Former Nursing Dean Ruby Wilson Honored

University recognizes work for innovation in nursing education and care

Nursing Dean Emerita Ruby Wilson

Dr. Ruby Leila Wilson is dean emerita of the School of Nursing, professor of nursing, assistant professor of medicine, and assistant to the chancellor for health affairs. She came to the nursing school as a young faculty member in 1955. In 1963, she was appointed clinical nurse specialist—Duke Hospital's first—providing care for dialysis and kidney-transplant patients in the Division of Nephrology.

Before coming to Duke, Dean Wilson was a staff nurse, head nurse, and night clinical supervisor at Allegheny General Hospital in Pennsylvania. She received a B.S. in nursing education from the University of Pittsburgh, an M.S.N. from Case Western Reserve University, and a doctor of education degree from Duke.

In her early years at Duke, Dean Wilson extended the reach of nursing at Duke, even as she brought her personal energy and vision to rethinking the profession. She helped develop an advanced medical-surgical nursing course and the first-ever master's program in clinical nursing, which became a national model for graduate nursing specialization; co-chaired a program to care for the Durham community in the event of nuclear war, the basis for mass-casualty drills for hospitals still in use today; and directed the first Primary Nursing Project, through which nurses were teamed with physicians to provide more comprehensive patient care.

An Experiment in Nursing Care

In 1961, when 16 senior nursing students expressed interest in demonstrating the difference in performance levels between nurses with BSN degrees versus those with diplomas, then-Professor Ruby Wilson and Eugene Stead Jr., chair of the Department of Medicine, encouraged them to pursue the first primary care nursing project in the country.

At that time, the BSN degree was not wholly accepted within the nursing service organizations of hospitals across the country, Wilson later recalled. While diploma programs had been around "[since the] days of Florence Nightingale, they weren't really quite sure about this nurse who had a degree and exactly how was she different."

The BSN students said they wanted to "practice clinical nursing as they had been taught and not as they had observed being practiced by RN's on the hospital units," Wilson said.

Under Wilson's guidance, the students were enrolled in a special graduate program and, with the support of the hospital, medical school and nursing school, they took responsibility for providing patient care on Hanes Ward, a private medical clinical unit with 35 patients.

During the year that the Hanes Project ran, Wilson and the graduate nurses tested a variety of approaches to patient care, adopting those that proved successful. Each patient on the ward was admitted to a nurse as well as a physician, and their needs were assessed by both. Nursing and medical orders were written side by side, on the same page, to improve communication to all caregivers. (Standard practice at the time was that only the nurses saw the doctors' orders.)

For the first time, patients were charged for nursing services, rather than including this as part of the hospital fee. The nurses even rotated onto different clinical services, such as endocrinology, cardiology and dermatology, to gain experience.

The patient-nurse-physician relationship was a focal point of the project, and soon staff physicians were asking to have their patients admitted to Hanes. The professional growth of the participating nurses was described as phenomenal.

-- From Duke Nursing Magazine, spring 2006.

As dean of the Duke School of Nursing from 1971 to 1984, she was known as an innovator. She encouraged professional development of the faculty; put in place a pioneering undergraduate curriculum combining core and clinical courses, a required independent study, and options for studying nursing in England or in rural community hospitals in North Carolina; and worked to re-establish the graduate program, designed for the clinical generalist or the specialist alike. This was one of the first graduate programs to offer part-time study, enabling graduate nurses to work and study at the same time.

Beginning in the late 1970s, Dean Wilson guided the School of Nursing through the challenging period of "retrenchment" at the university, which resulted in the closing of the school's undergraduate programs. Since that time, the graduate program in nursing has become a hallmark of the medical center.

An early nurse activist in legislative policy on matters relating to health and nursing in particular, Dean Wilson was often a lead representative of nursing organizations at the state and federal levels. She helped draft nursing bills, presented testimony to Congress, and collaborated with other nursing deans to advance a health-care agenda. She also worked to promote inter-institutional collaborations. Her efforts culminated in dual appointments of faculty and clinical staff members between Duke and Veterans Administration hospitals.

Dean Wilson has carried her service commitment into the local community and far beyond. Among many other involvements, she has served on the boards of the Duke Cancer Patient Support Program, the American Cancer Society, Triangle Hospice, and the Women's Forum of North Carolina. She has worked with the Rockefeller Foundation in Thailand to design a research-driven medical center with a new nursing curriculum. She has also been elected to both the prestigious Institute of Medicine and the American Academy of Nursing. As a member of the latter organization, she helped give direction to the 1983 Nursing Study, which recommended a National Institute of Nursing Research; she later helped select the institute's first director. She also served as a presidential appointee on the National Council of Nurse Training of the United States Public Health Service.

In recognition of her enduring support for the university and for the School of Nursing in particular, the School of Nursing building has named as one of its important features "The Ruby L. Wilson Patient Assessment Lab," in Dean Wilson's honor.