Dr Reid Ponte: What brought you into the nursing profession?
Dr Bankston: Interestingly, I wanted to be a teacher, but my mother suggested that I become a nurse. She told me that I did not have the patience to be a teacher, and she was right. She saw something in me that would serve others in a profound way. As a nurse, I've been able to do so.
Frankly, I never lost the desire to teach; helping people be the best they can be despite their current situation is my gift. It was early in my career when I realized that nurses could have a huge role in assessing the health and well-being of people from a holistic point of view, helping them along the growth continuum, as individuals or as family units; as communities and subsequently as populations. I realized that the educational preparation of nurses positioned them to understand people from a broader perspective than other health professionals. The fact that we are educated in the social and psychological sciences, the arts, the medical sciences, the organizational and management sciences, and more, including, of course, nursing science, forms the basis of our discipline and profession. This, in my opinion, mandates nursing to act in the interest of all those we serve. I acknowledge that I didn't go after that agenda initially. I found great joy in initiating and leading new programs in the practice settings. Early in my career, I was involved in the quality circle movement, advancing primary nursing and redesigning patient care collaborative models.
I realized that, in order to evoke change in organizations, one has to understand the psychology of change and individual motivation and engagement. To that end, my educational journey led to obtaining an MSN in psychiatric mental health nursing. That coupled with a focus in administration, as there were few nursing administration programs available at that time, prepared me to be a nurse leader, as well as psychiatric advanced practice nurse. That preparation has been instrumental in my effectiveness as a nursing leader and hospital executive.
Dr Reid Ponte: When did you realize that your commitment and focus needed to be social justice and health equity?
Dr Bankston: I have had the opportunity to be a clinical nurse, a behavioral health counselor, a nurse manager, a chief nursing officer, a chief operating officer, and chief executive officer. These roles provided me with a platform for advancing major changes in healthcare organizations focused on equalizing the resources for all people. There are so many disparities in access and quality of care, as well as racism, sexism, and classism within the walls of the organizations. Social determinants of health are so important for nurses to understand, to ensure equity in all areas of life for all people. I had the insight and the interest to do something about these things in my administrative roles.
I established formal relationships with the federally qualified health centers and the city health department primary care clinics in Cincinnati. Our medical center provided specialty care for this population. Two priorities for me were to repair the relationship between the hospital and the community and to develop a strategy to assume responsibility for vulnerable populations. Collaboration by nurses, physicians, social workers, clinical pharmacists, and others resulted in programmatic changes supporting a service line specifically for providing care to the poor. A multidisciplinary shared governance model was designed to support interdisciplinary teams providing outstanding care in partnerships with patients and families in their community. Because this work came at the end of a very tumultuous time in our community, I was asked to share what we were doing at our facility by participating in other broad community strategies culminating in my being viewed as one of the healthcare experts in Cincinnati.
Dr Reid Ponte: You mentioned this idea of "a 2nd act" in your career. What does that mean for you?
Dr Bankston: I spent the 1st 35 years of my career in service to patients and staff in hospitals. When I earned my PhD, I realized that I still had much to give, so I accepted a role as an associate dean at the College of Nursing at the University of Cincinnati. I wanted to influence nurses, students, educators, and administrators to recognize that the care of vulnerable populations is a unique and important specialty. With the movement of people aging in place, racial/ethnic changes, and more care being given outside hospitals, nurses are uniquely prepared to work with people in their homes and communities to improve their lives and conditions of living. Florence Nightingale identified the issues of social justice, the importance of understanding the environment, and the role of the nurse. She wrote about it, acted on it, and improved the lives of people, utilizing data and a thorough assessment of the environment.
While professional nurses and APRNs are practicing outside hospital walls more, there must be a desire and willingness to engage with people in their communities, to listen and hear about their issues and concerns to cocreate strategies for change. This is where health happens; this is how we transition from an illness model to a model of care focusing on health.
The AHRQ Patient-Centered Outcomes Research Institute got this right years ago when they initiated their funding programs. Funding wouldn't be awarded unless the project scope included people designing improvements in partnership with the researchers.
Dr Reid Ponte: You recently held the Child Poverty Collaborative executive director role. Can you tell us about the role and what you'd like JONA readers to learn from it?
Dr Bankston: The Child Poverty Collaborative is a collective impact organization that was developed by the mayor, business community, and some of the major nonprofits to address an alarming rate of poverty in 2015. In 2018, I led the establishment of an infrastructure and coordinated efforts to utilize evidence-based strategies by bringing together the hundreds of initiatives that already existed locally. As a nurse, I viewed this from a holistic perspective and saw it as a system issue. Specifically, how does the environment influence child/family in poverty? Certainly a very complex issue. I bring this up because what is important about any collective impact work is to acknowledge the amount of effort that must go into establishing relationships to begin the change process, listen to the community for existing strategies, and continue efforts and understanding of the systems that must be disrupted for change.
I hope that JONA readers can envision themselves as leading sustained long-term change for nursing practice and healthcare delivery that improves the social determinants of health for the people of America and the world. As professional nurses, we have the education to do so. We must get our voices heard and take risks.