Journal of Gerontological Nursing

Spotlight 

Reflections on 30 Years of Gerontological Nursing Science: The Doris Schwartz Gerontological Nursing Research Award Presentation

Linda R. Phillips, PhD, RN, FAAN, FGSA

Abstract

I was surprised and honored when I received the notice I had been chosen to receive this award. Quite frankly, it seemed to me there had to be some kind of a mistake. However, I was assured it was true, thanks to the nominator, Dr. Janice Crist, from the University of Arizona, and the support of several others, including Dr. Gerry Lamb and Dr. Elaine Rousseau. So I prepared to come to the meeting for the ceremony. In my preparations, I had a most astounding realization: I attended my first Gerontological Society of America (GSA) meeting in San Francisco exactly 30 years ago. Coming back here to receive the award, I couldn’t help but be nostalgic.

I attended my first GSA meeting because my mentor, Mary Opal Wolanin, told me I would come—and “Oh, by the way,” she said, “You will be giving a paper.” Not only did she insist I come, but being a true mentor, she paid my way. At the meeting, she introduced me to some of the “Grand Dames” of gerontological nursing research at the gerontological nursing interest group, which at that time could be practically held in a telephone booth. Being chosen for the Doris Schwartz award, coming back to San Francisco to receive it, and remembering that very first meeting made me think that maybe what I really wanted to do in this talk was to share my memories and thoughts about the future. I wanted to tell you about Mary Opal and the many important lessons she taught me in our many years together. Let me begin by outlining some of those lessons for you.

“Paragraphs are like Mexican pots.” One of the great fortunes of my life was Mary Opal inviting me to share with her in the writing of a book titled Confusion: Prevention and Care, which was published in 1980. Writing that book and working closely with Mary Opal in its creation was a truly amazing experience. However, the path to creation was not always easy. We often disagreed about what to say and how to say it. As a protégé, I should have been grateful and kept my mouth shut, but I was young and sometimes I just didn’t know any better. One day we were having a particularly heated argument about organizing some of the material, something that doesn’t really matter now. As often happened, I was “mouthing off.” In her exasperation, Mary Opal finally turned to me and said, “Linda, you need to learn that paragraphs are like Mexican pots—they are all different!” Point taken. From that, I learned there are many ways to say things, and all of them are right.

“There are many ways to mentor.” Mary Opal was an incredible mentor, and she always seemed to know what was needed and when. During the second World War, Mary Opal had been in charge of a nurses’ barracks in Missouri. When I asked her what she did in the war, she said she was “in charge of the care and feeding of nurses.” From that experience, she learned that mentoring is more than teaching; it is about feeding the body and the soul. She spent the rest of her life doing just that.

The first day I met Mary Opal, I visited her house during a break from school. We talked for several hours and finally I had to go back to class. Before she let me leave, she asked me if I had time to get lunch, and before I could answer, she was in the kitchen packing a sandwich for me. That was…

I was surprised and honored when I received the notice I had been chosen to receive this award. Quite frankly, it seemed to me there had to be some kind of a mistake. However, I was assured it was true, thanks to the nominator, Dr. Janice Crist, from the University of Arizona, and the support of several others, including Dr. Gerry Lamb and Dr. Elaine Rousseau. So I prepared to come to the meeting for the ceremony. In my preparations, I had a most astounding realization: I attended my first Gerontological Society of America (GSA) meeting in San Francisco exactly 30 years ago. Coming back here to receive the award, I couldn’t help but be nostalgic.

I attended my first GSA meeting because my mentor, Mary Opal Wolanin, told me I would come—and “Oh, by the way,” she said, “You will be giving a paper.” Not only did she insist I come, but being a true mentor, she paid my way. At the meeting, she introduced me to some of the “Grand Dames” of gerontological nursing research at the gerontological nursing interest group, which at that time could be practically held in a telephone booth. Being chosen for the Doris Schwartz award, coming back to San Francisco to receive it, and remembering that very first meeting made me think that maybe what I really wanted to do in this talk was to share my memories and thoughts about the future. I wanted to tell you about Mary Opal and the many important lessons she taught me in our many years together. Let me begin by outlining some of those lessons for you.

“Paragraphs are like Mexican pots.” One of the great fortunes of my life was Mary Opal inviting me to share with her in the writing of a book titled Confusion: Prevention and Care, which was published in 1980. Writing that book and working closely with Mary Opal in its creation was a truly amazing experience. However, the path to creation was not always easy. We often disagreed about what to say and how to say it. As a protégé, I should have been grateful and kept my mouth shut, but I was young and sometimes I just didn’t know any better. One day we were having a particularly heated argument about organizing some of the material, something that doesn’t really matter now. As often happened, I was “mouthing off.” In her exasperation, Mary Opal finally turned to me and said, “Linda, you need to learn that paragraphs are like Mexican pots—they are all different!” Point taken. From that, I learned there are many ways to say things, and all of them are right.

“There are many ways to mentor.” Mary Opal was an incredible mentor, and she always seemed to know what was needed and when. During the second World War, Mary Opal had been in charge of a nurses’ barracks in Missouri. When I asked her what she did in the war, she said she was “in charge of the care and feeding of nurses.” From that experience, she learned that mentoring is more than teaching; it is about feeding the body and the soul. She spent the rest of her life doing just that.

The first day I met Mary Opal, I visited her house during a break from school. We talked for several hours and finally I had to go back to class. Before she let me leave, she asked me if I had time to get lunch, and before I could answer, she was in the kitchen packing a sandwich for me. That was her way. She lived her convictions about mentoring: caring for me, giving me a hand up, and sometimes even being stern and angry. The point is that all of these were forms of mentoring. I only wish I was half the mentor she taught me to be.

“It is astounding to wake up and be 80.” When I came into gerontology, the standard joke was that gerontology was defined as 30 year olds telling 20 year olds what it is like to be 80. When I met Mary Opal, she was 70 years old. She was just beginning what turned out to be an incredible second career as an author and lecturer. I was privileged to be one of the few who had a mentor who actually knew what it was like to be older, because she was older. On her 80th birthday, I called her, and she told me she couldn’t be more surprised. She never expected to reach 80, and the most astounding part of it was that at 80 she felt exactly the same as she had at 20. She still had the same hates and loves, fears and joys. A great lesson to be learned about aging!

“Laughing at oneself is a good thing.” Mary Opal loved to laugh, and she wasn’t afraid to laugh at herself. One day I called her and she was laughing about a letter she had received. Two weeks before, she had heard loud popping sounds coming from her basement. When she went down the steps, she saw that several cans of tomatoes in her pantry had exploded. Irate, she wrote to the manufacturer, complaining. She included the code number from the cans in her letter. The day I called, she had just heard back from the manufacturer. The letter read something like, “Madame, we are sorry for your distress, but we really do recommend that you use our canned products before they are 10 years past the expiration date.” She loved to tell that story about herself!

“Opportunities for a good loud, long laugh diminish with age.” When Mary Opal was in the nursing home, I visited her, and we spent the morning laughing and talking and gossiping. At one point she said to me, “You know, that’s what’s wrong with nursing homes. There is almost nothing to laugh about. I miss it terribly. Everyone should have a good loud, long laugh every day. It’s good for the lungs.” I remember that every time I visit with an older person. The greatest gift to give is a laugh.

“Opportunities to advocate for what is right do not diminish with age.” Mary Opal was an advocate for the vulnerable until the day she died, perhaps even longer—who knows? I called her one day when she was in Air Force Village II in San Antonio, where she had retired with her husband. She was actively involved on several committees for the nursing home and dementia unit. That particular day, she was irate. It was Halloween, and the entire nursing home was decorated with paper skeletons. She was outraged at the insensitivity of the staff for not realizing that vulnerable older people do not need to be confronted with skeletons as decoration. She took her complaint directly to the administrator. And that is only one example. She spent her entire life advocating for what she believed was right.

“Penicillin killed nursing.” The day she said this to me, I couldn’t have been more shocked. I had never heard such a thing, but here is how her argument went: Before penicillin, sick people lived or died because of the nursing care they received. Medicine had no magic cures, and the contribution that nursing made to saving lives was very clear. After penicillin, excellent nursing care was nice, but not necessary. People could be saved without excellent nursing care. As a consequence, the independent contribution of nursing to the health of this nation became less and less evident until finally there came a time when we wondered if nursing was necessary at all. Data that “proves” the worth of nursing is beginning to become available, but it took us almost 50 years past the introduction of penicillin to get to this point.

“Those who suffer take priority.” Mary Opal believed that when an individual was suffering, the first priority was to provide comfort to the sufferer. She lived that belief in the way she treated students, how she interacted with colleagues, how she related to older people in nursing homes, and finally, how she dealt with her family and with me. It is a lesson of paramount importance that I am only beginning to learn.

One day, before she died, Mary Opal was looking back on her life and she told me that my generation of nurse scientists was the likeliest to solve the nursing problems of aging because we had been the most privileged—scientists in our group had doctorates. Mary Opal started her doctoral studies, but because of family responsibilities, she had been unable to finish. That had not been true for us. Most of us were doctorally prepared. In addition, we were “real” scientists. We had access to research dollars through the National Institutes of Health and had been given the resources and training to apply for those funds to solve important nursing problems of aging people. Mary Opal had high aspirations for all of us, and I know that one of these days, she and I are going to get to chat again, and I assure you that she is going to call for an account of how we have done. The question I will be required to answer is, “How have you done with all that was given to you?” I can imagine the conversation going some like this:

Linda: We have made astounding progress. When I first started in nursing, older people were routinely restrained in hospitals, they got pressure sores, and they were discharged without any planning for transitional care needs. Why, in the 30 years I’ve gone to GSA, I’ve seen remarkable presentations by nurse scientists on restraints, individualized care, bathing, dressing, meals and nutrition, and pressure sores. I’ve read the work of prominent scientists in nursing who have devised and tested interventions for incontinence, creative strategies for pain assessment, and protocols for dehydration, falls, and care transitions. Nurse scientists have tackled problems like family caregiving, end-of-life care, elder abuse, and neglect. In other words, let me assure you that nurses in my generation have made major contributions to solving the nursing problems associated with aging and building the science.

Mary Opal: Is that so? Well, let me think now. Wasn’t it your mother who, 4 years ago, spent 4 days restrained to a bed in intensive care, and wasn’t it impossible for you to get that changed because you were 2,000 miles away and the hospital had absolutely no mechanism in place to help you?

Linda: Well, yes, but that was unusual. That didn’t happen to anyone else.

Mary Opal: Oh really? Wasn’t it you who got a letter from the Joint Commission, who investigated your complaint about the treatment that said your mother had received the standard of care?

Linda: Yes…but that was several years ago. That couldn’t happen now.

Mary Opal: Oh really? Two weeks ago, wasn’t it your friend whose mother was in the hospital for a stroke and discharged home in 2 days with absolutely no discharge planning? Your friend had no idea what to do, did she? Her mother, who couldn’t even turn herself, had to be readmitted 2 days later, didn’t she?

Linda: Yes…but…

Mary Opal: You know, Linda, you better get this straightened out. You aren’t getting any younger, and your time is coming!

I believe Mary Opal has a point. We have made astounding progress in the development of our science. However, sometimes I think knowledge development and the realities of practice get farther apart every day. And, I’ve got to wonder, if we aren’t making a difference in the life of each and every older person who comes in contact with the health care system, what difference does advancement in the science matter? So, at one level we can congratulate ourselves—we have made astounding progress. At another level, perhaps the only level that counts, we are still not making a dent. We still have miles to go, and we’d better start today.

Thank you so much. If I could say “thank you” in 14 languages I would, but one will have to do. Thank you.

Linda R. Phillips, PhD, RN, FAAN, FGSA (pictured), Professor, Audrienne H. Moseley Endowed Chair in Nursing, and Director, Center for Advancement of Gerontological Nursing Science at the University of California, Los Angeles School of Nursing; Professor Emeriti at the University of Arizona; and former Co-Director of the Arizona Center on Aging and Director of the Arizona Geriatric Education Center, was selected as the 2007 recipient of the Doris Schwartz Gerontological Nursing Research Award, given in recognition of outstanding and sustained contribution to geriatric nursing research.

Photo Courtesy of Reed Hutchinson

Photo Courtesy of Reed Hutchinson

For more than 30 years, Dr. Phillips has been involved in the study of elder abuse in the home setting. She has completed a number of research projects on elder abuse funded by the National Institutes of Health and is currently funded by the Retirement Research Foundation to study elder abuse in assisted living. In addition, Dr. Phillips has studied the quality of family caregiving and improving care to older adults, particularly those with dementia, who are institutionalized. She has published many journal articles on gerontological nursing and has been invited to speak about the topic both nationally and internationally.

The Award, named for Doris Schwartz, a pioneer in gerontological nursing research, was presented by the Gerontological Society of America’s (GSA) Clinical Medicine section in collaboration with the John A. Hartford Foundation Institute for Geriatric Nursing, at the Annual Scientific Meeting, on November 17, 2007, at the GSA annual meeting in San Francisco, California. Her award acceptance presentation is featured here.

10.3928/00989134-20080301-10

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