Dr. Ulrich is a nationally recognized thought leader who is known for her research studying nursing work environments and the experiences of new graduate nurses as they transition from nursing school into the workforce and and for her leadership in developing the roles of nephrology nurses and improving the care of nephrology patients. Dr. Ulrich has extensive experience as a healthcare executive, educator, and researcher. She currently serves as a Professor at the Cizik School of Nursing at the University of Texas Health Science Center at Houston, as Editor of the Nephrology Nursing Journal, the official journal of the American Nephrology Nurses'Association, and as the Senior Partner of Innovative Health Resources, providing consultative services to healthcare organizations and associations. Dr. Ulrich has been a coinvestigator on a series of national nursing workforce and work environment studies and on studies of critical care nurse work environments conducted for the American Association of Critical-Care Nurses. She has numerous publications and presentations to her credit including her book Mastering Precepting: A Nurse's Handbook for Success, which was named a 2012 AJN Book of the Year.
1. What are the significant professional milestones in your career journey?
BU: I have had such a wonderful career with so many great opportunities that it's hard to pick just a few milestones. I'd like to tell you that I planned my nursing career, but that's just not how it happened.
Nephrology. The first milestone was more of a door opening to a world that I didn't even know existed. It came a year after I graduated from nursing school when I heard about a position in a hemodialysis unit in a large Army hospital. I was hired to open their home hemodialysis program, and they already had their first home patient scheduled to begin training in 6 weeks. What did I know about hemodialysis or kidney function? Not a lot. But I had done an independent study in my senior year working with a patient who was on hemodialysis and who had a kidney transplant, and I was intrigued. The specialty and I were both in our professional infancy, and we grew together.
Involvement in a professional association. I became active in what is now the American Nephrology Nurses' Association and eventually served as its President. In that role, I had to develop communication and leadership skills at a whole new level, as we defined the roles of nephrology nurses and worked with the U.S. Congress and Medicare to refine the standards of caring for nephrology patients. I was exposed to nursing and health care at a national level, and that influenced the rest of my career.
Management and education. I got my first management job as director of a hemodialysis unit. What did I know about management? Not much. But I had a boss who said he would teach me what I needed to know. And he did. It was a one-on-one management course, and I naively thought all managers got that kind of education and support when they took their first management position. By then, my horizons had broadened. I could see that education was necessary to be a better nurse and to have a more successful career, so I went back to school and got my master's degree. I taught for a bit, but I was drawn back to the pace and-dare I say-excitement of an acute care hospital and specifically an offer to open a comprehensive kidney institute and be involved in major research on advances in kidney transplantation. I was priviledged to have a chief nursing officer who saw my potential future better than I did, taught me to be an executive, and encouraged me to finish the doctorate that I had started while I was teaching. I went on to hold executive positions in healthcare organizations, to learn so much about so many things, and to develop treasured relationships with great nurses and other healthcare colleagues.
Writing and editing. I wrote my first article as a result of a challenge from one of the professors in my master's program. I didn't even tell anyone that I submitted an article because I was so sure it would be rejected. I wrote my first book because there was no nephrology nursing book available and I got tired of copying articles to use in educating nurses on the new specialties of hemodialysis, peritoneal dialysis, and kidney transplantation. I was honored to become the Editor of the Nephrology Nursing Journal 16 years ago. It's a different and powerful opportunity to influence nursing practice and the quality of care for our patients and to help others do the same. My book on mastering precepting was another book born from frustration and passion. I was working with hospitals across the country to implement new graduate nurse residencies. I saw great preceptors and not-so-great preceptors, especially when the organizations had moved people into preceptor positions without providing them with education in how to be a preceptor and support to function in the role. And I saw new graduate nurses who flourished or struggled based on the competence of their preceptors. I'm happy to say that that book has been very well received-especially by nursing professional development (NPD) practitioners who are providing both education and support to preceptors-and the second edition of the book will be published in the fall.
Education. Four years ago, I came back to one of my alma maters to teach in a nurse executive DNP program. It combines my experience as an executive with my love of teaching and helping nurses advance in their careers. Milestones occur for me every time my DNP students graduate, to do things that 3 years earlier they didn't know were possible, and advance their careers.
2. How have you seen the specialty of NPD grow/evolve/change during your career?
BU: Just as we have become increasingly evidence-based in clinical practice, the specialty of NPD has become evidence-based education and development, and it has gained its voice as a specialty. That has benefited nurses and patients.
3. From your perspective, what do you see as significant trends or gaps in nursing practice that NPD could address? What insights can you share related to the value of NPD in healthcare organizations now and in the future?
BU: I believe that all nurses (and other healthcare professionals) who experience a transition in level of practice or in a change in role or specialty deserve preceptors to do all the things a preceptor does to help them be successful-teach/coach, lead/influence, facilitate, evaluate, socialize to the role, protect, and role model. I also believe that preceptors deserve to be educated on how to precept and to be supported in the role. NPD practitioners are clearly positioned to lead both of these efforts and, in doing so, to influence the future practice of nursing and the careers of nurses.
4. What advice do you have for NPD practitioners in the context of today's health care and learning environments?
BU: Embrace uncertainty and change; learn to use it to do what you as NPD practitioners know needs to be done to improve nursing and patient care. For yourself, find your passion and pursue it. Don't leave your career to chance. Put yourself in the best position to be in charge of your career through advanced education, experience, and networking. You never know what opportunities will come, but you need to be ready and qualified when they do.