Karen A. Daley, PhD, MPH, RN, FAAN President American Nurses ...

Karen A. Daley, PhD, MPH, RN, FAANPresidentAmerican Nurses AssociationUNIVERSITY OF PENNSYLVANIA SCHOOL OF NURSINGPhiladelphia, PennsylvaniaCOMMENCEMENT ADDRESSMAY 14, 2012President Guttman, Dean Meleis, Faculty, Graduates, Family and InvitedGuests: I am honored to join you on this important day and to offer mycongratulations and a few words as you begin or advance your nursingcareers.Commencement is both a beginning and an end in life’s many passages. Itformally signals the completion of your studies, while simultaneouslylaunching you on a new life path, armed with the powerful knowledge andskills you’ve gained during your time at Penn.You are at the beginning of your journey as a member of a proud and trustedprofession, and the values instilled as part of your education will continue toinfluence you for years to come. What you do to live those values in theyears ahead will define you as a person and as a nurse.1

The road before you is an exciting one, filled with potential. Your first yearas a registered nurse or in a new, advanced role will no doubt both exhilarateand terrify you. Either way, I promise you it won’t be boring. Today, I askyou to think about what it would take for most days of your career to feellike that first year. How can you savor every moment, determined not tosettle into a familiar routine or get caught up in petty irritations? How canyou seize every opportunity to learn, grow and positively affect the lives ofyour patients, the conditions at your workplace, or the profession of nursing?I ask each of you to consider, what will be your legacy?The path to greatness is likely to be hidden in the nooks and crannies of dayto-daylife. Believe me; no beam of light will magically shine down to markthe way. Nursing trailblazers before you found their paths by payingattention to small signals—areas of need where no one else was focusing.They never worried who was supposed to deal with a challenge. They neverasked whose problem it was. They simply looked for a solution.Consider Lillian Wald. Lillian was born into a contented life, attending MissCruttenden’s English-French Boarding and Day School for Young Ladies.After graduation from nursing school, Lillian could easily have sought a2

comfortable position. Instead, this young woman from the Midwest set upresidence in New York’s Lower East Side, tending to orphans and teachingpoor immigrants how to care for their families. She is the pioneer of visitingnursing and was a determined advocate for women and people of color. In1922, The New York Times declared her one of the 12 greatest livingAmerican women.I’m certain that she didn’t set out on her career path with that honor in mind.Instead, she unknowingly built a legacy simply by paying attention to theinjustices around her and refusing to allow them to be someone else’sproblem.When Loretta Ford joined the profession in the 1940s, nurses were the faceof primary care, attending to well-baby visits, providing in-home care andhealth education for families, and delivering immunizations to preventdisease. For most, a bachelor’s degree was considered graduate education.As society evolved, and the medical community demanded more fromnurses and questioned their ability to provide the level of care they had doneso well for decades, Loretta Ford saw a need and an opportunity. Shepartnered with Dr. Henry Silver to create a new model of nursing practice3

California’s 22 nd district, a position that she holds to this day. Her deepunderstanding of nursing has made her a champion for our needs and thoseof our patients. She founded the Congressional Nursing Caucus, and she hasbeen a staunch advocate for policies that improve the climate for nursing andpatient care. Though Lois didn’t set out to create a legacy, she knew that herunexpected role as a member of Congress provided her a chance to advanceher chosen profession.Thousands of miles away in Alexandria, Egypt, Afaf Meleis watched herdetermined mother leave her family for nearly two years to pursue a nursingeducation in the U.S. She became the first woman in Egypt to earn abachelor’s and master’s degree in nursing. Inspired by her dedication, Afaffollowed her mother’s example, pursuing scientific answers to what she sawas difficult health care questions.She talks about herself as an accidental leader, having never planned tobecome an administrator. Yet, she has always seen the circumstances infront of her as opportunities for growth and development.5

Those opportunities led her here, to the University of Pennsylvania, whereshe has helped shape the university’s global perspective on nursing. Herwork has informed a new generation of nurses, world citizens whounderstand the role of nursing around the globe. Her legacy to her studentsand the nursing profession is impressive and lengthy, and it is still beingwritten. Dean Meleis, thank you for all you have done to seize opportunitiesand improve nursing worldwide.These revolutionaries—leaders in the fight for better, more accessible healthcare—started their journeys just as you do here today. They were all proudgraduates of nursing education; not satisfied with the status quo; they eachrecognized opportunities to transform the profession, and in doing so,created and left behind something bigger and better for the rest of us.Part of the journey that begins for you today as new graduates is not simplyto find a job in health care, but to find and develop your own opportunitiesto make a difference. This is particularly important at a time when our healthcare system does not always seem to prioritize or incentivize what’s best forthe patient. From a system perspective, patient-led care is a novelty, a new6

idea that the nation is struggling to embrace. But from our perspective—thenursing perspective—patient-centered care is all there is.There are few who would argue that our current health care system doesn’tneed changing – not simply for the patients who should be and often aren’tat its center – but also for those who provide the care. We are facingshortages across a broad spectrum of professional disciplines and populationneeds. As you grow in your career, I challenge you to think critically everyday about what could be changed. What could be better? Examine everyexperience—those that seem nominally important and those that seemgroundbreaking in the moment— for occasions to question, speak up,organize, and advocate.Your vision of your own nursing career and the legacy you want to leavebehind will develop as you gain experience and confidence in your practice.It will grow as a consequence of the passion and commitment you bring toyour patients and practice, and to your professional development. It willblossom as you network with others in your workplace or throughmembership and involvement in a professional organization. And your7

esolve will strengthen as you come to realize that caring for yourself is animportant part of caring for others.As your vision grows and your passion for improving situations for thoseyou serve deepens, there will be times when disillusionment threatens yourperseverance. You won’t receive rose-colored glasses when you leave todayand I won’t lie, the road ahead of us as we transform health care is achallenging one. Realize that frustrations will surface. Daily life may seemto get in the way of progress. Time will seem like your biggest barrier—there is just never enough of it! But promise yourself that you won’t allowfrustration or disillusionment to consume you. When challenges arise, Iencourage you to seek solutions. Through these challenges, we find newways of providing the best possible care to our patients. In solutions, we findthe kernels of innovation that can lead to positive change andtransformations in the way health care is delivered.You are entering your profession at a critical juncture in health care. It is atime that I believe holds great opportunity for nursing and for patients whosevoices have not always been easily heard. As I think of those opportunitiesand the exciting potential for nursing, I think of the legacy of those8

inspirational nursing leaders not bound by other’s view of our profession—leaders who focused on what was right for patients and who saw openings tobe a force for positive change.Before I leave you today to embark on your new nursing future, I have just afinal few pieces of advice that I’d like to share…Never forget your roots came from Penn – stay connected. Never lose sightof the fact that this is the place where you began your career and where somuch of your personal and professional growth is rooted. As new graduates,you are now counted among more than 15,000 proud, Penn nursing alumniwhose contributions span 47 countries. Among the many notable nursingleaders also associated with your university’s proud history is Dr. ClaireFagin, Penn’s first female president. In her tenure as nurse and as scholar,she has shaped the future of nursing education and hospital economics, andguided nursing practice through this lens. And Dr. Linda Aiken, who hascharted a new course for the nursing discipline and shares her passion forevidence-based practice with students and faculty at Penn today as the ClaireM. Fagin Leadership Professor of Nursing. They are just a few of the9

many inspirational leaders here at Penn that have helped to shape youreducation and the way you think about your profession.Seek out mentors – surround yourself with colleagues who will support andnourish your personal and career growth. Learn to listen to those who seepromise in you—even when you don’t see it in yourself. Learn to welcomeopportunities and accept challenges. You will grow from them.Take advantage of opportunities to grow professionally. And after you getyour professional sea legs, take time to give back – get involved with youralumni association, a specialty organization or professional network. I canassure you that you’ll get much more out of it than you put in.Never stop learning … it will keep your passion for nursing alive. I knowthis may be the last thing you want to hear today, but in the not too distantfuture, I hope you will consider furthering your education. We need peoplelike you to help prepare others for futures in health care and as contributorsto the science of our profession and to health care innovation.10

Take care of yourself… both physically and emotionally. Doing so will allowyou to be fully present for your patients and their families. Nursing is adifficult and challenging profession. It is also one of the most incrediblyworthwhile and rewarding ones you could have chosen. But to do your bestfor your patients, you must first care for yourself.I want to leave you with a thought that I hope will inspire you to commit to alife of learning and growing. "Teachers open the door, but you must enter byyourself.” This ancient Chinese proverb is right. In the end, you make thechoices that will shape not only the direction of your career, but the impactyou have on others whose lives you touch.Thank you again to Dean Meleis and members of the faculty for theopportunity you’ve given me to participate in this important day. Most of all,my sincere congratulations to the class of 2012! I wish you all well as yougo forward to use the knowledge and skills you have gained here at Penn tobetter the lives of patients and their families across the world. Make the mostof this valuable education and work hard to spot those little moments thatcan grow into great opportunities. You might not see your legacy now, but itis waiting for you to discover and nurture it. The world is counting on you.11