A simulated rural emergency hospital? Watch for it – UND Today – University of North Dakota

A Q&A with Maridee Shogren, the College of Nursing & Professional Disciplines new dean

Editors note: Maridee Shogren was named dean of the College of Nursing and Professional Disciplines in November after serving as interim dean of the college for 10 months. During her Q&A with UND Today, Dean Shogren talked about her long and varied career in nursing and education, addressing current worker shortages in the professions under her colleges umbrella, and CNPDs ambitious plans for the future.

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Tell me a little bit about your history with nursing. Howd you get involved with the field? I saw that you were also a practicing midwife.

My general interest in nursing was piqued in high school, but my career in nursing has evolved and changed greatly from what I expected it to be.

I received my Bachelor of Science in Nursing degree from UND and started my career as a critical care nurse. I worked in a cardiac intensive care unit in the Twin Cities for about five years; I absolutely loved my job and was cross trained to the surgical ICU, as well as the ER. Then I moved to very rural North Dakota, where there was not an ICU to be found, so I needed to really think about my career and what I was going to do next.

I met with the directors of the local clinic system and discovered that they were in need of someone to help with patient education. So, I worked with them to create a nursing educator position, and I greatly enjoyed teaching clients about their health.

Over the course of that work, I also met many different families with many different needs, but I really found myself loving the work that I was doing with expectant families. Even though the mothers received excellent care, they seemed to always have a lot of questions. Because of that need, I added prenatal education to my role, which led me to explore all aspects of caring for expectant families, including labor and delivery, and I found an unexpected love for womens health and obstetrics.

I had never really explored the field of midwifery before but the more I learned about it, the more I became convinced that it was right for me. I was accepted to the Frontier Nursing University in Hyden, Ky., and I knew the minute I stepped on their campus grounds that that was where I was supposed to be.

I practiced as a nurse-midwife in Colorado and eventually moved back to North Dakota in 2007. While in practice in Grand Forks, a faculty member at UND recruited me, and I joined the CNPD in 2008, coming back full circle to education.

While youve worked at UND, youve had quite a bit of experience writing and working on grants. Tell us a bit about that.

In 2014, I was a part of an interprofessional team that was focused on SBIRT, which is Screening, Brief Intervention, and Referral to Treatment. (Editors note: An interprofessional team is comprised of team members from two or more different professions for example, nurses and physicians, physicians and community health workers, social workers and psychologists who learn with, from, and about each other to enable effective collaboration and improve health outcomes.)

We looked at screening tools and education surrounding substance use in the clinic setting.

From that work, I became involved in two additional Substance Abuse and Mental Health Services Administration or SAMHSA grants in which I focused on perinatal mental health concerns and perinatal substance use. These grants provided me with a wonderful opportunity to translate my clinical practice expertise into training other healthcare professionals about needs specific to perinatal health.

Having that background of work, I found myself in a position to apply for my first grant through the Foundation for Opioid Response Efforts to start a program called Dont Quit the Quit, which was funded in February of 2020. The work that we did focused on providing care and resources for people with opioid use disorders who are also pregnant, postpartum or breastfeeding and living in very rural North Dakota. We worked with rural providers to increase their access to care for the treatment of substance use disorders and in particular, opioid use disorders.

We were able to help providers become waivered to prescribe medications to treat opioid use disorder. We also provided community education not only to people impacted by substance use disorder, but to their extended families, support systems, and healthcare and social service providers. We developed a fabulous relationship with the North Dakota WIC, and weve trained all the WIC agencies in a 12-county region on SBIRT and how to provide education about substance use disorders for families.

We also helped train nine postpartum doulas who are able to provide families with support right in their home communities.

It seems like your previous history of practice and education has prepared you for your current role. How have you seen it crop up in your tenure as Dean?

The largest impacts in my career that I feel have prepared me to serve as the dean of the College of Nursing and Professional Discipline, are strong background in academics and the opportunities Ive had to practice, teach, and understand the value of interprofessional healthcare.

Years ago, I taught in the interprofessional healthcare course at UND; its one in which students from multiple disciplines take the course together. One of the first things we did in the course was explain that effectively functioning healthcare teams understand each others roles.

So when I stepped into my new role, I started trying to better understand all three of our departments and our collective professions. Its a lot like learning new languages, and while Ill never be completely proficient in the languages of social work and nutrition and dietetics, I absolutely understand the value and importance of those professions and how their care impacts people and health, and now I get to advocate for the very professionals that I have worked with for years in clinical practice.

Another area that I really think was formative for me was the completion of my doctoral degree. Working as a nurse midwife is very much client-focused care; youre maybe working with one mother or one family unit. So when I completed my Doctor of Nursing Practice degree, my focus really shifted to learning more about population health, systems, and organizations to develop a stronger understanding about how we can make an impact on communities.

Looking at healthcare through that scope really broadened my thinking. Ive now seen the same phenomenon occur with our UND Doctor of Nursing Practice students. I think it really prepared me for my work with an interprofessional college, too.

The industries attached to the three departments of your college have been experiencing national shortages for a while. How is CNPD preparing students to transition between school and a career field that is currently so turbulent?

This is where I really would like our college to shine.

I became the interim dean for the College in February of 2022, but Ive been on faculty for about 14 years, so Im very familiar with working in the college. It has been important since Day One to help people understand the value of our college. Were a college of three departments; nursing, social work, and nutrition and dietetics, and all three departments blend beautifully together but remain uniquely different.

We cant change healthcare without all of us working together, so its been important to shift the focus to how we can collaborate, while were making sure that were recognizing the value of all three of our departments.

Social workers, nutritionists, registered dieticians, registered nurses and advanced practice nurses, and our researchers and collective faculty members are experiencing shortages, not only in North Dakota, but across the nation. So, we have to look at how were going to continue to move our college forward, how were going to increase enrollment in all of our areas, and how our professions can address their shifting educational and professional needs.

For example, our Social Work department has a long-standing history of preparing students to work in the areas of child welfare. Weve also got a number of licensed social workers on faculty who work in the areas of mental health and substance use. Were seeing a growing need for even more social workers to work in the area of geriatrics.

Our Dietetics students will need a masters degree to sit for their certification exam to become a registered dietitian nutritionists as of January 1, 2024. Food insecurity is in our state, and it is a profound nationwide issue, so we are working to make sure our graduates can help address the needs in this area.

One of the largest needs in nursing right now is for registered nurses, especially in our rural areas. So, we are trying to introduce our students to opportunities in rural areas and help them recognize the importance of staying in North Dakota to practice and be an integral part of our rural communities.

Rural healthcare is challenging, but we know our students can handle it! Its incredible how much the complexity of patient care has changed since I was a student, and were growing students who can address those complexities the minute they start their professional work.

Related to retention and recruitment, RAIN is a program unique to CNPD. What role does RAIN play at the College?

RAIN is a hidden gem in our college. RAIN stands for the Recruitment and Retention of American Indians into Nursing. This program has been in the college for over 30 years and has graduated over 300 bachelors, masters, and doctoral students.

The RAIN program is focused on mentoring and providing support to students, whether thats academic support, financial support, and/or emotional support, so that theyre able to feel comfortable in our college and at UND. We want our RAIN students, and all students, to feel very welcome here!

We are actually expanding our RAIN program to provide the same model of care to our social work and nutrition and dietetics students. Our RAIN director, Barbara Anderson, is actually a social worker, and she and the whole RAIN team are very supportive of this expansion.

Besides expanding RAIN, is there anything else exciting in the CNPDs future?

Were looking at ways to expand simulation in our college. One of the dreams I have is for the college to create a simulated rural emergency hospital. This would give students an opportunity to participate in expanded simulations over a longer period of time and experience shifts in a simulated setting. It also opens up the possibility for more interprofessional simulations, which allow students from our college to work with students from several other disciplines like medicine and psychology. Theres even opportunities for business and finance students, public health students, and those in the lab sciences.

I dont think anybody would be shocked to hear that we have a mental health crisis in our nation, and simulated hospitals would also give students an opportunity to learn about crisis intervention and caring for patients who present with an overdose or even suicidal ideation. I think if we could create this, we could help the students gain confidence in a very safe place while thinking critically through the complexities of these scenarios and ultimately be better prepared to deliver safe care when they are in practice.

An established simulated hospital also provides a chance for those who are currently practicing in the workforce to come back to UND for continuing education and team building experiences. This dream benefits the entire university and our local communities.

Finally, what does interprofessional collaboration look like in the CNPD? How are you handling the way that these distinctive fields overlap in the College?

Since early 2022, weve been exploring the areas where we can work together without losing our individual department identities. One example of our interprofessional work is our creation of an interprofessional writing team with faculty members from each department, who are working with Dr. Glenda Lindseth, our Associate Dean for Research. Theyre meeting frequently to start looking at writing grant opportunities that have more interprofessional focus.

Weve talked a lot about finding key themes or key areas where we could shine as a college and seek out funding opportunities in those areas, so that we can continue to grow.

Our college has so much potential! I am not sure people are aware of all the good work that is happening in this college. So, one of my goals is to make sure people know that were here, what were doing and what we are contributing to this university.

We have such a strong and experienced faculty and staff and we are very proud of our graduates. We are really in a building time at our college; were all focused on moving forward.

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A simulated rural emergency hospital? Watch for it - UND Today - University of North Dakota