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Frontier Nursing: Q & A with Linda Burnes Bolton

Linda Burnes Bolton

Linda Burnes Bolton — national influencer on health policy, vice president for nursing, chief nursing officer, and director of Nursing Research at Cedars-Sinai — talks about her true north, leadership, and how nurses can help light a path through the shifting topography of American healthcare.

Q. What inspired you to become a nurse?

A: I was ill as a child, and in and out of the hospital with respiratory ailments; the individuals who were the kindest to me, besides my family, were the nurses. That launched my lifelong commitment to caring for human beings. For me, that means using my knowledge and expertise to embrace the whole individual and to promote the wellbeing of my community. That idea has driven me throughout my life — it’s my true north.

Q: The landscape of healthcare is changing. How is nursing responding?

A: Florence Nightingale was one of the best scientists of her time. She asked questions like, “What if we group together patients who have these symptoms? What if we move the latrines over here?” “What if ?”: That’s the basis of scientific inquiry. Nurses are doing that now, asking questions like, “How can we help patients better understand their medications, thereby decreasing dangerous errors? What makes them stop taking their medications?” To understand such patterns, you have to go where people live and work to gather evidence. We’ve been doing this community-based participatory research for years, but it’s finally gaining ground elsewhere.

Q: Do you have a model for engaging nurses in healthcare and the community?

A: I call it frontier nursing. Frontier nurses rode into communities and conducted surveillance to figure out what was needed. Today, we need to explore and educate the community so people understand how to stay well. Nurses are trusted professionals and the right people to form partnerships. Over the next five years, one of our great challenges will be to transform the nursing workforce. Today, 65 percent of U.S. nurses work in acute care. At the Geri and Richard Brawerman Nursing Institute at Cedars-Sinai, we teach students that the bedside is only one element of their work. We prepare them to collaborate with pharmacists, social workers, and physicians to form a caring community.

Q: Can nurses influence healthcare policy?

A: Healthcare policy is about assessing the resources necessary to promote improvement in the human condition. Nurses have deep knowledge about this and can be the best advocates. One good example is our work to ensure all Los Angeles public schools have access to a nurse. Our mobile units provide that access in underserved communities. But real change will come when we get nurses on those school boards to say, “It is not okay for you to have children under age 12 here without someone who can provide immediate health services.”

Q: What makes a good leader?

A: Grounding in the basic science of nursing and nursing’s core mission of compassionate, quality care is number one. Number two is the ancient art of calling in diverse forces to examine an issue that would affect the neighborhood, community, or society. Leadership is not just about diversity but also inclusivity.


LINDA BURNES BOLTON, DrPH, RN, FAAN

EARLY LEADER
The eldest of 12, raised in South Tucson, Arizona, she was given the task of preparing her siblings for school each day. She assigned each younger child to an older child who was responsible for bathing and dressing the little one before either could have breakfast.

FIRSTS
The first in her family to go to college, and the only African-American nurse to graduate from Arizona State University in 1970. “When you grow up in poverty you can either allow statistics to deprive you of hope or you can decide to look at the glass half-full and to stretch yourself.”

KUDOS
Named among the top 25 women in healthcare by Modern Healthcare in 2011. President-elect of the American Organization of Nurse Executives board. Past president, American Academy of Nursing, and the National Black Nurses Association.

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