Nursing dean talks on health care system

With her daughter Caroline nodding off on her shoulder, Nursing School Associate Dean Mary Naylor spoke to an intimate gathering of students and faculty about the "evolving health care system" Thursday night. The discussion, held at Van Pelt College House and sponsored by the Nursing School and the Penn People in Residence program, focused on the opportunities and challenges facing today's health care professionals. Naylor, who has previously worked with the Senate Committee on Aging and received a Kellogg Foundation Fellowship to study health and social policy in countries throughout the world, stressed the value of interdisciplinary work in designing and testing models of managed care. "You cannot be effective in delivering services to people unless you have a very broad understanding of the world and the environment in which they live," she said. Naylor's work focuses on testing alternative models of health care in high-risk populations. Her research concentrates on clinical problems, the lack of basic resources and nutritional and safety issues in elderly populations. Naylor cited problems with delivering community-based care in a system largely dominated by a "medical approach" to treatment. This approach is concerned with the disease process in the body while the "nursing approach" considers the patient from a community perspective. And Nursing freshman Adlynn Parado added that "it is a doctor's job to cure and a nurse's job to care." Naylor emphasized that the present health care system places patients in a "dependent position." While other societies invest adequate resources in "prevention and promotion," the United States often denies health care consumers the opportunity to become fully informed about their illnesses. "Providers are giving the care instead of giving the public the knowledge to care for themselves," Naylor said. She also discussed the "sibling rivalry among health professionals," mentioning the conflict between doctors and nurses over the responsibility of patient care. "A team approach to care is an absolute must," Naylor said. And Nursing sophomore Laura Cobey noted that not only a doctor is able to handle the "entire spectrum" of medical responsibilities. College junior Ali Zaidi sparked a debate by posing a question about the value of a $130,000 Nursing degree from the University. Zaidi, a pre-medical student, remarked that nurses graduating from the University will never receive the expected return on such a large investment as they would if they attended medical school. "Medicine was aesthetically attractive when I was younger, and it's logically attractive now that I'm older," Zaidi said. "On the same note, why spend $130,000 for an English major?" Naylor countered. She cited the Nursing School's distinguished faculty and its association with major health centers as prime reasons for attracting potential applicants. And she added that nurses often earn the highest starting salary of any college graduates -- "but it eventually flattens out." Concluding the discussion, Naylor noted the present "out of the institution and into the community" movement. In the next few months, Naylor will start overseeing a managed-care facility for high-risk elders in West Philadelphia.