Alumnus Darrell Owens (DNP 2010) is Associate Medical Director for Palliative Care at the University of Washington Medical Center, Northwest Campus. During the COVID-19 pandemic, he emphasized the importance of palliative care in the response to COVID-19, empowering patients and families as they made care decisions. We sat down with him in July 2020 to discuss his path to nursing, the importance of palliative care, and more.
Q: What led you to a career in nursing?
I grew up in Florida, and in the 70s there was a television show called “Emergency!” focused on the start of the paramedic program in Los Angeles. And on that show, there was a nurse at the hospital who was always in charge of things, she was always doing things, and to this day, I remember that actor’s name. I have a picture of that actress—Julie London—in my office in her nursing hat, and she actually died on the same day as my father. She kept re-entering my life in all these different ways.
Then, when I turned 16, I joined the volunteer ambulance squad and once again, I was interacting with the nurses. I just thought, “That’s really something I want to do.” From there, I joined the Navy—I was a Navy Corpsman—and worked with some incredibly awesome nurses. I got out when I was 21 and went to nursing school at Emory in Atlanta, and then my first job out of nursing school was actually in the emergency room at Grady Hospital.
I really liked the fast pace of the emergency room, the excitement and seeing lots of different things. That truly drew me to the environment, and it ultimately would prepare me very well for palliative care.
Q: Walk me through the process of continuing your education and earning advance degrees. What led you to pursue further education, and how do you think your experience has impacted your career?
At Emory in undergrad, it’s really drilled into you that you will continue your education and get an advance degree.
Before going back for my next degree, I did a year at Grady and then I was a travelling nurse. After a year of traveling in ERs, I ended up in California. That’s where I started my palliative care career. It was in San Francisco, in 1992, in the AIDS epidemic. A colleague of my had gotten her Masters Degree in Health Care Administration at St. Mary’s in California. The program was great because it was a night school, but you had a cohort and classes a few nights a week, and this was not the process for a masters in nursing. To get your masters in nursing, you really had to have daytime classes—it was a very different scenario for people who were working full time.
After a while I ended up doing clinical nursing and clinical education all related to hospice and palliative care. That’s when I decided I really wanted to work in advance practice, and I found an MSN program that provided all of the classes on one night a week, and I had a schedule flexible enough to get my clinical hours. This degree was as a clinical nurse specialist, however, which is not recognized in the state of Washington. So then I went back and got a masters as a nurse practitioner. And each time I got an advance degree, I would rewrite my job description so it would fit that in palliative care.
Q: How did you select UAB for your DNP, and how has your degree impacted your career?
During this time I was working at University of Washington, I was on the Board of Directors of the Hospice and Palliative Care Nurses Association, and Dr. Pam Fordham (a two-time UAB School of Nursing alumna, former faculty member, and former co-director of the UAB Center for Palliative and Supportive Care) was on the board with me. She had launched the palliative care nurse practitioner program at UAB, so I got to know her and became very familiar with UAB. She recruited me to UAB because it was a post-Masters DNP, you could pick your emphasis, and there was a great palliative care emphasis. I didn’t need my DNP at that time, but I wanted to take my degree to the top of the nursing rung.
My DNP was really all personal, and I didn’t realize how much I would enjoy it. Coming out of a nurse practitioner program, where it is so intense, the DNP was something I got to do because I wanted to do it. There’s always stress when you’re going to school, but it’s different when you’re doing something for yourself.
My Capstone was also published, right out of the gate, by the Journal of the American Association of Nurse Practitioners. They still cite that paper today, and it was one of the only papers on primary palliative care, and it just launched a whole era. My capstone really pushed everything to a new level, in terms of outpatient palliative care. It was a gamechanger for other programs I’ve helped across the country, as well.
Ultimately, my DNP opened up any educational opportunity I want, in terms of teaching. This degree makes you sought after in terms of education. But I also think it just helps you have a seat at the table, from a recognition and process perspective. It truly has helped me become an advocate for advanced practice nursing at a higher level too.
Q: Is there a particular moment where you felt yourself steer toward palliative care?
So it was an accident. I had finished as a travel nurse, and I was in the Bay Area in California and chose to stay there. All of a sudden, since I was no longer a traveling nurse where they pay for some living expenses, I realized “This is expensive.” This was back when jobs were in the newspaper, and as I looked for nursing jobs there was a job for “hospice.” It was an after-hours job, and it would mean extra money. But during the interview, I was asked all these questions that didn’t have to do with palliative care, and long story short she offered me a full time job and I took it. It only took a few weeks to realize I had no idea what I was doing.
These were predominantly young men dying of AIDS, and they had pain issues. It was like they didn’t have a voice in their care. They needed help and they needed treatment, and no one was treating them right. All of a sudden, my advocacy hat came on. And I’ve never looked back, and I’ve never done anything since. That was 1992.
Q: How have 2020 and COVID-19 changed the way palliative care is viewed and discussed? How have they changed how nursing is viewed?
COVID-19 has elevated the role of palliative care within our institution, absolutely, and perhaps across institutions. I’m not sure how it has changed in the public, however. I certainly think it has elevated nursing to an even higher level than it was because nurses have gotten a lot of coverage and support. Nurses are the ones in and out of the room all day, and it has changed how the world views nursing.
Even at my hospital, they sent me a note saying “Thank you for single handedly saving our hospital during this crisis.” Palliative care allows for steps that make sure the right people go to the ICU, allows for attention to be focused on certain patients. And you’re working 24 hours a day to handle these cases. It certainly changed that I saw palliative care play a critical role in this emergency.
However, we have to step up and be assertive about how important the palliative care role is in the COVID-19 crisis and other emergencies. As an advanced practice nurse, I was able to assert “We have a role to play, we can help you,” and that made a lot of difference. At least on our campus, and I hope elsewhere, advanced practice nursing is now viewed as a critical component.
Q: What advice would you give a nurse or student considering palliative care?
They have to understand their reasoning for wanting to enter the field—not just because it seems sweet. They need to have a very clear understanding of why they want to do this work. It’s more than, “My grandmother had a bad death, so therefore I want to do palliative care” or other reasons. There needs to be a solid foundation for your motivation—advocacy and symptom management, things like that.
Then, they need to understand the path they want to take. Every nurse in a hospital has some degree of palliative care, and most nurses, if they experience caring for uncurable patients or terminal patients, something clicks with them. They go out and work in hospice, and I think that’s where the majority of palliative care registered nurses are employed.
Ultimately, I encourage everyone to be very thoughtful and as sure as they can be about this path.