award Recipient

American Academy of Nursing

Assistant Secretary of Veteran Affairs for Policy and Planning


Question 1. Awards for leadership are bestowed upon people whose achievements are clear to others. But perhaps some accomplishments from the award recipients are even more meaningful to them that are unrecognized. Can you share with us a past experience that describes from your perspective what others might learn about opportunities that cultivate leadership?

…I think probably saying that you don’t plan these things, they just seem to happen. And the real factor in this is to seize the moment, and be a risk-taker even if it’s just speaking up for your patients and then starting with better care, better programs. I think that naturally nurses are leaders in their own right but they just don’t really see that the things that are the very fiber of our profession are the real hallmarks of what a good leader is.

So, from my own example, I never really in my wildest imagination thought that I would be a veterans’ advocate. But as I saw how the veterans were being taken care of in the VA when I had to use it, I kept thinking there’s a better way to do this! and seeing that in fact a lot of veterans didn’t have the wherewithal to speak on their [own] behalf; and in actuality, that’s how I kind of merged into being able to use my background as a nurse, my dedication to seeing that the right things were happening, that the best was happening for our veterans. I didn’t really realize as I was laboring in this and working for the women who served in Vietnam – working for their recognition – that I was slowly becoming a leader. People had to actually point that out to me, where I was thinking, “well I’m just trying to do the very best I can to move this agenda.” So, you know the old saying that leaders are made not born? I think a lot of that is your investment of yourself into a goal or an issue, and all of a sudden you become a leader in that respect.

Question 2. Can you describe your work with some of the significant problems that you have come to know well from your career?

Let me just say that early on, I became involved with the veteran movement especially the Vietnam veterans’ movement, and the women veterans who served. I was struck by the fact that so many women veterans who served in Vietnam had strange and exotic diseases and were dying at a very young age – wondering what all happened to them, maybe in Vietnam. And at about the same time, being an advocate for having women and women veterans in research, I was contacted by a group that was actually doing a study on Vietnam veterans, and they were upset because women veterans were declining to be interviewed. This was probably the first study of the Vietnam Veterans Readjustment study.   My circle of friends were mostly women who served in Vietnam or in the military during that time, and this was an effort to try to get them to participate in a study that would actually do a better job of telling their stories or what was happening to them, and maybe to help unravel some of the questions I had.

But intead I became an interviewer for the study and my job was to try to talk people who had been selected to be subjects in the study – who had actually declined – and to talk to them about being in the study rather than not participating. That study was probably the first known health inventory for women veterans; it compared three groups of women – women who served in Vietnam, military women who did not serve in Vietnam, and a matched cohort of civilians. So, my question about health became almost like my passion because you just can’t start a study on Agent Orange and not get really into the nitty gritty of it.

And so, believe it or not, it became part of not only my study – my scholarly pursuits – but also I have a real passion for advocating for veterans and their families, especially for those who are having issues with health conditions associated with exposure to Agent Orange. So it was almost like a dual track of wanting to answer the questions but at the same time having the data, the information that would help answer those questions.

Question 3. What advice would you give to aspiring nurse leaders

For aspiring nurse leaders, I’ve always had a real special belief that nurses have a leadership role, and rightly so, because of the way in which we look at the world, the way in which we use data and information and facts. That’s a lot, not necessarily factored into leadership, per se, or to leading anyone or groups. So, for me, it kind of evolved, and starting out with wanting better conditions for veterans (which is a really vast and prolonged vista from which to choose many different avenues, actually). But the fact that I was a nurse, and wherever I went, and whatever I advocated for, I’ve always been one who believes that you should speak truth to power, even when it is not necessarily the easiest thing to do. When you’re challenging the system, just speaking truth to power really isn’t enough. You have to have your facts. You have to be very conversant in what’s going on with the issue that you’re addressing.

But I also feel that sometimes, for me, the bond that I have with the people I served with in the military is very strong and it doesn’t necessarily have to be people I actually know. It’s the people and understanding of the experience that people go through when they are in the military and keeping faith with them. I was lucky enough to know Virginia Henderson who is maybe is not as well-known today as when I was, when we knew her, it was the fact that she had defined nursing as being, doing for the patient what they cannot do for themselves if they were well and had energy, and all those things, that we have to be the voice of those who have no voice. And that’s kind of been my mantra. Because nurses can so well identify the issue and the arguments and the points that need to be stressed. It’s just the way we learn how to diagnose the problem and look for the solutions.

So, it’s a very natural part of nursing and I think many nurses, hopefully it’s changed, but back in the day that wasn’t something that people wanted to encourage in nursing – that you would be a leader. For me, this kind of quest to look for the justice of the situation: I had exquisite opportunities to be in the halls of Congress, to be before legislators and policy policymakers. And it is not because I said, “I want to be the leader” – it’s because my dedication to the veracity of the information and the authenticity of the information was very important. And often times that doesn’t happen when you’re trying to effect change in public policy. Sometimes the truth is the first victim of the situation.

In many ways, I believe that my nursing profession, my nursing practice, has been a wonderful way to frame my leadership style – that we listen to all people, we allow people to express their opinions, but at the same time our eye is firmly focused on the goal of what we’re trying to accomplish. And in policy and health policy, that’s health, but in some instances, like for example with veterans, sometimes it’s justice. So, I think it’s important for folks to remember why it was they came to nursing in the beginning, and if it was, as it was with me, to be sure to help other people – that’s a common theme. And it certainly gave me great courage to face some of these situations; and I can just say, [in] the film that you have of the symposium on Agent Orange, the emotions that were displayed by a lot of people in the room including some of the sons and daughters of veterans who, at first, had birth defects that are still a challenge for them today, to sit in that room and listen to them – it was listening just as you would listen to someone you were trying to help. And I think that is another aspect of nursing, that we are not necessarily adversarial, we are more of trying to find the common ground and a way forward. So, those are the leadership strengths that I think are natural or embedded in what we do as nurses. It’s just that maybe some nurses need a little confidence that, that also works once you are trying to accomplish other goals in patient care.