AT THE BOARD OF TRUSTEES’ RETREAT IN JUNE AT THE CLOISTER IN SEA Island, Dean Marla E. Salmon was called upon to give a presentation to the governing body of the University. Salmon spoke with conviction of a turning point for Emory’s nursing program.

Situated in the heart of Atlanta’s public health corridor—between the Rollins School of Public Health and the Centers for Disease Control and Prevention on Clifton Road—Emory’s Nell Hodgson Woodruff School of Nursing could become one of the top five nursing schools in the nation by 2004, Salmon said, and take the lead in setting a national agenda for the profession.

Her PowerPoint presentation clicked over the details: a 128 percent increase in external funding to $1.55 million; international nursing programs such as the Lillian Carter Center; a jump from thirty-seventh to twentieth in National Institute of Health rankings last year; stabilized student enrollment due in part to more scholarships and financial aid; cutting-edge research by faculty and graduate students on topics from pain management to sleep deprivation.

Indeed, the past few years have been a time of unprecedented commitment to Emory’s nursing program, with the arrival of Salmon in 1999, the introduction of a Ph.D. degree, and construction of the $22-million Nell Hodgson Woodruff building.

“There’s a lot of energy here and a general knowledge that we’re headed somewhere good,” says Salmon, who served as the chief nurse of the U.S. in the mid-1990s and has international stature as a researcher and consultant. “Nursing sits so squarely between the arts and sciences that it calls on a university to grapple with the cost of social good. Our alums are seldom rich. We’re not often in the limelight. We sit squarely in the conscience zone of universities.”

There’s nowhere Salmon would rather be. She grew up in Sebastopol, a small town of fertile ground and fruit orchards in northern California, as one of four children. Her father, a doctor, and mother, a nurse, cared for migrant workers regardless of their ability to pay. “My parents were so idealistic,” Salmon says. “Both had humble roots, and they taught us that being poor or wealthy was not a reflection of character—that the hardest working people are sometimes the poorest.”

Not surprisingly, she welcomed her role as a policy shaper during her six years in Washington, D.C., where she was director of the Department of Health and Human Services’ Division of Nursing from 1991 to 1997. “I have a very old-fashioned view of public service,” Salmon says. “The notion of a civil servant being the highest calling, to work on behalf of the common good.”

Salmon came to Emory from the University of Pennsylvania, where she was a professor and associate dean for graduate studies at the school of nursing. She holds a doctorate in health policy and administration from the Johns Hopkins School of Hygiene and Public Health and degrees in nursing and political science. Salmon has served on the faculty of several other universities, including Johns Hopkins, Minnesota, and North Carolina.

“I can’t imagine a piece of the equation that wasn’t here at Emory. So many variables spoke to me—the public health and international perspective, the sense of social responsibility,” Salmon says. “Civility and diplomacy are still very much a part of Emory’s culture. In the face of conflict, people really work to stay at the table and come back to the table. I treasure this.”

Emory’s School of Nursing has come a long way since its inception in 1905, when the school’s entire teaching inventory, according to Henry M. Bullock’s A History of Emory University, consisted of a microscope, a blackboard, and a skeleton. Lectures were given twice weekly by staff physicians, and the number of graduates ranged from two to ten in the early years.

Today, the school’s nearly three hundred students have access to the latest of high-tech tools in the new 100,000-square-foot Nell Hodgson Woodruff School of Nursing, completed in January. In the Center for Caring Skills, computerized mannequins produce a variety of heart sounds, breathing patterns, bowel sounds, and blood pressure measurements, and there are specialized models for the simulation of labor and delivery.

Opportunities for faculty have also broadened. Nursing professors are actively encouraged to do intensive research, seek grants, and pursue post-doctoral fellowships. Colleagues down the hall may include international nursing educators, such as a recent fellow from South Africa. A new Charles Howard Candler Chair of Nursing has been established, as well as a joint endowed chair with Wesley Woods in gerontology.

“Dean Salmon is one of the true leaders of nursing worldwide, and her understanding and leadership have enhanced the entire Woodruff Health Sciences Center,” says Michael M.E. Johns, executive vice president for health affairs. “She arrived two years ago with a set of goals and is making them reality. Over a short period the school has been immensely successful, with new programs, a balanced budget, an expanded role in research and collaboration with sister schools at Emory, and a palpable sense of academic excitement.’’

But troubling inequities still exist: The nursing school’s endowment, at $25.6 million, is much less than the School of Medicine’s $942.2 million or the Candler School of Theology’s $195.7 million, and salaries for nursing staff and professors (39 full-time, 120 adjunct) are among the lowest at the University.

”We are committed to addressing these concerns,“ Salmon says. ”We are now addressing long-neglected challenges in partnership with the University and health sciences.’’

As a Fulbright Scholar at the University of Cologne, where she studied Germany’s national health insurance and public health system, Salmon learned the value of international relationships. She has chaired the Global Advisory Group on Nursing and Midwifery for the World Health Organization, was a delegate to the World Health Assembly, and recently led a workshop for nurses from the former Soviet Union and Europe at the International Nursing Leadership Institute in Copenhagen.

“She’s been right up there with heads of state and has contacts throughout the world,” says Kathryn M. Kite, a colleague and director of the Lillian Carter Center for International Nursing, who accompanied Salmon to the Copenhagen conference in June. “She can always think of ways to empower people; she’s a true diplomat.”

James W. Curran, dean of the Rollins School of Public Health, admires Salmon’s devotion to projects that combine nursing, medicine, and public health. “Marla has strengthened these interdisciplinary ties,” Curran says, “while advancing the quality and reputation of the nursing school.”

More than ever, in this era of market-driven health care, Salmon believes nurses must serve as patient advocates for the ill, as voices for the forty million Americans with no insurance or access, and as collaborators with scientists, doctors, public health workers, and international colleagues to improve care.

“Nursing and medicine have never been easy careers,” says Salmon, whose daughter, Jessica, is studying to become a nurse. “But nursing affords the privilege of directly touching someone else’s life. There is inherent satisfaction and joy in that.”

Salmon’s desire is for Emory nursing students to develop not only technical skills and academic expertise, but the attributes of caring, courage, reflective thinking, and social responsibility. “I’d like to see the kind of student who wants to shape and improve the future,” she says. “Someone who is always a little troubled by what isn’t being done.”