Journal of Nursing Administration:
Departments: Inspiration Point
Adams, Jeffrey M. PhD, RN
Author Affiliation: Director, The Center for Innovations in Care Delivery, and Connell Nursing Research Scholar, Massachusetts General Hospital, Boston.
The author declares no conflicts of interest.
Correspondence: Dr Adams, Massachusetts General Hospital, 275 Cambridge St, POB4, Boston, MA 02114 (email@example.com).
This department highlights emerging nursing leaders and scientists who have demonstrated great promise and findings in advancing innovation and patient care leadership in practice, policy, research, education and theory. This interview profiles Maja Djukic, PhD, RN, assistant professor, New York University College of Nursing.
ADAMS: Thanks for speaking with me today Dr Djukic.
DJUKIC: Thank you and JONA for the opportunity.
ADAMS: Can you share with us a bit about your career in nursing?
DJUKIC: I like to say that I became a nurse by accident. Nursing is not a university major in Serbia, where I grew up, but high school–level vocational training. Coming from a family of engineers, physicians, and architects, I was expected to finish college, so nursing was not on the list of possible careers to pursue. However, when I was 17, I came to the US as a high-school foreign exchange student for a year. My host mom was a nurse educator. She suggested that I stay in the US and go to nursing school at the Tulsa Community College. Even though I knew little about nursing, I followed her advice. She was the 1st in the long line of mentors who helped me to continue to pursue a career in nursing. In 2009, I completed my PhD in nursing at the New York University College of Nursing, where Dr Christine Kovner was my primary mentor. The other inspirational mentors from NYU were Dr Barbara Krainovich-Miller, who was the director of the Nursing Education Master’s Program, which I completed in 2006, and Dr Terry Fulmer, the dean of the college at the time, who involved me in her research and served as a role model for transformational leadership.
ADAMS: What was it that helped you to gravitate toward administrative research?
DJUKIC: My journey is a result of my experiences as a staff nurse in adult critical care. I was often unable to care for my patients in the best way. I knew how, but the poor work environment often hindered my ability to deliver high-quality care. Coming from a country with limited resources to a country with many, I could not understand why working conditions for nurses were not better. I became dissatisfied with my job and considered leaving nursing. Instead, I pursued graduate education, where I became familiar with Dr Kovner’s research, which was one of the earliest to link nurse staffing to patient outcomes.1 Her work inspired me to commit to finding solutions to improve the nurses’ work environment. As a PhD student and then as a coinvestigator on the Robert Wood Johnson Foundation–funded RN Work Project (http://www.rnworkproject.org/), I worked with Dr Kovner and Dr Carol Brewer to build the evidence base linking the nurse work environment to patient care quality. I uniquely contributed to this evidence base by illuminating the importance of the physical work environment for nurses’ job satisfaction2 and their ratings of patient care quality.3
ADAMS: So does your current research build on that work?
DJUKIC: Absolutely, my current program of research aims to improve patient outcomes through system-level nursing workforce and work environment interventions. Examples of recent projects include “NYU3T: Teaching, Technology, and Teamwork” (http://dei.med.nyu.edu/research/nyu3t), a project funded by Josiah Macy Jr. Foundation to develop and implement technology-driven teamwork and collaboration education to undergraduate nursing and medical students at New York University (NYU)4; where I am collaborating with Dr Marc Triola; and a 2nd project “Assessment of RN Education and Practice Role Expectations for Quality Improvement and Safety.” This project is funded by the National Council of State Boards Nursing Center for Regulatory Excellence and the Robert Wood Johnson Foundation, where Dr Kovner and Dr Brewer are my collaborators.5-7
ADAMS: What are your plans for the future?
DJUKIC: My goals are consistent with the Institute of Medicine Future of Nursing key message #3,8 which urges nurse leaders to translate research findings to the practice environment and collaborate with other health professionals to redesign healthcare in the United States. With funding from the Robert Wood Johnson Nurse Faculty Scholar Program, I am partnering with the largest US public health system, New York City Health and Hospitals Corporation, which serves a primarily low-income and diverse population, to explore personal and organizational factors associated with implementation of evidence-based nurse work environment improvement strategies by nurse leaders in frontline and middle management positions.
I think that this research, built on an academic-practice partnership, will answer important questions about how to best support nurse managers as they lead evidence-based collaborative improvements in healthcare environments to improve patient outcomes. I hope that this line of inquiry will also make important contributions to the field of implementation science, where traditionally, the focus has been on identifying factors, processes, and interventions to promote the use of evidence-based clinical interventions by clinicians and not on the use of evidence-based system-level interventions by managers. My ultimate vision is to develop decision-support tools for nurse managers to accelerate translation of management-focused research into their practice.
As a future academic nurse leader, my goals include building expertise in teaching quality and safety competencies with technology across all levels of academic programs and serving in professional organizations that advance nurse leader education and practice based on the best available evidence.
ADAMS: Dr Djukic, we really look forward to your developing work and career.
DJUKIC: It has been great speaking with you.
1. Kovner CT, Jones C, Zhan C, Gerger P, Basu J. Nurse staffing and post-surgical adverse events: an analysis of administrative data from a sample of U.S. hospitals, 1990-1996. HSR Health Serv Res. 2002; 37: 611-629. PMCID: PMC1434654
2. Djukic M, Kovner CK, Budin W, Norman R. Physical work environment: testing an expanded model of job satisfaction in a sample of hospital staff registered nurses. Nurs Res. 2010; 59 (6): 441–451.
3. Djukic M, Kovner CT, Brewer CS, Fatehi F, Cline D. Work environment factors other than staffing associated with nurses’ ratings of patient care quality. Health Care Manage Rev. 2013; 38 (2): 105–114. doi:10.1097/HMR.0b013e3182388cc3
4. Djukic M, Fulmer T, Adams JG, Lee S, Triola M. NYU3T: teaching, technology, teamwork—a model for interprofessional scalability and sustainability. Nurs Clin North Am. 2012; 47 (3): 333–346.
5. Djukic M, Kovner CT, Brewer CS, Fatehi F, Bernstein I, Aidarus N. Improvements in educational preparedness for quality and safety. J Nurs Regul. 2013; 4 (2): 15–21.
6. Djukic M, Kovner CT, Brewer CS, Fatehi F, Bernstein I. Early-career registered nurses’ participation in hospital quality improvement activities. J Nurs Care Qual. 2013; 28 (3): 198–207. doi:10.1097/NCQ.0b013e31827c6c58
7. Djukic M, Kovner CT, Brewer CS, Fatehi F, Seltzer J. A multi-state assessment of employer-sponsored quality improvement education for early career registered nurses. J Contin Educ Nurs. 2013; 44 (1): 12–19. doi:10.3928/00220124-20121115-68
8. Institute of Medicine. The Future of Nursing: Leading Change, Advancing Health. Washington DC: The National Academies Press; 2011.