Proud Aussie nurse talks about heading up prestigious US nursing school

Patricia Davidson is a "proud Aussie nurse". She has been an RN since 1980 and has clinical, teaching and practice expertise in cardiovascular science and the care of vulnerable populations.

Starting her career at Wollongong hospital, Davidson is now flying the flag overseas as the dean of America’s number one nursing school at Johns Hopkins University in Baltimore, Maryland.

Taking on the role in 2013, Davidson has a unique insight into two vastly different healthcare systems and Nursing Review called the US to hear about life there, the importance of NPs and the similarities between US and Australian nursing.

You've been at Johns Hopkins now, which it's a world-renowned facility and university, since 2013. That must have been a stark change after spending most of your career here in Australia.

It wasn't such a stark change. One thing that you'd find is that schools of nursing and education and hospitals are pretty much the same all around the world. Even though it was a big shock to have to go back and do my licencing exam. It's probably more about similarities than differences.

What interesting research or innovations are coming out of the US at present?

I think there's certainly more innovative research in the nurse-led model of care in chronic illness. It’s so exciting to see a lot of the innovation in terms of telling how the use of apps and other digital technologies enhance healthcare. And there's a big emphasis in the US on the care of the vulnerable population, so in the School of Nursing we have some exciting projects that are looking at addressing issues such as food insecurity and housing. And even though we've had those issues within Australia, they're not really as amplified as they are here in the US, where the mechanisms for health and social services aren't as accessible and equitable.

Are there things you've learned from the American health system that make you think, ‘Wow, that would be great if we could bring these ideas back to Australia'?

I think in Australia we lead some tables, and it's actually very efficient and effective in healthcare delivery. One of the things that is particularly important, I think especially at Johns Hopkins, is the importance of nursing within the hospital and university leadership. And I think certainly here in the United States at Johns Hopkins, the importance of nursing and a nurse's role in terms of influencing healthcare is more recognised.

In what ways? Policy decisions?

I think in terms of policy decisions, most importantly, having nursing at the head of or on board tables. Also we're very excited that the head of the whole Johns Hopkins health system, which is over six hospitals and many operations internationally, is a nurse. So, I think there is a strong emphasis on the knowledge, skills and capabilities that nurses bring to healthcare, and their effectiveness at leading and managing healthcare systems.

You worked in academia in Australia for a long time. Are there things that the American university system does well, or could they learn some things from Australia in terms of teaching?

I think that across the world there are a lot of similarities. I would say [my former university] the University of Technology in Sydney, which is a leading school of nursing internationally, and Johns Hopkins would be very similar in terms of the educational preparation. I think one of the things that is different in the US was addressing the importance of the role of advanced practice nurses in healthcare delivery. The nurse practitioner will have been established in the US for over 50 years and so the role of the advanced practice nurse, and nurse practitioner specifically, is much more entrenched and recognised and valued in the healthcare system than it is in Australia at the current time.

You mentioned earlier some of the problems that the US faces with food insecurity, and I think that kind of leads into some of the great wealth disparity in that country. How have you found the health system? They don't have Medicare, they have more of a private insurance-based health system.

I came to the US at the time of the introduction of the Affordable Care Act, so as a consequence of that act, 23 million people, almost the population of Australia, had increased access to healthcare. So certainly, as you think in the media there's a lot of focus and attention on healthcare reform but, certainly, there is a lot of advantages to be seen from the healthcare system in Australia and the UK and other European countries where healthcare is recognised as an essential human right and part of living in a just and civil society. And so we really hope in the US that the healthcare reform continues and that increasing numbers of people there have access to healthcare.

Are your American colleagues jealous of the Australian and UK systems, or do you think they are quite happy with the way things are currently?

I think many people in the healthcare system, many of my colleagues, anyway, are envious of the system, where there's much more equitable access to healthcare and where healthcare is not tied to your employer, and that everybody has access to healthcare. So, I think that many people in the US would envy that system of healthcare.

As well as your role at Johns Hopkins, you are the secretary general of the Secretariat of the World Health Organization’s collaborating centres for nursing and midwifery. What does this role entail?

We are very excited to take this role, which was actually held previously in Australia at University of Technology Sydney. The role of the secretariat is to convene and communicate among the 42 collaborating centres of nursing and midwifery throughout the world, and we hope that at the World Health Assembly next month that it will be ratified by 2020, which will be the year of the nurse and the midwife. We’re also involved in working with the World Health Organization to facilitate an important report called State of the World's Nursing. We hope that this report takes data sets from all over the world and really tries to get a handle on a whole range of issues in nursing. Not just numbers of healthcare professionals and distribution, but also their role and functions in individual countries and how they contribute to healthcare outcome.

You're a dean and you have had various other management roles, do you miss the day to day practice and teaching of nursing?

Well, fortunately, I'm still pretty actively involved at Johns Hopkins. I teach. I don't directly practice any more, but I'm actively involved in a number of initiatives within the healthcare system. For example, I'm an executive sponsor for a quality and safety initiative at the unit-based level. And also, it's very exciting that I'm involved in a range of clinical research projects, and particularly, some projects looking at developing nursing models of care. So, they're very exciting and so I still feel that I'm actively engaged with the healthcare system.

While I was researching for our chat I was looking at your CV. It's like 90 pages long. I think everyone in the world knows of Johns Hopkins, so you're reaching the pinnacle of your career. Is there anything you want to tick off in your career next?

You know what? I think I'm just very honoured and humbled to have this amazing opportunity to be dean at the number one school of nursing in the US, at Johns Hopkins University, which is an amazing research university. So, what I'm really committed to for the rest of my nursing career is to continue to advocate for the importance of nursing and the role of nurses, and influencing the healthcare trajectories of the individual's families and communities. And I think that there's never been a better time to be a nurse and I feel that I'm very honoured to be at such an esteemed institution where I have the ability to advocate for the role that nurses play in improving healthcare outcomes.

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