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Terry Fulmer, PhD, RN It was her very first experience as a nurse that convinced Terry Fulmer, PhD, RN, that the best part of nursing was caring for older patients. Fresh from Skidmore College, where she earned her BS in Clinical Nursing in 1975, Dr. Fulmer had just started working as a staff nurse at Boston's Beth Israel Hospital, one of Harvard's teaching hospitals. "I discovered in the midst of this remarkable teaching hospital that I had this incredible autonomy and authority when working with the older patients," says Dr. Fulmer, whose mother was a nurse and who decided -- at age 5 -- that no other profession could possibly be more exciting or satisfying. "Older adults often need help with activities of daily living, and when they're very ill, they often need help with geriatric syndromes such as incontinence, confusion, and falls - and that's all in the domain of nursing care," she continues. "A physician might diagnose those problems but it's the nursing practice that creates a care plan to address them. With older patients, the most important component of care, by far, is nursing care. It's very motivating." In the 70s, Beth Israel was a particularly fortuitous place for someone realizing a passion for geriatric nursing. Harvard had just established a Division of Aging at the hospital and Dr. Fulmer rubbed elbows, on a daily basis, with a veritable Who's Who of Geriatrics. "Finding myself in the company of a world class group in the field of aging crystallized my commitment," to the field, recalls Dr. Fulmer, now a well known clinician, researcher, professor and administrator herself. She is currently Erline Perkins McGriff Professor and Dean of New York University's College of Nursing. After recognizing, at the beginning of her nursing career, that geriatric nursing was for her, Dr. Fulmer's first step was back to school. While working at Beth Israel, she earned her Master's degree at Boston College and started her doctorate. Before she'd even finished her PhD she was offered and accepted a position as assistant professor of nursing at the college, where she both taught and began doing research into the detection and prevention of elder abuse and neglect. Dr. Fulmer, who was soon promoted to associate professor, also headed the Beth Israel Hospital Elder Abuse Committee. Elder abuse remains a focus of Dr. Fulmer's research and is among several areas in which her work has had considerable impact. In addition to publishing scores of papers, sitting on key panels, and training healthcare professionals to detect abuse and neglect, Dr. Fulmer also played a key role in the development of the Elder Assessment Instrument, a screening checklist now used nationwide. "I've had families call and say that because of our work in this area, they recognized elder abuse in their families," says Dr. Fulmer, describing one of the reasons she finds research so gratifying. "I've also had nurses tell me they've been able to help patients because of our work. And I've heard from promising young scientists in nursing, medicine and other disciplines that they've been impressed by the work and want to carry it on. That's even better." After completing her doctorate in 1983, Dr. Fulmer continued on the faculty at Boston College and accepted an opportunity to serve as an associate director of the Harvard Geriatric Education Center, where she worked until 1987. That year, she was offered joint teaching and research appointments at Yale School of Nursing and Yale New Haven Hospital. Her husband, a businessman, took a job in New York City and their family - which includes daughters Nina, now 22, Holly, 20, and son, Sam, 16 - moved to Rye, New York. Fulmer commuted to New Haven. At the nursing school, she was first a research scientist and then associate professor of gerontological nursing. At the hospital, she was the clinical nurse specialist in geriatrics. In addition to doing research and teaching, she worked with other Yale faculty on the Hospital Outcomes for Patients who are Elderly (HOPE) initiative, aimed at improving hospital care for older adults. On the HOPE project, Dr. Fulmer focused primarily on further developing the Geriatric Resource Nurse (GRN) model, which originated at Beth Israel Hospital and took its current form at Yale. GRN programs provide registered nurses with ongoing, intensive hospital-based mentoring and training in the care of older patients, so they can serve as go-to experts for other nursing staff. "This is now a national model, which has been widely adopted," Dr. Fulmer says, with satisfaction. In 1991, Dr. Fulmer accepted a position as the Associate Dean for Research and, later, the Anna C. Maxwell Professor of Nursing, at Columbia University School of Nursing. At Columbia she also became the first nurse to be named a Brookdale National Fellow, an honor reserved for those with exceptional potential for leadership in expanding the gerontology and geriatric knowledge base. As a fellow under the mentorship of Columbia psychiatry professor Barry Gurland, MD, she did groundbreaking research into unnecessary restriction as a form of elder mistreatment. Along with clinical care and research, teaching and training have always been Dr. Fulmer's passions. At NYU -- where she moved in 1994, was appointed head of the Division of Nursing in 2002 and named Dean of the College of Nursing in 2005 -- she has been deeply involved in initiatives to improve both. At NYU she was, among other things, the principal investigator in the Geriatric Interdisciplinary Team Training Project, an initiative to improve care provided by teams of healthcare professionals. A native of a small town in upstate New York, she also directs a Burdick Rural Training Grant, and the Consortium of New York Geriatric Education Centers, which aim to improve training and education programs in areas with relatively few resources. In addition, she continues to teach students, from the undergraduate to the doctoral levels. "Working with students, every day, there's an "Aha!" moment when they understand that what they're doing is making the quality of life of their patients so much better," Dr. Fulmer says, describing the rewards of teaching nursing students to care for older adults. "You might, for example, show a student nurse how to provide excellent mouth care for an older adults who, as a result, improves her oral intake. It's amazing. All of a sudden there's this profound moment when you help them understand how pivotal their work is." "You know, I have the same passion today that I had when I started," adds Dr. Fulmer, whose younger daughter is now pursuing a career in nursing - to her delight. " I can't imagine anything I'd rather do than care for older patients and teach others to care for older patients."
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