Rachael Watman shows off her prized cow skull, as a passing plane causes dog Rebel to wonder how the skull ever got through airport security. Rachael Watman shows off her prized cow skull, as a passing plane causes dog Rebel to wonder how the skull ever got through airport security.

In May, I will leave The John A. Hartford Foundation to become the Vice President of Programs at the Rita & Alex Hillman Foundation. Naturally, I’ve spent time reflecting on my 13 years here. I’ve learned many lessons, gathered best practices, and worked with some of the smartest people in the nation.

The memory that stands out, however, involves a cow skull.

At a nursing conference in San Antonio, fellow Senior Program Officer Amy Berman and I made a field trip to a local Mexican market. Amy convinced me to buy a beautiful, though enormous, cow skull—long, pointy horns and all.

Amy assured me there would be no problem getting it through post 9/11 airport security. She would help! I did some research back at the hotel to see if Continental’s policies were as liberal as Amy’s, attempting to assuage my buyer’s remorse.

Cow skulls didn’t seem to be prohibited. We were in Texas. At airport security, I overcommunicated, repeatedly warning everyone that I had a cow skull and that I was taking it on the plane.

Amy was nowhere to be seen.

The skull made it through, and now proudly hangs on a little barn in my yard. It has come to symbolize three key maxims I have learned at The John A. Hartford Foundation.

1) Take Risks, Especially on Things of Value

I wanted a cow skull. My micro-barn needed a cow skull. I disregarded convention and went for it. As a result, my world is a better place.

The National Hartford Center of Gerontological Nursing Excellence takes risks. Many moons ago, one of the Directors of the individual Centers of Gerontological Nursing Excellence made the bold suggestion that we combine the efforts of the eight John A. Hartford Foundation-funded centers, along with their coordinating center, now housed at the Hartford Institute for Geriatric Nursing. This new collaborative umbrella structure would draw on the strengths of all, sustain their work, and collectively engage a committed group dedicated to optimal health and quality of life for older adults.

After years of hard work from a group of leaders, including Drs. J Taylor Harden, Ginny Pepper, Claudia Beverly, and Tara Cortes, the National Hartford Center has more than 60 members promoting their shared mission to enhance and sustain the capacity and competency of nurses to provide quality care to older adults through faculty development, advancing gerontological nursing science, facilitating adoption of best practices, fostering leadership, and designing and shaping policy.

The risk paid off. As a result, the nursing world is a better place and older adults receive better care.

2) Do Your Homework and Then Make Up Your Own Rules

Cow skulls were not explicitly prohibited as carry-on items, therefore they are allowed.

When we at the Foundation began to move from workforce development efforts toward programs that would influence change in the practice environment, we needed to implement a major grantmaking mechanism to support the thousands of gero-expert social workers, nurses, and physicians who would serve as our ambassadors.

Senior Program Officer Marcus Escobedo and I did our homework, asking the grantees what would help them enact real and sustained practice and policy change in order to improve the care of older adults. With the help of a team of colleagues, Marcus and I hosted focus groups, elicited feedback at conferences, and had many one-on-one meetings. This work became The John A. Hartford Foundation Change AGEnts Initiative.

This bold, new, rule-breaking initiative was unlike any other grant funded by the Foundation because, in large part, it was designed by our grantees. In partnership with the Gerontological Society of America; SCP; and thought leaders such as Drs. Laura Gitlin, Nancy Whitelaw, and Alan Stevens, we have reverse engineered grantmaking so the Change AGEnts can meet the needs of grantees.

We will be bringing a renewal of the Change AGEnts to The John A. Hartford Foundation Trustees in September 2016. The Change AGEnts Leadership team continues to push boundaries. Stay tuned.

3) Engage a Diverse Set of Stakeholders to Implement a Common Goal

To get the skull on the plane, I befriended TSA Agents, passengers, and crew. We became a team devoted to placing the skull safely in the prime real estate of the overhead bin.

Our new End-of-Life Care and Serious Illness initiative, led by Dr. Tony Back at the Cambia Center of Palliative Care Excellence at the University of Washington, represents the work of a diverse group of stakeholders toward a shared goal to improve serious illness and end-of-life care in the U.S.

In order to do this, Amy Berman, President Terry Fulmer, and I brought together key innovators in the field and many interested funders. The group met in June of 2015, and agreed to craft a national agenda and shared metrics to improve the care of the dying. This 3-year, $3.5 million grant was just approved at our March Board meeting, and much has already been accomplished.


My last day at the Foundation is April 29. This has been a wonderful experience. I would like to thank my fantastic co-workers, grantees, funding partners, and the Trustees of The John A. Hartford Foundation — together we made a difference in the care of older adults. I look forward to watching the Foundation thrive under the leadership of Dr. Terry Fulmer and Program Director Rani Snyder. I also look forward to my new work at the Rita & Alex Hillman Foundation.

I’m taking these three principles with me, and I’m keeping the cow skull.