Submitted: 10 May 2014
Three interview sessions: 23 January 2014, 1 April 2014, 29 April 2014
Approximate total duration of 3 hours and 50 minutes.
Interviewer: Tacey A. Rosolowski, Ph.D.
For supplementary materials:
Please contact, the Historical Resources Center, Research Medical Library:
Javier Garza, MSIS, email@example.com
About the Interview Subject:
Dr. Summers (b. 4 March 1951, Aurora, Illinois) joined MD Anderson 1997 as clinical administrative director for the hematology clinical program. From 1997 to 2000 she served as the Administrative Director of the Department of Nursing. From 2000−2003 she served as Chief Nursing Officer and Associate Vice President of Clinical Programs. Since 2003 she has served as the Chief Nursing Officer and Head of the Division of Nursing. Dr. Summers is Professor and Chair of the Department of Nursing, a department she was instrumental in founding.
These sessions provide a detailed portrait of the activities of oncology nursing at MD Anderson and beyond as the field continues to define and theorize its contributions to patient care and healthcare institutions. Dr. Summers is deeply connected to MD Anderson. She is passionately articulate about the hope that the institution offers to patients and about the role that nurses serve in care.
Major Topics Covered:
A varied work and educational history
History of nursing practice
Development of leadership abilities
Activities and structure of the Division of Nursing at MD Anderson
Oncology nursing at MD Anderson
Development of nursing research
MD Anderson’s Magnet designation
The Nursing Congress
Primary Team Nursing
Professional Practice Mode
Creating the Department of Nursing
MD Anderson as a matrixed institution
Interview Session One: 23 January 2014
Inspired to Enter Nursing: An Altruistic and Intellectual Profession
Chapter 1 / Educational Path
The Theory and Advantages of Primary Nursing
Chapter 2/ Overview
A Focus on Primary Nursing
Chapter 3 / Professional Path
A Master’s Program Leads to Oncology and to an Interest in Pain Management
Chapter 4 / Educational Path
Thinking about Leadership; Nurses as Self-Care Agents
Chapter 5 / Professional Path
Learning the Complexities of Nursing Care
Chapter 6 / Professional Path
A ‘Hunger’ for Leadership; A View on the Independent Practice of Nursing
Chapter 7 / Professional Path
An Evolution of Leadership Experience
Chapter 8 / Professional Path
A PhD Program and a Theory of Nursing and Leadership
Chapter 9 / Professional Path
The NIH and an Opportunity to Support Research Nurses
Chapter 10 / The Researcher
An Opportunity to Work at a World-Class Institution
Chapter 11 / Joining MD Anderson/Coming to Texas
Interview Session Two: 1 April 2014
Joining an Institution that “Grabbed My Heart”
Chapter 12 / Joining MD Anderson/Coming to Texas
Roles as New Director of Nursing: Working with Growth in a Matrixed Organization
Chapter 13 / Building the Institution
Associate Vice President for Clinical Programs: Challenges and Views on Communication
Chapter 14 / The Administrator
As Chief Nursing Officer: MD Anderson’s Magnet Designation; the Nursing Practice Congress; Primary Team Nursing
Chapter 15 / Building the Institution
Challenges in Nursing Today: Building an Expert Workforce
Chapter 16 / The Administrator
Interview Session Three: 29 April 2014
An Absence of Women in Executive Leadership at MD Anderson
Chapter 17 / Diversity Issues
The Division of Nursing: An Overview, the Professional Practice Model, and the Development of Nursing as an Autonomous Field
Chapter 18 / An Institutional Unit
A History of Nursing at MD Anderson
Chapter 19 / Overview
Activities as Chief Nursing Officer; Creating a New Academic Department of Nursing; The Future of Nursing at MD Anderson
Chapter 20 / The Administrator
Promoting “Top of License” Nursing Practice; the Future of Nursing at MD Anderson
Chapter 21 / The Administrator
New Healthcare Delivery System; Nurses and Work with Patients and Families; the Future of Nursing
Chapter 22 / Building the Institution
Interview Session One: 23 January 2014 (listen/read)
Interview Identifier (listen/read)
Chapter 01 (Educational Path)
Inspired to Enter Nursing: An Altruistic and Intellectual Profession (listen/read)
Dr. Summers talks about her family and her mother’s influence as a role model. She sketches her educational background and her path to her first job in nursing.
Dr. Summers explains that nursing attracted her because it is an interactive profession where the nurse positively influences the experience of another human being. She also underscores that nursing is intellectually rigorous and demands critical thinking skills and the ability to pull together data.
She next traces her path to college (George Mason University, Fairfax, Virginia, BSN, 1978). She talks about working as a nurse throughout her program and the mentoring she received from the nurses at her job.
Chapter 2 (Overview)
The Theory and Advantages of Primary Nursing (listen/read)
Dr. Summers gives an overview of “primary nursing” and its development as a central concept in nursing. She also discusses its advantages for clinical practice and care of patients.
Chapter 3 (Professional Path)
A Focus on Primary Nursing (listen/read)
Dr. Summers observes that she started in nursing at a key point when primary nursing practice was also beginning, and she selected a hospital that focused in this new area, taking a job taking care of orthopedic surgery patients. She talks her job at a medical surgical ICU and the mentors who encouraged her to think about her career and future, particularly as a leader in nursing.
Chapter 4 (Educational Path)
A Master’s Program Leads to Oncology and to an Interest in Pain Management (listen/read)
Dr. Summers talks about the impact of her Master’s program on her nursing practice and her vision of her nursing career. She discusses her commitment to oncology nursing and providing “high intensity critical care” to patients and family members.
She sketches her work history and the impact of working in a chronic pain clinic (not related to oncology). She explains social attitudes toward pain and notes her own subspecialty interest in pain and pain management. She tells a story about successfully using multi-modality interventions to treat an oysterman who was very injured and couldn’t work.
Chapter 5 (Professional Path)
Thinking about Leadership and Nurses as Self-Care Agents (listen/read)
In this chapter, Dr. Summers describes the impact on her career of her Masters program (MSN, 1981, Advanced Clinical Practice) and her specialization in Advanced Clinical Practice. She explains what that practice meant at the time and how her work in this area helped give her grounding for leadership roles.
Dr. Summers explains Dorothea Orem’s theory that the role of a nurse is to support a patient in his/her return to optimal heath so they can perform self-care. She stresses that nurses work as partners in a patient’s healthcare: Dr. Summers gives examples of how this works in practice.
Dr. Summers next talks about how she learned to think differently in her graduate program about self-care and also how she began to realize that she could have more of an impact on care as a leader. Dr. Summers describes her leadership style as “transformational” in that she serves as a role model and inspires people to be at their best.
Chapter 6 (Professional Path)
Learning the Complexities of Nursing Care (listen/read)
Dr. Summers talks about working at the Greater Southeast Community Hospital after receiving her Master’s. At this inner city hospital she focused on oncology and pain management and worked with great oncologists and physicians. She talks about the impact of working with patients in extreme poverty. She also recalls being nicknamed “LP” for Leader of the Pack –indication that her leadership impulse showed—and she started to see the impact she might have on nursing from a position of leadership.
Chapter 7 (Professional Path)
A ‘Hunger’ for Leadership; A View on the Independent Practice of Nursing (listen/read)
Dr. Summers begins this chapter by giving credit to JoAnn Duffy, who taught her many leadership lessons. Dr. Summers talks about different kinds of power. She recalls her involvement in an innovative and eye-opening initiative undertaken at Greater Southeast Community Hospital: a collaborative practice established between nurses and physicians, a first step in recognizing that nurses are not mere “doctor helpers.”
Chapter 8 (Professional Path)
An Evolution of Leadership Experience (listen/read)
Dr. Summers recalls that she had a “hunger for exploring management” and jumped at the opportunity when a position opened in Hematology at Fairfax Hospital. Dr. Summers explains why she was hired and also recalls that she had to teach herself management as there were no books available at the time. She describes the many functions she had to learn and how they became fascinating problems for her.
Dr. Summers observes that she has a pattern of taking on positions that demand confidence and competence and she meets them with confidence and sometimes less competence going in than is comfortable for her. Dr. Summers talks about her pattern of taking on positions that demand confidence and competence.
Dr. Summers gives examples and talks about learning lessons about management people. She then talks about her promotion to the Director of Nursing, which gave her responsibility for many inpatient units as well as for managing leaders. She then talks about her principles for leading managers and leaders to perform at their best.
Dr. Summers says that her habit of moving to leadership positions without having all the skills for the job is an “illness.” (She says she identifies with an article she read on “The Imposter Syndrome.”) She is constantly driven to perform at higher levels and notes that she made her moves when wanted to do something different. She is good at identifying new opportunities, not at maintaining an institution’s status quo.
Chapter 9 (Professional Path)
A PhD Program and a Theory of Nursing and Leadership (listen/read)
In this chapter, Dr. Summers notes that she was Director of the Department of Nursing at Inova Fairfax Hospitals for about a year when she felt she was losing her ability for sharp thinking. She decided to go back to school for her Ph.D (though she was still working; Ph.D. Health Care Administration, 1995). She talks about the struggle to get back in the habit of reading and synthesizing information. She also re-evaluated the stresses in her life and moved into a lower intensity job as a nurse educator while she was in her graduate program. Dr. Summers then talks about the ideas she encountered in this program: James Burn’s theory of transformational leadership and Jean Watson’s human caring theory. She saw crossovers between the two and ended up writing her dissertation on this subject.
Chapter 10 (The Researcher)
The NIH and an Opportunity to Support Research Nurses (listen/read)
In this chapter, Dr. Summers explains that she was recruited for NIH Clinical Services to develop cancer nursing research programs for research nurses. Dr. Summers explains Jean Watson’s care theory in greater detail and talks about its connections with transformational leadership. She then goes on to talk about her role at the NCI (where she arrived “knowing zip”): she developed a program to support research nurses proposing their own research projects.
Dr. Summers gives an example of a project proposed by a nurse on drawing blood. This demonstrates how a nurse brings a unique perspective to care situations and the issues/questions they raise can be quantified to improve care for all patients.
Dr. Summers next observes that she was a member of the Institutional Review Board at the NIH and learned a great deal about clinical research.
Chapter 11 (Joining MD Anderson/Coming to Texas)
An Opportunity to Work at a World-Class Institution (listen/read)
In this chapter, Dr. Summers explains that after her experience at the NIH, she took a position in the Clinical Center which presented her with a whole new learning curve. At this point, a recruiter called her about a position at MD Anderson. She tells the story of her interaction with the recruiter and explains that she was interested as a new position would allow her to put her dissertation research into practice.
Interview Session Two: 1 April 2014 (listen/read)
Interview Identifier (listen/read)
Chapter 12 (Joining MD Anderson/Coming to Texas)
Joining an Institution that “Grabbed My Heart” (listen/read)
Here Dr. Summers explains how she joined MD Anderson. She recalls getting a call from a recruiter, but was not really paying attention until she heard the name, “MD Anderson,” and said, “Wait, can you repeat all of that?” Dr. Summers expresses how important it was to be offered an opportunity to work at this institution. She then describes the early interview and how she came to the decision to try for the position at MD Anderson.
Dr. Summers recalls coming to MD Anderson and standing for the first time in the lobby of the Clark Clinic. She describes how what she saw “grabbed my heard and it hasn’t let go of me.” She recalls sensing hope at the institution. She recalls her meetings with people and her sense that people came to work at MD Anderson specifically because of their commitment to the mission. She notes that even employees not directly related to research or patient care were somehow driven by a sense that they were contributing to the mission, and that “anyone can be instrumental” in forwarding that mission. Dr. Summers notes that even though sad events occur at MD Anderson, but it is a hopeful and joyful place with patients who have a great generosity of spirit.
Dr. Summers continues talking about her interview process and describes the scope of the role she was to take on as Director of Nursing as well as the four week transition period in which she finalized her work at the NIH and came to Houston.
Chapter 13 (Building the Institution)
Roles as New Director of Nursing: Working with Growth in a Matrixed Organization (listen/read)
Dr. Summers begins with an overview of what she learned about leadership in her new role as Director of Nursing as she adjusted to the peculiarities of the institutional structure.
She talks about the institution’s organization in matrices, compares it to other institutions, nad notes that at MD Anderson “a lot of what we do seems to happen by magic.” She describes the challenges that arise from this structure at MD Anderson.
Dr. Summers next talks about the projects she worked on as the new Director of Nursing including the Mays Clinic and Alkek Hospital addition. She offers an example of how a MD Anderson decision-making proceeds and shares her leadership lessons.
She talks about the financial clarity that Dr. Leon Leach brought to the institution as the new Chief Financial Officer.
Dr. Summers also sketches how she developed a Professional Nursing Practice initiative. Dr. Summers says that she saw her role as providing the environment where nurses could excel.
Chapter 14 (The Administrator)
Associate Vice President for Clinical Programs: Challenges and Views on Communication (listen/read)
In this chapter, Dr. Summers sketches her three-year role as Associate Vice President for Clinical Programs. She explains that the role intrigued her because it focused on high-level organizational issues. She talks about working with Physician-in-Chief, Dr. David Callendar and comments on the matrix organization of MD Anderson.
Dr. Summers next reflects on leadership and tells stories of leadership lessons she learned. She explains that MD Anderson is different from other organizations because of its clinical leaders. She also revisits the issue of the matrix structure in the organization, stressing that there is no infrastructure to engage physician leaders as well as the rank and file.
Dr. Summers recalls leadership feedback she received from Dr. David Callendar.
Chapter 15 (Building the Institution)
Projects as Chief Nursing Officer: MD Anderson’s Magnet Designation; the Nursing Practice Congress; Primary Team Nursing (listen/read)
Dr. Summers talks about accepting the challenging position of Chief Nursing Officer. She notes that MD Anderson was in the process of preparing for its re-designation as a Magnet Institution (by the American Nurses’ Credentialing Center).
Dr. Summers explains why the Magnet designation is important to MD Anderson and describes how this designation supports the practice of transformational leadership. She explains that it connects to her role as Chief Nursing Officer and her goal of creating an environment in which nurses are in charge of decisions about practice.
Dr. Summers next talks about the Nursing Practice Congress and the model of Primary Team Nursing model she developed at MD Anderson. She explains how this involves scheduling nursing activities for an entire team and lists the benefits of this model for patients, the institution, and for team members.
Chapter 16 (The Administrator)
Challenges in Nursing Today: Building an Expert Workforce (listen/read)
In this chapter, Dr. Summers lists challenges she must address as Chief Nursing Officer. First she explains how she had addressed the lack of leadership succession planning when she took on the CNO role. Next she talks about establishing the “Launch into Nursing” program to provide orientation for newly graduated .
Next Dr. Summers talks about the current nursing shortage and the challenge this presents to building a qualified and expert workforce for the future. Dr. Summers describes her job as creating an environment for nursing practice that will attract the best and the brightest and also retain senior women. She also explains efforts underway to ensure that nurses perform at the top of their license.
At the end of this session, Dr. Summers speaks about the future of nursing.
Interview Session Three: 29 April 2014 (listen/read)
Interview Identifier (listen/read)
Chapter 17 (Diversity Issues)
An Absence of Women in Executive Leadership at MD Anderson (listen/read)
In this chapter, Dr. Summers observes that since her arrival at MD Anderson, there has been little progress in promoting women and minorities above the level of vice president: executive leadership continues to be white and male. She explains that the impediment seems to be a lack of self-awareness, and offers some examples of interactions that show how senior leadership does not see a problem. She observes that there is a similar problem in promoting women faculty and notes Dr. Elizabeth Travis’ work (Women Faculty Programs [Oral History Interview]) to advocate for women. Dr. Summers explains why the absence of women in leadership limits MD Anderson’s success. She also notes that, in other cancer centers, women serve as senior executives and MD Anderson is an anomaly, even among Houston institutions.
Chapter 18 (An Institutional Unit)
The Division of Nursing: An Overview, the Professional Practice Model, and the Development of Nursing as an Autonomous Field (listen/read)
Dr. Summers describes the organization of the Division of Nursing and major projects undertaken since she assumed leadership in 2003 to ensure that all membered are appropriately licensed and credentialed and that they are always developing nursing practice.
Next she speaks in detail about the Professional Practice Model refering to the “quality care model” depicted in an image produced for the Division. (See transcript for image used during this discussion.) She talks about elements of primary team nursing; self-awareness; professional partnerships; and professional recognition.
Dr. Summers also explains what “achieving autonomy” means for professional nursing and why it is so important to the development of the field. She sketches some of the history of nursing.
Dr. Summers goes on to explain how a team at MD Anderson created the model, revising a practice model in place when she took over the Division. She unique working environment for nurses at MD Anderson and sketches the varied areas in which they function.
Chapter 19 (Overview)
A History of Nursing at MD Anderson (listen/read)
In this chapter, Dr. Summers sketches the history of nursing at MD Anderson, beginning with the work of Renilda Hilkemeyer (interviewed for OHP). She discusses the contributions of former Nursing directors Joyce Alt and John Crosley, who led MD Anderson to its first Magnet designation.
Chapter 20 (The Administrator)
Activities as Chief Nursing Officer; Creating a New Academic Department of Nursing; The Future of Nursing at MD Anderson (listen/read)
Dr. Summers talks about her activities as Chief Nursing Officer (CNO) and Chair of the Department of Nursing, and offers her views on the futures of the Department and Division of Nursing.
She first talks about her appointment to the position of CNO in 2003 and sketches her main activities to develop patient care, the Professional Practice Model, the Clinical Nurse Advancement Program and the Nursing Practice Congress. She ensured that MD Anderson has Ph.D..
Next Dr. Summers explains a legacy she feels she is building: faculty hires in a new Department of Nursing to create an academic Department of Nursing equivalent in status to other departments. She observes that the creation of the Department of Nursing was not controversial. She offers her views on the future of the Department of Nursing.
Chapter 21 (The Administrator)
Promoting “Top of License” Nursing Practice; the Future of Nursing at MD Anderson (listen/read)
In this chapter, Dr. Summers talks about the future of the Division of Nursing. She explains the importance of ensuring that nurses are practicing at the “top of license,” noting that in the future nurses will work as coordinators of care. She explains some of the resistance she anticipates from stakeholders and nurses as the role of nurses changes and they are not available to perform roles (that are not “top of license”) currently expected of them. She notes that this change in nurses’ roles will transform MD Anderson culture.
Chapter 22 (Building the Institution)
New Healthcare Delivery System; Nurses and Work with Patients and Families; the Future of Nursing (listen/read)
Dr. Summers offers her views on how changes in the healthcare delivery system are affecting the institution and influencing changes in the practice of nursing.
She first sketches the financial pressures and “mindboggling” challenges of the current healthcare environment.
Dr. Summers goes on to describe the ways that nurses are uniquely positioned to attend to patients and families because of their education and roles in care.
[the recorder is paused briefly]
She then describes the institution-level Patient and Family Experience Executive Committee and notes ways she had already been addressing family issues.
Dr. Summers explains how she is addressing value-based care by focusing on clinical teams.
Dr. Summers next talks about the next steps for the field of nursing.
Dr. Summers concludes with words about how she would like to be remembered.
This interview with Dr. Barbara Summers (b. 4 March 1951, Aurora, Illinois) takes place over three interview sessions conducted in spring 2014 (for an approximate total duration of 3 hours and 50 minutes). Dr. Summers joined MD Anderson 1997 as clinical administrative director for the hematology clinical program. She is currently Vice President of Nursing Practice and also serves as the Chief Nursing Officer and Head of the Division of Nursing. Dr. Summers is Professor and Chair of the Department of Nursing, a department she was instrumental in founding. This interview takes place in Dr. Summers’ office in Pickens Academic Tower on the Main Campus of MD Anderson. Tacey A. Rosolowski, Ph.D. is the interviewer.
Dr. Summers received her BSN in Nursing in 1978 from George Mason University in Fairfax, Virginia. Continuing her education at the same institution, she received her MSN in 1981 in Advanced Clinical Practice and her PHD in Health Care Administration in 1995. Dr. Summers Just prior to coming to MD Anderson, Dr. Summers worked as a Nurse Specialist in the Department of Nursing at National Institutes of Health, Warren Grant Magnuson Clinical Center in Bethesda, Maryland (1993−1996). From 1996−1997, she served as Manager of the Department of Nursing at that institution, during which time she was recruited to MD Anderson. From 1997 to 2000 she served as the Administrative Director of the Department of Nursing. From 2000−2003 she served as Chief Nursing Officer and Associate Vice President of Clinical Programs. Since 2003 she has served as Vice President and Chief Nursing Officer and Head of the Division of Nursing.
In this interview, Dr. Summers traces the evolution of her thinking about nursing through her varied work and educational history: throughout, she comments on the evolution of nursing practice as a field and her own desire to have an impact at this level of professional practice. Her narrative of experiences at MD Anderson include detailed descriptions of the activities and structure of the Division of Nursing and her mission to develop not only nursing care at MD Anderson, but the stature of oncology nursing as a unique professional practice at MD Anderson. She speaks about MD Anderson’s Magnet designation, the Nursing Congress, Primary Team Nursing, and the Professional Practice Model, all which have evolved significantly under her leadership. She also tells how she created the Department of Nursing. Implicit in her discussions is the history of nursing’s evolution as a complex and autonomous professional practice (an important theme in the light of still-enduring notions that nurses are “doctors’ helpers.”)
This interview expands the understanding of the role of nurses and oncology nurses on patient care teams and in complex healthcare institutions. Her narrative provides a portrait of a woman who felt the impulse to lead very quickly and turned her skills to developing the practice of nursing. As her career has unfolded simultaneously with theoretical and practical advances in the field of nursing, her experiences provide a demonstration of evolution in the field. She also comments on her growth as a leader within different administrative structures: she provides insight into MD Anderson’s matrixed structure. These sessions provide a detailed portrait of the activities of oncology nursing, a field that continues to work to define and theorize its contributions to patient care and healthcare institutions. Dr. Summers is deeply connected to MD Anderson. She is passionately articulate about the hope that the institution offers to patients and about the role that nurses serve in care.