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Maureen Keefe Speaks from Experience:
Nursing a Profession with Potential
By Mary Chachas
Maureen Keefe's decision to become a nurse was considered somewhat novel in her family; her mother and several aunts were teachers. But, from pediatric nurse to administrator, her career choices reflect foresight and ambition, perfectly suited to the times and options available to her along the way.
In July 2001, Keefe became dean of the University of Utah College of Nursing, capping a career that has gone upward like a tower of building blocks. She is, however, a somewhat nontraditional academician, consistently combining hospital administration and teaching, experience that gives her an important perspective in dealing with a current major issue in the profession: the interwoven shortage of direct-care nurses and nurse educators.
"The thing that's great about a nursing career is the range of opportunity for work and intellectual growth. There is clinical work, teaching, research, and a melding of the three," said Keefe, R.N., Ph.D. She speaks from experience.
Drawn to nursing as a teenager when she volunteered as a hospital candy striper, she did her undergraduate work at the University of Michigan, Ann Arbor, receiving a bachelor's degree in nursing in 1970. Her first job, at Mott Children's Hospital at the University of Michigan, was "somewhat constraining," so she found a niche in public health with the Washtenaw County Health Department in Ypsilanti, Mich. A pediatric nurse, she managed a well-baby clinic for the health department and served as a school nurse for children with special needs.
Still looking to advance her career, she decided to become a pediatric nurse practitioner (PNP), and headed west. She had read about the nurse practitioner program at the University of Colorado, where the first such training program was created in 1965. The NP designation applies to a registered nurse with advanced academic and clinical experience who can work independently as part of a health-care team.
"It was an enriching experience for me. I studied with two leading pediatricians of the time, Henry Silver and Henry Kempe, and also completed my master's degree," Keefe said. Work as a pediatric nurse practitioner for a network of community clinics followed.
Her work at the University of Colorado had not gone unnoticed, however, and she was invited to teach in the nurse practitioner program and do research on two projects. One focused on preparing hearing and vision screenings for preschool children at a much younger age (3-4 years), and the second evaluated nurse practitioners' performance in patient care.
She enjoyed her research and faculty roles, and began working toward a doctorate in nursing, which she received in 1984. This was followed by a year as a postdoctoral research fellow in developmental psychobiology in the University of Colorado medical school's Department of Psychiatry.
She subsequently served for eight years as vice president for nursing research and education, and associate director of the Kempe Research Center at The Children's Hospital in Denver, then as associate dean for practice at the University of Colorado School of Nursing.
Her 20-year stay in Denver gave her children, a son and daughter, the stability of living in one place for an extended period, perhaps a response to her own family's frequent moves, she said. As a child, she lived in a number of different states; her father's work with the U.S. Bureau of Prisons required that the family relocate every two to three years.
When her children went off to college, she and her husband, Mick Gaviglio, went to South Carolina, where she became dean and professor of the College of Nursing at the Medical University of South Carolina in Charleston, a position she held from 1995 until she came to Utah.
Keefe was attracted to Utah by the college's strong education program, with its great variety of programs, 13 nursing subspecialties, and by the fact that Utah had one of the nation's first doctoral programs in nursing and has the state's only such program.
"The University provides doctoral-prepared nursing faculty for the state's eight institutions that train nurses and also for the Intermountain region," said Keefe, who holds the Louis H. Peery Presidential Endowed Chair at the U. "One of the factors in the existing nursing shortage is the shortage of nursing educators. We cannot admit more men and women into nursing programs unless there are faculty available to teach them, and we must figure out how to supply these educators."
This combined shortage is nationwide, and there is no easy solution.
A request by the Utah Nursing Leadership Forum for $2.2 million for faculty recruitment and retention, which would allow a 20 percent increase in enrollment in the state's nursing programs, was not funded by this year's Utah State Legislature. Now, the forum (a statewide group of 30 deans, directors, and chief nurse executives, chaired by Keefe) and the Medical Education Council of the Utah Hospitals & Health Systems Association will return to a legislative committee with specific strategies to address the shortage of registered nurses.
A 5 percent cut in the nursing college budget this year will require placing a cap on enrollment, limiting new baccalaureate students to 50 each semester, according to Keefe.
The lack of sufficient nursing faculty is one factor in the nursing shortage. This is complicated by the aging nursing workforce. Within the next five years, one-fourth to one-third of direct-care nurses and nursing faculty will retire, said Keefe, who serves on the University of Utah Hospitals & Clinics Board. Another factor is the increased demand for nurses within and outside the hospital setting, in areas such as critical care, long-term care and assisted-living facilities, outpatient surgicenters, and insurance and managed care companies.
Keefe believes the current nursing shortage will be severe and sustained enough to push aside traditional thinking about how to educate nurses and how to prepare enough nursing educators. One option the faculty is currently working on is a post-master's degree certificate to teach, Keefe said.
Keefe has been a researcher for a long time, and one of the things she wants to do is to support and strengthen the college's research mission. There are several funded research areas, the largest emphasis being in oncology nursing. Other research areas with growth potential are aging and end-of-life care, and women's health/midwifery.
Keefe also wants to propose mission-blending: a philosophy of working to integrate research opportunities with faculty practice and teaching.
Keefe, a member of the Johnson & Johnson Pediatric Institute Board, has studied fussy babies, and their mothers, for 15 years. She found out when she had her children that there was not good enough information on how to manage a fussy baby. Her daughter (who was a fussy baby) has suggested she title her next publication for parents "For Cryin' Out Loud."
A clinical model based on the premise that colic is a behavioral-state regulation disorder, similar to a developmental sleep disorder, rather than a result of milk allergies or gas pains, was tested by Keefe in South Carolina and in Denver. The four-year, federally funded study was called the REST regimen: reassurance, empathy, support, and timeout for families of fussy babies. Data are now being analyzed at the U of U.
Sigma Theta Tau, the nursing honorary society, has presented Keefe with its Research Excellence Award; she is now a member of the board of directors of Sigma Theta Tau International. She also is a fellow in the American Academy of Nursing.
Coming to Utah, a career move for Keefe, was still very much a mutual decision with her husband. An architect, he has always done consulting throughout the country, so they had no trouble deciding to move west, closer to their children and his parents. They like being near mountains or ocean. In South Carolina, they took up scuba diving; now, they're looking forward to hiking in Utah's mountains.
What does Keefe think of young men and women entering the nursing profession today? She describes them as an impressive and very well-qualified group with high grade point averages.
They're "passionate, bright, and energized with a can-do attitude," Keefe said. "They feel empowered and have ideas for health care. They see nurses as experts in healing and health promotion, and see the profession's potential."
We always welcome your comments about the magazine. Address letters to: Editor, Health Sciences Report, Office of Public Affairs, University of Utah Health Sciences Center, 50 North Medical Drive, Salt Lake City, UT 84132. FAX: (801) 585-5188. E-mail: Susan.Sample@hsc.utah.edu.