Q&A with Dr. Juanzetta Flowers (BSN 1966, MSN 1983, PhD 1985)

Three-time UAB School of Nursing graduate and pioneer for advanced practice nursing Dr. Juanzetta Flowers, PhD, RN, (BSN 1966, MSN 1983, Ph.D 1985) has spent her career advocating for nurses and nursing.

Her connection to the UAB School of Nursing started before the School made its move to Birmingham. Dr. Flowers worked to establish the School as a WHO Collaborating Center in the 1990s and is an active member of the Board of visitors.

She has also received many nursing honors, including being named to the Alabama Nursing Hall of Fame, the Alabama Health Care Hall of Fame, as well as the Alabama NAACOG Nurse of the Year Award, the Excellence in Nursing Leadership Award by the Nu Chapter of Sigma Theta Tau International, and being listed in Who’s Who in American Nursing, Who’s Who of American Women, and Who’s Who of Emerging Leaders in America.

What first drew you to the UAB School of Nursing?

For my BS degree, I was actually in the last graduating class in Tuscaloosa, when the UAB School of Nursing was known as the University of Alabama School of Nursing and before it moved to Birmingham.

 I was working as a public health nurse, and I was watching all that was happening for nursing at UAB and saw that everything exciting happened at UAB. My then husband and I were about to go to Germany for three years with Uncle Sam, so I told my husband “When I get back to Birmingham, I am going to get a job at UAB. Then, I’ll be there and if they have a new and exciting program, they will know I’m there.” That’s exactly what happened. I came back from Germany in 1971 and applied for a job. I told them I wanted a nursing job— outpatient, Monday through Friday, from 8-5. The Personnel Department said nothing like that existed, and I said “I know, but when it comes up, let me know.”

The next morning at 8-o’clock, this woman called me and said, “I think we have just what you are looking for.” The faculty physicians were opening a private outpatient clinic and looking for a head nurse. She asked if I could start the next Monday, and that’s how I came to UAB.

One of the many highlights in your career is the fact that you were one of the first nurse practitioners in the state. What was that experience like?

 A few months after I started at UAB, one of the doctors told me about a program—at the time called “Nurse Clinicians”—that was geared toward helping women with cervical cancer. Alabama had the worst rate of cervical cancer in the country at that time because we had 20 counties with no place to get a pap smear or pelvic exam. Most of the time, when women started to show symptoms and came in to get help, they were Stage 4 and it was too late. He asked if I would be interested in participating, and I said “You know, when the Universe gives you exactly what you want, it’s kind of bad to say no.”

I put out the word to recruit another nurse interested in the new and innovative program, and we became the first two nurse practitioners in the state of Alabama, even though we were called nurse clinicians at the time. We followed the doctors in OB/GYN around, spent a week with each of them, and did whatever they did. We also went to the medical students’ classes, went to the OR to do pelvic examinations, and spent any downtime in the library reading and studying anything new that we were seeing or hearing about. At the end of our apprentice year, we set up a program whereby we could train eight Public Health nurses every three months and then send them back to their counties to apprentice with doctors for nine months. These nurses would train, and learn, and then they were able to care for women in counties without physicians. After four years with that program, we went from No. 1 in the country for cervical cancer deaths to No. 50. We proved that nurses made a difference in saving people’s lives, particularly poor women living in counties without physicians.

As someone who helped lead the NP role in the state, what has it been like to see the changing role of nurses over the years?

UAB definitely was the leader in the state regarding nurse practitioners. At the time, physicians were not happy at the thought of a nurse doing what they thought was their purview, so for many years we were just trying to get our Nurse Practice Act extended a little bit to cover NP practice. We weren’t trying to be physicians—we were just trying to provide care for people in counties without physicians.

I was president of the Alabama State Nurses Association for two terms, and I lived in the legislative section of the Alabama state government. We had to keep pushing and keep lobbying for that ability to practice. That took about six years of hard work and hard fighting, and the ASNA continues to advocate for nursing today.

You worked with the School’s third dean, Dr. Rachel Booth, and watched the PAHO/WHOCC develop. What was that experience?

At the time, I was actually president of the Foundation for Women’s Health, an organization dedicated to improving women’s health in the state of Alabama. I was approached by the Dean of Public Health at that time, who said the Carnegie Institution wanted to create a program that invited physicians from different countries—at the time they were referred to as developing countries—who had better maternal and fetal outcomes than the United States. These physicians would come to the U.S. and talk about their country and their practices, and the Dean of Public Health wanted the Foundation for Women’s Health to sponsor it and bring this program to Birmingham. I spoke with our dean at the time, Dr. Rachel Booth. She agreed to help with the program. We invited 400 American physicians and 20 physicians from developing countries to Birmingham for a threeday program. That was how I got introduced to PAHO, the Pan American Health Organization, the USA part of the WHO. The WHO liaison in the United States then approached me during the program and said, “Your school should be a collaborating center.” We got a meeting with Dr. Booth, WHO, and the Carnegie representative, and that got the ball rolling. The whole process took two years, but we were then designated as the 7th WHOCC for Nursing and Midwifery in the United States.

You created a scholarship through the UAB School of Nursing in your husband’s name. What led you to do this?

My husband, Charlie, the Department Chair of OB/GYN  was an obstetrician and gynecologist and also one of the world’s biggest advocates for nurses. He was trained at Johns Hopkins, where nurses were well-respected, but he was also the son of a nurse, and he married two nurses—his first wife was also a nurse. So, when he passed away, it felt only fitting to name a scholarship after him. Wherever he went, every nurse he ever met knew he really respected us and the work we did. He knew how vital nurses are to the patient and the whole scheme of health care. He always told his Residents, “Listen to the nurses—they will tell you what the patient needs.”

How do you hope people look back at your legacy?

It always shocks me to hear someone refer to my legacy. I say my epitaph should read, “She showed up and said yes.” Because I could not have planned to do any of the things I ended up doing, since, at the time, most of them were new and innovative. Anything I have ever done, whatever I have been engaged in at the time, I have done it to the best of my ability and to the fullest of my ability. That has prepared me to say yes to new things, and also to not be afraid to do what needs to be done. Like with the legislation for extending the Nurse Practice Act, if you don’t give up when you know you’re right, then you will prevail.

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