Casey Shillam, left, and Grandma Pat. Casey Shillam, left, and Grandma Pat.

Note: I asked Casey Shillam, PhD, RN-BC, Nursing Academic Program Director and Associate Professor at Western Washington University, to write a blog for Health AGEnda to reflect on her role in 2013 as the Chair of the Hartford Gerontological Nursing Leaders (HGNL).

Among many accomplishments under Casey’s tenure, this group of more than 300 Hartford-supported nurses advanced their work via seven committees ranging from Peer Mentorship to Communications; authored a special issue of Clinical Nursing Research; organized a Policy/Leadership Town Hall with Hartford colleagues in medicine and social work at the 2013 annual meeting of the Gerontological Society of America; and made numerous presentations at national venues. Casey is a dedicated, creative, responsive, inclusive, and approachable leader.

Casey’s story below exemplifies these characteristics and demonstrates her collaborative, evidence-based, caring approach to her work with older adults. Thanks, Casey, for your contributions to the HGNL and to the field of nursing. And thanks, Grandma Pat, for inspiring Casey to inspire so many.—Rachael Watman, MSW, Senior Program Officer

My Grandma Pat has been the inspiration for so many of my endeavors in working with older adults throughout my nursing career. So I couldn’t help but think of her as I stood before my colleagues and friends at last fall’s Hartford Gerontological Nursing Leaders (HGNL) Business Meeting, held at the 2013 annual meeting of the Gerontological Society of America (GSA) in New Orleans, to transition the role of HGNL Chair to Dr. Bill Buron.

Together, Dr. Buron and I announced the launch of a campaign to raise funds for a HGNL award to support a future scholar in the program. I had no idea at the time how quickly that scholarship would take on a deeply personal meaning to me.

I opened the meeting with my own personal story of the impact the John A. Hartford Foundation and the program formerly known as Building Academic Geriatric Nursing Capacity (BAGNC) has had on my life. As I spoke, I had a vision in my mind of my beloved grandmother: vibrant, 83-years-old, strong-willed, unbelievably healthy, and my biggest fan.

I shared that I am the first member of my family to graduate from college and obtain graduate degrees, and that the financial support and the mentorship, networking, and career counseling I obtained throughout my undergraduate and graduate programs have launched me into the leadership roles I hold today. Through these leadership skills, I have substantially contributed to improving the health of older adults in our country in a variety of ways.

Throughout the talk, I pictured Grandma Pat’s loving smile encouraging me as I nervously shared these personal stories with my professional network. What I didn’t know was that in just three weeks’ time, she would be taken from us.

When I returned home from New Orleans, I learned that Grandma Pat had been admitted to the hospital for a urinary tract infection. In the few weeks that followed, the work of my HGNL colleagues from across the country guided my support of her hospital treatment and brought into focus just how great a difference the scholarship award we announced at the meeting can make.

Sadly, the ending of this story also demonstrated that we still have so much work to do.
My first step was to turn to the work of Lori Popejoy, 2002–04 Pre-doctoral Scholar, and her work on best practices for care coordination. I knew that my grandmother would likely need some physical or occupational therapy upon her return home, and because she lived alone, I wanted to ensure that she had a comprehensive plan in place to cover all of her needs.

A few days later, I learned that she had acquired pneumonia and would start receiving IV antibiotics, lengthening her hospital stay. I pleaded with my father over the phone to insist that all health care providers wash their hands and asked him to make sure that reminders be placed on her door and above her bed. He kindly sent me text messages including pictures of these posted signs, and he assured me that Grandma was making everyone “wash-up” before they touched her.

Drawing from the work of Teresa Goodell, 2010–12 Claire M. Fagin Postdoctoral Fellow, on the prevention of hospital-acquired pressure ulcers, I guided my father to insist that Grandma receive adequate hydration, nutrition, and mobility while in bed. I also relied on the work of Barb King, 2007–09 Pre-doctoral Scholar, in the importance of early ambulation. I learned that in the first eight days of her hospital stay, Grandma was not out of her hospital bed one time.

My father reported that the healthcare team felt she needed the time to recover from the infection before beginning ambulation, even though she was walking at least a mile most every day of the week before she was admitted. She had already developed pneumonia while in the hospital, and I could not imagine a worse fate than also developing pressure ulcers and losing her ability to walk independently. I never imagined that the worst possible fate was to come: In another three days, her infections became septic, and she died.

I was stricken with such unbelievable grief. It always amazes me when I experience these life events pertaining to the care of older adults in my own family, that my clinical background and scholarly expertise have no bearing on my human emotions and the personal impact of the emotional pain. I thought of how terribly I would miss the twang of her Southern drawl on our weekly phone calls, which we’d had since I graduated from high school. I instantly recalled her presence at the important events of my life: my graduation from nursing school, my wedding, receiving my PhD.

I will continue to honor her influence in my life the way that this story started: by encouraging my HGNL colleagues to contribute to the scholarship campaign. It is only through the continued support of preparing nursing scholars in the pursuit of changing practice to provide high-quality, safe, evidence-based care to older adults that we will continue to support the momentum created with the BAGNC program.

With the program transition to the National Hartford Centers for Gerontological Nursing Excellence (NHCGNE) at GSA, the future of the scholars and fellows program is uncertain. What is certain is that with even one scholarship, the alumni of this life-changing program can and will continue to make an impact on the future of gerontological nursing.

Contributions to the Scholars and Fellows program can be made at the HGNL website. Please consider the gift of giving.