Marla Salmon
brings to
 Emory ideals
 from the '60s,
 a work ethic
 from her
 parents,
 and a passion
 for nursing
 that is all
 her own.

 "I was a leftist,
 feminist, radical, war-protesting
 hippie," she once
 told a reporter
 about her
 college days.
 "It was great."

Dean Marla Salmon, the current chair of the World Health Organization's Global Advisory Group on Nursing and Midwifery, served as a member of the US Delegation at the 48th World Health Assembly in Geneva in May 1995, following in the steps of Nell Hodgson Woodruff (right) who also served earlier as a US representative to WHO.

She feels an important message to convey to nursing students 
is that the very
 existence of nursing 
"is derived from its
 social contract
 to do good for 
society and its
 members."

Dr. Salmon, shown here with President Bill Clinton, is no stranger to Washington. She served on First Lady Hillary Rodham Clinton's Health Care Task Force as well as being director of the Division of Nursing for the US Department of Health and Human Services from 1991 to 1997.

n the 1960s, about 5,000 people called Sebastopol, California, home. Most of them were farmers who worked the fertile Northern California fruit orchards. Of those, many were migrant farm hands from far-flung places like Brazil, Japan, and Mexico. They worked alongside Native Americans and the descendants of German Lutherans, who had moved into the area in the mid-19th century. Even by 1960 standards, Sebastopol was a tiny place. Still, it had a large enough Asian community to support a Buddhist temple, and it was idyllic enough to attract its own commune, Morning Star, which brought an antiestablishment contingency of hippies (and their children) into the mix. And then there were the Salmons. Everett Salmon, raised in South Dakota, joined the Civilian Conservation Corps as a teenager and eventually became a doctor with the assistance of the GI Bill. In 1945, he married a Missouri-born nurse named Marceline Adamson, who had served in the Cadet Nurse Corps and who became a partner in Everett's general practice. Both grew up without much money in the midst of the Depression, and they knew what it was like to work hard. They passed along those hard-working values to their four children: a journalist, two opera singers, and one nurse, their daughter Marla. That daughter grew to become the nation's chief nurse, directing the Division of Nursing for the US Department of Health and Human Services (DHHS) from 1991 to 1997. She has served on the faculty of several universities, including Johns Hopkins, Michigan, North Carolina, and Pennsylvania. This past summer, Marla Salmon, ScD, RN, FAAN, received her newest nursing assignment when she accepted the position of dean of the Nell Hodgson Woodruff School of Nursing. Through each of her tenures, Salmon (pronounced "SOL-mon") has carried her parents' sense of responsibility for the good health of neighbors and community. Her father believed in treating all patients fairly, and he took care of migrant workers despite their lack of health insurance or ability to pay. Her mother was a role model, too, bringing to nursing a strong belief in caring and courage. In writing about her own nursing values recently, Salmon recounted an experience her mother had as a student nurse. Although Marceline Adamson had been taught not to question doctors' orders, she did so one day during her training when she knew that a dosage ordered by a physician would be fatal if administered. "She knew that this act of disobedience could put a quick end to her not-yet-begun career," Salmon wrote about her mother. "Nevertheless, the compelling values of courage and truly caring for the well-being of her patient prevented my mother from acting in her own self-interest." The story made an impression on Marceline's daughter.

hese years later, after Salmon has firmly established herself as an energetic nursing leader with an international reputation, it is hard to imagine what she describes as her undistinguished high school career. However, she soon made up for lost academic time at the University of Portland. An undergraduate in the days when women at the Catholic university were not permitted to wear jeans or slacks to university functions, she protested with signs that read if priests could wear dresses, women should be able to wear pants. "I was a leftist, feminist, radical, non-Catholic, war-protesting hippie," she once told a reporter of those days. "It was great." She was also a diligent student, earning good marks that led to a BA in political science in 1971 and a BS in nursing in 1972. With those degrees, Salmon was just getting started in bringing her 1960s values to the world. At the completion of her nursing program, she traveled as a Fulbright Scholar to the University of Cologne, where she studied Germany's national health insurance and public health system. She brought those experiences back to the United States, where she began to tailor a career focusing on health disparities, public health policy, and health care ethics. She earned a doctorate with a concentration in health policy and administration from Johns Hopkins School of Hygiene and Public Health in 1977. She directed the patient advocacy program at Hopkins Hospital and later became its director of nursing and associate director of emergency medicine. She next held leadership positions at the University of Minnesota and the University of North Carolina. Her research has focused on nursing workforce issues, health care reform implications for nursing, health care policy, and public health and community nursing. During the mid-1980s, she was a W.K. Kellogg fellow and a fellow at the Hubert H. Humphrey Institute of Public Affairs. She has been no stranger to the role of principal investigator on national studies that examine public health nursing needs, community-based nursing curriculum, and other nursing workforce topics. She has taken her research findings on the road, presenting papers throughout the United States and Europe. Salmon's accomplishments received national recognition when she was appointed as the DHHS head nurse. Next came her position as professor and associate dean for graduate studies at the University of Pennsylvania, a six-year chairmanship of the National Advisory Council on Nurse Education and Practice, and membership in the US Delegation at the 48th World Health Assembly. She is the current chair of the World Health Organization's Global Advisory Group on Nursing and Midwifery. At each stage of her career, Salmon has brought a passion for nursing and public health to the wider world. In a sense, she's still articulating the values of hard work, equal access to health care, and the courage to do the right thing that she learned from her parents. Those values are consistent with her "hippie days" when she supported individuals' rights and political freedom. These days she's helping the Emory health sciences community define and articulate its own values, values that will ultimately help shape health care of the new millennium.

ust as Marceline Salmon inspired her daughter with a devotion to nursing and specifically to patients' rights, Marla Salmon is strongly committed to passing on that inspiration not only to her own daughter--who has chosen nursing as a profession-but also to her nursing students and faculty colleagues. Teaching and scholarship have long been central to her work. Among the lessons that Salmon wishes to impart to students is the essential role of caring in their profession. She warns against instruction that simply offers one simulation after another. "As we find more ways to teach that remove our students from the people they serve, we must work even harder to make sure that we don't overlook the human connections that teach caring," she wrote in a 1997 article in Nursing and Health Care Perspectives. In addition to caring, the lessons that Salmon emphasizes to nursing students are courage, inclusion, reflective thinking, and social responsibility. She wonders whether today's students really understand that the US health care system serves only some people, while more than 40 million others have no real access to care. She wonders whether students are taking time to reflect on the meaning of what they do. "We must educate more than schooled practitioners," she writes. And finally, she feels an important message to convey to nursing students is that the very existence of nursing "is derived from its social contract to do good for society and its members."

almon believes in signs. It was only natural then, when Salmon contemplated a move to Emory, that she look for signs. After all, she was happy at Penn. "I kept trying to find a reason why Emory wasn't a good fit," she says, "and I decided that I needed to spend a week here. I wanted to be in this environment and see if it matched the values that the university said it held." During that week, she talked with administrators, faculty, students, and total strangers. The message she received again and again was that, at Emory, she would be able to pursue the things she cared most about. She found Emory to offer a simultaneously reflective and vibrant environment with a nursing school that was launching a new doctoral program and soon breaking ground on a new building. She was excited about the possibilities of collaboration with public health faculty, with the university's commitment to teaching and internationalization, and with the health sciences' vision and strategic plans. In particular, the broad-based endorsement of nursing as a major academic unit of the Health Sciences Center and the university were important to her later decision to lead the school. Her administration will emphasize teaching, research, and service that directly impact patient care. She'll judge research development by its promise for improving the way in which nurses provide care. She'll encourage classroom teaching that builds nurse leaders who want to shape the future of the profession. She'll support service that is relevant to the community and that develops community partners with the school. Salmon predicts that the school will need to maintain a fast pace to act on some of the major health opportunities emerging at Emory. She hopes that the nursing school will play an important role in an initiative by Wesley Woods, a geriatrics center, to foster optimal aging that includes housing the elderly in community-oriented facilities rather than more expensive institutions. She wants to build on collaborations with the schools of Medicine and Public Health and neighboring institutions such as the Centers for Disease Control and Prevention. She hopes the School of Nursing can bring its expertise to the Winship Cancer Institute as the center reaches for a new level of distinction. "There's a natural energy right now throughout the nursing school," Salmon says. "The real challenge is to try to frame changes in a way that has more to do with shaping than engineering. The most important thing that I can do is describe the possibilities and enable those in the nursing school to make them happen." Salmon herself is no novice when it comes to making things happen. Her youthful idealism is now seasoned with the confidence and determination that experience can lend. Again, at Emory, she is rolling up her sleeves to enable great things to happen. There's no reason, she says, why Emory's School of Nursing can't be the best in the country. Parents Everett and Marceline would be proud.