Longtime Dean Sees Expanding Role for Highly Trained Nurses

Anne Rayner, VUMC

Colleen Conway-Welch
January 28, 2013

Colleen Conway-Welch, who is 68, has been dean of the Vanderbilt University School of Nursing for more than 28 years. She transformed a program focused on baccalaureate degrees to one that awards only master's and doctoral degrees, and, on the national stage, she has advocated broader roles and responsibilities for advanced-practice nurses. She will retire as dean at the end of the academic year and remain on the faculty. Here's her story, as told to Katherine Mangan.

My first job after college was in Honolulu at Queen's Hospital. We had no interns or residents, and the labor and delivery nurses managed the labor. The only frustrating thing was that after being with the woman throughout the labor, you had to step back so the doctor could catch the baby. When I became a nurse midwife, I discovered that, for nurses with master's degrees who were certified in certain areas, the world was their oyster. That's even more true today—you can go anywhere and do anything.

When I applied to become dean at Vanderbilt, in 1984, I felt the best thing to do would be to carve out a master's and doctoral program that would prepare graduates for the complexity of health care.

I was talking to a group of mostly elderly alumnae, all of whom had bachelor's degrees, and they were very suspicious about my intent to continue teaching baccalaureate nursing content without giving a baccalaureate degree, but instead an accelerated bridge to a master's degree. Way in the back of this crowd of ladies—I didn't know it—was the beloved former dean, Julia Hereford. I heard this little voice saying, "We gave our first baccalaureate degree in 1935 and our first master's in the 50s. We took risks every time. I think it's time we take another risk." You could almost see the Red Sea parting. People felt that if it's OK with Julia, it's OK with me.

We can't continue educating the way we're educating and be able to care for the additional 32 million people who are going to be wanting care under the new health law. We'll have to re-examine every sacred cow in nursing and medicine, and decide which we want to keep and which we should make into hamburger. I firmly believe that primary care will be owned by nurse practitioners in the next four to five years, and the physicians who are general practitioners will be going into the specialties.

The faculty shortage in nursing will force us to be more nimble and look at additional educational models. We're going to have to use more simulation and computerized patients to give students more experience learning about complex situations. I gave my first injection into an orange, but that was the state of the art back then.

Watching nursing evolve over my nearly 50 years as a nurse and nurse midwife has been very exciting. I've known since fourth grade that I wanted to be a nurse, and the field has never disappointed me.