Q&A with Dr. Cynthia Cleveland (DNP 2010)

Cynthia Cleveland 2019 sm (1)Birmingham VA Health Care System’s Associate Director for Patient/Nursing Services Cynthia Cleveland, DNP, RN, NE-BC, is a 2010 graduate of the UAB School of Nursing Doctor of Nursing Practice Pathway. She joined the Birmingham VA 25 years ago and was appointed as Associate Director for Patient Care/Nursing Services in June 2013. We recently sat down with her to discuss her journey to nursing, a passion for care and the impact her DNP had on her career.

What was your journey to nursing?

From high school, I thought I wanted to be a medical technologist, working in a lab had interest to me. I went to college to pursue a degree in biology, and I took a little detour because I got a lucrative job. When you’re 20 and people throw money at you, it looks like, “Hey this is what I’m going to do for the rest of my life!” I thought it was going to sustain me, but it wasn’t fulfilling, and I realized I needed a long-term plan, so I entered nursing school.

The reason I decided on nursing school is at the time, I had elderly grandparents and my mother and father were their primary caregivers. But I so enjoyed taking care of them, and I realized that I had a calling for providing care to patients or to people.

I went into nursing school really with a desire to help people. I thought a lot about working in a  lab, but then I realized I would miss that human interaction. My decision to go into nursing was based on my experience as a young adult, and then that experience of how it made me feel, being able to help people.

When you are growing up, you think “It’s all about me,” but then as you mature you realize it’s about others as well. Being in a profession that centers around caring and giving and being compassionate was what attracted me to nursing. Looking back on my 25 years as a nurse, I could not think of a more rewarding career for me. I have no regrets. I tell people that when they go into the role of being a nurse, it is hard work, but at the end of the day you feel you have made a difference. The impact of being a nurse has sustained me personally and professionally, and it’s a role that I would encourage anyone to pursue if they have a genuine interest in helping and supporting others.

 

What led you to pursue additional degrees, including a certificate in Nursing Service Administration and your doctoral studies in Healthcare Systems Administration?

I started nursing with a two-year degree, an associate degree from Lawson State Community College. I had a great experience at Lawson, but when I joined the Birmingham VA Health Care System, I had an aspiration to go into management. Hence, I knew I would have to pursue a higher degree. I really enjoyed being a floor nurse and working directly with patients, but I had a longing to be able to do more. I did not feel empowered as a staff nurse, and I wanted to be part of change that had overarching effects on care delivery.

At that time, as it does now, the VA offered educational support to go back to school. I took advantage of the opportunity and completed my bachelor and master’s degrees. When I got into management, I recognized that I needed a certification in health administration. After much studying I was certified as a health administrator. Because I wanted to know all I could know about strategic planning, budgeting and how to run a hospital I decided to pursue my doctorate. My goal was to be a well-rounded and educated hospital administrator. My DNP educator assisted me to meet my goal.

 

Why did you choose UAB for your DNP, and how did your DNP from UAB School of Nursing prepare you?

The doctorate program gave me a chance not only to look at the clinical side of the house, but also to look at the administrative side of the house — working with budgets, contracting, and strategic planning. I was exposed to a lot in my doctoral program.

I was required to have a DNP project, which was a project that I am proud to tell you 10 years later is still in place at the Birmingham VA Health Care System. My DNP project was called CAT, Critical Assessment Team, an early warning team that responds to early warning signs with the goal of intervening before a patient deteriorates or goes into a full cardiac or respiratory arrest. I felt like there were always precursors to a patient’s condition deteriorating and there was a window of time where there could be early intervention(s) to improve patient outcomes.

The CAT is still called the CAT ten years later and the positive patient outcomes are numerous. I take a lot of pride in that because it was just a project at that time, but the project evolved into so much more. I would not have met the goals for my DNP project or lead a project of this magnitude without the support from my DNP instructors.

In addition to that project, I really feel like that the UAB program pushed me to look outside of what was the norm and really pushed me to say, “There are things out there that we can do better as a nursing professional.” At UAB I felt like I was part of a community of life-long learners with the goal of improving the delivery of care. I also had the best academic advisor, Dr. Patricia Patrician, who really challenged and assisted me and recognized that I was an adult learner. She held me accountable to my work but understood there were some constraints working a full-time job and having a family. At the time, I did not understand the impact the DNP program would have on my life. I didn’t really take into consideration how it would change my way of thinking. My goal was to be a nursing leader and to lead by example, but the DNP helped me critically think about what was happening at the VA, how to apply evidence to make changes, and it really opened my eyes to the world.

 

What led you to the VA and a passion for Veteran’s care?

What’s interesting is I never really considered the VA when I graduated from Nursing School. I had accepted a scholarship with Children’s Hospital, and my goal was to work at Children’s because I love babies. But upon graduation, there was not a position available for me.

My cousin worked at the Birmingham VA for 20 + years as a nurse, and I talked with her about her experience and she shared a lot of insight into the VA as a health care system, shared with me the mission of the VA and just gave me a good recap of her career. Listening to her, I saw it was more than just a job to her — it was a passion. And I thought, “I want that passion. I want to be part of an organization where I can’t wait to get to work.”

I applied and was hired. I have stayed with the VA for 25 years because of the mission. It’s a very humble mission to care for our Veterans who have sacrificed so much. I think about my family members who have retired from the military and those who are currently serving every time I make a critical decision. Knowing I am making a difference in the life of someone, and in this case Veterans, through our many programs and through outstanding health care delivery, continues to drive me forward. That’s a mission I hold near and dear to my heart.

 

The UAB School of Nursing and VA work together to provide opportunities for nursing students and graduates. How does this partnership benefit nurses as well as Veterans?

The partnership between the UAB School of Nursing and Birmingham VA Health Care System has been a model for the country. I can honestly say there are very few clinical and academic partnerships that have worked as well as the one we have. It has to do with the mutual respect, and the support from UAB SON and the VA.

The VA benefits from evidence-based practice and research. We, at the VA, have a very active research department, but it’s not focused on nursing research. We have been able to collaborate with the School of Nursing to have a very robust evidence-based practice committee through our shared governance model, and because of that, we have a lot of evidence-based protocols written to enhance and improve care delivery. Many of the protocols are nurse driven. We solicit research ideas from our nursing staff to improve care delivery.

In addition to that, having UAB School of Nursing students complete clinicals at the Birmingham VA has opened the eyes of the students to all the VA has to offer. Students hear about the VA but do not know all the VA has to offer, but when they get here, they have a chance to connect with the mission and see the passion that drives the staff at the Birmingham VA. Even if they don’t come here for employment, they understand the competencies needed in caring for Veterans, no matter the setting. The partnership also gives us a pipeline for hiring new nurses who are familiar with the VA system since they completed their clinicals at the VA. You can’t underestimate the impact our students have on our Veterans. Our Veterans love the students and are very appreciative of them. We get a lot from the students, but the students also get a chance to work with America’s Heroes which is a humbling experience.

 

2020 is the Year of the Nurse, and it has presented several new challenges and opportunities. Did you see any changes in your role, and if so how?

The pandemic has really changed the world. Within my role, I am more focused on strategic planning, ensuring we have the resources we need to face possible patient surges. This includes providing a safe environment for patients and staff. We have a team that is strategically planning all the time to ensure our Veterans have access to care. During the pandemic the VA never stopped seeing patients, but we did have to curtail face-to-face appointments and move many appointments to virtual care appointments. This was necessary to ensure the safety of our patients and staff. This has included more than 293, 000 virtual care appointments, October 2019 to date. We have continued some face-to-face visits, for some specialties, but the safety of our Veterans and staff is our priority.

I’m also working with our staff closely to make sure they have not only what they need in their roles, but also have what they need for their mental health. The pandemic has taken a toll on us because it is a huge change in our lives, and with large changes, there come large challenges. As I reflect on the last few months, I can’t say enough about nursing as a profession. I do feel the motto 2020 as the Year of the Nurse is very appropriate because I have seen nurses do some amazing things. It has been a very humbling experience for me to watch our nurses. They have worked through this pandemic tirelessly, and we’re not at the end yet. Nurses across the country continue to persevere, and when we do come out of this pandemic, we are going to have a big celebration. But for now, we’re going to continue to do what we must do to care for our patients.

 

What advice would you give to future or new nurses?

What I would say to a new nurse is that nursing is a noble profession, but it is a profession where you work hard. There is a lot of gratitude at the end of your day, and there is always an opportunity to look back on the impact you make on someone’s life. I would also tell a new nurse: Don’t underestimate the impact you have. Hold your head up high, be proud of your profession, and come into your profession understanding we are caregivers – nursing is about care and giving. It is hard work, but you get to look back and say, “I made a difference.”

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