Toni Inglis Dec. 2012 UT-Austin School of Nursing Convocation Address

Bass Concert Hall, December 8, 2012

Thank you, Dean Stuifbergen, distinguished faculty, friends and families.

Congratulations, Class of 2012! Here you are. You’ve completed something extremely difficult, been in school, many of you, your whole lives. You’ve probably questioned yourselves again and again. Something incredible is happening to you right now, and I’ve been asked to delay the moment you get your diploma.

After commencement address, UTASON

I remember sitting out there where the families are when my daughter graduated from this nursing school. I know what you’ve been through. I was thinking, “How lucky the profession is to have her.”

I also remember sitting where you guys in the caps and robes are. I remember thinking, “Please, Lord, get that commencement speaker off the stage quick so I can get to that diploma before someone figures out there’s been a screw-up and I can’t graduate after all.”

I got here on a bus. In the 1970s, I had a degree in Spanish that I didn’t know what to do with. I sold sandwiches at the corner of Dean Keeton and Speedway and drove a UT shuttle bus. Those jobs were great fun, and the best part was getting to wear overalls to work!

My bus route went from Littlefield Fountain to the Married Student housing out on Lake Austin Blvd. Every morning around 7 a.m., this shy nurse got on my bus. Claudia was the only passenger on the 40-foot-long bus and gradually she progressed from the back to the front of the bus where I got to hear stories about her shift the night before. They were INCREDIBLE. They’d make me sad or outraged or they’d melt my heart. Humor wove a common thread throughout the stories.

I came of age when John Kennedy was president. I believe everyone is born wanting to make a difference in the world, but President Kennedy made me and my generation believe that we actually could.

It was obvious to me how Claudia — without even knowing it — was making a real difference in people’s lives. She was living the dream.

I began to believe that I could do what Claudia was doing. So, I went into nursing — for the stories and to make a difference. Plus, getting to wear scrubs to work every day had to be almost as great as wearing overalls.

I followed Claudia into neonatal ICU more than three decades ago. She left many years ago, but I remained until last year. We’re still close friends. Health care makes GREAT story, and it’s been a real privilege to be able to write those stories for pay for nearly 20 years alongside my neonatal job.

I am so proud that you are joining us into this noble profession. Don’t take my word for it. The Gallup poll has ranked nursing as America’s Most Trusted Profession every year since it was added to the list in 1999. We did get knocked to second place in 2001 when firefighters ranked first, but it took a terrorist attack to do it.

I know nursing school is a tough road. I’m sure you appreciate your families and friends who helped you get through it. I got an F for an entire clinical rotation. That instructor is not here today. But I really, really wish she were. Being a new nurse for me was a horribly bumpy road, but take heart, it’s not how you start out, it’s what you accomplish during your career.

You’re graduating from a top-tier university and a great nursing school. You’ll always be proud to say you have a degree from this school. You know now, patients are taken care of by health care teams, and nurses coordinate those teams. Many of your team members will have master’s and doctoral degrees, so, you’re wise to get a higher education.

Congratulations to the PhDs for reaching the pinnacle of nursing education. The baccalaureates and the masters — you’re amazing. I’ve met some of you at work and your infectious enthusiasm renews and inspires. And you are so smart and sharp! You could have gone into any profession; some of you already have. Many of you have other degrees.

Now listen. I want to personally thank each and every one of you for answering society’s call for nurturing by going into nursing. None of us did it to get rich, but the rewards are priceless.

A few years into my nursing career, in the mid-1980s, this disease that eventually was named AIDS came out of nowhere. Everyone in health care was terrified of contracting it at work. My brother, who lived in San Francisco, would call me, frustrated that the Food and Drug Administration would not release the AIDS drugs.

Like all the others in the mid-’80s, he died a horrible death young and only months after being diagnosed. That’s when I realized that policy was important and that it can determine if people live or die. I entered graduate school to study health policy at the nursing school and at the LBJ School of Public Affairs. Never again could I separate health care from policy.

You are entering your profession when health policy is on fire and when history is being made. Nursing is playing a critically important role in the transformation going on in health care.

I think that it all began with that frightening 1999 Institute of Medicine report that found upward of 100,000 people die in any given year from medical errors in hospitals. A prestigious study found last year that that number may be 10 times as high. Medicare is spending more than $30 billion a year on patients harmed, so patient safety has become a matter of policy.

Nurses know the answers to patient care issues. I can’t speak from personal experience about other hospital systems, but where I work and in other Magnet® and Pathway to Excellence® hospitals, nurses lead the collaborations that improve patient safety. Seton nurses led an initiative that virtually eliminated bedsores, and now we’re ranked first internationally in preventing them.

Here’s another example. There’s nothing sadder in the neonatal ICU than a full-term infant who was injured at birth. So, nurses and doctors got together and developed a bundle of best practices for obstetricians. Seton’s birth injury rate dropped like a stone from half the national average to zero, and Medicaid billing fell from half a million dollars to zero.

Now, if you asked those nurses if they were making policy, they’d say, “Nah, just working on practice guidelines.” But make no mistake, they ARE making policy and as their practice models spread throughout the country, it’s saving untold numbers of lives and injuries, heartbreak and billions of dollars.

Nurses know the answers. About 200 nurse-run clinics nation-wide, most associated with university schools of nursing and located in underserved areas, are providing primary care, prevention services and managing chronic diseases such as hypertension, diabetes, obesity and asthma. Their outcomes are phenomenal. UT Austin School of Nursing is associated with two nurse-run clinics that are vital to this community: the Family Wellness Center in East Austin and the Children’s Wellness Center in Del Valle. All of that activity is policy-driven.

I know you guys are engaged. After lying dormant for decades, the youth vote reawakened with a vengeance. That tells me you are awake to the world — and to the possibilities.

Just last month, Travis County voters approved your getting a brand new UT medical school right over there. That school will help this prestigious nursing school and the schools of biomedical engineering, pharmacy and others to create world-changing innovation. Policy matters.

If you completed an advanced practice track now or plan to in the future, pay attention to your state legislature. Another session begins next month, and those folks down there at the capitol will determine if you can practice to the full extent of your education. Even though Texas ranks last in access to care and has the worst shortage of primary care providers per population, Texas is one of five states that practically shackle nurse practitioners. That’s not acceptable.

This session, the legislative agenda of the Texas Nurses Association (that’s your professional organization) will continue to work on removing barriers to advanced practice, combatting the nursing shortage by continuing to fund nursing education and protecting you from workplace violence, so you won’t get beaten up at work. Policy matters.

You undoubtedly know the now legendary Winkler County nurses whistleblower story. As a result of that case, last session TNA passed a law, sponsored by nurse legislator Donna Howard, that will protect nurses from criminal prosecution for patient advocacy. Policy matters.

And now to the bomb of health care policy … something all the rest of the industrialized nations have: universal coverage. Finally.

Every U.S. president throughout the 20th century had universal medical care high on his agenda, but President Barack Obama got the job done. He succeeded where others failed by having a fierce determination and by learning from the mistakes of past presidents.

Lyndon Johnson used to say, “Make your move during the honeymoon, before the dead cats stink up the porch.” Obama made his move during the honeymoon; didn’t get drawn down into the mud-wrestling of the technical, nitty-gritty details like Carter and Clinton; and he did not cede to the enemies when defeat was imminent.

Fury and acrimony surrounded the signing of the law on March 23, 2010. That’s a nice way of saying that all hell broke loose. Almost half the state attorneys general filed suit; the U.S. Supreme Court ruled on its constitutionality (favorably); and many governors, including ours, have refused to set up the exchanges or expand Medicaid.

We forget that the same fury and acrimony surrounded the passage of Medicare in 1965, but it’s now an essential and popular program. We’re still in the eye of the storm, but on Oct. 1, 2013, almost all Americans can go to an insurance exchange website and shop for a plan that meets their needs. Demand for advanced practice nurses will skyrocket. So, get ready. It’s a new dawn.

You might be thinking about costs right now. With or without universal coverage, our country’s long-term prosperity depends on controlling health care costs, and the answers are coming from within the industry, not from the outside. Nurses are critical to finding the solutions for cost-effective, high-quality care. Look, if corporations producing commodities like TVs, microwaves and cars can make better products and save money by eliminating waste and increasing efficiency, so can health care.

In conclusion, you’ve chosen a terrific way to make a living and worked really hard to get here. I know you’ll be great nurses because you’re smart and you’ve graduated from this school. Nursing offers SO MANY paths. You may or may not stumble onto the one that’s right for you in the beginning, but have faith that you WILL find it. I promise

But understand … some of the work you do while off the clock can make the biggest difference. Policy is not a spectator sport. Not for nursing, not now. It’s messy and it takes tenacity, but it’s worth it because it’s the only way to make progress. Be a part of it, both where you work and through your professional organization. Now go out there and make a difference. Thank you.

Toni Inglis, MSN, RN CNS (retired), FAAN, a lifelong Austin resident, is a retired neonatal intensive care nurse and editor of NursingNews. She also wrote a monthly opinion column for the Austin American-Statesman editorial pages for 10 years.