Leaders in Nursing Education

Dr. Margaret Grey, Dean of Yale University School of Nursing

Thasin Jaigirdar
Dec 3, 2014

Dr. Margaret Grey serves as dean of Yale University’s School of Nursing, where she has been been since 1993. She also directs the Translational Research core for the Yale Center for Clinical Investigation. She was also founding director of the Center for Self and Family Management at Yale University. She is a Pediatric Nursing, with a specific focus on diabetes. She has also been elected to the Sigma Theta Tau Internal Nurse Researcher Hall of Fame and is recognized for for her contributions to Behavioral Medicine from the American Diabetes Association. We are excited to be featuring her today in our Leaders in Nursing Education Series.

How did you get involved in a career in nursing?

I was one of those people who wanted to be a nurse from a young age. I don’t know why I was interested in nursing. That was just me, and over time, here I am. My mother’s theory was that I read these books when I was younger, these series about a nurse called Cherry Ames. I thought nursing was the coolest thing from those books. I also had my tonsils removed when I was 4.5, which also sparked my interest too.

What does your Day-to-day life as a dean of a nursing school look like?

My day-to-day is very crazy. In a normal day, I’m in meetings with faculty and staff for a lot of the day, and when I’m not in the office. which is often because of a need to fundraise and to work on my own scholarly career, I am busy meeting alumni and others where I talk about what the school’s faculty and students are doing and the like. Evenings I am often in other meetings or entertaining alumni. My own scholarly work tends to come on the weekends because there isn’t time during the week. I end up working anywhere between 60 and 70 hours a week.

What is the most gratifying part of being a dean of a nursing school?

I view the position having multiple components: Being a cheerleader for the school, making friends, talking about things we are doing, our aspirations, and those sorts of things. The second piece of the work is making sure that we have the resources to do the things we need and want to do, and finally to be a good manager of the senior administrative group.

What I like the most is talking to the alumni and their experiences and learning more about the careers that they have had.

How do you envision the future of nurses given new healthcare policy changes?

I think that although nurses are still the largest number of healthcare providers in the country, it is clear that we as a country are facing a huge shortage of Primary Care Physicians. I expect nursing will take an increasingly prominent role in the provision of primary care as well as out of hospital population based care.

The data suggests that medical schools are not going to turn out the number of primary care providers partially because of the financial burdens that some people graduate from medical school with unless the payment system in the country changes. If we are paying based on the procedures we do, primary care providers will continue to be the bottom of the income barrel. Physicians do make more than nurses. Those who graduate from Yale School of Nursing graduate with even higher debt than some medical school students do, but their careers are different. This is because they come In with high undergraduate debt from top tier schools. However, they didn’t expect to make more money. They didn’t expect to do anything more than care for people wherever they are.

The more we look at inter-professional education and working in teams, we can influence how people practice when they get out in the positive way, the more likely they can solve the primary care shortage problem, so we can focus on population based health which ultimately may be the way payment systems will go.

Radical changes are going to be made. The procedure driven system is a huge problem. We need to pay to keep people well and manage chronic illness well, which nurse practitioners do exceptionally well. It’s going to take a lot more than a couple of new approaches to solve that problem.

Now-a-days many nurses are picking up additional degrees such as their MBA or PhD. What are your thoughts on this trend?

A great majority of nurses are going on in the field of nursing and stay within the field. The growth of  nursing practice does allow people to go on and get a practice doctorate analogous to an MD. Yale is only a graduate school, with no undergraduate nursing school. We see huge numbers of applicants for the Masters, Doctor of Nursing Practice, and PhD programs which is good because  we need more people prepared at the doctoral level.