As a healthcare leader and a viable part of a fast-growing city, St. Lucie Medical Center has always looked for innovative ways to meet the healthcare needs in its community. Inspired by the 12-bed hospital model at Baptist Healthcare System in Miami, St. Lucie Medical Center is reorganizing its nursing delivery model.

St. Lucie has updated its delivery model to incorporate professional nurses at the bedside whose main focus is integrating evidence-based practice in a way that compliments medical care as well as the individual needs of the patient and family. In partnership with Florida Atlantic University, through the American Association of Colleges of Nursing (AACN), a curriculum was pioneered that is designed to develop Clinical Nurse Leaders (CNLs). CNLs are masters’ prepared nurses whose curriculum focuses on advanced clinical assessment skills and provides participants with the knowledge base required to assist patients and families as they move through today’s very complex continuum of care.

St. Lucie Medical Center recognizes the value of the CNL role and made the decision to implement the project on two units prior to the CNLs graduation. It is not a simple process to change the care delivery process. It takes examining your nursing philosophy and principles and being willing to take a risk. However, the program is expected to yield many advantages including a decrease in RN turnover, patient length of stay and patient complications, while increasing focus on evidence-based nursing practice.

St. Lucie Medical Center is already witnessing significant impact in patient outcomes, the continuity of care and patient, physician and nurse satisfaction. It is also seeing improved core measure results and improved communication between attending physicians and consultants. In addition, the pilot units had no core vacancies due to nursing recruits and did not need to use nursing agency staff.



The evolution of nursing staff development takes us from its roots in hospital based diploma nursing programs to the present wide range of services offered. Just as Joint Commission requires seamless continuum of care evident via documentation in the medical record, it also requires consistent processes for staff education, evident via documentation in the employee file.

Nearly ten years ago Nowicki (1998) made twenty one predictions for nursing staff development:

  1. Change will be constant in our future.
  2. Traditional ways of thinking will be challenged and become obsolete.
  3. Organizations and departments will continue to restructure their operations to focus on quality and customer service.
  4. A majority of healthcare workers will be grouped into some form of a team to most effectively accomplish their work.
  5. Empowerment will lead staff to higher levels of responsibility, accountability, and ownership of their jobs.
  6. Leadership development will be a critical ingredient in the overall success of an organization.
  7. The paradigm of a traditional staff development department will become obsolete. While staff development will always be needed and present in organizations, it will be integrated in ways we have yet to imagine.
  8. Roles for staff development educators will be redefined, but they will continue to exist.
  9. Educators will need their own network of support.
  10. Collaborative relationships with educators from various practice settings will begin to bridge the gas among academia, business, and community education.
  11. Educators will become increasingly recognized as experts of the education process and facilitators of learning.
  12. Educators will spend an increasing amount of time developing educational opportunities for advanced level practitioners.
  13. Greater emphasis will be placed on the value of life experiences in addition to formal education.
  14. The days of providing “nice to know” information will be gone forever.
  15. Traditional methods of evaluating learning will take a back seat to more innovative, efficient and effective ways.
  16. Patients and their families will demand quick, yet comprehensive education to understand their health problem and how to manage it.
  17. Education will play a major role in understanding and valuing cultural diversity.
  18. Everyone will need sophisticated computer skills.
  19. Technology will explode and create numerous avenues for learning.
  20. A vast majority of nurses will belong to specialty nursing organizations and be certified in at least one specialty.
  21. Political involvement will continue to be a vital link in creating our future.

Sound familiar? While nurses usually make up the largest group in a healthcare facility, all staff deserves equal consideration. Many adults are returning to school, expect to advance in their careers, and value educational benefits offered at work. Recruitment, retention and employee satisfaction, as well as the competition must be considered when evaluating educational benefits.

Parker and Asselin (2004) beckoned the nurse educator to study forces that require change, a transition from a nursing focused to a hospital-wide education department. Examples of external forces include state and agency regulation (ex. facility inspections, re-licensure requirements, Medicare guidelines) Joint Commission accreditation and regional student clinical placement needs. Determination of internal forces requires an assessment of the nursing education department’s alignment with organization goals, organizational structure, and educational needs of clinical and non-clinical staff, competency assessment, facility expansion, committee participation, and patient care issues. Defining hospital wide education needs to be determined. Once the advantages of a transition are identified, planning strategies may follow which include consideration of department resources, collaboration among key departments including Human Resources and Information Services, and close contact between educators and management and staff.

Opportunities are plentiful for the staff development specialist to impact the workplace. The dynamic pace of today’s healthcare environment is fertile ground for providing services that benefit both staff and the organization’s present needs and future challenges in education. Administrators and educators in South Florida hold the keys to enact these possibilities.



The College of Medicine currently evolving at Florida International University (FIU) is a new and exciting development for the healthcare community, and for South Florida, in more ways than one. When it admits its inaugural class in 2009, the nascent college will be the fourth allopathic medical school in the state and one of just 127 in the United States. As a public school with state financial support, it will make medical school affordable for qualified prospective students from every segment of the community, and will have a significant positive impact on access to healthcare for the region’s underserved populations. By boosting biomedical industries, it will eventually generate thousands of new jobs for the region and is expected to add $78 million to state assets.

Perhaps most significantly, the FIU College of Medicine represents a dramatic and visionary departure from traditional medical schools in its curriculum, philosophy and relationship to the community.

John Rock, M.D., founding dean of the College of Medicine, says that the conceptual foundation of the new medical school is an innovative program called Medicine and Society that will serve as a model for 21st century medical education. “We have a special curriculum that we are very excited about,” he says. “Medicine and Society means that we place enormous emphasis on the community. Right from the beginning of their medical education, and throughout the four year program, students will serve on interdisciplinary teams. These teams of medical, nursing, social work and public health students will ‘adopt’ households in selected neighborhoods and address all the health needs of those families. When appropriate, most topics we teach will be in reference to the neighborhoods; clinical and classroom experiences will integrate that experience. Students will learn team building and those skills will carry over into the clinical settings.”

Rock says that the goal of the groundbreaking program is ultimately to improve quality of life in the neighborhoods. “We will bring the resources and power of the entire university to the targeted neighborhoods. While many medical schools have community health experiences, none have the scope or depth of this program.” The emphasis on community is not restricted to the medical school curriculum. FIU is a public university and the College of Medicine will reflect the mission, engaging the community in multiple ways, including recruitment of students from the region, partnerships with existing community institutions and a focus on the cultural diversity of the region.

“Recruitment of students from South Florida is essential to solving the physician shortage,” says Rock. “We need medical students to be invested in staying here. We hope that our strong emphasis on community health and cultural diversity, and training in primary care, will encourage our graduates to remain here. Right now, only one quarter of medical students trained in South Florida practice here.”

Appreciation of the South Florida cultural climate is another distinctive aspect of the College of Medicine approach. Rock says the school will produce culturally competent physicians who will demonstrate sensitivity to the complexity of the regions diverse groups and an awareness of the health issues particular to each. He speaks of this as a “celebration” of the region’s multicultural landscape.

Efforts to establish the new medical school began at FIU in 2004. The Florida legislature and Board of Governors granted approval for the school in 2006, and Rock was brought on board as dean earlier this year. He has been busy recruiting the faculty, developing the curriculum and research programs and preparing for accreditation. Rock has a stellar background in both medical education and public health and most recently served as chancellor and chief executive officer for Louisiana State University (LSU) Health Sciences Center, where he established the School of Public Health. Rock also oversaw the statewide Charity Hospital System in Louisiana. He is board certified in reproductive endocrinology and is the author of over 250 publications and 83 chapter and textbooks.

Pending approval from the Liaison Committee for Medical Education (LCME), the College of Medicine will begin accepting applications next year for its inaugural class of 40 students. LCME made a site visit in November and it is anticipated that provisional accreditation will be granted soon. The College of Medicine will be based within the FIU Life Sciences Complex at University Park.

FIU has signed an operating agreement with Jackson Health System that will make Jackson North the regions newest teaching hospital. According to Rock, “Jackson North will be our medical home. Part of our mission is to help hospitals advance their own missions, through residency programs. We look forward to partnering with the community’s hospitals, building bridges that will enable us to provide quality public medical education and improved health care for South Florida.”



Florida International University (FIU) College of Nursing & Health Sciences (CNHS) celebrated the graduation of its very first PhD in Nursing student when J. Craig Phillips, LLM, MSN, ARNP, BC, ACRN, received his diploma at FIU’s Spring graduation commencement ceremonies on April 29, 2008.

Phillips may now add PhD to his credentials after successfully defending his dissertation, Social Factors Influencing Antiretroviral Therapy Adherence Among Black Men Living With HIV Who Use Illicit Drugs. Phillips knew he wanted to be a nurse researcher since he first started his nursing career. In particular, he was interested in studying health disparities among minority populations. Not only was he adamant about pursuing his doctoral nursing degree, but of doing so at FIU. “While I was working on my master’s nursing degree here, there was talk of launching the PhD [in Nursing] program. Considering that I had already built strong working relationships with my graduate nursing professors, coupled with FIU’s reputation as a leader in minority-related studies, I decided to wait until the PhD in Nursing program was established at the CNHS. This was my one-and-only choice.”

His doctoral degree is the culmination of a highly successful academic career at FIU CNHS. Phillips was awarded both a research grant and the 2007 Gloria Smith, RN Scholar designation from the American Nurses Foundation for his dissertation project – two highly prestigious national achievements that are rarely bestowed to doctoral students. FIU Nursing also honored Dr. Phillips, a 1999 Master of Science of Nursing graduate from the program, as a Top 25 Outstanding Alumni for his professional achievements when it celebrated its 25th Anniversary last year.

Phillips, who also holds a Master of Laws (LLM) degree from St. Thomas University School of Law (Miami, Fla.), is a Clinical Nurse Specialist/Coordinator of Research for Mercy Hospital in Miami,

Fla. He uses his legal and nursing practice experiences to help develop and implement aggression control programs, policies and procedures to assure patient and staff safety when dealing with a broad range of behavioral issues from suicide prevention to management of patients in acute psychiatric crisis situations.

Besides his work with Mercy, Phillips served as co-chair for the Association of Nurses in AIDS Care Scope and Standards Task Force, where he collaborated with leaders in the field of HIV to develop the scope and standards of HIV/AIDS nursing care, which has been published by the American Nurses Association. Phillips is currently also an Adjunct Clinical Professor in Community and Mental Health Nursing for the CNHS, and Director of Clinical Research Operations for FIU Stempel School of Pubic Health.

Phillips remarked on being the first graduate of FIU’s PhD in Nursing program, “I am both proud and honored to have this distinction. Not just because of what it means to me personally, but more so because of what it means to the College. Faculty members and administrators gave so much of themselves to get this program off the ground and make it a success. My graduation represents their countless efforts and unwavering commitment to make this a top caliber program.”

Divina Grossman, PhD, RN, ARNP, FAAN, Dean of the College commented, “We could not have asked for a better pioneer graduate from our young PhD program. Dr. Phillips is an accomplished nursing professional and a fine example of the high caliber of graduates from the CNHS. We congratulate him and commend his professors Dr. Dorothy Brooten, Dr. JoAnne Youngblut and Dr. Sandra Gracia-Jones.”

Dr. Phillips will continue in his nursing research endeavors, having accepted a faculty position with the School of Nursing at the University of British Columbia in Canada.

FIU’s PhD in Nursing program was approved by the Florida Board of Governors in October 2003, and was launched in the Fall of the following year. The program was developed in direct response to two key issues affecting the development of nursing education and the profession’s role in the healthcare system: (1) the shortage of doctorally prepared nursing faculty – a deficit which impedes the ability of academic nursing programs to increase capacity in response to the nursing shortage; and (2) the need for more nurse scientists to conduct research on health disparities and the needs of minority populations experiencing disproportionate morbidity and mortality from all causes.



Jackson Health System’s Administrative Fellowship program is still going strong and accepting applications for the 2009 program through February 13th. The program helps graduates gain experience in healthcare administration by providing opportunities for them to work with existing JHS administrators for more than a year.

The first four fellows who completed the program remain with JHS in key positions: Laura Gomez is director of operations for Jackson Memorial Hospital; Melissa Harriott is a senior planner for JHS Business Development; Tabassum Khan is director of Physician Services; and Rashard Johnson is director of operations for Holtz Children’s Hospital and the JMH Women’s Hospital Center. Janelys Hernandez, the current fellow, began the Operations Track last Fall.

As an academic health system, Jackson has offered fellowships, residencies and internships for physicians, nurses and other clinicians for several decades. The Administrative Fellowship program, launched in August 2006 as part of the system’s leadership development initiative, compliments the clinical programs and the system’s strategic vision and mission. It is also another way Jackson gives back to the community. The program has been extended from 12 to 18 months to ensure the graduates gain an in-depth learning experience in healthcare administration while completing critical project assignments across the organization in various rotations.

Applicants can apply for the 2009 program by completing the necessary forms on Jackson’s Web site at www.jhsmiami.org. Prospects must demonstrate scholastic capability with at least a 3.0 GPA. They must also have exceptional leadership, communication and analytical skills as well as a high level of learning agility with internship experience.