In a cross-country career move, David Vlahov, RN, PhD, is taking the helm at University of California-San Francisco School of Nursing. In this role, he aims to guide a transformation of advanced nursing roles while easing into an outdoors-oriented lifestyle in an urban region of sandy beaches, scenic trails and clanging cable cars.
He left his post as senior vice president of research and director of the Center for Urban Epidemiologic Studies at the New York Academy of Medicine to become the nursing schools dean April 1, the first male nurse to hold the position in the schools 100-year history. An initial goal is setting priorities for a new era of nursing education in a volatile healthcare reform environment and shaky economy.
Vlahov expects a stalled nursing shortage to visibly re-emerge and grow during the next five to 10 years because of the escalating medical needs of baby boomers and an exodus of experienced nurses retiring from a profession where the average age is 50. I see more demand for patient care from an aging population and fewer nurses to provide it, he said. One reason I like coming in as dean at UCSF is because it gives me a platform to work with nursing school leaders across the country on where we need to be in five, 10 or 15 years.
New era of RN Leadership
In a poor economy with high unemployment, nurses in California and elsewhere are delaying retirement, expanding their hours or adding shifts to assure financial stability at a time when other family members incomes could be in jeopardy. Hospitals, meanwhile, have trimmed budgets and cut back on hiring new RN graduates, putting a temporary squeeze on once-plentiful entry positions.
Theres some complacency over the size of an adequate nursing workforce because the shortage doesnt seem as bad as predicted, but I emphasize this is a lull, Vlahov said.
When the UCSF position arose, Vlahov said he initially was reluctant to leave the East Coast, but after visiting the campus was sold on the professional opportunities and personal rewards offered. Among other pluses, UCSF pioneered one of the nations strongest programs on HIV risk behaviors and treatments, a field where Vlahov has done extensive research and community outreach.
In posting Vlahovs appointment in a campus email Dec. 7, UCSF Chancellor Susan Desmond-Hellmann, MD, MPH, said he brings a unique blend of experience, leadership skills and interests to the post vacated two months earlier by Kathy Dracup, RN, DNSc, FNP, FAAN, who returned to teaching. Dracup led the school through a decade of growth that saw research grants triple to nearly $40 million, the endowment double to $26 million and enrollment jump 40% to 724 post-graduate students.David Vlahov, RN
Timely Road Map for Change
Vlahov sees the Institute of Medicines recent Future of Nursing report as a timely road map for nursing school leaders to use in building innovative approaches to education, attracting more PhD candidates, fully using advanced RN skills and improving data collection to leverage public healthcare decisions.
UCSF certainly can contribute to and advance the agenda in each of IOMs four recommendation areas, he said.
He supports a UCSF initiative exploring ways to increase residencies that guide a nurses practice for the first years in a new or unfamiliar patient care setting where dropout rates are unusually high. In addition, scope-of-practice barriers that keep RNs from practicing to the fullest extent of their training need to be removed, he said.
A new generation of nurses needs to be nurtured, better prepared and more integrated into the healthcare system, Vlahov said.
Building Integrated Team Care
UCSFs nursing school is pushing a trend toward interprofessional practice as an effective model for patient care, one of the IOM recommendations, Vlahov said. Clinical simulation labs are preparing to train students in different health disciplines to interact and communicate as a team.
To further boost the concept, UCSF recently opened a 22,000-square-foot Teaching and Learning Center dedicated to creating a culture of collaboration among future nurses, doctors, dentists and pharmacists.
Some of the tough work is done and the infrastructure is coming into play, so its an exciting project, Vlahov said. UCSF is in the vanguard of providing interprofessional education that will benefit California and the country.
Cultivating Outside Support
Along with promoting a collaborative model of care as millions of uninsured people gain health coverage under the federal Affordable Care Act, Vlahov also supports UCSFs commitment to a global health agenda. I look at global health as a two-way street, said Vlahov, who initiated the International Society for Urban Health and served as its first president.
The top-ranked nursing school has an excellent track record of winning federal funds for research and educational grants that likely will remain intact despite the tough economy, said Vlahov. He plans to meet with traditional donors, cultivate relationships and tout the schools virtues at various healthcare forums to champion financial support.
Vlahov said hes ready to embrace the California lifestyle and will live in San Francisco, where he will be joined this summer by his wife, Robyn Gershon, DrPH, associate dean for research resources at Columbia Universitys Mailman School of Public Health. The couple have two children and three grandchildren and met as students pursuing doctoral degrees at Johns Hopkins University.
If I have to move away from New York City, San Francisco is a really wonderful choice. Theres fabulous food, great weather, and Im impressed with people Ive met who really take advantage of the outdoors, said Vlahov, who enjoys cycling and hiking.