2024 APNA Award for Innovation – Individual

Diane Vines, RN, PhD, CNS, RRT

Working in support of vulnerable populations has been a passion for Diane Vines from the very beginning of her career. She began her work as a nurse, moving throughout the nation alongside her military spouse – working first in a segregated hospital in St. Petersburg, FL; next within the state hospital system in Pennsylvania, then for a small psychiatric hospital in Chula Vista, CA; and finally in the Bowery and the South Bronx. She served in a variety of roles with one factor in common. Diane shares, “working with the unhoused and vulnerable people became the love of my life.”

Diane says, “I initially didn’t see myself working past the RN level, but my husband consistently encouraged me to further my education. I owe a debt of gratitude to Vanderbilt University, where I completed my Bachelor of Nursing Science (BSN) and was first introduced to Psychiatric-Mental Health (PMH) nursing.”

Opening her first PMH nursing practice in Boston in 1978, Diane also taught and worked on her PhD at Boston University (BU) while serving as Director of Ambulatory Nursing at Boston Children’s Hospital. Doors were opening and Diane was selected to be the first civilian nurse White House Fellow in 1982 – one of 14 Fellows out of 1200 applicants. This opportunity provided unique access as she served as special assistant to the U.S. Secretary of Education and directed the National Adult Literacy Initiative with Second Lady Barbara Bush. She moved back to California to run the arts initiatives for the California State University (CSU) system, and served as Dean of Health and Vice President for Academic Development at the CSU, leading entrepreneurial activities at 22 campuses throughout the state.

Diane explains, “My White House Fellowship truly broadened my horizons and changed my life. I’d love to see more PMH nurses applying for it and experiencing additional community service accomplishments.”

Moving north to Oregon, Diane joined the Oregon University System as Vice Chancellor and was loaned to the Oregon Governor to lead his healthcare workforce initiative. She then returned to teaching at the University of Portland and lead their community health outreach as a faculty member. While teaching, Diane noticed that nursing students who came from more privileged backgrounds experienced big changes in their perspectives after working in area homeless shelters. She shared, “Many nursing students are afraid to go into PMH nursing and come to us with preconceived ideas. It takes real experiences to learn those ideas are not true.”

Diane came back to California to serve as Dean and Professor of Nursing at Mount Saint Mary’s University where students served in many programs for vulnerable populations. In 2016, intending to retire and see patients in her PMH practice, she instead moved to the Coachella Valley in California and began to serve on the faculty at CSU San Bernardino. She additionally took on the role of Director of the Nursing Street Medicine Program at CSUSB, a new program working to increase access to health care by serving vulnerable populations – including the unhoused, low-income seniors, migrant workers, and their families.

“You can see more people when you go where they gather. So, we go and provide healthcare and clothing at places where our partner organizations provide showers, food, and other outreach services,” she clarifies.

Diane also co-founded a collaborative of over 30 organizations that provide outreach services of some kind in the area, to encourage cooperation among organizations and prevent duplication of effort.

In addition to reducing emergency room and acute care facility visits, under Diane’s leadership, the Nursing Street Medicine program began leveraging an innovative approach to teach empathy and behavioral health communication skills to BSN nursing students.

“We began providing foot soaks to the homeless. The homeless person sits on a chair with a cushion while a nursing student sits on a low stool and soaks the homeless person’s feet in Epsom salt and essential oils. The student asks about their lives and listens to the stories, while they examine the homeless person’s legs and feet. They dry the feet and massage them. We find that our homeless participants often cry through the experience, getting emotional that someone is really listening to them,” Diane describes.

The experience for the students is profound and has been proven to change predetermined ideas and improve future patient care. “The foot soaks teach nursing students reflective listening, improved therapeutic communication skills, ways to find commonalities with others, and the need for increased levels of compassion for vulnerable populations – including those with mental illness and substance use disorders. All this takes place in a safe and supportive environment where homeless individuals can receive care and share their experiences,” Diane answers.

The Nursing Street Medicine Program has had hundreds of patient contacts, received positive feedback from students, secured generous grant support and achieved high satisfaction rates among partner agencies. The program has made a notable attitude change among nursing students, as evidenced by surveys conducted before and after their program participation.

Students involved in the program report feeling more comfortable working with homeless individuals, improved communication skills with mentally ill people, and a greater willingness to provide care to vulnerable populations. Due to the program’s success, it’s been replicated through several additional sites – including the Mayo Clinic and Bellevue Hospital in New York – while expanding to include medical students as well.

Diane has presented the findings of her innovative work throughout the world, driving awareness for PMH nursing and improving the quality of care provided to vulnerable populations. She continues her dedication to improving health care access and making a big impact on outcomes for underserved communities.