May 5, 2006

VUMC Reporter Profile: Pilon’s career dedicated to refining art, science of care

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Vanderbilt University School of Nursing’s Bonnie Pilon, D.S.N., R.N., at home with schnauzer Dexter.
Photo by Anne Rayner

VUMC Reporter Profile: Pilon’s career dedicated to refining art, science of care

Bonnie Pilon, D.S.N., R.N., senior associate dean for Practice Management in the School of Nursing, at the Vine Hill Clinic.
Photo by Anne Rayner

Bonnie Pilon, D.S.N., R.N., senior associate dean for Practice Management in the School of Nursing, at the Vine Hill Clinic.
Photo by Anne Rayner

Pilon helped launch the Careflite air ambulance program in Texas.

Pilon helped launch the Careflite air ambulance program in Texas.

Landscaping, gardening and various improvement projects keep Pilon and her husband, Rick Smith, busy at the couple’s Warner Park-area home.
Photo by Anne Rayner

Landscaping, gardening and various improvement projects keep Pilon and her husband, Rick Smith, busy at the couple’s Warner Park-area home.
Photo by Anne Rayner

Pilon and her family enjoy active vacations, including rafting, camping, visiting Major League Baseball parks and traveling in the United States and abroad.

Pilon and her family enjoy active vacations, including rafting, camping, visiting Major League Baseball parks and traveling in the United States and abroad.

There's got to be a better way.

That's what Vanderbilt University School of Nursing's Bonnie Pilon, D.S.N., R.N., has told herself at various crossroads in her life.

It's a philosophy that has served the senior associate dean for Practice Management well. Her passion about health care delivery and drive to improve the system has translated into VUSN now operating five employer-based clinics, three Metro public school clinics, and five community clinics across Middle Tennessee, including West End Women's Health Care.

Pilon began looking for better ways at a young age, and she's kept moving forward ever since.

“Study hard, get good grades, get a scholarship and go to college,” was what Tod and Dot Pilon told daughter Bonnie as she was headed out the door for her first day of kindergarten in Olean, N.Y. Proud parents of humble means, the Pilons viewed education as the key to all good things in life and repeated the mantra often to Bonnie and younger sister, Patty. It worked.

Pilon's was the first generation in her family to go to college. Education has been a constant companion through many turns in her life and career, and, not just formal education, but hands-on experience. Pilon is living proof of, as she calls it, “taking it in, tucking it away and using it someday.”

Volunteering at an Early Age

When the recession hit the Northeast manufacturing industry that employed Tod Pilon in the mid 1950s, he and Dot filled a U-Haul with all their belongings and headed to Clearwater, Fla., where Bonnie and her sister spent the rest of their childhood.

“I was volunteering in the local hospital when I was 16, the earliest possible age I could do it,” said Pilon.

Norma Compton, her neighbor, was a registered nurse in the pediatric unit at nearby Morton Plant Hospital. While most volunteers worked three-hour shifts, Pilon worked the 3 to 11 p.m. shift because she was interested in nursing and, well, she had no other transportation to get back home.

“I would get out of school each Friday, come home, change into my candy striper uniform and head to the hospital,” said Pilon. She eventually picked up additional shifts during her three years of volunteer service. “Norma was a terrific role model and a wonderful nurse. That experience really exposed me to things, and I began to formulate my own ideas about health care.”

Pilon's formal nursing education started on full academic scholarship while at Barry University in Miami, a four-year liberal arts women's Catholic college (now co-ed).

“Since age 12 or so, I knew I wanted to do something in health science, which no one called health science in those days,” said Pilon. “My big decision was whether to go to medical school or nursing school.” She had the grades to do either, but felt that nursing would provide her a better balance of work and home life. “I have been absolutely thrilled about my decision to go into nursing ever since.”

During her undergraduate studies, she was inspired by author Joyce Travelbee's concept of nursing as the “interpersonal use of self” within an evidence-based context. “That notion of using oneself in a therapeutic way to help people respond to illness and injury appealed to me then and still does today. For me, Travelbee's pre-theory work touched on both the art of caring as well as the science foundation of health care.”

First Job as a Registered Nurse

Pilon graduated from college on a Sunday and started work at the Miami VA Hospital the very next day. “I'm no fool,” she admits. “I took the job that paid the most.”

She worked nights on one of the medical/surgical units where staffing ratios two nights a week were one nurse for 55 patients, and there was a lot to accomplish each eight-hour shift. She recalls mixing drugs, filling a cart with as many bottle IVs as she could fit and feeling like she was roller skating up and down the L-shaped ward, something she says would never happen today.

She learned a lot in that unit, but transferred to the surgical intensive care unit (SICU), where she picked up another set of skills. The SICU was doing early work in areas such as pulmonary wedge pressures and intracranial pressure monitoring. Renal kidney transplant patients came there as well. At that time, not all end-stage renal patients got dialyzed, so candidates were selected by committees.

“I remember one of our patients, Willie Jackson,” she said. “He was a Korean War veteran with end-stage renal disease. He was not chosen for dialysis and eventually died. To me he really epitomized what wasn't working in the health care system at the time.

“I knew there had to be a better way, and because of what my parents engrained in me about education, I knew I needed to go back to school to get more knowledge and skills, to gain more understanding, to improve things. Although in those days 'improvement science' had not yet emerged in the U.S. I just wanted to make a difference and felt the need to know more to do that,” she said.

Love at First Sight

With Willie Jackson in mind, she decided to pursue her master's at the University of Florida while working full-time at Shands Hospital, rising to the position of Emer-gency Department/Trauma Center manager.

There, hospital administrators convened a large group of representatives from all critical areas of hospital operations to revise the hospital's disaster plan. Pilon was at the meeting and kept interjecting ways the hospital nursing service could strengthen the disaster plan. Eventually Pilon's boss playfully replied, “OK Bonnie, you make it happen.”

Then, a man's voice from behind her quipped, “I knew that was going to happen.” Pilon turned around to see who made the comment and in doing so met the person who would become her husband of nearly 28 years. Pilon and Rick Smith were married 18 months later.

Smith's new role as a C.P.A. for the Internal Revenue Service took the couple to Dallas, and Pilon soon worked for the Methodist Hospital System. Her first task was getting North Texas' first air ambulance program off the ground within four months. In addition to securing the helicopters, outfitting them for service and training flight nurses, Pilon served as a flight nurse in the new Careflite program. It was common for her to attend management meetings wearing her flight suit and then immediately head to the flight deck.

Pilon and Smith jumped at the chance to move to Birmingham, Ala., in 1983 to be closer to their families. As a director at Baptist Medical Center, Pilon was faced with another crossroad in health care and once again turned to education to help her with the changing environment.

“In 1983 and 1984 the Medicare prospective payment system (DRGs) was being implemented at all acute care hospitals in the U.S. We went from 85 percent occupancy to 51 percent occupancy almost overnight. It was a very hard time in a lot of places. I was thinking there must be a better way.”

With 3-year-old Jennifer and 6-month-old Patrick in tow, Bonnie enrolled in the doctorate program at the University of Alabama at Birmingham in December, 1984.

“It was definitely a time of laughable contrasts,” she says. “Until noon every day I'd be making million dollar decisions for the hospital system, and then I'd drive across town, hunt for a place to park, run into the classroom and remember that there, I didn't know anything.”

She had a chance to teach some senior level classes in the UAB baccalaureate program and was encouraged by Carol Dashiff, former department chair at VUSN, to join the VUSN faculty in 1989 and became Health Systems Program Director in 1990. She also consulted for various domestic and international health systems and served two years as the chief nursing officer at Saint Thomas Hospital. Pilon rejoined VUSN in her current position in 1999.

Life at VUSN

Under Pilon's leadership, VUSN has brought health care to where people live and work. She oversees clinics that have handled nearly 21,000 patients and 511 deliveries during this fiscal year.

“Bonnie has a tremendous amount of energy. She believes in what she's doing. She's committed to serving people through her clinics and supporting her staff,” said Smith.

“What drives Bonnie is her caring for people who, for whatever reason, have limited access to health care,” said Terri Crutcher, M.S.N., R.N., manager of the VUSN-run Vine Hill Clinic. “She's always looking for other possibilities to meet the needs of our patients.”

Although Vine Hill is known for handling an underserved population, it also is a health care resource for working and insured customers, including Pilon, Smith and their children. Smith said he likes the service and level of care. Pilon said her family goes to Vine Hill “because we have a great product and believe in it.”

Pilon also believes in her students and VUSN's Health Systems Management (HSM) program. It combines finance, accounting, leadership and strategic planning to train the health care leaders of the future.

Many of the school's HSM faculty are former students and some are serving in roles that directly impact health care policy at the state and national levels.

Just last week, Pilon received the Tennessee Primary Care Association's Logan Beasley Leadership Excellence Award for her work in finding solutions to increase access to quality health care.

“Bonnie works tirelessly to reflect the voice of the underserved,” said VUSN Dean Colleen Conway-Welch, Ph.D.

“She is an outstanding business woman, constantly creative in seeking community partnerships, and testing new and effective evidence-based responses to health care needs of the patients and families who need primary care.”

“I am in awe of the energy and passion Bonnie brings to her role,” said Harry Jacobson, M.D., vice chancellor for Health Affairs. He describes Pilon as part magician, part acrobat and part contortionist to be so effective at what she does.

“All the while her patients are never aware of all the work and effort it takes to provide them with great care,” he said.

With her rich foundation in health care and surrounded by colleagues and staff who she is quick to share any accolades with, Pilon will continue to look for innovative ways to deliver care to the underserved, to train tomorrow's health care leaders and to champion the nursing profession.

Pilon says it's an exciting time to be in health care.

“I've pretty much always known I'd have a career in health care, and it's been everything and better than I thought it would be.”

Married to Her Best Friend

Throughout the different cities, various jobs, continuous education and family milestones, Rick Smith has been at Pilon's side.

“I always tell people I married my best friend,” Pilon said.

The couple winds down most days with an evening meal and lively conversation. “We talk about everything; about our kids, about our miniature schnauzer Dexter, or just anything that comes to mind,” Smith said. “Bonnie and I have wonderful intellectual discussions.”

They both are also crazy about their children.

“We loved them even before they were born, and we have really enjoyed being parents together,” Pilon said. “Being a parent is the best — and toughest — job I've ever had.” Smith adds, “We have terrific kids.”

Jennifer, 25, is leaving her position at an Atlanta-based law firm to pursue her M.B.A. at Owen School of Management. Patrick, 22, is attending Western State College of Colorado, where he is majoring in biology and double minoring in chemistry and recreation. He serves in the National Guard and is contemplating a career in health care.

Additionally, Pilon and Smith enjoy doing home improvement projects at the house they purchased three years ago near Warner Park. They each have home offices, where Pilon starts working at 6:30 a.m. most days, with Dexter always nearby.

The couple garden and have ambitious plans for this spring and summer. The newest home project is their new kitchen, which Pilon designed.

After years of the clutter that comes with busy lives and raising a family, Pilon is pleased at the clean lines and use of space.

Family Vacations

Bonnie and Rick are dedicated parents. Their family vacations have been both silly and legendary.

Just like her parents before her, Pilon purchased a pop-up camper and would set off for the open road each summer. Their camping trips took them to Maine, Niagra Falls and Sault Ste. Marie, Canada, and across western North Carolina, seeing countless landmarks along the way.

Jennifer giggles as she recalls her fondest and funniest traveling adventures with the family. One year, they spent weeks on a baseball-themed vacation, driving to many major league baseball fields. When they were heading back, Pilon added another point of interest to their travels — something right out of one of her favorite movies, Field of Dreams.

“Mom got the idea that it would be fun to visit the farmhouse and field from the movie,” said Jennifer. “You could visit the actual farm house in Dyersburg, Iowa, see the field and watch baseball players outfitted in vintage White Sox uniforms play a real game.

“Afterward, the players would walk into the nearby cornfields, just like in the movie. The best part was we got to follow them into the cornfields as well. We all thought it was so cool.”

Then there's the 2005 vacation to Ischia, a small island in the Bay of Naples, Italy. The family arrived there for a day of sightseeing with no means of transportation. They opted for a rental car and were astounded when the clerk drove up with a bubble gum pink convertible, the only pink car on the lot and, they soon found out, the only pink car on the island.

“We thought maybe it's the car they give to all Americans,” Patrick laughed. “Just picture us fitting into this tiny pink Fiat, setting out to drive on the scenic roads and beaches on a blue-sky day in Italy. It was just so embarrassing that we had to laugh at ourselves.” The pink car is now an inside joke for the family.

In Her Children’s Eyes

Jennifer says her mom is an important role model who is constantly teaching by doing.

“I still learn from my mom. If she didn't know how to do something, she would find a way to do it. I try to be like that in my job and my life,” she said. “She loves what she's doing and has taught me that whatever you do, be passionate about it.”

One example is a phone call from daughter to mother last summer. “Mom was teaching a class of 300 students and was grading 15- to 20-page papers for each. I asked her if she could get someone to help her and ease the load.

“Mom refused, saying she wanted her students to get the comments from her, that her students deserved her personal attention.”