“I would love to see integrative and wellness initiatives in older adult care,” says Sarah Campbell, associate clinical professor at the Sue & Bill Gross School of Nursing and assistant director of DNP student wellness and experience for the school.
Campbell achieved her Doctor of Nursing Practice from The Ohio State University at the height of the Covid pandemic. In 2020, she implemented a cognitive behavioral therapy program with prelicensure nursing students to see if it could reduce their stress, anxiety and depressive symptoms. At the same time, she recalls, “I was teaching advanced health and physical assessment virtually for the first time, both my parents had strokes seven weeks apart, then my whole family got Covid…I don’t know how I got through it.”
Her DNP study, chaired by her mentor at Ohio State, Dr. Bernadette Melnyk—the first chief wellness officer at any U.S. university —“got remarkable results. Despite the turmoil of the pandemic, participants reported significantly decreased stress and anxiety.”
Campbell “got through it” too. On reflection, she credits the strong support and encouragement of her mentors and colleagues at work, the tolerance of her family—“my husband and children were saints,” she says —and the importance of prioritizing practices such as daily prayer and meditation. “I take the principles I learned during that challenging time as lessons I try to pass on to our DNP students today,” she says.”
“At the Student Health Center on the UC Irvine campus, where Campbell has her clinical practice, she is working to build on the success of her DNP study. She explains that the potential of DNP initiatives to have immediate impact continues to motivate her.
“DNPs are leaders at getting research into the field,” she says. “Research typically takes years to be put into practice. DNPs implement it much sooner, which is why we need more DNPs throughout healthcare. DNPs can lead and shape policy by applying research findings and making informed, organization-specific recommendations based on appraisal and evidence.”
Changes that Campbell would like to effect include “really solid programs for student wellness in place for our school.” She is seeking to explore the impact of physical (exercise-based) interventions on students’ perceptions of wellness, and would like eventually to make both physical and mental health programs accessible to students at other schools under the UC Irvine health sciences umbrella. These students are destined to become practitioners and, Campbell argues, will be better able to guide their patients if they understand both the health and the quality-of-life benefits of building resilience and feeling well.
“Provider wellness is key to provider success,” she explains.
“Personal experience with wellness techniques gives providers the skills to be proactive in their approach to health.”
Campbell speaks from experience. Before returning to UC Irvine to teach and earn her DNP exam, she worked as a family nurse practitioner in private practice, with a special interest in geriatric health. The nursing of older patients, particularly in the family context, demands a comprehensive, flexible approach that marries well with the individualized concerns of wellness.
“The most important concept is shared decision making,” she says, describing her work with older patients. “We think we know best but maybe we have no idea what the patient’s values are. Blanket statements for everyone make no sense. Consider asking them, ‘What’s most important to you, day to day? Let’s discuss it—how do we get you there?’ As a provider, you’ve got to get creative sometimes. Don’t waste your breath preaching.”
For Campbell, geriatric care feels personal. “My parents took my grandma in when I was three or four years old,” she says. “She had COPD, and my brother and I were never sheltered from that. It didn’t feel scary, it felt normal. It was, ‘Hey, can you help us with grandma’s oxygen tank?’ And my great aunt had rheumatoid arthritis and diabetes, and was the sweetest, most caring person—despite all that, she used to care for us. I would see her in pain when she didn’t know I was looking. I grew compassionate. I appreciate that my parents did that.
“Older people deserve our very best attention,” she continues. “My question to them is, “How do you want to be the best version of you, and how can I help make that happen?”
Despite her obvious passion for her work, it was not immediately clear to Campbell that she should be a nurse. She began school as a performing arts major before eventually switching to nursing—to no-one’s surprise but her own.
“My parents said, ‘Thank God!’” she recounts, “because they always thought nursing was for me. But they wanted to let me fly.”
I would love to see more use of non-pharmacological interventions to reduce geriatric depression and stress.”
Sarah Campbell
After gaining her AS (Nursing) and while taking her BS, Campbell worked as a full-time hospital nurse “on a pretty intense cardiac and renal by a cardiologist she was working with on a heart failure outpatient program, who pointed out that becoming an NP would allow her to practice independently in an outpatient setting.
Returning to UC Irvine in the family nurse practitioner
program, she specialized in internal medicine, which allowed
her to “see patients aged 12 and up—a grandparent, a parent,
a child…I could see familial patterns and I loved that.”
To complete the program she was placed with a “really tough” preceptor, a physician in internal medicine. That experience changed the course of her career.
“I saw how I could work with older adults in private practice,” she says. “I adore older patients. I love what they bring us, I love hearing their stories. Seeing the same patient over and over, developing a relationship with them. I thought, ‘This is it.’ I was done for.”
Campbell took a job at her preceptor’s practice immediately after she graduated. She stayed for six years before embarking on her DNP. Now, a new ambulatory care hospital is due to open at UC Irvine, and Campbell will transition back to care of older adults there. She plans to incorporate her DNP experience into her practice.
“Polypharmacy is a big problem in gerontology,” she points out. “I would love to see more use of non-pharmacological interventions to reduce geriatric depression and stress.”
Use of the term “wellness” has become common in the sale of goods and services that may be unproven and are sometimes expensive. In healthcare, the concept is substantial. It means adopting practices that help maintain a state of mental, spiritual and physical stability such that people enjoy being alive: not just surviving, but thriving. For older people, wellness can be the key difference between a life of fulfillment and one of fear.
“Geriatrics is a complex specialty,” says Campbell. “It takes time. You’ve got to support families making tough decisions; you’ve got to be flexible to what each individual needs. I try to help them be able to delight in their time together, to remind them that everyone deserves joy.”
