Confronting Public Health Challenges in The Year of the Nurse

In December, I was honored to be the featured guest on the webcast “Voices of Leadership” at the Harvard T.H. Chan School of Public Health. The series invites leaders to speak candidly about their experiences confronting major public health frontiers and how they have worked to bring about positive change. I traveled to Cambridge to record the show, which was live-streamed around the world.  

2020 is the International Year of the Nurse and the Midwife so I was pleased to be able to put the spotlight on nursing – not only discussing my background and what drew me to the profession, but also the importance of a strong and thriving nursing workforce to the many global challenges we face today. 

To see what I said, you can take a look at the original webcast, “Harnessing the Power of Nursing to Build a Healthier World: A Conversation with Dr. Stephanie Ferguson,” here.

To see what I wanted to say, read the Q&A below:

Q: Tell us about your path to nursing.

A: I wanted to be a nurse as far back as I can remember. Some of my relatives worked as health professionals and I loved hearing the stories of one of my cousins who was a nurse. Another RN who made a big impact on my life was the public health nurse in Appomattox, VA, where I grew up. She was the nurse not only in Appomattox, but all over the county. I was impressed by how many people she cared for. She made me believe I could make a difference and make the world a healthier, better place. 

Soon I signed up to be a volunteer candy striper at the local hospital and then a nurses aide at Centra Health in Lynchburg. I earned my BSN from the University of Virginia (UVA) and my MS from the Medical College of Virginia, Virginia Commonwealth University and then returned to UVA for my PhD. 

My early career included working for various governors in the Commonwealth of Virginia on women’s and children’s health issues, including a newborn screening program for sickle cell disease and other hemoglobinopathies. I worked as a neonatal intensive care unit (NICU) nurse at the University of Virginia Health System and advanced from there to lead and manage health systems in Virginia. I spent a year as a White House Fellow during the Clinton Administration and then moved into academia, as a professor at Howard University, George Mason University and Stanford. Eventually, I entered the global arena, working for the International Council of Nurses and the World Health Organization. 

What’s clear from my trajectory is this: focus on whatever illuminates your path and ignites your passion. Just like Florence Nightingale’s lamp, your dreams and goals will light the way forward.  

Q: You’ve committed a big portion of your career to public service. Why? 

A: As I said, from a young age my heart was set on making a difference. Public service lets you make the greatest difference. Sustainable change starts at the grass roots level. If you want to impact that change, you focus on the public.   

Q: Why not just do clinical work as a NICU nurse? Why did you choose to move beyond that to become an academic and a nurse leader? 

A: When I was working in the NICU, I witnessed so many teen pregnancies, I was driven to do something. I wanted to confront the problem at its roots and work with adolescents and their families, their friends, their teachers and community leaders. This work as an advocate sparked my passion for public service and finding ways to improve public health outcomes.

Q: What key skills have you learned from government service? 

A: So many skills! Above all, the art of effective compromise. How to work with others to effect change. Collaboration, partnerships, advocacy, the policymaking process, impact, sustainability. It’s all so important. 

Q: How did your decision to become an entrepreneur and start your own consulting firm amplify your work? 

A: I am the founder, the president and the CEO, so it’s pretty much all down to me! When I come to the table, I set the agenda, determine the methodology and select the partners I want to work with to make the greatest impact. Entrepreneurship is incredibly liberating and rewarding in so many ways.  I’m able to be the funder and the decision-maker. 

Q: How can nursing advance public health, and vice-versa?  

A: Nurses have been at the forefront of public health as far back as the days of Florence Nightingale – and earlier. We are highly experienced in managing populations and caring for the underserved. Public health can create innovative educational initiatives, as well as opportunities for continued learning and leadership in sustainable development, social determinants of health and health equity. 

Q: What advice can you offer women interested in global leadership in public health or nursing? 

A: If this is your dream, if this is your goal, go for it. Just do it. 

Q: When it comes to career choices, do you believe in planning, or serendipity?

A: A bit of both. Be open to the serendipitous opportunities that come your way, but also do some planning to be sure you have what it takes to earn a seat at the table. Do a self-assessment to determine your strengths and pinpoint areas for improvement. Then make a plan for how you’ll fill those gaps. Do you need to develop your competencies, hone your skills, go back to school, pursue a certification? How will you make it happen?

Q: How do you know if you’re choosing the right career path? 

A: Follow your passion and determine what it takes to be successful on that career path. Then take it for a test drive! If you don’t try it out, you’ll never know if it was the right choice for you. If you do not ask to participate, to lead, to take that journey, you will not know. 

Q: What are some key things to watch for as your career advances, particularly if you are one of only a few women in leadership? 

A: Taking on too much. Learning to say no. My rule of thumb is this: one yes to three nos. Learning to say yes and no is key to managing your energy, life and career. 

Q: Over the course of your career with WHO and ICN, when you worked in the 100+ countries around the world, what surprised you most? 

A: The resilience of people in so many different settings. Papua New Guinea is a good example. The indigenous population lives in a remote, jungle environment with limited health resources and infrastructure. There’s civil unrest and tribal warfare. Women are not valued members of society. Yet we were able to enlist the help of women to develop interventions to decrease HIV and AIDS, ensure safe pregnancies and deliveries, and decrease infant mortality.

Q: Given your work on health care reform during the Clinton Administration, did you come away with any lessons learned that apply to the current health care debate?

A: Yes, the administration did not get health reform passed, as you know, but it did get the Children’s Health Insurance Program (known as CHIP) implemented and increased funding for research at NIH, both of which continue to make a huge impact today. The lesson I learned is the value of sustainable, incremental change. Just because you aren’t going to get everything you want doesn’t mean you shouldn’t try to get something that you want. 

I also learned that, when it comes to health reform, big, sweeping changes are incredibly difficult to pull off. We need to ensure that everyone has a voice. And we need to allow health workers to do the work they are educated and licensed to do. 

Q: WHO has declared 2020 the year of the nurse. Considering where the field was when you started and where we are going, are you optimistic or pessimistic about the future of nursing?  

A: Definitely optimistic. My work with WHO and ICN and the Nursing Now campaign is evidence of progress. Nursing Now is a global initiative to raise the status and profile of nursing. The goal is to empower nurses to take their place at the heart of tackling 21st-century health challenges. I salute those nurses who paved the way and the current and future generations that will continue to pursue excellence in nursing and health care. 

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