Nursing School Well Prepared for Future, Dean Says in Final State of School Address

By Lisa Cisneros

Kathy Dracup

In her final state of the school address, UCSF School of Nursing Dean Kathy Dracup, RN, FNP, DNSc, FAAN, cited a decade of progress that will leave the top-ranked school well prepared for the future despite the economic challenges ahead.

Dracup reported that since she became dean in 2000, the school has:

  • Tripled its research grant funding, from $12.6 million in 2000 to $39.4 million in 2009;
  • Doubled its endowment, from $13 million to $26 million and
  • Increased enrollment by 40 percent from 521 to 724 students.

Boosting the pipeline of nursing students is important given that more than 1 million new and replacement nurses will be needed nationwide by 2016, according to the US Bureau of Labor Statistics.

At UCSF, the school must also prepare for an expected retirement wave since the majority of ladder-rank faculty members are aged 50 and older.

Dracup, who delivered her final state of the school address on Feb. 19, will be “stepping up to the faculty” relinquishing her role as dean of the nursing school in October. A UCSF committee continues to conduct a national search for her successor.

Over the next few months, Dracup will lead the school through a time of transition as the campus prepares to implement recommendations from the administrative and operating efficiencies work group. That group, which includes School of Nursing Associate Dean Zina Mirsky, is charged with recommending how to achieve operational efficiencies and reducing UCSF’s $3.1 billion budget by up to $40 million. The work group’s recommendations will be presented to UCSF leaders in late March or early April for discussion with the goal of finalizing an action plan by June.

Dracup said she is driven and determined to lead the school through this trying period by focusing on what attracted her to UCSF in the first place —  the talent, uniqueness and entrepreneurial spirit of the students, faculty and staff.

Realizing the Mission

During this time of transition, Dracup said, it helps “to be anchored to our mission and vision” as spelled out in the UCSF Strategic Plan and the priorities set forth by UCSF Chancellor Sue Desmond-Hellmann, MD, MPH. By focusing on those priorities — education, discovery, patients/health, business and people — UCSF can ensure that its mission can be achieved, she says.

To address these priorities, Dracup said that the school will take a number of actions, including raising student/professional fees, boosting philanthropic support, prioritizing new initiatives, consolidating or discontinuing selected programs and implementing best practices in managing reduced resources and workforce.

“Ultimately, we all want to provide the same level of service or better with fewer dollars,” she said. “Whether that is achievable depends on the amount of thoughtfulness and commitment we put into it. The reality is that we will all have to change the way we do business.”

Dracup acknowledged that the school — indeed all of UCSF — will have to look at new ways of doing business more efficiently and will need to become more accountable to metrics — in student achievement, educational innovation and scholarship funding, for example — to monitor and gauge the success and outcomes across the University.

The University of California and UCSF have been moving in that direction since Mark Yudof became president of the 10-campus system. UCSF has produced and posted its progress report for Yudof for the past three years on the UCSF Strategic Plan website. The 2009 progress report is available here [PDF].

Bracing for the Budget

Dracup will be conducting town halls this spring to inform the community about the 2010-2011 budget and how the recommendations by the work group will affect the school.

On the bright side, the school continues to lead the nation’s nursing schools in research funds awarded by the National Institutes of Health (NIH) — a recurring feat since 2003. UCSF received $8,972,922 from the NIH in fiscal year 2008-2009.

Philanthropy to the school has grown to $70 million — with six new endowed chairs funded and two endowed chairs pledged, she noted. About 20 percent of the school’s alumni, now numbering more than 8,000, are increasing their contributions to the school’s mission each year. 

While the school’s share of state funds accounts for only 23 percent of its total budget, that entire amount supports the educational mission, employing faculty and staff, Dracup explained. This fact makes any reductions in the state budget particularly difficult because of the increased number of students now enrolled in its graduate programs.

Permanent reductions to the school’s budget have amounted to 7 percent in 2008-2009 and 10 percent in 2009-2010, part of which was offset this fiscal year by savings from the UC-mandated furlough program, which continues through August.

One of the toughest decisions Dracup had to make this year in the wake of shrinking state support is to discontinue owning and operating the nurse-run clinic Valencia Health Services. Mission Neighborhood Health Center (MNHC) is the new owner of the clinic, which has been renamed the MNHC Valencia Clinic. She admitted that this news caused “heartache for many of us who have seen the practice grow” since it opened in 1996. But the harsh reality is that the “majority of nurse-run clinics is not a viable economic model,” Dracup said.

Dracup also reported that this fiscal year the school will see the end of its Gordon and Betty Moore Foundation support for faculty. The Moore grants have been an important advancement toward alleviating California’s nursing shortage by producing new faculty for Bay Area nursing schools.

Adding to the budget woes, the school faces increasing costs for employee retirement, IT infrastructure recharges and unfunded 2009-2009 academic salary increases, Dracup said.

For its part, the School of Nursing, upon the advice of its Faculty Council, convened an academic program efficiencies task force in March 2009 to develop a list of recommendations for consolidation or reduction of current program offerings in the school. The task force report is posted here [PDF].

Improving Education

To ensure its ongoing leadership in educational innovation and accreditation, the School of Nursing will continue to critically review its programs. The nursing school reviewed its PhD and its Masters Entry Program in Nursing last spring and is nearing completion of a two-year process to review and revamp the core curriculum in the Master of Science program, Dracup said.

The nursing school continues to take the lead in expanding interprofessional education at UCSF thanks to the efforts of Jeff Kilmer, director of Student & Curricular Affairs, who partners with his colleagues across campus. One of the most exciting developments on that front is the construction of a simulation lab on the second floor of the library on the Parnassus campus. The lab will provide opportunities for students from all four schools to participate in interprofessional learning and build confidence before contact with real patients in a safe environment where mistakes become teaching moments, Dracup said.

Achieving excellence in academia also depends on the diversity of its faculty and staff. “We know that health care outcomes are improved when there is a diverse workforce and we want our nursing students to reflect the diversity of our community,” Dracup said.

The number of underrepresented students in the nursing school went from 150 to well over 250 this year. “This is real testament to the commitment of student affairs office,” said Dracup, who also thanked the school’s Diversity in Action group known as DIVA.

The nursing school also doubled the number of male students from 50 to 100, reinforcing the idea that the nursing profession should not be stereotyped or gender specific.

Among the most vexing issues to resolve is providing sufficient financial aid to students who are struggling with the fee increases that have more than doubled over the past decade and mounting debt, Dracup acknowledged.

Nursing students are graduating with larger amounts of debt (averaging about $30,000) and those who don’t seek higher loans are making up the difference by working more hours on top of pursuing their education. “Clearly, we need to continue to look at ways to support students and to help donors see the importance of investing in their education,” Dracup said.

Chancellor Desmond-Hellmann is keenly aware of the need to better support students. She has asked Joseph Castro, PhD, vice provost of Student Academic Affairs and special assistant to the chancellor, and Carol Moss, vice chancellor of University Development and Alumni Relations at UCSF, to lead a team focusing on increasing student financial aid.

As the campus community welcomes new members of the leadership team and ushers in a new era of transformation, Dracup reflects upon her nearly 40-year career at the University of California. It’s been a remarkable journey for Dracup, who earned a Doctorate in Nursing Science from UCSF and a Master of Nursing degree from UCLA. She has achieved national and international recognition for her investigation in the care of patients with heart disease and the effects of this disease on spouses and other family members.

And as dean, she credits the talent and generosity of the faculty and staff for the school’s many achievements.

Looking forward, Dracup remains optimistic about and eager to act upon the opportunities ahead. Indeed, as the clock ticks in her remaining tenure as dean, Dracup likens the experience to the waning hours working a nursing shift in the Intensive Care Unit: “I feel like I have a lot to do.”

Related Links:

UC regents to look at changing policy on fees
SF Gate, March 11, 2010

UCSF School of Nursing

Chancellor Provides Update on Administrative, Operational Project
UCSF Today, March 1, 1010

UCSF Boosts Efforts to Support Students in Multiple Ways
UCSF Today, January 5, 2010

UCSF Chancellor Issues Update on Priorities, People and Budget
UCSF Today, November 6, 2009.