Vanderbilt School of Nursing Assistant Professor Leanne Boehm, PhD, RN, FCCM, received an R01 grant of more than $3.6 million over five years to examine, with her collaborators, the efficacy of telemedicine services among people recovering from post-intensive care syndrome. This effort, funded by the National Institute on Aging, is the first PICS longitudinal cognitive impairment intervention study.
The Vanderbilt-led study will build on the burgeoning national effort to unite ICU clinicians and primary care providers in providing comprehensive care for patients starting when they are discharged from the ICU and continuing through transitional outpatient care.
“Following ICU discharge, patients have problems lasting months to years that often go unaddressed,” Boehm says. “Primary care providers—and even ICU clinicians taking care of these patients—do not know much about PICS.”
PICS affects up to 80 percent of intensive care unit survivors with a range of cognitive, physical, mental, and socioeconomic impairments—which may result in a poorer quality of life for sufferers and their caregivers. Studies have found that in a broad group of adult ICU survivors in all age groups, 33 percent to 50 percent develop ICU-acquired dementia—a symptom of PICS—which the National Institutes of Health now designates as Alzheimer’s Disease and Related Dementia. The ICU Recovery Center at Vanderbilt and the Critical and Acute Illness Recovery Organization were developed to establish ICU recovery clinics that address PICS.
“Only recently have we started to characterize what PICS assessment and management looks like across ICU recovery clinics,” Boehm says. “We’re seeing so much variation in what clinics are doing. This made us wonder which screening and intervention elements were the most important in ICU recovery clinics.”
To answer these questions, Boehm and her collaborators, including Dr. Carla Sevin, director of the ICU Recovery Center and co-chair of CAIRO’s post-ICU clinic collaborative, and James Jackson, director of behavioral health at the ICU Recovery Center, have developed a telemedicine-based randomized controlled trial to assess how a structured multidisciplinary ICU recovery clinic intervention can help patients and their caregivers live healthier, happier lives. Sevin and Jackson are recognized international leaders in establishing and implementing ICU recovery clinics.
The study’s multidisciplinary intervention will convene a physician and nurse practitioner, a psychologist or psychiatrist, a social worker, and a pharmacist to evaluate patients in the domains affected by PICS—specifically, the cognitive, physical, mental health, and socioeconomic challenges. Caregivers will be assessed for PICS-family and caregiver burden.
The evaluation will result in a care plan tailored to each patient’s needs and shared with their PCP. “Providers will talk with the patient about their assessment, care plan, what they can expect, and the resources to help them in their journey,” Boehm says. “Our team, all familiar with the ICU experience, have a multidisciplinary view of ICU-started problems and serve as a bridge in the transition of care from the ICU to their PCP or specialists. Our primary aim is to see if this intervention can improve cognition, mental health, physical function, social network, and patient activation.”
The choice to make this a study of telemedicine services was considered intentional. “ICU recovery clinics tend to be at major metropolitan academic medical centers, with limited services for patients in rural settings or those with new or worsening disability,” Boehm says. “Telemedicine helps address targeted access and availability gaps in PICS assessment and management.”
The pandemic made the study’s virtual component possible by rapidly adjusting and adopting digital services. A pilot study conducted by Boehm confirmed that patients, providers, and caregiver groups could engage in telemedicine and were willing to accept care through online platforms. The pilot study also informed best practices for efficient and supportive telemedicine ICU recovery clinic assessments; mental health and socioeconomic discussions will be conducted privately, and broader physical health discussions will be with the full group of providers.
Boehm’s other collaborators include Dr. Nathan Brummel, a former clinical fellow in Pulmonary Disease and Critical Care Medicine at Vanderbilt School of Medicine, Marianna LaNoue, professor of nursing, and Joanna Stollings, a medical intensive care unit clinical pharmacy specialist at VUMC.
Vanderbilt University School of Nursing Associate Dean for Equity, Diversity, and Inclusion Rolanda Johnson, PhD’98, received the Vanderbilt University Joseph A. Johnson Jr. Distinguished Leadership Professor Award at the university’s Spring Faculty Assembly.
The award recognizes a faculty member who has proactively nurtured an academic environment where everyone feels valued and where diversity is celebrated. It is named for Joseph A. Johnson Jr., the first African American to earn a Vanderbilt bachelor’s degree and the first to earn a doctoral degree.
In recognizing Rolanda Johnson with the award, Vanderbilt University Chancellor Daniel Diermeier says, “Rolanda’s experiences in nursing — as a clinician, educator, researcher, and administrator — inspired her to make a difference in the lives of those who experience health disparities and inequities and are often overlooked. Her passion is educating nurses to better meet the healthcare needs of all populations and delivering high-quality, culturally sensitive care to all patients. Among her efforts at the School of Nursing was advocating for holistic admissions, contributing to more diverse enrollment.”
Johnson has positively impacted equity, diversity, and inclusion on regional, national, and international levels. She serves as membership chair for the Tuskegee University National Nursing Alumni Association, was the inaugural chair of the American Association of Colleges of Nursing’s DEI Leadership Network (DEILN), mentors for the AACN Diversity Leadership Institute, and a member of the American Nurses Association National Commission to Address Racism in Nursing Education Work Group. She co-founded Nashville’s chapter of the National Black Nurses Association. Johnson also served on the U.S. Pharmacopeia Health Equity Advisory Group.
At Vanderbilt School of Nursing, Johnson helps faculty create inclusive curricula and classrooms, offers guidance to student affinity groups, and is exceptionally skilled at recruitment, retention, and inclusion. Her research and scholarship focus on increasing EDI in nursing education and assisting vulnerable populations.
“Most recently, Dr. Johnson co-developed and co-directed the inaugural Vanderbilt Academy for Diverse Emerging Nurse Leaders, a one-week immersive for nurses who have been in leadership roles for less than five years,” says Pamela R. Jeffries, PhD, FAAN, ANEF, FSSH, dean of Vanderbilt School of Nursing. “This was an amazing week for 18 fellows from academia and healthcare systems all over the country. Many described the program as ’life-changing.’ The academy is well poised to be sustainable and in the long-term, will help to mitigate the diversity disparities evident in nursing leadership.”
Senior Associate Dean for Academics Mavis Schorn, PhD, FACNM, FNAP, FAAN, nominated Johnson for the leadership award. “She has advanced equity, diversity, and inclusivity by developing a strategic plan focusing on both recruitment of diverse individuals while also creating a welcoming environment where everyone feels like they belong,” Schorn wrote. “She led the efforts to create a diversity statement for the school and later led efforts to update it to include antiracism language. She has worked with all the admission committees to ensure the admission process is holistic.”
Johnson will carry the Joseph A. Johnson, Jr. Distinguished Leadership Professor title for one year.
“This award was a wonderful surprise,” she says. “I am humbled to receive this honor. While I am the honoree, the VUSN family deserves accolades for ‘WE’ have accomplished much and will continue to be leaders in diversity, equity, and inclusion in nursing and healthcare.”
Earlier this fall, Vanderbilt University School of Nursing named Dr. Rolanda Johnson, PhD, MSN, RN as the new Assistant Dean for Diversity and Inclusion. Johnson, who is also the assistant dean for academics and associate professor of nursing, has replaced Assistant Professor Jana Lauderdale, who returned to her faculty role. Johnson is continuing to shape and foster VUSN’s environment of inclusivity. We spoke with Dr. Johnson to learn more about her experience and her goals for VUSN.
Dr. Rolanda Johnson
What has been your career path so far and how has it led you to your current role as assistant dean of diversity and inclusion?
My desire to work as a health care professional began when I was elementary age. As an 11th grader, I decided to attend nursing school. I completed my Bachelor of Science in Nursing degree at Tuskegee University in 1985. Those were very formative years of training and education when I gained a wide range of clinical experiences with diverse populations. After graduating from Tuskegee University, I worked in a community hospital in Montgomery, AL, at Fairview Medical Center where I was exposed to people who I now know had limited access to health care. At Fairview Medical Center, I witnessed a sense of family among employees who were dedicated to providing the highest level of quality care to all that were in need with genuine caring attitude. I later began employment at Jackson Hospital in Montgomery, AL, working in numerous roles including that of nurse educator and clinical nurse specialist. During this time, I obtained a Master of Science in Nursing from Troy State University located in Troy, AL. Working as a nurse educator, I developed a desire to have a greater impact on African American health. Shortly, thereafter I began doctoral studies at Vanderbilt University and later obtained a Doctorate of Philosophy in Nursing Science degree. I have worked in numerous roles of nursing including clinician, educator, researcher and administrator, which led to my current position.
How has your professional background influenced your passion for diversity and inclusion?
Throughout my education trajectory, I have always been keenly aware of the health disparities and inequities some groups of individuals face. I am employed in Nashville while residing and working with my husband in an extremely underserved rural county in Mississippi. The social determinates of health naturally impact the health status of many. Who you are, where you live and what you have, sadly, monumentally impacts the quality of care one receives and access to health. As an educator, I work with students across the spectrum who are often impacted by these factors either individually or through family and friends. For me, all of these experiences have translated to my desire to make a difference in the lives of those that are often overlooked and to help others see the integration of all facets that impact the lives of our students and their performance.
Where did your passion for diversity and inclusion in the nursing field begin?
My passion for diversity and inclusion began during my studies at Tuskegee University. Those were very formative years of training and education. The wide range of clinical experiences with populations across the socioeconomic spectrum and from rural Tuskegee, AL, to metropolitan Atlanta, GA, opened my eyes to the varying degrees of heath care and access for different groups of people. Naturally, at that time I could only assess health disparities from my early developmental lens but these experiences have proven to be instrumental in guiding my nursing career.
For the past 20 years, I have resided in Macon, MS, a low-income, rural community, and have been employed approximately 300 miles away in metropolitan Nashville, TN. This has afforded me the opportunity to observe health care delivery cycles and the degree of effectiveness across diverse populations including associated gaps and health disparities. This phenomenon has fueled my passion to educate advanced practice nurses who will be equipped to fill these gaps and better meet the health care needs of all populations. The key to have advanced practice nurses who can deliver quality culturally sensitive health care.
How do you define diversity and inclusion at Vanderbilt?
Within VUSN, our core belief is that all students, staff and faculty regardless of our differences should feel included and equitable. This is reflected in the VUSN diversity and inclusivity statement, which states at VUSN “we are intentional about and assume accountability for fostering advancement and respect for equity, diversity and inclusion for all students, faculty and staff.” The full statement can be found on the VUSN website.
What are you most excited about with your new position?
The most important part of my new role is the possibility of enhancing the culture climate within VUSN and creating a path for continued improvement for years to come. I am humbled to be a part of this endless journey. I hope to leave an indelible imprint of creating a difference in this area within VUSN.
What strategies do you feel will have the most positive impact on the Vanderbilt Nursing community?
The umbrella strategy is to transform the level of diversity and inclusion within VUSN by minimizing bias across our core areas of academics, faculty practice, research and informatics among faculty, staff and students. Additional strategies will be to improve the cultural climate of VUSN for all students, faculty and staff and to increase the diversity representation among faculty, staff and students.
What are the biggest challenges that you will face in your new role?
The biggest challenge is to keep the diversity and inclusion momentum moving forward within VUSN. Within any organization, change is often difficult and once that change has occurred, it is so easy to be complacent with past accomplishments. The test is to bask in accomplishments for the moment and then move forward to the next challenge and goal.
What diversity goals do you have for yourself and Vanderbilt’s School of Nursing?
My goal is to pursue a high level of excellence in health care by finding creative ways to deliver this level of care to underserved populations. From a diversity and inclusive view, I desire to minimize bias, improve the cultural climate and increase diversity representation in faculty, staff and students within VUSN.
Get ready to kick off National Nurses Week! This annual event to recognize the compassionate and critical work nurses perform and to celebrate the profession begins tomorrow, May 6 and lasts until May 12.
The week provides time to honor the role of nurses in their own lives and in the collective national landscape.
This year’s theme: Nursing: The Balance of Mind, Body, and Spirit reflects the American Nurses Association’s designation of 2017 as the Year of the Healthy Nurse. The theme points to the delicate and essential equilibrium that nurses must find to successfully thrive in such a distinctly unique profession.
National Nurses Week is marked throughout the nation in all kinds of settings—from healthcare settings to nursing schools.
Vanderbilt, which has both a medical center and a nursing school, has events including a blessing of the hands and a state of nursing address by the chief nursing officer. There are awards to recognize outstanding nurses and a dean’s diversity lecture that will examine how the nursing profession as a whole can meet the needs of a diverse population.
At the nursing school, where more than 900 students take classes, there will be several versions of birthday parties for Florence Nightingale whose birthday is marked every May 12.
“We are having an ice cream social for the students just to say, ‘We’re glad you’ve chosen nursing and this is our way of celebrating nurses,’” says Norman.
Here are a few ideas to celebrate National Nurses Week either with colleagues, family, friends, or by yourself:
Have a party
Nurses deserve to have someone else take care of them, so having a reception at work or meeting for lunch with your nurse friends offers time to stop and celebrate.
If you supervise other nurses, be sure to thank them for all they do. They are the front lines of patient care and perform superhuman feats each day.
As Norman says, the week also offers a time for nurses to consider the journey that brought them to where they are. Norman says she is frequently reminded of her own journey.
“It is a time for us to reflect on the choice we made back when we were deciding on our profession,” she says. “To be able to try to meet the needs of others—that’s a privilege. To teach others how to do that—that’s an even bigger privilege.”
See Our Champions of Nursing Diversity
Sign up now to get your free digital subscription to Minority Nurse