November 2011 APNA Member Profile: Q & A with Peggy Halter, PhD, APRN

Dr. Peggy Halter is Associate Dean at Ashland University's Schar College of Nursing in Ohio. She also serves as Co-Chair of APNA's Institute for Mental Health Advocacy and is a past president of the Ohio Chapter. You may recognize her name from your PMHN textbooks - she is the editor of Varcarolis and Halter’s Foundations of Psychiatric Mental Health Nursing (2010), and co-edited Essentials of Psychiatric Mental Health Nursing (2009).

How did you get started in nursing?

A reassuring and life-altering back-rub by a sympathetic nurse after a C-section with my second daughter inspired me to become a registered nurse. Two months later I was enrolled in nursing school. Six years later I was employed in (thanks to a 1987 nursing shortage) the stress management unit at Akron General Medical Center. In 1990 I added a freshly minted MSN from Kent State along with a position teaching psychiatric mental health in a baccalaureate program.

Teaching nursing and mentoring has been invigorating and gratifying. As I move into the new role of Associate Dean at Ashland University's Schar College of Nursing, a relatively new program, I am able to help faculty develop their scholarly work, coordinate a sizable HRSA grant, and help plan a graduate program. Involvement in professional associations, personal research, and textbook writing allows me to give back to the profession and the people for whom we advocate.

How did you get involved in health policy and the APNA Institute for Mental Health Advocacy?

In 1996 the American Association of Colleges of Nursing provided new criteria for core curriculum in masters program, one of which was the incorporation of policy in health care. Despite having no background in policy and politics, I was asked to develop and teach this course. As my knowledge grew, so did my social network as students brought in guest speakers that included legislators, board of nursing members, and leaders in professional nursing associations. In 2003 I became the chair of the local Ohio Nurses Association legislative committee and in 2006 was appointed to the Ohio Nurses Association's Health Policy Council. I knew very little about the interface of state politics with how nurses practice at the time and said very little during the first year's meetings...

One of the best decisions I have made has been to seek out strong mentors, individuals who are accessible and responsive. In 2001, I was enrolled in a PhD program and needed to set up a 90-hour health policy internship. I approached Dr. Mike Hogan, the Ohio Department of Mental Health Director, at a NIMH conference to ask if he knew anyone in Ohio who could mentor me. He responded that he would be happy to be the contact himself.

From that internship I learned about the intense politics involved in running a state mental health system. At the same time, Mike was asked by President Bush to chair the President's New Freedom Commission on Mental Health. While I was thrilled to have such a direct line of information about the commission, I secretly hoped that I could have formal involvement, if not on the commission, then maybe on a subcommittee. It didn't happen.

As it turned out, there were no nurses on this commission. Unthinkable. A mental health policy influencing body such as this had no representation from the largest group of mental health care providers in the nation.  Mike and I had several spirited discussions about this issue. He maintained that nurses did not ask to be part of the commission. He agreed to address this issue with me at APNA's Annual Conference in 2007. The presentation, "Nursing representation on the President’s New Freedom Commission” generated some real buzz. I was able to make connections with APNA members who were deeply interested and involved in advocacy issues and also with those who wanted to be.

In 2008 the APNA Board of Directors convened a group - Diane Wieland, Christine Tebaldi, and me - charged with developing the structure for the Institute for Mental Health Advocacy (IMHA). Since then, the IMHA has grown into a steering committee of 10 members and an expert panel of about 150. While the group is young and still evolving, it has already been involved with a multitude of national issues including health care reform and contributing to the development of the DSM-V. 

How do you stay up-to-date on health policy issues/current events affecting the profession?

Until this semester, I taught a class of more than 50 graduate nursing students in a health policy course. There are few better ways to know a subject than to teach it. The textbook, supplemental readings, issues presentations, and speakers were a constant immersion into health policy. The Kaiser Family Foundation tutorials and videos and the Public Broadcasting videos are excellent resources that pare down complex issues into digestible bits.

As a member of the Ohio Nurses Association's Health Policy Council, I regularly review state legislation affecting nurses and healthcare. As a co-chair for the IMHA, there is a steady stream of documents and issues from APNA to appraise and share. I also read the news every morning and I listen to National Public Radio for a couple of hours a day.

To keep things in perspective I watch The Daily Show with John Stewart and The Colbert Report online as I get ready for work. While these programs tend to follow a fairly predictable partisan path, they invariably make me laugh while highlighting the too-frequent hypocrisy of politicians and the national media.

Tell us a little bit about your work on PMHN textbooks....

Nursing was a second career. During my late teens and early twenties I worked in advertising - specifically, typesetting, with a bit of layout and design. I became quite a fast typist and gained an eye for style and form.

I loved to write and as a nursing professor had an impetus in the form of promotion and tenure requirements to engage in scholarly work. One of my early publications, a pilot study that looked at the influence of stigma on nursing students' attitudes toward depression, caught the eye of an amazing woman, Elizabeth Varcarolis, author of Foundations of Psychiatric Mental Health Nursing, a leading undergraduate text. She contacted me to ask if she could include my article in her depression chapter. I was bowled over. 'My article? Of course, I am honored!'

The next thing I knew, I was reviewing chapters for the 5th edition of her text. Elsevier (the publisher) then decided to develop a shorter "Essentials" version of Foundations and asked me to join as second author. I will never forget the day that book was delivered to my office, it was so exciting! To add to the exhilaration, this text was later awarded an American Journal of Nursing Book of the Year Award in 2009.

Still more surprisingly, Betsy Varcarolis announced her retirement and offered me a plan of succession to take over Foundations beginning with the 6th edition. With the help of experts at Elsevier, I somehow signed-on several new contributors, revised multiple chapters, and edited 36 chapters and 842 pages. Now, after a year or so off, the whole process is starting again with edition number seven and a new version of DSM around the corner.

Any closing words?

Nurses are tremendously dedicated to patient care and improving their lives, yet we do not always have the reputation of being as supportive of our peers as we should be. I am not referring to horizontal violence and bullying, but rather the exact opposite – purposefully nurturing and networking with our colleagues, particularly the new ones. I applaud the work that  APNA is doing in linking leaders and potential leaders through their board, institutes, councils, committees, and task forces.

I encourage you to remember those times in your life where others have helped and influenced you and then consciously set out to do the same. As is the case with that nurse who once gave an ailing new mother a backrub, you may never know the difference that you made. I cannot imagine another career choice that would have been more fulfilling.