Dr. Gillian Adynski (UNC-CH ’20) turns her desire to make an impact on global health into action by pursuing her research goals in Namibia

Gillian I. Adynski, PhD, RN (UNC-CH ’20), Postdoctoral Research Fellow, National Clinician Scholars Program, Duke University, litynski@email.unc.edu. June 11, 2021 |

This week I am taking one of those rare breaks from academia where I am spending time with family and reflecting on the impact of the past year, we as a society have all faced dealing with the COVID-19 pandemic. Being a nurse, this year has been difficult to say the least. I am both a clinical nurse and a nurse researcher, and I put countless hours and stress into my career this year caring, fighting, and advocating for my patients in the emergency department while simultaneously focusing my research career as a post-doctoral fellow with the National Clinician Scholars Program where I study the global health and nursing workforces. This week I had the rare chance to reflect about my role as a nurse and why if this profession can be so stressful both emotionally and physically demanding why do we enter into it?

One thing I have heard many times since I entered into the field of nursing is that nursing is a calling. And since being in the field now for over half a decade, I can see that rings true for nurses. The profession itself is difficult, on its best days. It’s not pleasant to tell patient’s family members their loved one has passed despite every emergency intervention or to be so stressed on an emergency room shift that you neglect all of your basic needs such as a lunch or bathroom break. Yet when exploring my own call towards entering into this profession it was just something that I felt I had to do so that I could make an impact on the world. Not only did I feel I needed to become a nurse but I felt I needed to make an impact globally in nursing.

So, listening to my own instincts and inner calling, I knew I needed to create my own space in nursing to explore a

career path where I could make the world a better place than in which I found it. The day I heard about the Hillman Scholars in Nursing Innovation Program I knew I needed to apply as though it called me into it. I know Hillman Scholars Program in Nursing Innovation would offer me the all the opportunities and resources I needed to develop the skill set to build the career I wanted, and maybe if I was able to be persistent, hardworking, and a little lucky I could use those skills to make an impact on the world.

Not only did Hillman create space for me to focus on my research starting early in my undergraduate studies, but I was able to spend time creating experiences outside of

the classroom, and outside of the traditional academic university setting. Since I knew I wanted to work in global health, I was able to begin working with IntraHealth International. In the summer between my first and second year of my PhD, I was able to begin interning with IntraHealth on one of their projects stationed in Namibia which focused on expanding HIV services across Namibia’s rural and remote areas by expanding nurse’s scope of practice to be able to initiate and prescribe HIV medications. I traveled and lived in Namibia that summer, and met countless nursing role models including both Namibian and American nurses who were working in public health, influencing health policy, and really making a tangible impact on the lives of Namibians. I was so impressed by the hard work they put into their projects, meticulously focusing on the details of projects and relentless refusing to stop until projects were done correctly, and the individuals receiving services were able to access their HIV medications and receive HIV services.

I knew I wanted to continue working with IntraHealth for my dissertation. I was exposed to multiple mentors within Namibia as I worked closely with IntraHealth to develop a research question that would be would compliment their ongoing work. I was interested in the perspectives of rural and remote nurses as they had this expansion in scope of practice as well as evaluating if the change made an impact in the health of Namibian’s living with HIV. I saw how these health workers were backbone the health system. Without the nursing staff, how could we deliver care to the patients? I saw nurses in Namibia facing the similar issues as nurses face in America. I witnessed the stress nurses experienced while delivering care, I saw facilities without the adequate nursing staff they needed to do their jobs well. So, working with IntraHealth and my mentors at UNC-Chapel Hill I was able to create a dissertation around two main research questions:

1) What is the impact of nurse staffing on HIV outcomes of Viral Load Documentations and Viral Load Suppression?,

2) What is the impact of nurse’s job attitudes (stress, burnout, job satisfaction) on nurses’ abilities to do their jobs well?

Thanks to the Rita and Alex Hillman Foundation’s Advancing Early Research Opportunities Grant I was able to return to Namibia again and collect my own primary data to answer my research questions.

As I was approaching my own graduation from my PhD and the Hillman Scholars Program in the spring of 2020, it was more important to me than ever to return to what called me to this profession in the first place, making an impact in the world. And for that reason I am more interested than ever in health policy on the global stage. In the spring of 2020, just before the COVID-19 pandemic broke out I applied for the Hillman Interdisciplinary Inquiry Award to travel to Geneva, Switzerland to attend the World Health Assembly in May 2020 with IntraHealth International. I was so excited to travel and watch some of the highest level health policy makers make key decision about the state of the entire world’s health. When the COVID-19 pandemic broke out it undeniably impacted the world, the World Health Assembly only became available to me remotely. I was disappointed I would no longer be able to physically travel to Geneva. However, I was simultaneously more excited than ever to see global policy makers work through an emergency the size of this pandemic and how they were able to adapt and remain resilient to handle the global pandemic.

At the point when the World Health Assembly came around, I was tired. I was working clinically through the pandemic at the same time as defending my dissertation, which is not an easy task. I had put long hours into my work that spring and was exhibiting a horrible demonstration of a healthy work life balance. As is often the case when you swing into overworking yourself, you distance yourself from the reasons you entered a profession in the first place. You lose sight for the purpose behind going into the emergency department and taking care of patients. You lose sight of how writing words down on a paper could possibly help nurses halfway around the world, or influence policy makers to make changes.

It was exactly as I was having that moment of feeling very far from an understanding of why I entered into nursing that I tuned in for the World Health Assembly. There I saw individuals from all around the world make statements on the health needs of their countries. I saw clinicians and scientist be policy leaders. I saw policy makers cite science and statistics. I was able to hear discussion about how to deal with the COVID-19 pandemic. I was returned to the purpose of my own work. I channeled this energy into a Hillman led team research project at UNC Hospital exploring the stress, coping, and work place environments of nurses and nursing assistants during the pandemic.  We were able to mobilize together and our work received an AERO grant to fund the project. Participating in the World Health Assembly I was able to remember why I was called into nursing in the first place; to make an impact in spaces like these. In the middle of the pandemic, where my nursing life had become stressful, I felt grounded in purpose and drive to once again repair the world, make it a better place than the one we entered into. As I graduated from my PhD that same May and finished the Hillman Scholars Program, I was able to leave the program  in the same state I entered it in knowing that I had followed a career that is my calling, and I was headed into a direction where I can repair the world in some way through a commitment to advocacy through policy, science and action.