Q&A: A Few Minutes with Susan Gennaro
A one-time NICU [neonatal intensive care unit] nurse, Connell School of Nursing Dean and Professor Susan Gennaro is leading a study to identify patterns in pregnant women who deliver early. At the same time, she’s busy directing a team of faculty devoted to educating and mentoring the next generation of nurse leaders to provide care in an ever-changing world. Recently, she spoke with Kathleen Sullivan of the Chronicle.
You’re an award-winning nurse researcher known internationally for your work in perinatal nursing. What is your current research about?
I am the principal investigator of a grant funded by the National Institute of Nursing Research looking at developing a risk pattern for women more likely to deliver preterm, so that we can do some screening that would make a difference. In this country, about 50 percent of women who go into preterm labor don’t deliver early. One of the things we were interested in was, could we get some information that would tell us who would deliver early and who would not? Then maybe we could treat prematurity differently.
The problem is we still don’t really know what starts labor. And if you don’t know what starts labor, it’s really hard to know what starts preterm labor.
We are collecting data on early [before 34 weeks] preterm deliveries at sites in New York and Texas. We are following two groups: women who come in with preterm labor — we follow them to see what happens to them — and women who have normal, healthy pregnancies with no risk factors and deliver preterm. We are trying to see if the predictors for who has preterm babies are the same. Is it stress, diet, smoking, cytokines (proteins involved in your immune system)?
There is an emphasis at the Connell School on global health care. How do you define global health care and why is it so critical to BC nursing students’ formation?
Having nurses who are well-educated, global citizens who can provide health care in a global context is a strategic aim the faculty feels very strongly about. There’s a lot of migration in the world. So if you are working in health care you very likely will be caring for someone who is from a different country. You need to know something about their health beliefs and practices because what we think about health and illness is to a certain extent socially constructed.
How you look at disease becomes very interesting from a global perspective in terms of how you develop health care and what kinds of outcomes you can expect. For example, there are certain kinds of mental illness that have different outcomes in India than they do here. India does a better job than the United States with regard to breastfeeding. Those things are interesting to look at and to try to figure out if there is something we can do differently. It’s hard to be a nurse leader — and that’s what BC is creating — if you’re not able to look out of the box and think about what works in other countries or what helps to explain why something isn’t working here.
What is the Connell School doing to broaden students’ global perspective?
I’m very excited about a four-week global health course, open to all students, we are offering this summer that will look at different health considerations from a cultural context. Students from Switzerland are coming to take part. We are going to be talking about palliative care — how you treat people who are chronically ill and possibly dying — and forensic nursing issues, like domestic violence. What you believe culturally makes a difference in how you do things, so it will be interesting to explore these issues with people from a different cultural background.
We are very interested in our nursing students being able to live abroad. We have worked with the Office of International Programs to develop a program in Ecuador where students can spend a whole semester and not only take courses but also do their community health clinical. There’s also a global health course in Ecuador in the summer. We have service trips that are associated with courses — service learning. Our students just came back from Haiti.
How is a Boston College-educated and trained nurse different from other nurses?
I look at the [Connell School of Nursing] mission statement every day when I walk in through the front door and it speaks to the BC nurse being scientifically based and technically competent, but it also speaks to caring for the whole person. There are values of Jesuit education that have to do with teaching people how to discern.
I was fortunate enough to do a Halftime retreat a little while back and I was really proud of the questions people were asking, like “Where do I put myself in the world?” At BC, there is the notion of educating a student to be a critical thinker and an informed, educated human being who is able to be a leader, a researcher, a person who has the critical skills to adapt to the world and to help change the world.
For people outside the health care field, what would you describe as the biggest change to nursing practice over the past 10 to 20 years?
The ideas of “what a nurse is” and “what a nurse does” have so radically changed. Patients have so radically changed. Twenty years ago, the people who are in ICU right now would have been dead, and the people on the floors would have been in ICU. We are sending people home who never would have been sent home. When I was taking care of people in the ICU 20 years ago, I thought they were really sick. But now they’re really, really sick.
It is very expensive to treat people in the ICU. So, at the same time, we realize we need to do more with health promotion. Nurses have done a huge amount of research and are helping people think about their health behaviors. We are living longer, but living longer means living with chronic disease, like cancer, diabetes and heart disease. Doing research on how you stay the healthiest is very different than it was 20 years when we didn’t have as much of this. Seventy percent of the disease burden in the world is with chronic diseases.
Certain racial and ethnic groups are underrepresented in the health care field. What are things the Connell School is doing to address racial and ethnic disparities in nursing?
Throughout the health care field, we see a real difference in terms of whom we’re caring for and who we are. We have been really working on ways to increase diversity in the faculty and in the student body. We have a New Careers in Nursing program, funded by the Robert Wood Johnson Foundation, that [CSON Associate Dean] Pat Tabloski has led for underrepresented or socioeconomically disadvantaged students in our direct-entry master’s program. We have our KILN (Keys to Inclusive Leadership in Nursing) program for undergraduates. We are providing minority fellowships in our doctoral program. We have a Diversity Advisory Board that meets twice a year that helps us think about how do we recruit, how do we retain and how do we help people get the best jobs.