Madeline Wake, on nursing and academics

By Bree LeMaire, MS, RN
October 16, 2003

How did you move from nursing to being a chief academic officer?

I've always loved nursing and have clung to my nursing identity. Nursing has been exceptional preparation for my provost role. First, nurses are problem solvers. I apply analytical abilities to any new complex challenge. Second, my relationship skills are beneficial to this leadership position. Third, the nursing habit of beginning from the patient or client's value set is incredibly important. In academic life, every discipline has its own worldview. As a nurse, I have learned to notice and work within the context of another's perspective.

How did you get into nursing and academics?

I'd always been interested in science and wanted a life's work where I could make a difference. There was a faculty member at St. Francis who always talked about the science of nursing when it wasn't typical to speak of the "science" of nursing as opposed to a set of skills. That was what I wanted.

I came to academics after being a clinical nurse specialist in cardiac and diabetes care. In that role, I did a lot of teaching. I liked the marriage of nursing and teaching and came to Marquette in 1977.

What is your favorite teaching memory?

One of the ideas I developed for the senior nursing students was the concept of "classroom shared governance." This course on nursing trends was subtitled "tools for the revolution" and addressed how we could shape nursing to meet the needs of the future. Students decided on class topics, evaluation methods and learning designs. The goal was to prepare students for joint decision-making within a clinical setting.

One year, the students presented a 50-page paper on revision of the curriculum. Many of their proposals were adopted. The class was a lot of fun to teach as it empowered the students and demonstrated how partnering could produce excellent results.

What are the most important components of an effective nursing department?

The focus has to be on the patient. The system must offer professional nurses the freedom to deliver care in whatever means makes the best sense for patients and health outcomes. While finances matter, the best bottom line is to look first at patient needs and meet them in solid ways.

What nursing boundaries need to be challenged?

We definitely have to look at nursing roles and work in light of the shortage. We have to look at the way nurses can make the biggest difference in terms of improving the health of the population. Changes in practice and education will follow.

Nurses in any setting spend time doing things that don't need a high level of preparation (such as paperwork) when we need to be involved in diagnosis and treatment of human responses to health and illness. We have to redesign a system that supports the professional practice of nursing. This means making more time and space for nursing to be available for intellectual and holistic efforts.

What is necessary so nurses have the most up-to-date knowledge and skills?

It's essential to have an individual professional who knows how to learn, to evaluate information and to judge its worth. Continuing education has to be more than just a program, but has to have connecting content that is practically oriented and not just theoretical.

What is the Wisconsin redesign program?

This is a statewide response to the nursing shortage. The senior VP at Covenant Healthcare and the senior VP at Aurora Health Care, the dean of nursing at Marquette and the dean at the University of Wisconsin-Milwaukee in nursing started it more than two years ago. All are nurses. We set aside any competition and territorial considerations and focused on the "work of nursing" and health care delivery. Much the same as what I said about nursing boundaries, we look at how to define what nurses do within the workforce.

Anything special you'd like to add?

I immerse myself in any job I have, but at the heart of it all, I'm still a nurse. Sometimes I miss my nursing colleagues. I know nurses who have become a circuit court judge, a business owner and a legislator, and we all say we miss our nursing contacts. I cherish the fact that nursing is my profession. My day-to-day work may be administrative, but I know nursing has given me this incredible foundation of skills and gifts to bring to different arenas.