Johns Hopkins School of Nursing Dean Patricia Davidson, past and present

Image caption: Patricia Davidson: “Coming here not only fulfilled a lifelong ambition of mine, but I thought that taking this position could afford more opportunities to nursing and women globally.”

Image credit: MARSHALL CLARKE

Assembled on stage at the 2014 Johns Hopkins universitywide commencement was a cadre of deans and administrators garbed, as is custom, in academic regalia signifying the elite institutions from which they had graduated. Among them sat one dark-haired woman in a striking—albeit somewhat unfamiliar-looking—silver-and-red robe. The sash and colors represented the University of Newcastle, a public research university located in the coastal city of the same name in New South Wales, Australia. The wearer was Patricia "Trish" Davidson, the fourth dean of the Johns Hopkins School of Nursing, who had been in the post only seven months.

Davidson says that moment on stage reminded her why she had long admired Johns Hopkins, and why she boldly chose to leave her many friends and family to relocate to the United States after decades of distinguished work as a nurse clinician, researcher, educator, and administrator in her home country.

"Here were all these people with their Yale, MIT, and Harvard robes, and here I was from a university, while distinguished in Australia, nobody had probably ever heard of before," says Davidson with an unmistakable Australian accent. "But that's what always attracted me to this university—this sense of excellence without elitism, its global orientation, and a commitment to inclusion and diversity. Coming here not only fulfilled a lifelong ambition of mine, but I thought that taking this position could afford more opportunities to nursing and women globally. In fact, I think I've done more for nursing back home in Australia by taking this job than if I had worked there for another 10 years."

Davidson, who joined Johns Hopkins in September 2013, says news of her appointment had an immediate ripple effect.

"I can tell you, my physician colleagues took notice. They were like, nursing in Australia must be OK if I was good enough to get this job at Johns Hopkins," says Davidson with a robust laugh that comes easily for a woman clearly energized by the opportunities and challenges that lie before her.

Davidson, a global leader in cardiac health for women and indigenous peoples, spent 23 years as a frontline clinician and nurse manager before shifting her focus to research and teaching. Just before her appointment at Johns Hopkins, Davidson served as professor and director of the Center for Cardiovascular and Chronic Care at the University of Technology, Sydney. She was also professor of cardiovascular nursing research at St. Vincent's Hospital there.

But she was no stranger to Johns Hopkins and Baltimore.

Davidson had collaborated with JHU faculty members in research, teaching, and professional activities for a decade and spent time at the SON as a visiting scholar in 2007, 2009, and 2011. She also had several occasions to come to Baltimore and the United States as a fellow of the American Heart Association.

When she took the dean's position, Davidson said she felt both honored and humbled to succeed Martha Hill and take over a school that in just three decades of existence has become one of the nation's most prominent and respected.

She had come a long way from being the girl in southeast Australia who entered nursing only by chance.

Davidson was born in Canberra, the Australian capital founded in 1913 and located diplomatically halfway between Melbourne and Sydney. The eldest of three children, Davidson describes the 1960s version of Canberra as a small, homogeneous, middle-class town filled with civil servants. Her father was a patents attorney, who, like many others, had only recently relocated to the area for work.

She recalls a happy childhood, shattered later by tragedy. At age 16, Davidson lost her mother to ovarian cancer. The death would have a profound impact on her, though she wasn't aware of it at the time. Her mother's illness exposed her to the work of nurses whom she carefully observed during time spent on visits to the hospital, and later when they cared for her mother at home.

Still, Davidson left high school thinking she would pursue a career in political science or law.

"I've always been interested in human rights and social justice—roles of advocacy," she says. "I thought perhaps political journalism lay in my future."

Davidson, however, could not embrace her studies and left college after just one year. She got a job waitressing, but two years in she knew she had to find a profession where she could grow and realize her potential. One day, a co-worker mentioned she was going to quit work and become a nurse. Without much thought, Davidson decided to join her.

"I remember having to sit down for a career guidance session before I could start training, and they tell me, 'It's great that you want to do nursing, but we think that you would do a lot better as a history or English teacher' [laughs]. Different days. But I, of course, went into nursing anyway, and I loved it immediately."

Nursing back in the 1980s in Australia still followed the very traditional English model where rank replaces name and one wore uniforms and starched hats. Davidson says she enjoyed the immediacy of the profession, and her inner nurturer and caregiver instinctively rose to the surface.

"One of the things people don't truly understand about nursing is the intensely analytical and empathic relationship that a good nurse has with a patient," she says. "It is the most privileged occupation in the world. I look back on my life, and you really share in people's deepest sadness and greatest joys. This intimacy of humanity gives nurses a unique perspective and place in the world. I remember vividly my first cardiac arrest. I can still see everything today like a flashbulb moment. The look in his eyes when he realizes he's about to die, and my reaction. Oh, I have to do something about this. I have to call a code and be there for him."

Davidson spent several years working in an ICU and then performed hospital outreach and specialty work, dealing mostly with patients with heart failure and multiple chronic conditions. She would later join the Aboriginal Medical Service in western Sydney. She called her time in the AMS an "amazing experience" and marveled at the resilience of people whose health outcomes were abysmal compared to those of the rest of the population. She took away from the experience an understanding of the social determinants of health and how one's future orientation on life could impact his or her actions.

"If you are homeless or have no money to feed your kids, or you're feeding a drug habit, you don't care whether or not you take your tablets or have another 10 cigarettes," she says. "There's this prevailing sense of, so what?"

She next went back to school to earn a BA in education from the University of Wollongong in 1985, adding a Master of Education degree, majoring in the clinical curriculum, from there in 1993. The next phase of her professional life would be as a researcher.

Less than one month into her research career, a cardiologist colleague called Davidson into his office and said he wanted her to go to an American Heart Association meeting in the States. "I did, and that experience changed my view on what nurses could do, and I came back to Australia thinking this is what I want to do. I knew I could make a difference," she says. "As a researcher you can shift the dial in terms of populations and give patients a real voice. But to be taken seriously, I had to have the same credibility as everyone around me."

She re-entered school to earn a PhD, which she received from the University of Newcastle in 2003.

For the next decade, Davidson worked to support individuals living with chronic conditions and to develop innovative models of transitional care. A primary objective of her work has been to improve the cardiovascular health of women and underserved populations through development of innovative, acceptable, and sustainable initiatives within Australia and beyond.

Davidson remains deeply interested in global health issues and serves as counsel general of the International Council on Women's Health Issues.

"I think the health and well-being of women, and their participation, really dictates the social agenda," Davidson says. "There is emerging evidence that female representation on boards and in business alters the dynamic and ethos of the way people work together."

Cheryl Dennison Himmelfarb, director of the School of Nursing's Office of Science and Innovation and an associate professor in the Department of Acute and Chronic Care, says that Davidson's work in cardiovascular research and palliative care in heart failure has been both innovative and groundbreaking. "She has really reframed the conversation on palliative care, not as an end-of-life death sentence but as an opportunity to make people as comfortable as possible and improve the quality of life," she says.

Himmelfarb first met Davidson when she visited Johns Hopkins in 2005 for a heart conference. Himmelfarb says what struck her about Davidson was how engaging she was, and giving of her time to share thoughts on research and nursing.

"I really connected with her. I'd known her by name through the literature and her reputation as a stellar researcher, but I was impressed by how amazingly warm and approachable she is," she says. "She can be quite disarming, and the way she connects with people is a real strength. She's a voice you want at the table."

Since her arrival at the School of Nursing, Davidson has focused on first getting a lay of the land, moving forward initiatives started by her predecessor, and working to lay out a vision for the school's future.

Some of her priorities are bettering the health outcomes of East Baltimore residents and forging an even deeper bond with the schools of Medicine and Public Health.

Michael Klag, dean of Public Health, says that Davidson reached out to him early and often during her first days in Baltimore. Klag says he was taken with her engaging personality and collaborative spirit.

"Maybe it's being Australian and having an island mentality, but she has a natural sense to partner with others and an openness to ideas," says Klag, who communicates with Davidson almost daily. "She's obviously very smart, but what I noticed in particular was how she created enthusiasm and is clearly open to new challenges. Her decision to come here from Australia demonstrates that."

Paul Rothman, dean of the School of Medicine and CEO of Johns Hopkins Medicine, served on the search committee that identified Davidson. Rothman says that he and other committee members enjoyed their interaction with Davidson and saw in her an effective leader.

"We thought she had a very thoughtful vision of where the nursing profession was going and how to lead the School of Nursing into the future," Rothman says. "She also brought an international view and unique set of experiences that could serve the university well, we thought."

Rothman, who also interacts with Davidson frequently, says that Davidson is an effective communicator, a great listener, and someone with boundless energy that should serve her well.

Davidson says she realizes that some had misgivings about the dean's position going to someone outside the country, and worked early on not to shy away from the issue. She would make jokes about it in meetings, and introduce herself as the new lady with the funny accent.

"University President Ron Daniels was brave and very visionary appointing someone international like me to this post," she says. "I think it's affirmation that we do live in a global world and we need to be international citizens. And I think Johns Hopkins has really led that way. What happens in East Baltimore has an effect throughout the world. People are people. People need to eat well. People love their families. People need to feel safe and secure. It's not a difficult formula."

In recent months, Davidson has focused on the launch of the school's new Master's Entry into Nursing program, which will enroll its first class in fall 2015. The program will emphasize leadership, global impact, quality and safety, and evidence-based interprofessional education in addition to offering innovative clinical opportunities. She also continues to champion the role of nursing any chance she gets, as evidenced by the letter she wrote to The Baltimore Sun this summer to discuss the critical and selfless role nurses are playing, and will continue to play, in addressing the Ebola outbreak.

As for what lies on her agenda in the coming months, Davidson says that she will continue to strategize and find ways to strengthen and augment an already strong education and research program. She's following, she says, the mantra of "if it ain't broke … ."

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