October 3, 2003

Terrell Smith — Champion of Families

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Terrell Smith sits in front of the mural in the fifth floor outdoor play area at Vanderbilt Children's Hospital. Her office window overlooks this area, which reminds her of what she's here to do. Dana Johnson

Terrell Smith — Champion of Families

Smith in a meeting. Dana Johnson

Smith in a meeting. Dana Johnson

Terrell Smith meets with Janet Cross, director of Child Life Services. Terrell is the administrative liaison for Child Life as well as many other services at VCH. Dana Johnson

Terrell Smith meets with Janet Cross, director of Child Life Services. Terrell is the administrative liaison for Child Life as well as many other services at VCH. Dana Johnson

From left, Shelby, Billy, Terrell, and Caleb Smith share a hammock in their backyard in Brentwood. Dana Johnson

From left, Shelby, Billy, Terrell, and Caleb Smith share a hammock in their backyard in Brentwood. Dana Johnson

Terrell talks with her pet parrot Toulouse, who is nearly 20 years old. Dana Johnson

Terrell talks with her pet parrot Toulouse, who is nearly 20 years old. Dana Johnson

Her desk is pushed up to the large window in her office for a reason. Below her window is the fifth floor outdoor play area for patients at VCH. She stands at her desk and motions to the view outside.

“You see, there’s a cancer patient right now,” she says as she looks through the tinted glass. “There are days when you look over to that right side, next to the pediatric intensive care unit, and you see a family just falling apart in tears. Then you look over to the left and see the kids with cancer. It keeps you grounded, reminds you what you’re here for.”

When Terrell Smith, RN, MSN, stops speaking, her eyes brim with tears.

“I love what I do,” she says. And you believe it.

Smith is an administrative director for Vanderbilt Children’s Hospital. She is the liaison for operational services like Nutrition Services, social work and environmental services. But the job that takes most of her heart and soul is directing family-centered care at the hospital.

“Family-centered care, in the broadest sense, means welcoming the family as partners in the care of a child,” Smith said.

Her favorite way to describe this change in healthcare is a “Madeline“ story. The children’s book follows the smallest student in Miss Clavel’s school. Madeline comes down with appendicitis. The story reads: “Outside were birds and trees and sky. And so 10 days passed quickly by… VISITORS FROM TWO TO FOUR read a sign outside her door.”

Smith wrote about that passage in a nursing publication, saying that in the old days, “children turned into patients and families were transformed into visitors. It is said, only somewhat in jest, that the initial procedure performed on hospitalized children was the ‘parentectomy,’ the complete removal of the family from the child’s daily life.”

Smith is here to see that never happens in the Monroe Carell Jr. Children’s Hospital at Vanderbilt. When a high-level decision is made, she ensures that the families have been appropriately involved and that their needs have been met. But those around her would agree she manages to do her job with true southern congeniality and a hefty dose of humor. It’s a blend of attitudes and strong values Smith has earned in a life and career strewn with turnabouts and amazing timing. It seems whatever circumstance presented itself, Smith made choices that lead her down a solid path to this very role; and it fits her like a glove.

A native of Birmingham, Ala., Smith’s career has been mostly in pediatric nursing — a calling she nearly didn’t hear. Good thing her mother was paying attention to the woman her daughter had become.

“I was planning to go to Sullins, which at the time was a girl’s finishing school in Bristol, on the Tennessee/Virginia border,” recalls Smith. “It was my 17th birthday, Sept. 6, several days before I was to leave, when my mother gave me the gift that changed my life. It was a nurse’s watch, with a second hand.”

That seemingly subtle hint, that she might find her heart’s desire in the field of nursing, was more like a wallop on the top of the head to Terrell. The next day with full support of her family, Terrell frantically worked to switch into a Birmingham nursing school days before the classes began. She never looked back.

What followed was three decades of adventure.

“I was finished with school and actually started as a staff nurse at Children’s Hospital [in Birmingham] at age 19. So I was basically an adolescent orienting as a nurse on the adolescent unit.”

But she was wise beyond her years — or maybe it was more like driven by naive idealism — because the next turn in her career led her to a poor community in Brazil as a member of the Peace Corps. She led a nursing unit at a Brazilian hospital through desperately poor conditions. Her adventures taught her to speak fluent Portuguese, and to have an appreciation of North American medicine.

In the late 1970s, she returned home to Birmingham, Ala., to the children’s hospital where she had worked for several years. But this time she was a well-seasoned pediatric nurse with a world of experience under her belt.

A co-worker in Birmingham at that time, budding children’s hospital administrator Jim Shmerling, recalls working with her under difficult circumstances.

“A child died, and I had never experienced a child who died,” recalls Shmerling, CEO of Vanderbilt Children’s Hospital. “I remember going with Terrell to talk with the family and how compassionate and how well she communicated with that family in that difficult time. I was so impressed. She gave me a great respect for people who work in children’s hospitals.”

Many years, and several jobs later, Smith would cross paths with Shmerling again. This time, the turnabout was Shmerling’s.

“I was being approached about becoming the CEO at Vanderbilt Children’s [Hospital], but I was reluctant because I was happy in Memphis at Le Bonheur. It was 2002, and I ran into Terrell at a national association meeting. We got on an elevator and she told me what a fool I was for not considering coming to Vanderbilt. Her husband was on the elevator too and couldn’t believe the way she was talking to me,” laughs Shmerling. “It was because of her persistence and enthusiasm that I decided to take another look.”

Smith’s engaging combination of frankness and congeniality isn’t lost on many. It endears her to friends and colleagues, but perhaps her drive to succeed and her high standards didn’t serve her well on dates, because by the time she reached her 30s, Smith was still single. By then she was pursuing a master’s degree in nursing administration in Birmingham, but as luck would have it, another birthday brought her another turn of events.

Smith’s friend asked her what she wanted for her birthday that year. She told this friend she wanted a nice man who had a head sized to fit through the door. The friend sent Billy Smith to pick up Terrell on a blind date. Love blossomed over a shared interest in good food and good books, but it may have been the cheap air fares offered by Southwest airlines that made it stick.

“We had started dating when we both lived in Birmingham, but then she took the job in New Orleans and the plane tickets were so cheap, we just started commuting back and forth to see each other,” said Bill.

“$49, round trip,” smiles Terrell. “We love Southwest Airlines.”

They were married and began a long term, long-distance marriage that had Bill, a dentist, traveling from Biloxi to practice dentistry, during the week, and then back to Terrell in New Orleans on the weekends. They did that almost a year.

Then Bill decided to make a career change, and move to Tennessee to do consulting work. Terrell looked for work too. She found the administrative director position at Vanderbilt Children’s Hospital.

“This happened to fit,” says Terrell. “It was like fate.”

That was 1993. Terrell still had many adventures ahead of her.

VCH icon Judy Koonce says what sticks in her mind the most is the image of Terrell, cool under pressure in the basement of Vanderbilt Hospital on the evening the tornado struck in 1996.

Terrell was the administrator in charge and had to deal with a couple hundred people, many of them children, who had evacuated their patient rooms for the safety of the basement.

“She had a cell phone in one ear, a walkie-talkie to the other and her beeper, and it seemed like they were all going off at the same time,” remembers Koonce. “But she said ‘I’m in charge’ and got milk, juice and diapers to the basement for those people. She was there until 3 a.m. making sure everyone was safe.”

Then there was a water emergency when a busted water main cut off fresh water to the Medical Center; and then a fire in the Pediatric Intensive Care Unit that forced an evacuation. She was in charge both those times too.

She’s been through the wringer more than a couple of times, but always came through. She says when days are difficult, she has a ‘bad day drawer.’ She pulls out letters from friends, patients, and admirers from over the years.

One letter-writer tells her he sees God honoring her work and that she continues to make a difference in the lives of children and families. Another is from a nurse Terrell rehired, thanking her for giving her a second shot. Terrell is well known to taking the time and energy to nurture those around her.

These are the things people know about Terrell. She truly likes people. Many know, for instance, that she parks in the shuttle lot way off campus — on purpose. She just likes to visit on the ride over, chit chat and get to know people. She’s personable, loyal, caring and tough. But she has her secrets. We may as well blow the lid on a few of them now.

First there’s her name. ‘Terrell’ is actually Barbara Ann Terrell Smith’s maiden name. She was 35 when she married Bill, and was, well, opinionated.

“Barb and Billy Smith sounded pukey.” Terrell said (yes “pukey”).

“I just couldn’t do it, and at the time, an instructor at school told me I’d be the fourth Barb Smith he knew, and I’m not that common,” she smiles.

The combination satisfied her and appeased her husband’s desire to have a wife that would take his admittedly common last name.

Terrell is also an animal lover. She has had several parrots as pets over the years. Right now, she has an African Grey, named Toulouse. Toulouse has been a great source of fun for Terrell and the source of at least one good story.

“Right around Christmas time the year after we adopted our daughter Shelby, we had neglected to clip his wings and he managed to get away from us,” Billy said. “He flew into a neighbor’s tree and wouldn’t come down. Terrell got very worried and stood out there in the cold to keep an eye on him for hours. That night happened to be the luminary night in our neighborhood in Brentwood, when people drove around to see all the lights. The police chief noticed Terrell and saw the bird in the tree. The next thing we knew, a fire station was bringing a ladder truck. People were driving by and stopping. A crowd gathered, the holiday lights were on, Dr. Raiford’s wife, Lisa, was serving hot chocolate, and a spotlight was trained on Toulouse,”

Billy shook his head in embarrassment. “There was great applause when Toulouse was finally brought back to earth safely.”

That legend is nearly as good as the time one of Terrell’s three dogs got into a skirmish with a skunk. Billy was away that evening, so Terrell filled a plastic tub with gallons of tomato juice and washed the pup up. But the next day Billy met Terrell for lunch at the hospital and went through the cafeteria checkout before her.

When it was Terrell’s turn, the cashier, long time employee Roger Rister, sniffed the air and asked her if she smelled a skunk.

“I was mortified,” recalls Terrell. “I was sure I’d gone through that whole morning smelling up hallways and meeting rooms without knowing it. Then Billy fessed up. He’d put Rister up to it.”

When you sprint through life, as Terrell Smith does, you’re bound to run into a few more things than the average person does.

“Every time I walked with Terrell anyplace there would be some mishap that would happen and she would stop and try to fix it,” says Debbie Arnow, assistant administrator and director of Acute and Critical Care Nursing, with a smile. “Whether it was a picture that started falling off the wall she’d be trying to hold it up, or someone who needed assistance, she’d stop and give it. But the best one was the time we were walking to Medical Center North a few years back, and a goat had evidently gotten out of a lab somewhere. The next thing I know, there’s Terrell, running across the plaza trying to catch it. Terrell will try to fix whatever she can; she’ll try to catch the goat.”

That sounds like a pretty good motto, but the goat Terrell will always pursue is a shuffling of the priorities of any system that doesn’t put the family first. Family is a precious word for Terrell, who is adopted and has chosen to adopt two children herself. The Smiths became a family of three shortly after moving to Nashville.

“It was Palm Sunday 1993,” Billy said. “We got a call. They said we had a little girl and we could pick her up in four days. We went to the Baby Super Store right away but had no idea what to buy. We picked up some wipes and came home.”

Shelby is now a beautiful 10 year old with long dark hair.

“It was really Shelby who decided she had to have a sibling,” said Terrell. “She reminded us that if she didn’t have a sibling that her family would be so small. She already has no cousins or aunts and uncles. We couldn’t argue with that.”

So this summer, the family adopted a boy from Russia. They traveled with Shelby an hour and half from Vladivostok, on the Sea of Japan, to meet 5-year-old Caleb.

“Shelby even picked his name,” said Terrell. “We looked the name up in the Old Testament, and the passage in Numbers was: “Because my son, Caleb, has a different spirit and follows me wholeheartedly, I will bring him into the land which he came to and his children will inherit it.”

The family thought that was very appropriate for their new son. Caleb came home to Nashville to begin life with his new family on another important birthday, Terrell’s mother’s 94th birthday. Nothing, says Terrell, could have pleased Silver Terrell more.

Billy, who is back to dentistry, walks the walk with his wife on putting family first. Now with the two kids, he has cut back to working part time as the dentist to the inmates at Riverbend Maximum Security Prison.

Terrell does her part. She took a month off work to bond with her new son, and then took a day off every week in the month of August as well. Co-workers say she doesn’t miss school events and she works smart during the day so as not to cut into her family time.

But staying grounded in life is something Terrell and Billy Smith work at even when they aren’t at work or with the kids. The couple takes mission trips with their church, First Baptist of Nashville, and offer dental and health care to low-income people in Brazil.

“We feel like we need to do things for people that are not as blessed as we are,” said Billy. “I think we did the right thing, Terrell and I, in getting married and following the course of life we have; I’ve never had any doubts.”

Terrell agrees.

“We’ve been truly blessed in life, we try to challenge ourselves to find ways to give back,” she says.

And if Terrell ever has any doubts about the point she has come to in life and at Vanderbilt Children’s Hospital today, she says all she has to do is look out that window.