Meet the Expert
A PART OF ORPCS DISCOVERY NEWSLETTER
ORPCS Nurse Scientist Presents at the Western Institute of Nursing (WIN) Conference
In April 2023, Zaina Alzawad, PhD, MANP, M.Ed, RN, Nurse Scientist in the Office of Research Patient Care Services presented a poster entitled "Parental Stress in the PICU: A Concept Analysis" at the Western Institute of Nursing (WIN) 56th Annual Communicating Nursing Research Conference.
The aim of Dr. Alzawad’s study was to develop a conceptual model for understanding parental stress in the Pediatric Intensive Care Unit (PICU), guided by the Walker and Avant framework. The conference brought together nurse scientists, faculty, and students from diverse regions, fostering dynamic discussions and networking opportunities.
The WIN conference encompassed a wide range of research topics, providing a diverse platform for sharing valuable research findings. Dr. Alzawad found it particularly rewarding to connect with fellow researchers and learners from different schools and institutions. This diverse gathering not only exposed her to a variety of perspectives, but also facilitated collaborative opportunities for future research endeavors.
Written by: Zaina Alzawad, PhD, MANP, M. Ed, RN
Dr. Zaina Alzawad presenting her poster at the 56th Annual WIN conference
American Academy of Ambulatory Care Nursing’s 48th Annual Conference
Stanford Health Care’s Ambulatory Care Shared Leadership Council presented a poster at the American Academy of Ambulatory Care Nursing’s 48th Annual Conference which was held April 12 – 14, 2023 in Orlando, FL.
The poster presentation entitled “How Do You ‘C’ Yourself in Shared Leadership? Utilizing A Central Council Structure to Foster Connection, Collaboration, and Communication in Ambulatory Care Shared Governance Councils” included presenting authors: Sierra Kane, MSN, RN, CNL, AMB-BC, Director of Ambulatory Nursing; Kevin Tsui, DNP, RN, NEA-BC, Director of Strategic Initiatives – Patient Care Services; and Jodi Mae Shiba, BSN, RN, ONC, past chair of Ambulatory Shared Leadership Coordinating Council and Registered Nurse Coordinator in Orthopedics. Dr. Chrystal Lewis from the Office of Research Patient Care Services, supports the ambulatory care service line, and assisted in their poster development. The poster’s focus was enhancing collaboration on practice standards and facilitating communication between frontline clinicians in the clinical environment through shared governance. Additionally, Ambulatory Nursing Directors, Charlene Platon, MS, RN, FNP-BC and Sierra Kane, MSN, RN, CNL, AMB-BC were recognized for their contribution to the newly revised Scope and Standards of Practice for Professional Ambulatory Care Nursing, 10th Edition. Stanford Health Care’s Ambulatory Nursing leadership team returned from the conference invigorated and are currently writing and editing abstracts for next year’s conference.
Written by: Chrystal Lewis, PhD, RN
(L to R) Jodi Mae Shiba, Dr. Kevin Tsui, and Sierra Kane present their poster at the AAACN conference
(L to R) Sierra Kane and Charlene Platon, Directors of Ambulatory Nursing with the Scope and Standards of Practice for Ambulatory Nursing
(L to R) Jodi Mae Shiba, Kevin Tsui, Charlene Platon, Sierra Kane, and Chrystal Lewis at the 48th AAACN Conference
2023 American Organization of Nurse Leaders Conference Presentation
The American Organization of Nurse Leaders Conference, “Inspiring Leaders,” was held in Anaheim, CA from May 2-5, 2023. A concurrent session was presented by Dr. Michelle Y. Williams and Cecelia L. Crawford (for Dr. Yan in absentia) entitled “History of Racism in Medicine: The Nurse Leader’s Role in Health Equity.” This inspiring offering drew 120 participants and focused on race in medical research, the workforce, and patient care. Dr. Williams opened the session using a nursing leader lens and invited the attendees on a journey exploring a historical timeline of the persistence of racism in American medicine/healthcare and its contributions to producing inequitable social systems and health disparities.
Dr. Crawford began the journey back in time from 1790-2022, with specific examples of Black midwives contributions to women’s health, the infamous Tuskegee Syphilis Study with a presidential apology to the unknowing participants, the “immortal” HeLa cells of Henrietta Lacks, and the societal improvements to communities of color by the Black Panther Party. Legislative milestones were discussed and included Brown vs. Board of Education (1954), the Voting Rights Act (1965), Medicare/Medicaid Act (1965), and the Affordable Care Act (2010). Professional organizations were profiled and featured a public apology by the American Medical Association for excluding Black physicians (2008), their appointment of its first Chief Health Equity Officer (2019), and the historic American Nurses Association’s release of the “Racial Reckoning Statement” (2022). Other discussion topics included the COVID-related hate crimes against Asian American, Hawai’ian, and Pacific Islander populations, and the use of race in clinical calculations and screening metrics.
Dr. Williams traveled from the past into the future with a discussion of national trends evolving in US healthcare for chronic disease care, such as heart disease, cancer, diabetes, and mental healthcare, addressing the needs of a more diverse, aging population, gaps in access to high quality and affordable healthcare, and advances in technology. The presentation then shifted to focus on the role of nurse leaders in advancing health equity, with an emphasis on preparing and increasing diversity in the nursing workforce via cultural competency training and addressing social determinants of health (SDoH). A case study illustrated the impact of SDoH with a story of a young Black woman who was pregnant and developed gestational diabetes and metabolic syndrome, capped with Dr. Williams’ own personal story.
Stanford Health Care and ORPCS exemplars were spotlighted as Dr. Williams described the monumental achievement involved in founding the Stanford Medicine Black Nurses Association Chapter, with her as the founding president. Other examples included the SHC FY Operational Plan highlighting workforce representation and health equity. The presentation concluded by exploring nurse leaders’ roles in advocating for health equity, identifying healthcare disparities, engagement with legislative leaders, building a supportive infrastructure, and committing to prioritize health equity within organizational policies and goals. A question-and-answer period extended beyond the allotted time period, with engaged participants speaking with both presenters about how to foster a culture of equity to improve the quality of care and reduce the damaging effects of racism in medicine, nursing, and society.
Written by: Cecelia L. Crawford, DNP, RN, PHN, FAAN
(L to R) Dr. Cecelia L. Crawford and Dr. Michelle Y. Williams
Dr. Cecelia L. Crawford and Dr. Michelle Y. Williams Present at the Nurse-to-Nurse Incivility Symposium
On May 19, 2023, the Chin Family Institute for Nursing held a symposium at the Los Angeles Zoo entitled “Nurse-to-Nurse Incivility: The Elephant in the Room. Using a unique opportunity to observe zoo animal interactions and an animal-centric theme, the event sought to immerse attendees in the science of nurse incivility and bullying, with a deep dive into best practices and solutions to mitigate/prevent hostile work behaviors.
Dr. Lorie H. Judson and Dr. Cecelia L. Crawford opened the event with a keynote presentation “New Nurse Incivility and Why It Matters: What, So What, Now What?” Using the elephant in the room metaphor, they outlined the results of a 2018 integrative review on nurse incivility. The top nursing leader challenges were described in detail by Dr. Crawford, with a discussion of targets, perpetrators, triggers, and overarching themes. She noted that the review was limited in that the study samples included primarily white female nurses in the United States’ Midwest, with a lack of representation by people of color and male nurses. Dr. Judson described the cascading effects of unacceptable workplace behaviors leading to lack of community, fractured care delivery, toxic work environment, and an erosion of professionalism. The discussion continued with “What You Can Do” and “What All of Us Can Do,” and emphasized the positive impact when nurse leaders “Lean In and Lean Forward.” The presentation explained an escalating model for situational interventions for inappropriate behaviors and concluded with an uplifting message of defining people by the quality of their relationships.
Dr. Williams was the invited keynote presenter in the afternoon discussing “Nurses’ Psychological Trauma - Structural & Systemic Factors: Improving Human-Centered Civility In Nursing.” Incorporating a favorite zoo animal theme involving elephants and micro pigs, she discussed the key guiding principles to embed mutual respect and effective communication into a culture of human-centered civility in nursing. Using a health equity lens, Dr. Williams discussed examples of regulatory and governmental agencies’ policies and laws that prohibit workplace bullying, verbal abuse, intimidation, and sabotage, and includes The Joint Commission, 1964 Civil Rights Act, California State Board of Nursing, and American Nurses Association (ANA). An in-depth examination of toxic behaviors, structural racism, and microaggressions was followed by the tactics and structures needed to achieve civility and prevent unacceptable behaviors.
Maslow’s Hierarchy of Needs provided the context needed to achieve workforce equity across all healthcare settings. Dr. Williams specifically highlighted strategies for advancing civility, which include 1) ANA Code of Ethics, 2) ANA Scope and Standards of Practice, 3) justice, diversity, inclusion, and equity principles, and 4) communication strategies. Dr. Williams shared Stanford Health Care’s milestones achieved since 2020 as an illustration of how to develop a culture of human-centered civility.
Dr. Williams concluded the session by encouraging participants to embrace mutual understanding and empathy to overcome workplace challenges, seek reconciliation, and instill joy at and in work. This presentation resonated with the 100 symposium attendees. Many nurses spoke with Dr. Williams at length and asked when she would be presenting on future health equity topics.
Written by: Michelle Y. Williams, PhD, RN, & Cecelia L. Crawford, DNP, RN, PHN, FAAN
(L to R) Dr. Michelle Y. Williams, Dr. Nancy Blake, Chief Nursing Officer at LAC_USC Medical Center, and Dr. Dan Weberg, National Executive Director, Nursing Workforce Development and Innovation at Kaiser Permanente.
(L to R) Dr. Michelle Y. Williams and Dr. Patricia Chin, Founder, Chin Family Institute for Nursing at California State University, Los Angeles.
Dr. Michelle Y. Williams’ Presentation At 2023 Virtual Nursology Conference
Nursology, the annual nursing theory conference, provides a global forum for nurses to gather and discuss nursing theory as a means of developing and disseminating the current scientific knowledge for nursing practice, research, education, and healthcare policy. Nursology was inspired by the work of 4 prominent nursing theorists from UCLA: 1) Dorothy Johnson [Behavioral Systems], 2) Sr. Callista Roy [Adaptation], 3) Betty Neuman [Systems], and 4) Afaf Meleis (Transitions). The Virtual Nursing Theory Week was held from March 16-20, 2023, with the theme of “Creating Communities to Inspire Nursing Knowledge Development.” This years’ conference forum featured two ORPCS presentations with Dr. Michelle Y. Williams, Dr. Maria O’Rourke, and Dr. Chrystal Lewis.
On March 16, 2023, Dr. Williams and Dr. O’Rourke spoke on “The Organizational Research Infrastructure: Theory-Driven, Hardwired, Sustainable Nurse-Led Research Practice and Knowledge Development.” Dr. Williams opened the session with a discussion of how to amplify aspects of innovative leadership that promote the nursing profession’s commitment to “do no harm” through professional practice excellence. She explained how infrastructure development can lead to a focused approach to address health equity with an authentic presence. Key presentation segments included relevant models and frameworks (Neuman, King, Marker, O’Rourke), the concept of health equity, and the professional role of nurse scientists. Dr. O’Rourke expanded on the nurse scientist role by displaying and discussing the evolution of the Professional Role Driven Practice Model, which incorporated an adaption of the O’Rourke Model and an obligation to “do no harm” at the point of care. Dr. Williams continued the dialogue with specific examples of strategic framework components and the founding of the Stanford Medicine Black Nurses Association Chapter. The session concluded with visual display of the M.Y. Williams Organizational Research Excellence Structure Model, which amplifies innovation concepts that promote the nursing profession’s commitment to “do no harm” through professional role-driven practice excellence.
On March 17, 2023, Drs. Williams and Lewis presented “Leveraging Networks to Generate Nursing Knowledge: A Health Equity Concept Analysis.” The presentation focused on the health equity concept analysis developed by ORPCS team members Drs. Chrystal Lewis, Cecelia L. Crawford, Lynette Apen, Alice Yan, and Michelle Y. Williams. Because of the current ubiquitous and inconsistent usage of the term “health equity,” the presentation focused on the need for a specific definition and clarification. Further discussion included examining defining attributes of health equity, what must happen to achieve health equity, and the consequences (all positive) of achieving health equity. The question-and-answer session was particularly engaging and evolved into new collaborations with colleagues across the United States who share a passion for health equity.
The presentations by Drs. Williams, O’Rourke, and Lewis demonstrate Stanford Health Care’s Office of Research Patient Care Services deliberate intentionality in the creation of nursing theory and further positioning Stanford Health Care to be a unique innovator of nursing theory direct to clinical practice.
Written by: Cecelia L. Crawford
Drs. Michelle Y. Williams and Maria O’Rourke delivering their presentation