May 2013

Meet the Trailblazers

Three Recent Grads Improving Healthcare at Home and Abroad

Maternal Health

When the class of 2013 tosses their caps in the air on May 21 at CUSON graduation, they will join the ranks of alumni who work as leaders in varied nursing roles across the country and around the world.

“Columbia nursing students come to the program with a wealth of experience from their previous careers, community service, and global work,” says Karen Desjardins, Assistant Dean of Academic Affairs. “After they graduate, their clinical and research skills, combined with their passion to improve healthcare, ensure they will be the next generation of nurse leaders.”

Here are three examples of exceptional alums from the last five years.

Pat Moreland, MS, '03, DNSc, '10
Building a Healthcare Infrastructure in Rwanda

Pat Moreland always felt a pull towards Africa. As a pediatric nurse practitioner student at CUSON, she cared for HIV positive children in South Africa and Ghana. Five years later for CUSON’S DNSc program, she wrote her dissertation on HIV-exposed Rwandan children using data collected from the Mailman School of Public Health. 

Today, she lives and works in Rwanda, using her skills as a clinical nurse and researcher to transform the Central African nation’s health care education system.

Moreland is one of 30 nurses and 100 physicians working with Human Resources for Health—a seven-year program launched in 2012 by the Rwandan Ministry of Health.  The program is a partnership with the Clinton Global Initiative, US AID and several American universities including Duke University, where Moreland is a faculty member at the School of Nursing. Recruited to address Rwanda’s critical shortage of skilled healthcare workers, faculty members from the top US medical and nursing schools train staff members at Rwandan hospitals as well as at medical and nursing schools.

She has spent the past year teaching nursing students in the rural Kabgayi School of Nursing how to recognize and treat children with malaria, pneumonia, and malnutrition—conditions that wouldn’t necessarily be fatal in the US but are among Rwanda’s top pediatric killers.  Moreland, who has signed up for a second year, also advises the school’s director on policies and faculty development.

In addition to the clinical education she received at Columbia, Moreland is also putting her research skills to good use: For one project she plans to measure a program treating severely dehydrated Rwandan children, and for another, examining the correlation between women having children at a very young age and the level of malnutrition in their offspring.

“Living and working here has given me incredible insight into life in a country with limited resources,” says Moreland. “A child who has congenital heart disease in the US can easily have surgery and will likely survive. But Rwanda doesn’t have the resources to perform most surgeries, and most of the children aren’t even diagnosed when they have these types of conditions.”

Working in a country marred by a savage genocide 20 years ago, she believes she is helping heal the country’s physical and psychological wounds.

“You see people on the street with huge scars and missing limbs,” says Moreland. “These people need time to trust you, and allow you to teach them. That’s why we’re here for the long term.”

Elizabeth Heetderks, BS MS '07, '09 
Merging Medicine and Nursing

The pace of working in the neural ICU at NewYork-Presbyterian Hospital can be overwhelming.  Stroke patients helicoptering into the unit and transplant patients coming out of surgery needed immediate and constant attention.

But Elizabeth Heetderks soon grew accustomed to the intensity of the ICU, and today credits her clinical rotations as a CUSON student preparing her for her current role as a hospitalist at Howard County General Hospital, a community hospital run by Johns Hopkins Medicine in Columbia, Maryland.

As one of 30 hospitalists there, Heetderks diagnoses, treats and admits 12-15 patients a day. They come from the Emergency Department or via their primary care provider to the 450-bed facility.

“While I wanted to work in a hospital setting doing acute care, I also wanted to provide comprehensive care to very sick people,” says Heetderks, who also teaches and precepts nursing students at Chamberlain College of Nursing.  This fall she starts a PhD program in nursing.

“I have time to talk to them about things like their diet and why they are taking their medications,” says Heetderks. “A hospitalist is a very good fit for nurse practitioners.”

Deanna Tolman, DNP, '11 
Playing Primary Care Detective

For close to a decade, the patient—a woman in her early 30s— suffered from such severe diarrhea that she took disability leave from her job, rarely left the house,  and couldn’t commit to a romantic relationship. Even after visits to four physicians, including a GI specialist, and receiving an upper and lower endoscopy, the cause of her ailment remained a mystery. Some of her previous providers even suggested that the cause was psychological.

This kind of case perfectly suited Tolman’s practice at Head2Toe Healthcare, her facility in Aurora, CO, where she is the sole provider. Initial visits last 90 minutes and subsequent visits last 45 minutes to an hour, far longer than the typical 10-15 minutes most patients receive with their primary care doctor. Using a model of primary care where she sees fewer patients each day, she has adequate time to identify her patients’ health problems. To keep her overhead costs down, Tolman also serves as the site’s receptionist; draws blood from patients, and painted and assembled the IKEA furniture herself.

During her thorough interview, Tolman discovered the patient’s gallbladder had been removed a decade earlier. She suspected that bile was leaking into her colon as a consequence of the surgery, causing her severe diarrhea. Tolman prescribed a medicine to stop the leakage. A few weeks later, the patient called her. The diarrhea had finally stopped.

“Primary care is a lot like detective work,” says Tolman. “You have to gather all of the clues or you could round up the wrong suspect or end up with no suspect.”

One method she uses to analyze healthcare clues is evidence-based medicine, a skill she credits form her DNP program at Columbia.

“At Columbia Nursing, I learned an enormous amount about statistics, what constitutes a good study or a poor study,” says Tolman. “A patient came in recently with a long history of marijuana use who was having issues with his thyroid. I showed him the evidence that marijuana negatively impacts your pituitary gland from a recent study. I would never have done that before attending Columbia.”