Deborah C. Varnam '99
(MSN). Owner/operator and nurse practitioner, Varnam Family Wellness Center, Shallotte, NC.

"Good nurse leaders are invaluable to patients. My patients are always asking me about health care issues because they know I'm advocating for them. They know I'm their partner in health care and not just their caregiver."

Photo by Cliff Hollis
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Pirate nurses provide leadership in complex health care environments

By Amy Ellis
ECU News Services

When Mary Chatman ’90 ’94 ’12 was a nursing assistant, she got adrenaline rushes from “dealing with blood and guts.”

Today, as second-in-command of a 654-bed academic medical center, she gets a greater thrill from equipping others to succeed in the work she used to do. And she credits the College of Nursing at East Carolina University for her leadership prowess and perspective.

With more than 1,300 students enrolled across all degree programs, ECU’s nursing school is the top producer of new nurses among the state’s four-year academic institutions, according to a recent report received by the University of North Carolina Board of Governors. Moreover, since the college opened its doors in 1960, it has provided one constant amid an ever-evolving health care environment: graduates prepared not only to be great nurses, but also great leaders.

“Good leadership is needed at all levels of nursing, from staff nurse to high-level management,” says Sylvia Brown ’75 ’78, dean of the college. “Now that so much inter-professional work happens both at the bedside and in the boardroom, nurses need a special skill set.”

When a health care organization or related business needs someone to pilot a team, industry leaders consistently turn to ECU nursing graduates. According to Brown, that’s because the college is intentional about equipping nurses to tackle the most pressing challenges of the region and the industry.

Many of the challenges close to home are related to workforce shortages, Brown says. About 3,500 nursing jobs are vacant statewide. And most nurses working in eastern North Carolina have two-year degrees, so ECU graduates—with their four-year degrees—are often thrust into leadership early on in their careers.

From a broader perspective, she says, most challenges arise from a health care culture that increasingly regards a team approach as the best way to deliver care.

“It’s important to note that the qualities paramount in good leaders are also required of good team players,” she says.

Beyond basic nursing skills, Brown says, a nurse leader’s toolbox should include good communication skills, an open mind, a team mentality, mentorship, patient advocacy, a big-picture focus and an understanding of processes. She says the culture within ECU’s College of Nursing breeds all those qualities.

A broader scope

Chatman says her perspective on nurses in leadership has changed a lot in just five years.
Debra Wallace

Dr. Debra Wallace '85 (MSN), Associate dean for research and Daphine Doster Mastroianni Distinguished Professor, UNC-Greensboro School of Nursing; and director, UNC-G Center for the Health of Vulnerable Populations.

"The College of Nursing instilled in me the importance of persevering and being goal-directed -- qualities that are crucial for effective leadership."

“The scope is so much broader now,” she says. “It used to be that nurses led nurses; now nurses lead a lot of stuff.”

As chief operating officer for Memorial University Medical Center in Savannah, Chatman leads the day-to-day operations for the center’s nursing divisions, patient care services, outpatient clinics, human resources and a variety of MUMC institutes. She joined the center in 2009 after a healthy stint as vice president and chief nursing officer for then-Pitt County Memorial Hospital—now Vidant Medical Center—in Greenville.

Chatman says her role requires her to be nimble, industry-savvy, a good communicator and an effective mentor—qualities ECU instilled in her at every academic level.


Linda McCoy '91
(MSN), right. Retired oncology clinical nurse specialist, Nash General Hospital, Rocky Mount. Shakeerah McCoy '10 (MSN), left. Clinical nurse specialist and transitional care program coordinator, Nash General Hospital, Rocky Mount.

(Photo by Cliff Hollis)

"While we vary in our areas of interest and years of experience, my mother (Linda) and myself have both been able to create innovative change in our respective practice environments because of the educational experiences we received at the ECU College of Nursing.

"The college prepares clinical nurse specialists like us to lead the continued development of the nursing practice environment through appreciation and understanding of the patient and family, other nurses and the overall health system.

It provided us with the knowledge and skill set to effectively participate in shared governance councils . . . to develop new programs for the organization . . . to serve as mentors . . . and to lead efforts to further health promotion and disease prevention in the community we serve."
“Today’s nurse leader needs a broad understanding of nursing as well as operations—operations of a hospital, an outpatient facility, a school of nursing,” she says. “You may not have to run all these things, but you definitely will have to interface with them all.”

Chatman says the College of Nursing taught her not only the role of a nurse leader, but also how to look the part, how to play the part and the importance of mentoring others along the way “to ensure nursing won’t lose its place at the table in multidisciplinary discussions.”

The Engelhard native says the culture of diversity she experienced at ECU contributed to a “social intelligence” that daily aids her interactions with people from all walks of life and with different attitudes about health care.

As an undergraduate student, Chatman says, her nursing professors taught her how to process information in new ways and explore possibilities.

“I graduated from a tiny high school where we all learned how to read and regurgitate,” she says. “I didn’t know how to extrapolate, how to think critically. But my professors knew exactly what I needed.”

At the master’s level, Chatman says, they taught her how to translate the technical nursing skills she’d then mastered into strategic thinking.

And when she returned as a professional leader to pursue her doctorate, she says, her professors-turned-peers openly acknowledged the tensions that arise as colleagues change roles, and they helped her deal with them constructively, always modeling accessibility, peer support and good mentorship.

Leadership and patient care can coexist

Family nurse practitioner Debbie Varnam ’92 ’99 says the College of Nursing taught her “to be more—and better—than what society says is the standard, to think outside the box and persevere even when it’s uncomfortable”—skills critical to an FNP in an M.D. world, she says. Varnam owns and operates a family wellness center in the 1,800-person township of Shallotte in coastal Brunswick County.

Kent Dickerson
Kent Dickerson '08 (MSN)
Director of nursing,
Beaufort County Community College, Washington, N.C.

"The ECU College of Nursing gave me the confidence to work within the realm of nursing education. I took my cues from the faculty and how they provided leadership to me . . . through an environment of autonomy, accountability, patience and guidance -- which are essential for any leadership position. They also encouraged networking with peers, which I have found is essential."
“Around here, lots of providers aren’t aware of the patient care autonomy nurse practitioners can have,” she says. “I’ve had to trudge a new road with the hospitals here. They didn’t know what to do with me at first.”

Varnam says ECU’s nursing program taught her to focus on processes and potential and the health care environment as a whole.

“We’re facing a provider crisis,” she says. “We will need more and more nurse practitioners in the field. Each FNP class that ECU graduates is helping to alleviate that shortage.”

Varnam says ECU armed her well for the front lines of primary care leadership in an underserved area. The day she opened her practice in 2006, patients were walking in before she’d gotten her supplies unpacked. She’s since hired an additional practitioner, and the practice continues to grow by four patients a day.

Peer support, mentorship and patient advocacy top the list of Varnam’s passions. She’s the regional director for the American Association of Nurse Practitioners. She lectures nursing students and serves as a clinical preceptor for multiple nursing programs in the Southeast. She does a lot of health policy work.

“Good nurse leaders are invaluable to patients,” she says. “My patients are always asking me about health care issues because they know I’m advocating for them. They know I’m their partner in health care and not just their caregiver.”

Having grown up in Greenville, Varnam says ECU was a natural choice for her. After earning her bachelor’s degree and working in various staff nurse positions, she chose to become an advanced practitioner because she wanted to assume more leadership without giving up direct patient care. It’s what keeps her grounded, she says.


Jessica Griffin '01
(BSN), Staff nurse, special care nursery, James and Connie Maynard Children's Hospital; and co-liaison, Pirate Nurse Network, Vidant Medical Center, Greenville. (Photo by Cliff Hollis)

"Like a home needs a good foundation, I was wonderfully prepared for a leadership role by my instructors and mentors in the College of Nursing.

I am so grateful they taught me the value of hard work, dedication and the importance of building on your individual passions. They taught me that nurses and leaders can do the most good when they find their best fit."

Leadership at all levels

One reason ECU excels at cultivating successful nurse leaders, Brown says, is that leadership concepts are embedded in the curriculum from the moment an undergraduate student enters nursing school.

As first-semester juniors, all nursing students take an introductory course in professional nursing. They conclude their senior year with another nursing leadership course.

Every master’s-level student takes a class in health care quality, safety and policy as well as health care finance and economics courses. Among the eight specialties offered at this level is a nursing leadership concentration. Recently, U.S. News & World Report ranked the college’s online master’s programs fifth out of nearly a hundred programs nationwide.

ECU’s doctorate of nursing practice prepares nurses to lead inter-professional health care teams. The doctorate of philosophy equips them for leadership in research, policy, administration and educational settings.

In recent years, BB&T Leadership Enhancement Fund grants have fostered many ECU nursing leadership initiatives. In 2006 they helped create the East Carolina Center for Nursing Leadership, the first of its kind in North Carolina. Housed in the College of Nursing, it provides continuing leadership education for nursing students, faculty and practicing nurses statewide, not to mention individual mentoring relationships with experienced nurse leaders.

Another weapon in the college’s leadership development arsenal: the service-learning opportunities students get.

“Nursing is about health promotion and prevention,” Brown says. “We shouldn’t prepare our future nurse leaders in hospitals only, where the sickest people are. Our program chooses to prepare them in settings like schools, also, where they can learn how to affect people’s health for the long term.”

Chatman believes another of ECU’s weapons is its geography. “Because of its position in eastern North Carolina, the college attracts rural talent,” she says. “It’s important for patients to be able to relate to their caregivers. We want our workforce and our leadership to mimic the population we serve because that contributes to better patient care perception, better patient care and better outcomes. Recruiting local and regional talent increases the chances that talent will stay in the area.”

Although Pirate nurses are practicing in every state, ECU administrators say approximately 92 percent of ECU’s post-graduate degree holders are employed in North Carolina, and more than half are working in eastern North Carolina.

Dr. Warren Newton, director for the North Carolina Area Health Education Centers, extolled ECU’s track record of cultivating successful nurse leaders. AHEC’s mission centers on improving access to quality health care for North Carolinians, in part by addressing workforce needs.

Warren cited the ECU-AHEC collaboration to offer the region’s many associate’s-degree nurses an online RN-to-BSN program.

“ECU recognized long ago that future nurse leaders would require a bridge to post-baccalaureate education to prepare for leadership in an era of continuous change,” he says.

Cathy Bunch '94 (BSN), Professional development coordinator, Center for Learning and Performance; and co-liaison, Pirate Nurse Network, Vidant Medical Center, Greenville. (Photo by Cliff Hollis)

"My educational experiences through the ECU College of Nursing have given me a foundation on which I have developed my leadership abilities, and they taught me to lead by example. Helping lead the Pirate Nurse Network has enabled me to combine my two biggest passions: nursing and being a Pirate!"