Dean Baernholdt Blazes a New Path

Marianne Baernholdt, PhD, MPH, RN, FAAN, started her tenure as dean of the University of Virginia School of Nursing in September. This marked a homecoming for Baernholdt, who previously served as a faculty member of both the nursing school and the UVA School of Medicine's Department of Public Health Sciences. She returned to UVA from the University of North Carolina at Chapel Hill, where she served as associate dean of global initiatives, interim dean of research, and founding director of its Pan American Health Organization/World Health Organization-Collaborating Center in Quality and Safety Education in Nursing and Midwifery.

Bearnholdt takes the School of Nursing helm at a particularly challenging time for the field of nursing, which is reeling from the impact of the COVID-19 pandemic. A May 2022 report from McKinsey states, "Over the past two years, nurses consistently, and increasingly, report planning to leave the workforce at higher rates than the past decade. Twenty-nine percent of responding RNs in the United States indicated they were likely to leave their current role in direct patient care, with many respondents noting their intent to leave the workforce entirely."

In this Q&A we asked Baernholdt to discuss how UVA School of Nursing can address this difficult climate in the coming years and her overall vision and goals for the School.

Welcome back to UVA, Dean Baernholdt.  What inspired you to accept this position as Dean of the School of Nursing?

I was not looking for a job at the time, but the Executive Search Team at UVA reached out to me and said they had a unique opportunity and thought I would be a great fit. I previously worked at UVA and knew it was a great school. Furthermore, I was intrigued by the opportunity to influence nursing education as well as practice. So straddling both of these areas is what really excited me. Most of my work as a scholar and researcher has been on practicing nursing—focused on frontline staff nurses and now frontline clinicians. Now I could have influence in those areas, not just by studying them, but by  taking part in making improvements. It is unique for a nursing school dean to be on the executive leadership team and have this influence.  

Since you serve on the leadership team, what are some of the most pressing challenges and opportunities for collaboration between the School of Nursing and the UVA Health System?

The person overseeing the Health System's nurses is Kathy Baker, Chief Nursing Officer, and we frequently collaborate on many projects. She works closely with Wendy Horton, CEO of UVA Medical Center, and I serve on the executive leadership team with Wendy. We discuss what's going on at the hospital and how we can improve things and develop our future plans. Dr. Kent, CEO of the UVA Health System, is very inclusive and wants everyone's opinions and input. I genuinely believe we have a unique opportunity to capitalize on the close relationship between the nurses in the School of Nursing and nurses in the Health System. This aligns closely with one of my goals: to make it easier for faculty and staff to work in both areas.

The past couple of years have been incredibly challenging for nurses and the nursing profession due to the pandemic. How do you envision the School of Nursing addressing these challenges and giving students and nurses the tools and structure they need to succeed?

In UVA Health's new ten-year Strategic Plan, one of our goals is to be the best place to work. The plan provides clear actions and initiatives to guide improvements over time, and we have already begun implementing some of those changes. It is also essential to have transparency. For people to stay and feel connected and respected in this environment, their voices must be heard, and Dr. Kent has put people in place who understand this approach.

On the education side, we are increasing our capacity to educate top-notch nurses and prepare them for the realities of health care today. Additionally, we are working with the new Essentials from the American Association of Colleges of Nursing—an outline the necessary curriculum for bachelor's, master's, and Doctor of Nursing Practice programs and expected competencies of graduates. We will be accredited based on these new guidelines along with over 700 or so four-year school of nursing programs.

We are among the most challenging nursing schools in the nation and have many qualified applicants for limited openings. Due to the nationwide shortage, we don't have enough nursing faculty, as many of them are retiring. To address this issue, we are educating more students to become nurse educators, which includes more than teaching; they must also be skilled researchers. Furthermore, we recently received an incredibly generous gift from Bill and Joanne Conway. With that gift, they provided significant funds for educating more PhD students. The last piece is classroom space. How can we gain the space necessary if we have more faculty and clinical placements? We are moving forward and addressing that issue as well.

What are some of the dynamic research initiatives taking place at the School of Nursing?

Our researchers have received several substantial grants since I arrived. One is to develop an intervention for insomnia in people with dementia, and one is looking at HPV prevention for women—an electronic intervention. This work is taking place in Nicaragua and is funded by NIH-funded grants. Another is focused on using artificial intelligence (AI) in the ICU to provide better care and help predict how patients are faring. This gives us a powerful tool beyond the blood pressure, respiratory rate, and other vital markers we monitor. We are also part of a national consortium looking at dementia in caregivers with research funded by the Alzheimer's Foundation, and we have people researching pain management for cancer patients and another to help pregnant women with disabilities.

You have a deep background and perspective on global issues in nursing. How do you see that experience helping UVA?

That's part of the work I did at UVA in my previous position, and I continued that effort at other institutions. The components of health care and nursing are similar worldwide. The problems we face and opportunities to improve are comparable—they're just in different contexts. When we speak to professionals from other countries, we hear about similar challenges—they don't have enough access, nurses, or other resources. There may be differences, but we have an opportunity to learn from each other. The solutions used in one place might work or be adapted in another part of the world.

You mentioned the importance of the Conway gift that supports scholarships, recruitment, and retention. How else could philanthropy benefit the School of Nursing?

Endowed professorships would enable us to attract even more talented faculty members. Plus we also need space for teaching and training. Another area that would benefit from philanthropy is further support for community engagement and well-being. We are nationally known for teaching clinicians to be compassionate and supportive of each other. And my area of interest is the clinician well-being piece. Richard Westphal PhD, RN, PMHCNS-BC, PMHNP-BC, FAAN, and Peggy Plews-Ogan, MD, lead that grant effort for the School of Medicine and Nursing.  That grant will expand their Wisdom, Wellbeing, and Peer Support Training program, which focuses on well-being of healthcare teams. It helps them understand trigger points caused by stress, trauma and burnout that may impact patient care. Furthermore, it gives our health professionals effective tools and practices to manage bias and discrimination from patients and peers.

Additionally, we have the compassionate care initiative that Dorrie Fontaine, RN, PhD, FAAN, and dean and professor emerita, started to support training in resiliency and compassionate care. This provides guidance to nurses on handling stressful work environments. In terms of community engagement—we currently have a donor funding a nurse at a nursing home in West Haven. This individual helps with preventive care, which is what we want to do. But, with more support, we could do more in that area.

Lastly, an organization is only as good as its people. And I want to be sure that we continue to focus on supporting our outstanding team and recruiting top talent who will add to our capabilities and capacity. They are doing critical work and helping to educate the next generation of nurses and creating and discovering new and better solutions that lead to better health.

This article was authored by Rick Kessel. 

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