Barbara J. Hatcher, PhD, MPH, RN, FAAN

View Large Image Download to PowerPoint

Barbara J. Hatcher PhD, MPH, RN, FAAN, is the director for the Center for Learning and Global Public Health at the American Public Health Association (APHA) and Secretary General for the World Federation of Public Health Associations. In her role at APHA, she is responsible for providing science-based programs and projects that educate and build capacity for international and domestic public health at individual, institutional, and community levels. At the World Federation, she is responsible for the strategic realignment of this world organization. Most of her career has focused on public health.

How did you come to your position at APHA?

Dr. Mohammad Akhter, then executive director of APHA, asked me to consider employment at APHA and redesign its scientific and professional affairs. He knew of my previous work and experience, and he was trying to put together a diverse work group.

In addition to the positions you hold, you also are a Robert Wood Johnson executive nurse fellow. How do you think that experience changed you as a leader?

The leadership program really focuses on five areas: self-knowledge; risk taking; creativity; interpersonal and communications; and inspiring and leading change. I believe I have changed in all areas to some extent, but the one that really has changed the most is that I am more of a risk taker. With the dual positions that I have now, I have to be a risk taker because there is no set path, and I am working across the globe to make change. A lot of what I do hasn't been done before. Risk taking is important in being able to move forward, not fear failure. Failure is really a stepping stone for change, something you can learn from.

You were fortunate to have such guided learning in risk taking. Think for a moment about the people who don't have this great opportunity. What would you say to them about how they could develop their risk-taking behaviors?

I guess the best way to answer that question is to quote Nelson Mandela, whom I admire. One of his quotes is “As we are liberated from our own fear, our presence automatically liberates others.” So to me, risk taking is taking a calculated step forward, not fearing the failure or the disapproval that we normally fear and that keep us from having the impact we might want to have. I think you have to see yourself as open to change and free! Only a person who risks is free!

You mention Nelson Mandela. Are there specific individuals whom you would describe as your mentors? How did they influence you?

Well, I don't think I had mentors who might meet the traditional definition. I do think, however, first and foremost my lifelong mentor was my father. He was involved in community work and in making a difference. He had a series of firsts as an African American in Connecticut state government and in community and civic affairs in my hometown, Waterbury, and across the state. I learned from him the commitment to excel but not to do it in a manner that didn't connect back to helping other people. He was so influential that I had boyfriends from long ago come back to talk with my father; they would ask his opinion about something they were considering in their lives. And the funny part is that, as children growing up and particularly as teens, they often were afraid of my father. Once they knew him, they saw that his advice made sense and that he spoke as a concerned adult.

I could name nurses, like some of my supervisors or Margaret Dolan from UNC (University of North Carolina). As an African American nurse, I would be remiss if I didn't say I stand on the shoulders of other black nurses who went before me. They paved the way for many of us today who have opportunities they could never dream of. While they may have never reached positions of national significance, they were available to me, supported and encouraged me, and are the nameless heroes we all know about.

Those are great thoughts! You obviously live your life as a pioneer and focus on making a difference. For example, you were part of the team that produced an excellent report, “Wisdom at Work,” that focused on keeping older nurses in the workforce. In what areas do you think we are making progress for keeping older nurses in the workforce?

Where we are making a significant difference is that we are acknowledging the need to look at the issue and that we need to retain the older nurse. I think society and the workplaces have a stigma against age. I don't think it is any different for nursing since we are part of society. Knowing that it is important to retain older nurses and that they have something to contribute is very important. We've paid a lot of attention to adapting the physical environment and to the benefits that might help retain older nurses.

Now, what we have not done as well is harness nurses' intellectual capital. I think it will take more thinking about job redesign and systematic mentoring to help, at least in the short-term, the impending nursing shortage. We need to determine what kinds of gaps will exist when people leave. That might give us some clues about what the people who follow will need assistance with.

View Large Image Download to PowerPoint

The Washington Post carried an article in the February 17, 2008, issue on the dwindling ranks of nuclear experts. It is no different for nursing. The ranks of our experts are dwindling. When these nuclear experts begin to retire in large numbers in a few years, we are going to have serious problems. The same will be true for nursing. Harnessing knowledge in the nuclear field is focused on simulation and technology. Partnering younger nurses with older nurses would seem to be more effective because much of what we need to transfer can't be simulated. Nursing has much to learn from other fields as we are a reflection of society at large, no matter what our discipline.

View Large Image Download to PowerPoint

Name:

Barbara J. Hatcher

Hometown:

Waterbury, Connecticut

Current Job:

Director, Center for Learning & Global Public Health and Secretary General, the World Federation of Public Health Associations

Education:

BS from University of Connecticut, MPH from University of North Carolina, PhD from George Mason University

First job in nursing:

Evening charge nurse, Waterbury Hospital

Best advice for aspiring nursing leaders:

Lead with your heart!

Being in a leadership position gives me the opportunity to:

Influence the future of global public health and mentor the next generation of public health leaders

Most people don't know that I:

Served for almost 15 years in the Army National Guard and was called up for active duty during Operation Desert Shield/Desert Storm and was stationed in Saudi Arabia. I was chief nurse of the 115th Mobile Army Surgical Hospital (MASH) that combined with an active duty unit from Germany to become an expanded combat support hospital. We were located not far from the Iraqi and Kuwaiti borders.

One thing I want to learn:

I never have one thing—photojournalism, ethnomusicology, playing the kaban from Somalia

One word to summarize me:

Passionate

What was the most valuable thing you learned from working on the team that produced the report?

At the time that we did the report, we learned how much we had not concentrated on this issue, despite the projected shortage being less than 5 years away at the time we started the work. This is really a thread for me: we don't do enough intersectional learning where we learn from other professions and industries. We sometimes have this view that nursing is this thing unto itself, yet we are only one segment of society. What's happening to us is happening in the bigger broader world as well. The extent of the workforce shortage problem may vary among groups, but it is not unique to one group of workers.

Speaking of those types of societal changes, many disciplines are focusing on higher levels of education for their workforce. At least five states require a bachelor's degree for public health nurses. Do you think this is a trend?

I hope it is a trend. When I graduated from nursing school, public health nursing required the bachelor's degree. Today, like then, public health nursing is really taught at the baccalaureate level. I really value associate degree nurses, but it is just not realistic for a student to gain all that is necessary for nursing and for public health nursing in 2 years.

What is so distinctive about public health nursing that you think it requires a bachelor's degree?

I think public health nursing requires synthesizing a lot of areas. You have to think about populations and making changes. When you look at preparedness and re-emerging infections, you need someone who can build on a lot of information and focus on keeping populations well.

Let's hypothesize that in 10 years the majority of states say public health nurses have to have a bachelor's degree; how would the system be different?

Well, I'm not sure we have a system! Maybe we could have systems that begin to focus on keeping people well, facilitating self-care, and helping people negotiate the kinds of services they need to enhance their health, seek emergency services, or respond to a need in their community. You don't see that kind of emphasis in a lot of health departments anymore. We could bring back those kinds of services that so many communities are lacking.

By and large, public health at the state level is not doing what it could. We have let public health erode over the past several decades. In part that is because we tend to focus on hospitals and health systems because they employ so many nurses. So we have ignored public health. Part of my reason for wanting to be involved in Wisdom at Work was that I thought I could bring the public health perspective. The problems facing hospital nursing are so broad, though, that it is a challenge to integrate something else like public health or long-term care into these discussions.

Thinking about the other areas such as public health and long-term care is important as well, and we need the same kinds of discussions we have had about hospital-based or health system-based nursing. And if we don't think in a systems perspective, we are short sighted because what happens (or not) in public health affects the intensity, complexity, and types of conditions that nurses in hospitals and then long-term care facilities must care for.

You have had a variety of leadership opportunities in nursing and public health. Was there some “ah-ha” moment that brought you to where you are today?

I have several, and believe it or not, Cherry Ames made me want to become a nurse! My mother always thought I was going to be a history teacher. My mother would buy me Cherry Ames books, though. Cherry Ames was always adventurous and independent. I loved Cherry Ames, Visiting Nurse, Cherry Ames, Flight Nurse, and on and on. As a young girl, I saw nursing as a way to address my desire of wanting to care for other people and to create change. I never saw nursing as hospital nursing, which is perhaps why I am in public health. I never saw nursing as confined by a building or systems. And no matter what needed to be done, Cherry Ames always could do whatever needed to be done! It reinforced for me that I could do whatever I needed to do.

How great! So did Cherry Ames have a book about leadership, or could you tell us from all of your experiences, including those within APHA and the National Black Nurses Association, what advice you would have for nurses early in their careers?

My advice would be to do what you are passionate about. For success, put forth your best. Overnight success takes an average of 5 to 8 years. (I know some of us think that it comes tomorrow.) Control your own destiny. Leadership is a combination of experience, passion, and creativity, and it's all about relationships.

I think we can learn from history as well. For example, Florence Nightingale had ideas we still haven't accomplished. We can learn from the past, and we need to take the good from the past into the future.

Speaking of the future, what do you think the role of nurse leaders will be in addressing global health challenges?

Laurie Garrett, who writes a lot about public health issues, talks about how more and more money is being directed toward the world's poor and sick and is focused on narrow, disease-specific problems versus looking at the broader issues such as the public health systems. Nursing has an opportunity to provide visionary leadership in global health. If we look back, for instance, to Florence Nightingale and what her epidemiological approach did for public health, we can learn from that and bring it forward to improve global health.

As I have done my work, I have come to see that much of the disparity across the globe is not because of lack of money; it is because of lack of will and our commitment to our own self interests. We get in certain situations and think only about ourselves, our hospital, our clinic, our whatever. We have to link our discussions to the bigger world. I really think that nursing needs more of a commitment to social justice and equity and to providing the moral and ethical leadership to make the world a better place to live. As the largest group of health professionals across the world, I think we should be having a tremendous impact! I think we need to see the world as a big orchestra and we are the conductor. It is our job to make the music right.

View Large Image Download to PowerPoint

Almost everyone looks to others in leadership positions and wonders what their jewels of wisdom would be. What are yours?

I have lots of those, but I will share a few. The first is from Bobby Kennedy: “Some men see things as they are and say why. I dream things that never were and say why not.” Second, learn to emphasize your strengths and the strengths of others. The third comes from John Hasse and his Leadership Lessons from the Jazz Masters. To me, this is a great example of looking at intersections, and as I said previously, I don't think we learn enough from other disciplines to improve our profession. His first point and one with which I agree is listen closely. Remember that leadership has no exact script. Hasse suggests you look at a jazz band. The members may seem to be in complete sync, but they aren't always. They listen to connect to each other.

His next point is to find your own sound. So what makes you different? How can you build on those strengths? To me that is being your authentic self. You need to find out what is best for you and you do what is best for you. The next is to take risks and improvise. We are all improvising because life isn't scripted. With each new issue, we have to build on the past to arrive at a decision. The next point is to remain fresh and innovate. This is about transforming the old and familiar into something new and fresh.

His next point was about jam sessions, and they were really about breaking down hierarchy. Collaborate creatively is his next point, and leadership requires collaboration in various ways to achieve what is desired. It is about the mutual benefit of your organization or community or state. Finally, find and nurture great talent. Leadership isn't just about you, it is about others. Finding the right team and helping them and having them help you create better outcomes.

Are there any parting thoughts you would want others to know?

You have to know who and what you are to move forward. There is an old Ashanti symbol, sankofa, which is symbolized by a bird heading forward but facing backward to pluck an egg from its back. That proverb says that you should take from the past what is good and bring it into the present in order to make positive progress. Sankofa means that we must go back and reclaim our past so that we can move forward and understand who and why we are as we came to be today.