Dr. Mary Koithan is facing more than a few unknowns as she prepares to become the next dean of the WSU College of Nursing. Will there be faculty and staff in the building when she begins her new job on July 1? What’s the plan for instruction in the fall semester? And how in the world do you sell one house and buy another given social distancing and travel challenges posed by the COVID-19 pandemic?
We spoke to Dr. Koithan via Zoom recently about what attracted her to the WSU College of Nursing and what’s important for the future of nursing education and the nursing profession.
Here are her remarks, some of which were edited for length:
WSU: What drew you to the WSU College of Nursing?
Koithan: “There are three things that stood out for me. I make a lot of my decisions based on values and mission, and I looked at your values and thought, ‘There’s a synergy between us.’ The second thing is where you are and who you are. There are a lot of similarities between Eastern Washington and Southern Arizona and Southern Nevada where I’ve spent most of my professional life. And third, I like working for land grant institutions.”
WSU: What do you consider your most personally fulfilling achievement so far in your career?
Koithan: “The Arizona Nursing Inclusive Excellence program that we started three years ago, funded by a nursing workforce diversity grant from HRSA. I have an awesome team and it’s the most fun I’ve ever had in academics, to be honest. It’s been more than I ever thought we could achieve in a very traditional academic setting. We admit nursing students who typically wouldn’t have had a chance to be in our program, then we provide an intensive academic support and enrichment program. We’ve graduated 26 students who have all passed the NCLEX or their NP certification exam the first time. It’s not without its struggles, but I do think we’ve learned a lot about students from diverse backgrounds. The joy is in the lessons learned about how to work very successfully with these students.”
WSU: Last year you received an award recognizing your work on diversity and inclusion, both in hiring and in student recruitment. Lots of people talk about the importance of these but you made them happen at the University of Arizona. What is a lesson you learned in that process?
Koithan: “Changing a culture takes an incredibly long time and it’s easy to get discouraged. A lot of time we measure forward progress through behaviors and actions. I’m really pleased when I hear people say the right words, when they think about the potential for diversifying or for trying something different, or even being more introspective and reflective about how their behaviors have impacted a student’s success. I’ve learned to not make assumptions, to allow people the latitude to embrace things in their own way and in their own timeframe. To help someone feel included and participatory is a skill. I also think your faculty is really open to inclusive excellence so it’s exciting to me.”
WSU: A mentor once advised you, “Do what you love – not what you should.” You’ve said it changed the way you have approached everything you’ve done since then. What did you stop doing, or start doing, because of that?
Koithan: “Until that moment I was doing what I should have been doing as a tenured faculty member. I was participating in two R01 (NIH grants) at the time, I had a previous grant, and I was always trying to get ready for the next grant. But my heart truly belongs with communities, with vulnerable populations and I felt like I wasn’t living that value. So, I went to the dean, who had been encouraging me at that time to step into administration, and I said to her, ‘OK, I’ll do this but I want to be the associate dean for community engagement.’ I really wanted to spend my time working on projects with communities, to think about what integrative health and whole person/whole systems health meant for populations, communities and for students. The grants that I write now are fun to write. I see them in my head before I ever write them. All along the way it’s been fun.”
WSU: The WSU College of Nursing is moving toward holistic admissions. Tell us about your experience doing that at the University of Arizona – what it means in practice and how it benefits a college of nursing?
Koithan: “That makes me extremely happy by the way. A lot of schools are moving toward holistic admissions, but many have been funded to do that work; the faculty at WSU are doing it because it’s the right thing to do.
What holistic admissions means to me is that we are going to treat our students like we treat our patients, as whole people. You think about who would make a successful nurse, not a successful student. They don’t have to have the best GPA. They need to be able to make really good, practical decisions. Nurses have to be able to think on their feet and be creative. I want somebody who is willing to work hard, who has a sense of right and wrong. People who aren’t willing to sell their soul or take the easy way out. For me holistic admission is looking at that whole person and saying, is this applicant going to have the qualities that will see them through a 30-, 40-year career in nursing?
Faculty need to be clear about the qualities we want to see. More than values, holistic admissions has to be based on literature and what we know serves students well in the long run. I think as a land grant institution we also need to say, what does the community need, what does the state need? What kinds of knowledge does the state require in our healthcare providers?”
WSU: The college is also working through a curriculum change that shifts focus to wellness from disease. Much of your work has focused on integrative nursing. Can you tell us about this and why it’s been a research and operational focus for you?
Koithan: “My interest started way back in the ‘70s when I was in nursing school. We learned to care for the whole person. We were focused on this sense of well-being, understanding that people can achieve as sense of wholeness and purpose even when they’re physically spent. Nursing is about more than just the physical body; it is so much more expansive.
I also think I’m drawn to integrative nursing with its focus on wellness for two other reasons. First, I truly believe in using the least invasive intervention possible. I honestly think we are overmedicalizing our entire existence. There is no attempt to use a less intensive intervention even when the complications and side effects of the medication are obvious. I know that least intensive interventions work when used at the right time with the right conditions. If we teach people in our community to manage their own symptoms and to reserve the emergency department or even urgent care visits for time when they really need them, we will make health care more accessible and less costly with much better health outcomes.
Then the third reason for embracing a focus on wellness is based on my own health experiences. I was hit by a car in my senior year in nursing school. I had a compound fracture and spent many weeks in the hospital and then months on crutches. I learned the power of your mind in terms of pain control, motivation, and regaining function. I’m also a cancer survivor of 20 years. The disease wasn’t bad, but my mental health – fear and anxiety – was pretty bad. I again learned the power of my body’s intrinsic knowledge and the value of taking a less intensive approach to some of the symptoms.”
WSU: You’ve advocated for self-care for nurses – that’s got to be exponentially harder right now in the COVID-19 pandemic. What would you say to a critical care nurse right now?
Koithan: “First, thank you. And I commend you because you’re facing your fears. It’s very easy to get disheartened, to sink into that negative ‘we don’t have enough of anything.’ One of the best ways to do self-care in crisis situations is to find joy. And to remind yourself of the positive moments and then holding onto them. Before you close your eyes at night, think of one thing good that’s happened that day. Then the first thing in the morning take 10-15 minutes by yourself and set your intention for the day, reminding yourself to find joy when there is joy, to acknowledge your sorrow, and to be grateful that you have the opportunity to know both. I think that’s part of self-care – acknowledging when you’re sad and being gentle with yourself. I would tell them don’t expect every day you’ll feel great. But give yourself latitude to find joy.”
