B.S.N. University of Arkansas School of Nursing, 1968
M.S.N. University of Tennessee School of Nursing, 1982
MHA, Baylor Univ., Waco, TX, 1997
Assoc. Director Patient Care Services (Nurse Exec.), South Texas Veterans Health Care
System, 2000-present
Chief Nurse, South Texas Veterans Health Care System, 1997-2000
Resident, Audie L. Murphy VA Hosp., San Antonio, TX, 1996-97
I earned my Bachelors in Nursing from the University of Arkansas School of Nursing in 1968. As a new graduate, I entered the Veterans Administration (VA) in Fayetteville, Arkansas in 1968 when the VA was called the Department of Medicine and Surgery. While earning my Masters in Nursing from the University of Tennessee in Memphis, I was a Head Nurse and later Supervisor of Nursing Service in the Memphis VA. I applied for the National Assistant Chief Nurse Training Program and was accepted in June 1989. After one year in the Nashville, TN VA as an ACNS Trainee, I accepted my first Assistant Chief Nurse position in the Muskogee, Oklahoma VA. In January, 1992, I was recruited to the Audie L. Murphy VA Hospital in San Antonio, Texas, to an Associate Chief Nurse position. My intent was to be in San Antonio about three years, apply for Chief Nurse vacancies, and move up in my profession within the VA. Within my first year in San Antonio, the VA’s national leadership changed considerably. The Under Secretary and my own service’s Nurse Leader were recruited from outside the VA “family,” a first for the VA. The intent was to instill private sector business practices within the VA. Directors began recruiting for Chief Nurses from the public sector to add nurses with business experience to their senior management group. I had no health-care business experience or education. I had the unique opportunity to spend three months working with the Director and the Associate Director within the first year at San Antonio for the expressed purpose of better understanding the broader scope of those two positions and to participate in small projects for the Associate Director. It was at that time that I learned of the U.S. Army-Baylor University Graduate Program in Healthcare Administration from my Director, Jose R. Coronado, FACHE.
Mr. Coronado is an alumnus of the Army-Baylor Program, Class of 1972. I believe him to be the most notable alumnus that I have had the distinguished pleasure to know and to have as my Preceptor. Over his many years service as the Director of the now South Texas Veterans Health Care System, Mr. Coronado has served as Preceptor to many Health Administration Residents from several programs throughout the nation. For the past several years, he has managed the VA Graduate Health Administration Training Program (GHATP). He has recruited other Directors to be Preceptors for many new graduates who have progressed throughout the VA. Most noteworthy, however, is his serving as Preceptor to at least one graduate each year for the past 20 years, and many years he has had two graduates learning under his leadership. Many have progressed to Director status in the VA; many are Service Chiefs or Administrative Officers in their respective field, and some have left the VA to pursue CEO status in the private sector. He has definitely impacted on the Health Administration profession throughout the United States. As the Manager of the VA’s GHATP, he has also coordinated the recruitment of selected VA employees to the Army-Baylor Program. He has served as Preceptor to two of the graduates and will soon be Preceptor to two additional graduates. Mr. Coronado is a long-standing member of ACHE and earned his FACHE status several years ago. In the STVHCS, he stresses the importance of every employee to seek certification in his respective professions/field. The STVHCS supports several employees to attend the annual ACHE Conference in Chicago. Within the past few years, the VA has expected those in top management to be certified in their field. Because of Mr. Coronado’s guidance and encouragement, the STVHCS is far ahead of some of it’s “sister” VAs in meeting this challenge.
In the early 1990s, the Army-Baylor Program made available up to four VA positions in their program. I applied for and was accepted to begin in 1995, and successfully completed all requirements for graduation in the Class of 1997. While in the didactic phase of the program, I developed many close friends. Even though I may not see them often, it is always very nice to run into them and see what more they are all doing in their careers. While a student, one learns to work in a group at the highest level. Although highly competitive among students, we all strived to make sure each one of us succeeded. One becomes a member of another extended family. You share the pain, the joy, the accomplishments, and the unfortunate failures with the entire class. My classmates often said to me, “tell us what you really think, Sandy!” I guess I have always been direct, but came to realize it even more with my Baylor friends. Although I had been in the health care field for over twenty years, I was exposed to a much broader picture of the ever-changing health care arena, and learned skills I never believed I would need in my career. Our class was only the second class to have laptops distributed to us and the second to be able to utilize the new technology in the classroom setting. I came to rely on and truly appreciate the computer. At the end of my didactic year, I earned CHE status in ACHE.
During my Residency year, Mr. Coronado felt it important that I not be directly associated with the “clinical” side of the house, so that my training would be solely administratively focused. I accomplished several projects that have impacted services in the STVHCS and gained a much broader understanding of Graduate Medical Education. I completed my Graduate Management Project, “Implementing Product Lines in the VA System.” During the last three months of my residency, I was detailed to the Prescott, Arizona,VA Hospital to serve as Acting Chief, Nursing Service. While I was away, Mr. Coronado began implementing product lines in the STVHCS.
After returning to the STVHCS in September 1997, I assumed the role of Associate Chief Nurse for Operations. In June, 1998, after an intensive interviewing process, I was named Chief, Nursing Service in the STVHCS. In November, 2000, I became Associate Director for Patient Care Services (Nurse Executive). Under my leadership, Nursing, Nutrition and Food, Chaplain, Social Work, Prosthetics, Recreation, and Voluntary Services support the physicians in providing patient care throughout the STVHCS. I serve on STVHCS, VISN 17, and National Nursing committees and councils. I am now directly involved in strategic planning, financial, equipment, space, and human resource decision-making processes. I serve as VISN17’s representative to the VA’s National Nursing Executive Council, which studies programmatic issues and makes recommendations and decisions for change in the entire VA’s Nursing Service. Currently, I am in a small working group that is writing a Nurse Manager Core Curriculum to be utilized nation-wide in developing Nurse Managers. It is that group of nurses that will be the future nurse leaders in the VA. I believe my association with Mr. Coronado and my attending the Army-Baylor Program have provided me the knowledge and experience needed to accomplish my long-standing career goal to be a Chief Nurse and to exceed that goal by becoming an Associate Director. I have approximately 33 years VA service and look forward to an ever-changing healthcare environment for the next few years before my retirement. My focus now is on influencing succession planning for services I supervise and planning for the future of the STVHCS. We find our System to be growing in patient population and in scope. We are recognized as a System that has the greatest potential for furthering the VA/DOD sharing of services. I continue to be involved with the Army-Baylor program indirectly by serving on Orals Panels when requested. I find that experience, believe it or not, to be much more stressful than the student role. On one particular panel experience, I definitely came to fully understand the faculty’s desire to have students succeed and their anxiety when one does not do well in orals.
As a student, I believed the program to be extremely intense. I believed the didactic phase should be extended by six months. However, now I believe it should remain a twelve-month didactic phase. I do believe consideration of the extent of the residency should be more flexible for those who have been in the healthcare field for many years, particularly if in an administrative role for several years.