Much has been written in contemporary society about the characteristics necessary to become a leader. Yet, the concept of leadership still can be elusive because of common myths about leadership that individuals choose to believe. However, one important aspect of leadership is that it often is thought to be a transient circumstance. According to Isabel Maitland Stewart, an early American nursing leader, sociologists and psychologists who have studied the nature and conditions of leadership seem to agree that effective leadership depends on three main factors:
First, there must be a situation that calls for leadership- usually a crisis or a complicated condition of affairs that cannot be disentangled by ordinary individuals or by ordinary methods. Second, there must be a group that is responsive to leadership, and sufficiently homogeneous to arrive at some common basis of understanding and cooperation. Third, there must be a leader who is capable of meeting the specific situation - one who has initiative enough to step out a little ahead of the rest and who, at the same time, possesses a combination of traits acceptable to the group (Stewart, 1940, pp. 13-14).
Assuming these factors are at least fairly adequate, it does not take one long to conclude that Priscilla Ebersole has been an outstanding leader in nursing. Whether the situation called forth the leader, for indeed all the factors were present, or the leader discovered the need and created the movement, need not be of concern. Dr. Ebersole possibly would have been a leader in any field she may have chosen, but in the field of gerontological nursing, she found a congenial cause and ample scope for her unusual abilities. Her clarity of vision, high ideals, creativity, and clinical experimentation have affected nursing profoundly.
Warren Bennis, a professor at the University of Southern California who has studied corporate executives, emphasizes that leaders think about doing and do the right thing. This process promotes futuristic thought as well as contemplation of dreams, missions, strategic intent, and purpose - all of which comprise the essence of leadership. Dr. Ebersole's career trajectory in geriatric nursing exemplifies this process although she believes her career "...has really just been a path through open doors and never a well laid out plain." Perhaps this was facilitated by the fact that she was "...unwilling to abandon a pursuit once begun." Interestingly, Dr. Ebersole never had a clear set of long-range goals in her life but more often selected whatever attractive option happened to come along. Hers has not been a typical journey in nursing because she never planned to be a nurse. The convenient and challenging opportunity originated with the initiation of a new program in nursing at College of San Mateo, a community college 10 miles from where she lived. By this time her youngest daughter had begun school.
Priscilla Pierre Ebersole was born in Salem, Oregon the year prior to the Great Stock Market Crash of 1929. She was the eldest of seven children. The Pierres lived in numerous places wherever her father could find work, which resulted in her attending 18 schools before completing the eighth grade. She completed high school in Olympia, Washington and attended 1 year of Cascade College in Portland, Oregon before marrying Raymond Ebersole in 1948. Raymond had been in the United States Occupation Army in Japan. According to Dr. Ebersole, his sister and mother collaborated to be sure they would meet and, thus, distract him from returning to Japan.
The Ebersoles moved to California in 1951 where Raymond began working for United Airlines at the San Francisco Maintenance Base. They had two daughters and two sons; eight grandchildren currently add to the rich family structure. After tending to family responsibilities and working in bookkeeping and accounting, Dr. Ebersole entered the College of San Mateo and graduated with an Associate of Arts degree in nursing in 1965. Of 55 students entering the program, only 1 8 graduated. From this beginning emerged a steady academic progression which culminated in the achievement of a PhD (1986) in Health and Human Services from Columbia Pacific University in San Rafael, California. Numerous academic degrees and programs (BSN, San Francisco State University, 1971; MSN, Adult Psychiatric Nursing, University of California, San Francisco, 1972; Post Master's degree, Geropsychiatric Nursing, University of California, 1973; Gerontological Nurse Certificate, University of Southern California, Los Angeles, 1978) provided a rich background for what was to become Dr. Ebersole's life work, a sustained and deep personal interest in aging, life history, and the therapeutic aspects of reminiscing.
Most of Dr. Ebersole's nursing practice and teaching has focused on psychiatric and geriatric specialties. She began psychiatric nursing when a new, small unit (10 beds) opened in a community hospital. At that time, federal money was available for graduate education in psychiatric nursing, which prompted her to attend the University of California, San Francisco. There she met Irene Burnside and completed postgraduate education in geropsychiatry under her mentorship. Dr. Ebersole's special interest was life review, fostered by the stories of her grandmother. "My grandmother traveled from Missouri to Washington in a wagon train in 1880, and I loved her stories. I still love the amazing stories of the very old."
Major influences in Dr. Ebersole's career trajectory in geriatric nursing included various mentors and individuals who took an interest in her and her work. In addition, opportunities that arose and built on one another provided the stepping stones to her success in the field. Although many of these opportunities were circumstantial, "being in the right place at the right time with helpful people," Dr. Ebersole's determination and persistence paved the way for major accomplishments in a nursing field which was still in its infancy. Geriatrics was a latecomer to nursing, receiving little if any attention prior to 1965. In addition to being the year of Dr. Ebersole's graduation from her basic nursing education program, 1965 also was the year when Medicare was instituted. According to Dr. Ebersole, the most dramatic changes in geriatric nursing education, practice, and research include:
* A gradually increasing recognition of the need to include geriatrics in basic nursing programs.
* Graduate nursing programs with endowed chairs in geriatrics and gerontologie nursing.
* The growth of home care.
* Federal recognition and support of advanced nurse practitioners as primary providers of health care.
* Significant clinical research on aging that can be implemented in practice.
The emphasis of nursing research was no longer merely on faculty's and students' attitudes toward aging but on clinically relevant research designed to improve nursing care to a vulnerable population - elderly and aging individuals. Dr. Ebersole has advocated strongly for the protection of elderly individuals through the use of qualified nurses and promoted the strategies she believed would achieve this end.
Dr. Ebersole contends the major pathfinders in geriatric care always have been nurses. She has focused on several: Irene Burnside, Mary Opal Wolanin, Sister Marilyn Schwab, Doris Schwartz, Eldonna Shields, Sister Rose Bahr, Laurie Gunter, and Virginia Stone. All of these women were early nursing leaders Dr. Ebersole knew well. She believes the field currently is being led by Mathy Mezey, Terry Fulmer, May Wykle, Kathleen Buckwalter, Ann Luggen, and Cornelia Beck. She labels these nurses as
...pathfinders, individuals who are creating new paths and opportunities for nurses interested in the field.... They are many-faceted individuals, active in organizational leadership, education, research, and grooming newcomers to the field.
Yet a major pathfinder in gerontological nursing has been Dr. Ebersole, who has demonstrated what is possible in the most difficult situations and provided inspiration in the most challenging circumstances.
Numerous obstacles, challenges, and issues will face geriatric nurses in the years to come. Dr. Ebersole believes the major obstacles remain the same as those of the past: salaries that do not reflect the knowledge requirements and responsibilities required of practicing nurses; insufficient faculty sophisticated in gerontologie knowledge; too few faculty available to provide appropriate fundamental education toward geriatric specialization; and restrictive health care policies on state and federal levels that may discourage creative efforts. Equally important are the ethical issues. Hard decisions will have to be made regarding the distribution of resources. According to Dr. Ebersole, an inordinate amount of health care dollars are spent to keep very old people alive for a few extra days or weeks. This skewing of medical services toward hightech, often inhumane care must be curtailed. Resources must be distributed more evenly through the population, and better care must be provided for individuals with chronic diseases. The outcome is that with the ability to sustain life despite numerous illnesses, chronic disease management will be the major issue in the future. Perhaps the greatest challenge to future geriatric nurses will be the same as that faced by Dr. Ebersole: "I believe the confrontation with self when dealing with the most vulnerable situations of other humans is difficult and humbling as well as rewarding."
Speaking to the current status of geriatric nursing, Dr. Ebersole claims the issues noted above mandate that great strides in geriatric nursing will occur in long-term care because acute care seldom identifies geriatric care as a specific component of concern. As such, adequate resources must be available to ensure care of elderly individuals in nursing homes and in their homes is exemplary. In addition, caring for elderly individuals in long-term care settings must not be a source of corporate income. Currently, provider corporations are able to make large profits at the expense of elderly individuals and the taxpayers. Dr. Ebersole believes society has an obligation to support its elderly individuals, not just adequately, but very well. Although it is costly to achieve this, nationalizing this aspect of health care must be considered. She states, "I am terribly biased on this issue, but I believe all long-term care should be truly nonprofit."
Dr. Ebersole has had a long and illustrious career. For almost 30 years, she has invested her talent, knowledge, and experience in the development of a credible, specialized field - gerontological nursing. Her activities in nursing education and practice are many. She has served in various offices and committee seats and acted as a consultant to various governmental agencies throughout her nursing career. These include:
* Directing filming of Gerontological Nurse Practitioners: The New Professionals (1981).
* Acting as consultant to the Commission of California State Government Organization and Economy as they formulated recommendations regarding nursing home care to be presented to the legislature (1982).
* Serving as a member of the Nurse Practitioner Faculty Organization Committee to define minimal competencies of nurse practitioners (1982 to 1984).
* Serving as a member of the National Invitational Consensus Conference to Identify Baccalaureate Gerontologie Nursing Competencies (1990).
* Serving as a contributor to Health Services and Resource Administration, Bureau of Health Professions, United States Department of Health and Human Services, White Papers statement of National Agenda for Geriatric Nursing Education (1995).
Equally important are Dr. Ebersole's research activities that are far-reaching and especially significant to the progression of gerontological nursing practice. From 1981 to 1984 she was granted a 3-year leave from San Francisco State University to direct field activities of a 13-state project to recruit, educate, support, and integrate gerontological nurse practitioners into nursing homes. The project was funded by the W.K. Kellogg Foundation, administered by the Mountain States Health Corporation of Boise, Idaho, and coordinated with five participating universities.
Throughout her lifetime, Dr. Ebersole has been recognized for her accomplishments. Her honors and awards include:
* Distinguished Alumni of the Year at College of San Mateo (1987) and San Francisco State University (1988).
* Educator of the Year award at the annual convocation of the American College of Health Care Administrators (1987).
* Induction in the Alumni Hall of Fame from San Francisco State University (1998).
Although Dr. Ebersole officially retired from San Francisco State University in 1995, she continues to be actively involved in nursing activities as a professor emerita. In the fall of 1988 she occupied the Florence Cellar Endowed Chair in Gerontological Nursing at Case Western Reserve University, Cleveland, Ohio. Aside from campus activities, Dr. Ebersole continues to write, lecture, and present workshops nationally and internationally.
Dr. Ebersole is a prolific writer who has interpreted modern trends in both nursing education and nursing practice. Her extensive knowledge is used widely, and her publications are regarded as valuable resource materials. Her most recent publications include:
* The fifth edition of Toward Healthy Aging: Human Needs and Nursing Response (1998) with P. Hess.
* Care of the Psychogeriatric Client published in 1990.
Both of these nursing texts were given the American Journal of Nursing Book of the Year awards. In addition, Dr. Ebersole has written numerous articles related to geriatric issues and nursing and has served as the acting editor of Geriatric Nursing since 1991. These publications are particularly important to Dr. Ebersole as she reflects on her nursing legacy: "I hope my impact on geriatric nursing has been primarily as my texts and Geriatric Nursing editorship have contributed to improved clinical care of the elderly."
Dr. Ebersole is truly a nursing leader who has contributed to the knowledge and practice of nurses in general and specifically of nurses working with elderly individuals. She firmly believes that leaders in geriatric nursing must study history. Her ongoing study of the personal and professional development of gerontologie nurse pioneers attests to that belief. Dr. Ebersole is one of those nurse pioneers who is well known for her modesty and concern for others. She stated:
I think whatever leadership I have exerted in the field has been on an individual level. I have not had the inclination toward organizational leadership but fully enjoy moving someone else forward with whatever resources I am able to provide. Research has not been an important focus of mine, but furthering the efforts of others toward research is important to me, and I am committed to keeping geriatric nurses aware of our history and heritage.
Dr. Ebersole continues to be a mentor and role model for all who know her. She has inspired numerous individuals to study and research all aspects related to the care of elderly individuals. She has accomplished what she believes others who have gone before her have accomplished. She stated:
We have numerous leaders and pathfinders to provide inspiration. Though the issues are different and each individual leader is unique, they show what has been possible in most difficult situations. I suppose the inspiration is the most significant aspect of leadership.
Whatever characteristics are ascribed to leaders and leadership, Dr. Ebersole embodies them all. She is a class act, and her writings will remain as the classics in her field.
- Ebersole, R (Director) (1981). Gerontological Nurse Practitioners: The New Professionals [Film]. Saskatoon, Saskatchewan, Canada: Tri-Media.
- Ebersole, R (1990). Care if the psychogeriatric client. New York: Springer.
- Ebersole, P., & Hess, P. (1998). Toward healthy aging: Human needs and nursing response. St. Louis, MO: Mosby.
- Stewart, LM. (1940, February). Our founders. Nursing Education Bulletin, 13-14.