What is the true cost of nursing care? How can hospitals build optimally efficient nursing care systems to maximize value?
These are the types of questions John M. Welton, Ph. D., RN, FAAN, a professor at the University of Colorado College of Nursing in Aurora, Colo., is trying to answer as a scientist specializing in health systems research. Read on to learn about his career journey and how his research is using big data to improve health care.
NN: Can you share a little bit about your nursing career journey?
John: Well that’s an interesting story. I was a volunteer fireman on Long Island back in the late ‘70s and was thinking of going to nursing school, but was hesitant because it wasn’t “cool” to be a male nurse. My fire chief was a nurse and he encouraged me to overcome the stigma and follow my heart, and the rest is history.
NN: What sparked your interest in health systems research?
John: I’ve always been a systems thinker, so moving into a formal research role investigating nursing care systems seemed like a natural fit. My pathway was paved by my mentor, Dr. Edward Halloran, at the University of North Carolina at Chapel Hill. He introduced me to the work of Florence Nightingale – one of our most important systems thinkers in nursing—and John Thompson, who was a nurse on the Yale team that invented the Diagnosis Related Group (DRG), which is the basis for hospital payment in most developed countries.
Thompson modeled nursing intensity into the initial DRG formula, based in part on some of the work Nightingale did in the late 1800’s; unfortunately, the nursing component of the DRG was removed before it was implemented in 1983. The focus on trying to measure nursing value has been a primary motivator in my current work, to make nurses visible in healthcare payment and policy making.
NN: What advice do you have for nurses who are considering pursuing advanced degrees?
John: Find a job at a place you love and stay there for a couple years to get the experience you need to lay a foundation for the rest of your career. I also encourage new graduates to take at least one graduate course a semester to keep in the practice of studying and learning new things.
NN: What is the most exciting milestone you’ve witnessed in nursing over the past few years?
John: The emerging science of genomics and personalized medicine is a good example of where we are headed. For example, genomics can predict how someone may respond to a certain drug or the future possibility of contracting a disease. How can nurses contribute to this new reality? To a degree, it’s working with patients with known mutations like diabetes, and delaying or mitigating the effects through education, diet, coaching, surveillance, etc. Personalized nursing based on genomics and many other data can identify risk factors as well as response to treatment. Nurses have a key role in this emerging science.
NN: You presented your research at the 2016 American Nurses Association Annual Conference. What do you think are the greatest benefits of attending nursing conferences? How can nurses can implement key learnings from conferences into daily practice?
John: Networking, without a doubt! A commitment for any nurse who is going to a conference is to come back and tell their colleagues what they learned and how these new ideas can fertilize dialog and action to improve patient care in their individual setting. A conference is just one way of disseminating new ideas. These have to be put into practice to the benefit of the patients, families and communities every nurse serves.
NN: Is there anything else that you would like to add?
John: After 36 years, I am still very proud to say I am a nurse. It has been my honor to be a nurse educator, helping to launch the careers of the next generation of nurses. These upcoming providers are bright and capable, and have the same exuberance, passion and dedication I’ve seen my entire career. I am confident they will lead us forward for generations to come.