The nation's new chief public health nurse, whose career started as a candy striper in a small-town hospital, believes that human touch and common sense-trademarks of the nursing profession-will define nursing's ever-expanding role as the health care landscape evolves.
Sylvia Trent-Adams was appointed the 10th chief nurse officer of the U.S. Public Health Service (USPHS) in November 2013. The position was created 65 years ago in the Office of the Surgeon General and carries the rank of Rear Admiral. Since her swearing in on January 17 in a ceremony of pomp and Navy tradition, the 48-year-old mother of two daughters said, "It's been very busy, overwhelming, and exciting. I'm learning my new role and responsibilities."
Trent-Adams grew up on a farm in Concord, Virginia. She said she always wanted to help take care of sick family members. Her great aunt was a nurse, and Trent-Adams grew up listening to her grandmother offer homespun advice to ill relatives. When she was 12 years old, she began spending her Saturdays volunteering as a candy striper at Lynchburg General Hospital, where she delivered mail and magazines to patients.
She went to Hampton University in Virginia on a Reserve Officers' Training Corps (ROTC) scholarship, earning her bachelor of science in nursing. She went on to earn a master of science in nursing and health policy from the University of Maryland, Baltimore, and a doctorate from the University of Maryland, Baltimore County.
She served as an officer in the U.S. Army Nurse Corps for five years, working at Walter Reed Army Medical Center and at hospitals at Fort Sam Houston, Texas, and Fort Stewart, Georgia.
"It is the best training any nurse could ever have," she said. "You have to be a nurse, a soldier, a manager, a leader. Walter Reed prepared me for multidisciplinary care." While there, she worked with Dr. Robert Redfield, a pioneering AIDS researcher.
In 1992, after finishing her army commitment, Trent-Adams joined the Commissioned Corps of the USPHS, where she served in various nursing and policy positions. She was also a cancer research nurse at the University of Maryland Medical Center.
As deputy associate administrator in the HIV/AIDS Bureau of the Health Resources and Services Administration, a post she assumed in 2013, she helped manage the Ryan White HIV/AIDS program, named after the late teenager who contracted AIDS from tainted blood during a medical procedure in the 1980s. The $2.3-billion program finances medical care, referrals, and support services for uninsured and underserved HIV patients as well as training for medical officials.
Ryan White suffered discrimination when he got the disease 30 years ago. Trent-Adams remembers those days all too well, when even some hospital staff shunned patients out of fear of contagion. "My patients had very poor survival rates; they died within weeks, even days," she recalled.
Although we have come a long way since then, the movie Dallas Buyers Club is bringing renewed attention to the stigma surrounding AIDS in that era. "It's so easy for people to forget that happened[horizontal ellipsis] it's unfathomable now," she said. "But the diminished fear is a blessing and a curse: it's desensitized the population" to the seriousness of the disease.
Trent-Adams assumes her new position at a time of breakthroughs in AIDS and HIV research.
"In the mid-1990s, the antiretrovirals hit the market and we were all blown away," she said. "Now, the technology around gene therapy potentially leading to a cure is exciting. It gives us all pause. The best thing about it is, it puts us out of business."
It's also an exciting time for nursing, she said, with nurses in key positions in government health agencies and programs. She said the Affordable Care Act creates a new landscape in which the role of nurses can drastically change. "We can be involved in many ways: clinically, with creating policy, at the bedside, and creating innovative strategies.
"Nurses bring common sense to solving problems, which has not been recognized enough," she said. "Nurses spend more time with the patient than any other health care provider."
And as health care becomes increasingly bureaucratic and corporate, some things about nursing will never change, according to Trent-Adams. "Nurses connect[horizontal ellipsis] we have that personal touch."-Patrice O'Shaughnessy