While working on her master's thesis at the University of Washington School of Nursing in the mid-1980s, Julie Metzger came across a study that made her laugh. The study, which had surveyed women on their menarche experiences, found that women recollected receiving information on menstruation and puberty primarily from their mothers. "I laughed out loud, thinking, 'Think about those conversations,'" Metzger recalls. This experience ended up shaping the trajectory of her career.
Imagining the wide variation in how the mother-daughter interactions played out-from "factual" to "celebratory" to "horrifying"-led Metzger to an idea: what if she created a puberty-focused class in which preteens and their parents learned together? She envisioned a "fun and funny" gathering that wouldn't just present information about puberty and related topics, but would also facilitate ongoing dialogues within families.
A few years later, while working as nurse manager on the pediatrics unit at Allegheny General Hospital in Pittsburgh, she shared her idea with a colleague involved in community education who encouraged her to make it a reality. After much preparation and development work on Metzger's end, they advertised the class ("For Girls Only: A Heart-to-Heart Talk on Growing Up") to local schools and were met with overwhelming interest-so much so that Metzger ended up teaching back-to-back sessions to meet the demand. "It's been that way ever since," she says. "If we offer the class, people come."
GREAT CONVERSATIONS
Metzger relocated to Washington State in 1990, and continued teaching her class at Seattle Children's Hospital-where, years prior, she had started her career as a staff nurse on an adolescent unit, and where, she says, "I learned more from the adolescents than you could possibly learn from anyone." The reasons for her patients' hospitalization varied from appendectomy to cancer. "Any diagnosis, they were on that floor because of their age," she says. "So we took care of them, acknowledging who they were as people developmentally."
The hallmark of Metzger's teaching approach is meeting her target age group-10-to-12-year-olds-at a developmentally appropriate level. "We don't talk down to this age group, and we don't talk over them," she explains, cautioning that doing either is an easy mistake to make. She calls what she does in front of her classes a "performance" that fuses her clinical expertise with her theatrical nature. "I speak with the authority of a nurse and with the spirit of Ellen DeGeneres."
Eventually, after years spent cultivating her knack for tackling puberty-related topics in front of audiences, Metzger decided to broaden her work by partnering with a physician who specializes in adolescent health care, Robert Lehman. The two worked together to reach more children-both girls and boys-and their families. They founded a company, Great Conversations, through which an expert team of health educators teaches preteens and parents throughout the Pacific Northwest and the San Francisco Bay Area. Its two main four-hour classes-"For Girls" and "For Boys"-fill up quickly. Metzger says that more than 16,000 people have attended Great Conversations' classes in the past year.
The classes combine an interactive mix of humor (Metzger, for example, sticks a sanitary pad to her shirt to show how it stays in place), storytelling, and information on subjects like body changes, the opposite sex, decision making, and friendship. The instructors follow a general script to ensure consistency of information across classes. But as a teacher, Metzger emphasizes that facts aren't her only priority: she wants to create an openness between parent and child that will thrive long after the class is over, enabling them to have a "base of understanding" wherein questions and dialogue are comfortably shared. "The first thing I want them to think is, 'That was more fun that I thought it was going to be.' And 'We just heard the same information together; let's continue that conversation in the car.'"
As a case in point, Metzger often sees parents bring each of their children to the class as they reach adolescence. "What's amazing about that is we're not inventing puberty. I don't have a patent on periods. I'm giving the exact same class," she says. "You could assume that mom has the information she needs to talk to her next three daughters after she comes with the first one-but people come back. It's not just the facts. It's the experience itself-sitting there together and thinking, 'Now, because of this, our relationship is actually different.'"
In fact, Metzger says that although the class is directed toward the preteen attendees, it's their parents who walk out most transformed. "Most parents have not had a chance to laugh about these topics, or to share stories," she says. And because of their shared experience in the class, the children learn a valuable lesson: their parents are accessible for questions and discussions. "It changes the conversation in families from the way it was headed when they first walked in."
Currently, Metzger is exploring how Great Conversations can reach more families, both in person and, perhaps, online. She and Lehman are at work on a new edition of their book, Will Puberty Last My Whole Life?, which provides answers to common questions from both girls and boys. And she's also the author of This Is Me, a journal for girls filled with writing prompts.
NURSES AS TEACHERS
"I think all nurses are teachers," Metzger says. "Part of a nurse's work is communicating information to people to help them live their lives fully. Whether you are at the bedside, in a clinic, or out in the community, the work of teaching is foundational to what nursing is about. And for me, claiming that truth and honing that skill is just part of the fun of our profession."
Metzger admits that while attending nursing school, she didn't think she'd last long in the field: "I thought, 'Well, this is a good start to something." But she soon learned that her chosen career path could be a vehicle for providing vast opportunities. "Nursing opens doors to so many wonderful experiences," she says, crediting the profession for enabling her to do what she considers the most rewarding work of her life. "I don't think that could have happened without being a nurse first."-Diane Szulecki, editor