Ann Cashion, UTHSC alumna
Ph.D., RN, FAAN
After working as a critical care nurse for nearly 20 years, Ann Cashion wanted more for her career.
In 1995, she decided to go to school for a third time to get a doctoral degree in nursing. “I wanted more challenges, but I still wanted to be very patient focused,” says Cashion (HSC ’98). The challenge she found through the Ph.D. nursing program at UTHSC, the first offered in Tennessee, was to be more involved in the expanding field of nursing research.
“It established a solid foundation that provided the skillset and tools to help me think bigger than one patient and myself and solve clinical problems using the research process,” she says.
Cashion’s second career as a nurse scientist led to her current role as a scientific director of the Division of Intramural Research at the National Institute of Nursing Research (NINR). NINR, founded in 1986, is one of 27 institutes and centers that make up the National Institutes of Health. NINR’s Division of Intramural Research focuses on studying the molecular mechanisms of symptoms and their environmental influences experienced by patients who have digestive disorders, cancer-related fatigue, traumatic brain injuries or post-traumatic stress disorders and determining ways to treat the symptoms with clinical interventions.
Cashion likens the research in her division at NIH to a college within a university and her role similar to a department chair or dean. She oversees researchers and conducts her own research, which is focused on why some kidney transplant patients are at a greater risk for weight gain, obesity-related diabetes and cardiovascular disease.
As a nurse scientist, Cashion combines the caring for patients with research. Conversely, a molecular biologist or another type of researcher might begin research by examining a narrow area like certain kinds of cells, but “they are not always sure how to connect findings to the patient,” she says. A nurse scientist, Cashion explains, “turns that paradigm upside down and starts with a clinical question,” such as why an individual is gaining weight.
An Arkansas native, Cashion earned her undergraduate degree at the University of North Carolina at Chapel Hill and became a registered nurse in 1978. She returned to Arkansas to practice and later earned her master’s degree as a clinical nurse specialist in the ’80s. She began the Ph.D. program when her youngest of three sons started kindergarten.
After finishing her degree, Cashion remained at UTHSC as a faculty member and served as professor and chair of the Department of Acute and Chronic Care in the College of Nursing. Cashion says that nursing is a perfect career for her because it offers many varied opportunities that she has taken advantage of, such as the day she got an opportunity to work in the NINR director’s office for a year. She joined NINR in 2011 as a senior advisor to the director and was later recruited to her current position.
“Get your Ph.D. earlier in your career so you have longer to conduct research. You can be a productive scientist longer,” she says. “I’m seeing nurses coming earlier to Ph.D. programs, so that is exciting.”
For more information about the NINR’s Division of Intramural Funding, visit http://www.ninr.nih.gov/researchandfunding/dir.
Laura Barnes, UT Knoxville alumna
RN, BSN, MSN, NEA-BC
Throughout her more than 40 years at East Tennessee Children’s Hospital in Knoxville, Laura Barnes has seen the nursing profession grow and become more complex. In her own career, she started working as a staff nurse and rose through the management and administrative ranks to become vice president for patient care services and chief nursing officer before retirement.
“The vast critical-thinking skills that nurses need to take care of patients today and the technology involved in taking care of patients today has gotten much more complex than the many years ago when I started out as a clinical nurse,” says Barnes (Knoxville ’84, ’87), who retired in February 2015.
When she first became a nurse, it was through a diploma she received at a local hospital, and then she went to UT Knoxville to earn her bachelor’s in nursing and master’s in maternal child nursing. Today, it is hard to keep straight the variety of opportunities available to students upon graduation from either undergraduate or graduate programs.
“I think when I graduated from nursing school, you were much more limited in what you could do,” she says. “There are so many ways you can choose to practice the art of nursing. I think that gets broader every year as new opportunities arise and health care changes.”
Barnes’ first management position was as head nurse of the pediatric intensive care unit, and then she became involved in managing different areas such as critical care. She developed a home-health department and child-life department, and she was one of the administrative liaisons to the hospital’s family advisory council. “Throughout my years, I was privileged to be in management in a variety of roles, but the focus on the care of the child was always at the center in each role,” she says.
While her time spent directly with patients diminished, she found ways to be an advocate for nurses at the hospital by “supporting staff in their roles and trying to make it a great place for them to practice nursing and removing barriers that they may have to provide the best care of kids and their families,” Barnes says.
Before retiring, Barnes helped start a nursing research council in collaboration with the UT Knoxville College of Nursing as part of nursing’s shared leadership model at the hospital. One study was focused on culture and how a family’s care affects their beliefs and how nursing responds to different cultures in providing care.
In reflecting upon her own experience as a child having surgery and watching the nurses who cared for her, Barnes likes to ask new nursing graduates why they chose to work at East Tennessee Children’s Hospital. “The vast majority had experience as student, patient, friend who was a patient,” she says. “I think those experiences are more important than people realize.”
Mandy Braswell, UT Martin alumni
APN, CPNP, BSN, MSN
RN-BC, BSN, MSN
Mandy and Anthony Braswell met in the nursing program at UT Martin, and both decided to continue their training with a master’s degree. But, as nurses, their careers have taken different paths.
Married with two young sons, the Braswells live in Milan. On work days, Mandy (Martin ’06) travels southwest to her job in Jackson as a certified pediatric nurse practitioner overseeing the Jackson-Madison County School Health Clinic. Anthony (Martin ’06) travels northwest to Paris, where he works at Henry County Medical Center in nursing informatics. His official title is clinical analyst, but he introduces himself to people as a nurse.
After graduating from UT Martin, they went to Nashville, where Anthony was already working as a surgical nurse in the intensive care unit at Vanderbilt Medical Center. Mandy immediately began her master’s degree in nursing at Vanderbilt University while working at St. Thomas in the neurosurgical unit. She finished her MSN in 2007. Anthony thought he wanted to be a nurse anesthetist, but he soon realized surgery was not his thing. Knowing Anthony liked to work on computers, Mandy suggested informatics, which basically is the interaction of technology and patients through things like electronic health records. He finished his master’s in nursing informatics in 2008.
The next year, they moved to Mandy’s hometown of Milan, and while neither actually works in the city, they found jobs nearby.
Mandy’s job satisfied her desire to work in a medical field with children. Her patient could be any public school student in the county. “We were only the second county in the state to have a school-based health clinic,” she says. “My hope is there will be more of these clinics because I feel like we are able to see children who don’t see a pediatrician regularly.”
With the increase of technology in the health-care field to meet federal standards and incentives for meaningful use of technology, clearly informatics will continue to be in demand. “As we go further along, those standards will get more strict about what is required,” Anthony says. “I think it will continue to expand and, once we are at a final point where all final requirements are in place, someone will be needed to maintain it and make it more efficient.”
Lisa Vanderwall, UTC alumna
CRNA, APN, BSN, MSN
Lisa Vanderwall knew she wanted to continue her education and become a nurse anesthetist. And why not? All the ones she met loved their jobs.
Vanderwall (Knoxville ’07, Chattanooga ’12), who is from Dayton, Tennessee, earned her bachelor’s in nursing from UT Knoxville and worked at Erlanger Health System in Chattanooga for two years before going to UT Chattanooga to earn her master’s degree and be licensed as an advanced practice nurse (APN) and certified registered nurse anesthetist (CRNA).
She first became interested in health care as a high school student. She enjoyed science and math and had the opportunity to shadow a pediatrician and other kinds of doctors.
“It didn’t feel right,” she says. “Then I got to shadow a nurse and a nurse anesthetist. I never met one nurse anesthetist who didn’t love her job. I felt like that definitely said something about the profession. Even during nursing school, every time I talked to a nurse anesthetist, I never met one that said it was an awful job. They all loved what they did.”
As a nurse anesthetist at Erlanger, Vanderwall sees five to 10 patients a day, sometimes ranging in age from newborn babies to the elderly.
“A lot of times we are the only person in the room with the patient from the pre-op area where they are scared to death and might have just received an awful diagnosis, and we follow them through the inter-operative period and afterward,” she says.
This nursing niche demonstrates the increasing autonomy of nurses at all levels, and the demand for them because their level of care, while safe and high quality, is cost effective within the current health-care and insurance landscape. In Tennessee, nurse anesthetists must be overseen by a physician, but the nurses handle the large share of patient care.
Vanderwall also spends her days at work teaching current students from several programs, and she’s passing along the good news about her chosen career. “I get to explain why I love what I do,” she says.
Photos by Adam Brimer