All of Washington state’s 7 million residents deserve equal access to high-quality holistic health care. To make that access a reality, leading nurses spend considerable time visioning, advocating and collaborating to inform and transform the health-care system. Together with government agencies and community partners, their bold, coordinated work builds a foundation for a healthier future for all. Every day, through research, education, policy, programs and practice, their efforts improve the way health care works for everyone.
Making History
Nancy Woods’ mother taught her that she could do anything. Both her parents valued education. While in college, Woods found her calling when she discovered the nursing profession. After completing her doctorate at the University of North Carolina while teaching at Duke University, she joined the faculty at the University of Washington.
Influenced by the women’s movement in the 1970s, Woods recognized a giant gap in women’s health-care research: There were no scientific studies of menstrual-cycle symptoms for healthy women. Health-care providers had to generalize based on studies of those who were severely physically or mentally ill.
Her studies helped to amplify women’s voices, empowering them in their own care.
Woods wondered: How could practitioners offer adequate and evidence-based care to half the population based on such limited information? She decided they couldn’t. So, early in her career, she spearheaded the first of hundreds of studies and publications to inform women’s health.
Nancy Woods, Ph.D., R.N., F.A.A.N., former dean of the UW School of Nursing and nurse leader in promoting women’s health
In addition to providing important information about how to better care for women, her studies helped to amplify women’s voices, empowering them in their own care. Her work expanded the field of nursing science related to women’s reproductive health across the lifespan, including menopause. The Seattle Midlife Women’s Health Study, for example, tracked participants for two decades.
In the 1990s, Woods became dean of the UW School of Nursing. During a decade in that role, she expanded the school’s reputation and funding levels. She also continued to promote a better health-care future for everyone. She redoubled efforts to make the school more inclusive, equitable and diverse, and she publicly apologized for the school’s past failures to encourage, support and admit African American and other underrepresented students.
In 2017, just before retiring, Woods served as the interim associate dean for diversity, equity and inclusion and professor in the Department of Biobehavioral Nursing and Health Informatics. During her 50-year career she witnessed and oversaw dramatic changes in the nursing profession and the health-care field. Finishing her career in these very forward-looking positions was yet another way to meet the future.
Nurses Influence
In leadership positions throughout the state, nurses consistently shape important health-care policy and work to improve systems. Through their research and practice-based knowledge, they inform holistic solutions.
Expanding Care
Boldly enacting health-care policy initiatives requires immense knowledge and expertise. Nursing leaders all over the state with strong advocacy backgrounds accelerate the process — leaders like Sofia Aragon, executive director of the Washington Center for Nursing, and Patty Hayes, director of Public Health – Seattle & King County.
The result? More people covered by insurance. Currently more than 94% of residents now have health-care coverage, thanks to expanding Medicaid and the state’s health benefit exchange. In January 2020, at least 150,000 education employees and their families will have access to affordable health-care benefits through the School Employees Benefits Board Program. And starting in 2021, Washington state will offer the nation’s first public health-care coverage option to help stabilize costs and cap premiums.
Nurses also support policies that honor and empower the whole person. Managed care that integrates physical and behavioral health for the state’s 1.6 million Apple Health (Medicaid) clients offers transitional mental-health services in community settings closer to friends and families. The Long-Term Care Trust Act, going into effect in 2025, provides dollars for long-term daily care needs. To ensure the quality of patient decision aids that help people better advocate for what they need, Washington state laws now require certification of these tools.
Population health is another key area in which nurses can inform policy to improve lives. For example: Legislation going into effect in 2020 increases the legal age for tobacco use to 21. A strategy focused on eliminating hepatitis C in Washington state by 2030 involves education, outreach and improving access to medication. And addressing the opioid crisis means more education, more access to medication-assisted treatment and updating prescribing policies.
A recent $550,000 grant to the UW School of Nursing supports outreach and services for pregnant and parenting women with opioid-use disorder. This research-based work aims for better mother-child relationships and improved social and psychological outcomes for children.
Ongoing Advocacy
In 2018, Gov. Jay Inslee appointed executive nurse Sue Birch as director of the Washington State Health Care Authority. In her role, she focuses on transforming health-care delivery through policy and finance.
Another executive nurse on her team, MaryAnne Lindeblad, the state Medicaid director and a UW School of Nursing alumna, works to make care more accessible for more than 1.8 million Washington residents.
One of the ways the organization works toward transformation is by encouraging accountable, coordinated, integrated care. This care includes the innovative approach of paying for the value received rather than the service performed.
Through data-driven measurement, efforts to keep costs in check, and policy reforms that ensure that more people have coverage, these leaders help to realize a healthier Washington.
Dedicated Persistence
Seattle nurse Eileen Cody has been a constant champion for affordable, quality health care since 1994, when she was first appointed to the Washington State House of Representatives.
She played an instrumental role in the implementation of the federal Affordable Care Act, increasing coverage for more Washingtonians and ensuring that the state’s online marketplace, Washington Healthplanfinder, became a model for other states.
A unified vision and voice can break down barriers and create change.
As the chair of the House Health Care & Wellness Committee, Cody advocates for patient safety, public health services, legislation that ensures that mental health is covered as fully as physical health, and legislation supporting increased vaccination rates.
A neuro-rehab nurse, Cody recently retired from Kaiser Permanente (formerly Group Health Cooperative) after 40 years. In addition to her legislative leadership on behalf of patients, she is also a founding member of District 1199NW SEIU Hospital and Health Care Employees Union.
A Unified Voice
Diane Sosne knows that having more well-trained nurses will help Washington meet its current and future health-care needs. As the president of the SEIU Healthcare 1199NW union, she represents 42,000 registered nurses and other health-care employees in Washington.
With her background as a psychiatric nurse, Sosne has witnessed individual transformation. In multiple leadership roles locally, nationally and internationally, she’s also seen the power of large groups and understands the way a unified vision and voice can break down barriers and create change.
In Sosne’s role with the union, she helped found the SEIU Healthcare 1199NW Multi-Employer Training Fund in 2008, in collaboration with a medical center and four other employers. The program continues to grow and bring more people to the profession through outreach, education funding, future-focused apprenticeships and training programs.
Trailblazing
High school students participate in “Stop the Bleed” during the UW School of Nursing’s Nurse Camp.
In 1879, Mary Mahoney became the first African American to graduate from a nursing school in the United States. Some 70 years later, when Frances Terry became the first African American to receive her Bachelor of Science degree from Seattle University’s nursing program and the second in the state to graduate from such a program, most hospitals still wouldn’t hire nurses of color, and some patients would refuse their care.
Terry wanted future nurses to have more access and opportunities than she had. So did Ann Foy Baker, also an African American nurse, who inspired Terry by joining with other nurses to form the Mary Mahoney Professional Nurses Organization. Over her 50-year career, in addition to other leadership positions in the profession, Terry contributed to the organization, helping to give scholarships and mentor up-and-coming professionals.
Today, nursing schools in Washington recognize the need to do more. The fact is, many potential nurses may never find the profession in the first place. And a more diverse workforce will better serve the health-care needs of a diverse public.
Mary Mahoney Professional Nurses Organization being recognized with the Pete Dyer Heart of Nursing Award.
To support that vision, every year the University of Washington, Seattle Children’s Hospital and Washington State University host low-cost summer camps for teens to introduce them to the nursing profession.
A more diverse workforce will better serve the health-care needs of a diverse public.
East of the mountains, the WSU Na-ha-shnee Summer Institute invites Native American and Alaska Native high school students to Spokane to learn more about working in the field of health science. On the west side, camp outreach efforts focus on teens with diverse backgrounds, including low-income and minority students, who may be unaware of nursing as a career option.
Statewide, these programs make a personal and professional difference: They result in enthusiastic new recruits, excited to have found their vocation and to pave the way for others.
Social Change
Betty Bekemeier & Kerryn Reding
At a time when breast cancer has become more treatable and curable, black women are 40% more likely to die of the disease than white women. That adds up to five black women a day dying from breast cancer. University of Washington Associate Professor Kerryn Reding’s research focuses on how to eliminate that gap and improve those odds as quickly as possible.
Professor Betty Bekemeier’s work complements and supports Reding’s efforts by focusing on increasing health equity in communities. A UW faculty member at the School of Nursing, lead at the Center for Studies in Demography and Ecology and director of the Northwest Center for Public Health Practice, her evidence-based work helps public-health leaders change outcomes. This progress includes interventions that reduce barriers to care for people with cancer and cardiovascular disease and adults with diabetes.
The Health Care for the Homeless Network offers interdisciplinary teams sensitive to the effects of trauma, discrimination and stigma.
Denise Drevdahl, a graduate program coordinator and professor at the UW Tacoma School of Nursing & Healthcare Leadership, seeks to make similar strides in changing education so that the profession fosters more equitable outcomes. Recognizing that educating nurses on cultural competency has not addressed disparities, Drevdahl focuses on the bigger picture. Looking at emerging research on societal structures that contribute to disparities in health care, she’s helping to bring this broader lens to nursing programs and classrooms, to better care for everyone.
Support Systems
Dr. Josephine Ensign (left) observes as a student interacts with a homeless youth during one of the UW’s pop-up cafes. These cafes provide young people with food, medical services and other resources to help them find appropriate shelter.
U.S. veterans have unique health-care needs. For example, 20% of veterans who served in Iraq or Afghanistan have experienced either a traumatic brain injury or PTSD. Retired Army Lt. Col. Frankie Manning has spent much of her career focused on expanding access to medical care for veterans, including women. Working at the U.S. Department of Veterans Affairs, she’s helped set up outreach, clinics, screenings and mobile medical units around the state.
Individuals and families experiencing homelessness also have unique care needs. The Health Care for the Homeless Network, led by public-health nurse and UW graduate Jody Rauch, addresses those needs. Supporting everyone’s right to health care, the network focuses on meeting people where they are with interdisciplinary teams sensitive to the effects of trauma, discrimination and stigma. The team works to provide coordinated medical, dental and mental-health care and community and housing support.
To address the needs of homeless youth, three UW Doctor of Nursing Practice students implemented a nurse-run clinic. With a permanent service-learning placement at Peace for the Streets by Kids from the Streets, an organization based in Seattle’s Capitol Hill neighborhood, an ongoing set of volunteers, including UW School of Nursing Associate Dean Anne Hirsch, ensure that struggling young people know about the available health resources and how to access them.
As costs rise in the Puget Sound region, housing and food insecurity also impact college students. UW Tacoma Associate Professor of Nursing & Healthcare Leadership Christine Stevens recognized that students needed help and designed a survey to get more information. The survey highlighted the fact that students in Tacoma struggle more than those on other campuses and need more support. To address a 30% rate of food insecurity, the UW Tacoma Office of Equity & Inclusion created a food pantry that now provides ongoing support to students.
Volunteers, including UW School of Nursing Associate Dean Anne Hirsch, ensure that struggling young people know about the available health resources and how to access them.