As professor and associate dean for research and Ph.D. studies in the MUSC College of Nursing, Teresa Kelechi, Ph.D., will step into the role of interim dean of the College this summer. She has a wealth of clinical and research experience and serves as the David and Margaret Clare Endowed Chair and the director of recruitment for the South Carolina Clinical & Translational Research Institute.
Progressnotes recently sat down with Kelechi to tap into her vast knowledge of the world of nursing practice and research.
How did you evolve from being a clinical care nurse to a renowned nurse researcher who is helping to guide best practices?
When I was starting my master's degree, there was a training program funded by the NIH to lure more nurses into the field of aging as they looked ahead to the future needs of the baby boomers. I loved older people, especially the older people in my family, so I was attracted to this path and became a gerontological clinical nurse specialist.
I ended up specializing in wound care, but I had exposure to many other problems that older people face, like falls, incontinence, poor foot care – all kinds of things that impair their functional abilities and quality of life. I kept seeing older folks that really couldn't take care of themselves the way they wanted to.
And I knew there were things I wanted to change, but I didn't know how to go about making those changes with a widespread impact. I needed a research skill set to be able to study problems of aging so we could figure out what to do, and especially how to help people do a better job at monitoring themselves. So I got my Ph.D. in 2001 and devoted my career to the idea of self-monitoring and empowering people to understand how to help themselves.
Congratulations on your upcoming induction into the International Nurse Researcher Hall of Fame! What are you most proud of in your career so far?
I’m proud of the work I've done to help people with symptom management, just to foster the idea that they can help themselves with easy, low-cost interventions like ice or a frozen bag of peas placed on a painful, inflamed area of the legs. So beyond taking pills or doing medical treatments, they can take away their fiery symptoms in a very doable way. These types of small acts can be life-changing for individuals who suffer from conditions that would otherwise be debilitating.
As a nurse researcher, I've been able to go beyond being a clinician and advance what we do for people and what they can do for themselves from an evidence-based perspective. By performing research funded by the NIH through the National Institute of Nursing Research, we can change practice and have a worldwide impact on people’s life quality.
You will step into the role of interim dean for the College of Nursing this summer. What are you most looking forward to in that role?
I’d like to build on the work that Dean Weglicki has put into place over the past five years. I’m excited that I don't have to build systems from scratch, but what I get to do is shepherd and watch the growth of some really exciting opportunities.
For example, we are leaders in the nation around online learning. The College of Nursing was one of the first in the country to develop an online curriculum for our Ph.D. program. And this was not just posting PowerPoint slides online – the College developed educational frameworks that worked in the classroom and then translated those models to engaging online learning.
We are also a nationwide leader in palliative care. We have an endowed chair for that program, and we embedded palliative care training into the curriculum for all students. On the research front, we are studying how best to support people with serious illnesses and how to provide advance care planning.
And we have some new faculty who have great ideas. I'm excited to watch the changes they bring and support them so they can grow new programs.
How has the College of Nursing evolved over time, and where is it headed next?
Our students and graduates have always been community-based providers, with nurse practitioners out in the community and a big presence in clinics and gatherings.
And then when the global pandemic changed everything, one obvious effect was the expanded role of telehealth-delivered care. We have faculty who are national leaders in that space, and nurses here formed their own models of care, so moving forward we will continue to influence how telehealth looks not only locally but statewide.
We know that telehealth has already had an impact on school-based delivery of care for children with chronic conditions like asthma, and we are also researching the long-term impacts of telehealth on people who are at home or aging.
Students are involved in telehealth throughout their training within the College, including video conferencing and using peripheral technologies that can be plugged into smartphones for patient assessment.
Finally, MUSC entered the arena of simulation early with augmented virtual reality and high-fidelity simulators, and we continue to push the boundaries of using these tools to train the next generation of students. But we’re also using them in novel ways, such as offering disaster training in a way that streamlines the training without requiring large amounts of resources from state agencies.
What types of problems does nursing research aim to solve?
Nursing research covers the whole lifespan, from newborns with fussy baby or irritable baby syndrome to teens with sickle cell disease who are transitioning from being dependent on parents to being independent adults to aging people and enhanced end-of-life care.
As a group, nurse researchers aim to advance nursing practice, shape health policy and impact the health of people worldwide by eliminating pain and symptoms caused by disease. For me personally, I like to solve problems that affect individuals with chronic conditions and help them do better at managing their health and well-being.
Some of the big areas in nursing science right now are the need for more health equity and a better understanding of the social determinants of health. As an example, there are patients who cannot make it to their appointments for various reasons, and without access, their medical care will be lacking even if health care is available in their area. People need access to nutritious food and need to have satisfying social interactions for true health. And in my research I’m studying loneliness and wound healing and looking at biomarkers that influence the healing process – we know that if people are lonely, they're not healing.
What do you see as the big priorities in nursing care over the next 10-20 years?
Based on reports from our nursing governing bodies, we are going to need to transform the way we educate our nurses and provide care because more and more people want to receive care in their homes. Right now, 61% of the nursing workforce is dedicated to hospital settings. And these settings are of course necessary for many situations, but families want options and alternatives to the hospital.
Telehealth is taking care of one segment, but I envision that health care providers are going to need to learn to provide more specialized and acute care in home settings as well as many more mini settings such as minute clinics in which care for chronic and serious conditions can be managed.
While we already have home health to some extent, we will need to optimize what that means and what it looks like. For example, can we use smart technology to monitor patients from their homes? I see this as the next step in care – it will not replace nurses but will help us do better. We can jump in faster; we can do the right things at the right time.
And the resources are going to have to shift to cover changing needs. Social care needs are the driver of most chronic management, so we will need to address that issue. We will need to be mindful of what the training needs are going to be, how the funding will flow, and what the policies are going to look like.
It’s going to be an exciting and challenging time with lots of transformation.
Progressnotes Spring 2023
