Q and A with Professor Jennifer Dohrn

Q- How has nursing in India evolved in the last 75 years?

Dohrn - The nursing profession has made impressive breakthroughs. To have any kind of a robust healthcare system, you need an engaged workforce of nurses as the core. As nurses, we have this unique connection to the communities we serve, we are the ones doing preventative care, and we are the ones who understand people's approach to health. So it is important to invest in a vigorous nursing workforce. And India has done this over the last 75 years since independence. 

Q- What are some lessons we can learn from the Indian nursing system?

Dohrn - India has sizable challenges with communicable diseases and at the same time has made notable contributions across the globe for treatment. One example, which I share with all of the students that I teach at CUSON, is India's approach to polio. In the 1990s, India, with the World Health Organization and partners, launched a campaign to eradicate polio.  While eradication is almost impossible, the effort was to at least eliminate polio from being a major cause of morbidity and mortality, especially amongst children. India created a model which we could all learn from, combining government will and healthcare leadership with resources to implement a national campaign reaching every sector of society. Nurses went to the community and trained community members to administer the polio vaccine.

Q - What can be done to improve nursing skills in India?

Dohrn - I can only offer an outsider’s perspective on how India can build its nursing capacity. The Indian Nursing Council has established an educational initiative for nursing curriculum to integrate simulation learning knowledge and skills, which will greatly increase nurses’ capacity. For many women from the rural areas, nursing is a path to rise out of poverty, and also to claim independence with a skill that helps you serve people. So I think this is an appropriate approach -- find young women who want a different kind of life and offer them skills to improve healthcare. And I've seen this replicated in my work over the last eight years. An impressive model in India is the Bel-Air College of Nursing in Panchgani. The college takes young women from the surrounding community and gives them life skills to survive, and be independent and high quality nurses.

Q - Can you tell us more about your work on simulation-based nursing techniques?

Dohrn - Simulation learning can enhance critical thinking, improve communication, problem solving, and clinical skills through practice. Before simulation learning, students would be assigned to a nurse working in a busy clinic. In such situations, the nurse might often not have time to supervise 30-40 assigned students and tend to her patients at the same time. So simulation learning creates a very realistic scenario with cases to practice and to get the skills so that when you go out to work, you are equipped with a set of proficiencies and a deeper mastery of the nursing management process. The Indian Nursing Council has built a simulation center in Delhi, for nursing students, educators and practicing nurses to improve their competencies. CGC | Mumbai facilitated us for our President’s Global Innovation Fund (PGIF) grant to help support simulation learning by building a simulation center with our partners.at the Bel-Air Hospital and College of Nursing in Panchgani, Maharashtra. Now the nursing schools around the area can also learn from the center.  

Q - How has the nursing profession evolved after the pandemic? 

Dohrn - I think the pandemic really reinforced the significance and impact of nurses. Nurses were right on the frontline. They saw such incredibly hard situations and patients dying without any access to palliative care, without being with their family members.  Doctors and nurses have different skills, different capacities to provide care, and we can't function without each other. Nurses need doctors, and doctors need nurses. In epidemics and pandemics, the health crisis demands this shared approach, that we work together as a team. This was seen during the current COVID pandemic too. Yet as soon as vaccines were introduced, and it started to look like we were somewhat in control, nurses receded from being recognized. We are also witnessing nurses leaving the profession across the globe. They are tired, they need emotional and mental care, they need to be recognized, and salaries need to be sufficient. There are many conflicting forces at present that must be addressed. And we do have a responsibility to take care of all the nurses on the frontlines and to honor them.  

I'm hoping that nurses can find ways to regroup and reorganize. Our voices are loud and we have the lessons from the COVID pandemic still fresh in people's minds of our critical role. We need to advocate for nursing leadership at all levels of governance. The positive side is that I see many more admissions to nursing schools. People are inspired to join the profession.

Q - CGC | Mumbai has facilitated internships for students from CUSON. What makes this experience important for students?

Dohrn Having nursing students learn in other countries is essential. The pandemic showed us that we need to have a global perspective based on health equity. I think students get a different understanding of how nurses work and what the community needs are, what are the different cultural and societal views influences on health care. It really teaches them to be globally-minded, and work for equity. With this framework, I helped develop a program called the Global Students Clinical Experiences about seven years ago.  Students can apply before graduating and spend their last six weeks learning under the leadership of nurses in other countries. We are currently in 15 countries and the CGC | Mumbai is a central partner. We built a relationship with the Bel-Air College of Nursing in Panchgani and St. Philomena’s College in Bengaluru in India. One of the reasons why this program works well is that CGC | Mumbai is our base. Before the students go to Panchgani or Bengaluru, they take part in an orientation at the Center. The session prepares the students for what they are going to experience, educates them about the big picture, different cultures and approaches. And that becomes our base, our foundation. CGC | Mumbai is part of what makes the program work. It has been a treasured relationship. We have over 70 students applying in the upcoming year. 

Q - India is one of the top sources of healthcare professionals across the world. What would be your advice to students aspiring to pursue a career in nursing?

Dohrn - I will ask nurses and nursing students to have a human rights perspective. We are a profession that believes in serving our community and our society and to seeing that there are no disparities.

Q - As part of the Faculty Advisory Committee of CGC | Mumbai, why do you think the Center is relevant for Columbia faculty, students, and the local community?

Dohrn - CGC | Mumbai has been relevant to our School in many ways. It has a great vision, flexibility, and the ability to build a collaborative relationship that everyone who is involved learns about India and their speciality. Whether it is climate change, nursing or other schools that are involved, the Center allows us to learn in the most rigorous way, about issues and how they affect Indian society and what it means to what we are teaching our students. It has been a real honor when I was invited to be on the Faculty Advisory Committee because I connected with so many other schools here at Columbia University. The Center has helped pull us together and break us out of our silos and it changed the way we could operate globally as well as within India.