- Email: [email protected]
A Passion for Nursing
THOUGHTS & OPINIONS
A Passion for Nursing In Memoriam of Dr. Sharron Smith Humenick Mary Ann Stark
As epidural and cesarean rates climb, a nurse leader provides a model for effective advocacy for normal birth and supportive care for women and their infants. Dr. Sharron Smith Humenick had a passion and devoted her life to providing women with adequate support for natural, empowering birth and successful breastfeeding. Lessons from her life’s work can inspire nurses in our specialty to be tireless and passionate advocates in practice, education, and public policy for supportive nursing care. Dr. Humenick died on September 9, 2006. JOGNN, 35, 681-683; 2006. DOI: 10.1111/J.1552-6909.2006.00101.x Keywords: nursing—normal birth—pregnancy— childbirth education—breast feeding Accepted: August 2006
Since the Journal of Obstetric, Gynecologic, and Neonatal Nursing’s inception 35 years ago, childbearing practices have changed considerably. Electronic fetal monitoring was relatively new in 1971 and offered hope that poor perinatal outcomes could be reduced if not eliminated. Episiotomies were standard practice; few certified nurse-midwives were available to care for childbearing women. Prepared childbirth was gaining momentum, as it offered women control in childbirth in opposition to medicated labors and birth with forceps following spinal or general anesthesia. Cesarean delivery and labor epidural analgesia were far more infrequent than they currently are; an elective cesarean delivery was inconceivable. As multiple interventions and procedures have become routine in childbirth, costs, potential adverse effects, and unintended consequences have multiplied. In reflecting on the lack of evidence to support
many medical procedures during childbirth and the strong evidence for intensive labor support, a nurse leader recently asked, “where are the voices for change … (for) less overtreatment and far more support” (Albers, 2005, p. 68). For more than 35 years, Dr. Sharron Smith Humenick was a tireless and passionate voice for normal birth and supportive care for women and their babies. She devoted her life to providing women with adequate support for both a natural, empowering birth and successful breastfeeding. Lessons from her life’s work can inspire nurses in our specialty. For new nurses, Dr. Humenick’s work provides guidance for an effective and productive professional career. For the majority of nurses in the aging workforce, Dr. Humenick was a model, a leader who mentored and shared her passion so that others could carry on the work she began. Dr. Humenick devoted her time and energy to educating others, conducting research, affecting policy, and mentoring others to share her passion and focus for promoting health of mothers and infants through normal birth and breastfeeding.
T
he work of this nursing leader can inspire novice and expert nurses for a productive and effective career.
Dr. Humenick’s devotion to promoting normal and empowered childbirth and breastfeeding grew from her belief that birthing experiences are important
© 2006, AWHONN, the Association of Women’s Health, Obstetric and Neonatal Nurses
JOGNN 681
to personal development. Experiences that are challenging can be strengthening. Women who find inner strength during normal childbirth are better able to meet the challenges of parenting. To meet the challenge of normal birth, women must be well supported. To this end, Dr. Humenick devoted herself to preparing both families and nurses for normal birth. As both a childbirth educator and one who prepared childbirth educators, she was actively involved for more than 35 years in preparing families for birth and educating nurses on the value of labor support. The evidence strongly suggests the value of being prepared for childbirth (Humenick & Howell, 2003) and the value of labor support (Hodnett, Gates, Hofmeyr, & Sakala, 2003; Kardong-Edgren, 2001). In response to this, Dr. Humenick asked, “how much more research do we need”? (S. Humenick, personal communication, April 21, 2006). Knowing that women need support in labor, she provided education on effective labor support husbands, support persons, and nurses. Additionally, she served as the editor in chief of The Journal of Perinatal Education for the last 10 years and wrote numerous books for practicing nurses, four of which received the prestigious American Journal of Nursing (AJN) Book of the Year award. All these activities focused on her commitment to support families in normal childbirth and breastfeeding. In addition to her work as an educator, Dr. Humenick focused her research on promoting the health of women and children through breastfeeding. Her research on the measurement of human milk maturation and the clinical problem of insufficient milk syndrome has been recognized internationally. As an early investigator of lactation and the recipient of two grants from the National Institute of Nursing Research, Dr. Humenick conducted important research that provided early practice knowledge for lactation consultants and nurses.
T
o meet the challenge of normal birth, women must be supported by nurses and families who are prepared for this role.
Dr. Humenick’s influential work provided her opportunity to influence public policy, especially in the area of human lactation. She actively supported breastfeeding in her workplace and at the state, national, and international levels. On the campus where she taught, she established a breastfeeding/lactation station for breastfeeding mothers, whether they were students or faculty. She testified before the Virginia legislature was invited to appear before Congress, gave presentations nationally and internationally, 682 JOGNN
and served as a representative from the Breastfeeding Expert Panel of the American Academy of Nursing to the U.S. Breastfeeding Committee. Finally, Dr. Humenick was a mentor to many who shared an interest in normal birth and breastfeeding. Because she was very clear about her focus, she poured her time and energy into those who shared her vision. As a busy and accomplished nurse educator, editor, and researcher, she had many demands. When asked to give time and energy to someone who shared her passion, this request “always goes to the top of the list” (S. Humenick, personal communication, April 21, 2006). Mentoring requires a great deal of time but Dr. Humenick found that in mentoring she was able to encourage others to accomplish many things. “Do good work and support others to do good work” drove her commitment to mentoring (S. Humenick, personal communication). Dr. Pamela Hill is one recipient of Dr. Humenick’s mentoring. When Hill learned of Humenick’s work (1987) on the milk maturation index, Hill contacted Dr. Humenick, who provided “the life jacket needed for survival” in her career (P. Hill, personal communication, April 7, 2006). The two worked in different areas of the country and arranged several meetings. They met at a conference they both attended and at a restaurant when Dr. Humenick was driving with her family on a vacation through the state where Hill lived, and they finally worked in Dr. Humenick’s basement to write a grant to study insufficient milk supply. Hill recognizes Dr. Humenick’s “generosity, wisdom and willingness to share” as a mentor that was the launch of her research trajectory (P. Hill, personal communication, April 7, 2006). The grant was funded, and their collaborative work provided practicing nurses information about insufficient milk supply and breast engorgement (Hill & Humenick, 1989, 1994, 1996). Dr. Humenick’s work as a mentor provided the personal fulfillment of meeting others and establishing friendships with those who shared her vision.
N
urses with a passion should be knowledgeable of the research continually maintain skills that support their passion.
Many lessons can be learned from Dr. Humenick’s successful career in advocating for normal birth and breastfeeding. First, nurses should be clear about their passion in nursing. Dr. Humenick focused her work on her passion and did not deviate from it. While Dr. Humenick worked Volume 35, Number 6
to support normal birth, she recognized that interventions, such as labor epidurals are available and part of the health care system. She advised nurses not to advocate for unnecessary interventions. She used the analogy that during a marathon, a sag wagon is always available; however, those who support the runner do not encourage the runner to climb immediately into the sag wagon. Nurses can encourage women to have a normal birth, providing them with supportive and creative nursing care to facilitate labor and meet its demands. Second, nurses with a passion should be knowledgeable of the research in the area and continually maintain skills that support their passion. Dr. Humenick demonstrated this in her continuing work with nurses, childbirth educators, and parents. Third, think long term and not short term. Early promises of continuous electronic fetal monitoring (CEFM) reducing negative fetal outcomes diminished when later research suggested primarily an increase in cesarean delivery and operative vaginal delivery with CEFM (Priddy, 2004). Likewise, Dr. Humenick suggested that we do not know the long-term effects of elective cesareans and labor epidurals on women and their families. What is lost in the long term with these interventions is the empowerment of a normal birth. Last, Dr. Humenick advised that nurses should work toward something positive. This work is good for the soul and provides personal gain in satisfaction and networking with others. I honor Dr. Sharron Humenick’s memory for her work during the last 35 years to promote normal birth and breastfeeding and the lessons she taught many through her passion for nursing care of women. Mothers, babies and nurses have lost an exemplary author, researcher, mentor and advocate. We will all miss her.
November/December 2006
REFERENCES Albers, L. L. (2005). Overtreatment of normal childbirth in U.S. hospitals. Birth, 32, 67–68. Hill, P., & Humenick, S. (1989). Insufficient milk supply: Exploration of a concept. Image: The Journal of Nursing Scholarship, 21, 145–148. Hill, P., & Humenick, S. (1994). The occurrence of breast engorgement. Journal of Human Lactation, 10, 87–93. Hill, P., & Humenick, S. (1996). Development of the H & H lactation scale. Nursing Research, 45, 136–140. Hodnett, E., Gates, S, Hofmeyr, G. J., & Sakala, C. (2003). Continuous support for women during childbirth. In The Cochrane Library (Issue 3). Oxford, England: Update Software. Humenick, S. (1987). The clinical significance of breast milk maturation rates. Birth, 14, 174–181. Humenick, S., & Howell, O. (2003). Perinatal experiences: The association of stress, childbearing, breastfeeding and early mothering. Journal of Perinatal Education, 12, 16–39. Kardong-Edgren, S. (2001). Using evidence-based practice to improve intrapartum care. Journal of Obstetric, Gynecologic, and Neonatal Nursing, 30, 371–375. Priddy, K. (2004). Is there logic behind fetal monitoring? Journal of Obstetric, Gynecologic, and Neonatal Nursing, 33, 550–553. Mary Ann Stark, PhD, RNC, is an assistant professor at Western Michigan University, Bronson School of Nursing, Kalamazoo. Address for correspondence: Mary Ann Stark, PhD, RNC, Western Michigan University, Bronson School of Nursing, 8379 Phoebe Street, Kalamazoo, MI 49009. E-mail: mary.stark@ wmch.edu
JOGNN 683
A Passion for Nursing In Memoriam of Dr. Sharron Smith Humenick Mary Ann Stark
As epidural and cesarean rates climb, a nurse leader provides a model for effective advocacy for normal birth and supportive care for women and their infants. Dr. Sharron Smith Humenick had a passion and devoted her life to providing women with adequate support for natural, empowering birth and successful breastfeeding. Lessons from her life’s work can inspire nurses in our specialty to be tireless and passionate advocates in practice, education, and public policy for supportive nursing care. Dr. Humenick died on September 9, 2006. JOGNN, 35, 681-683; 2006. DOI: 10.1111/J.1552-6909.2006.00101.x Keywords: nursing—normal birth—pregnancy— childbirth education—breast feeding Accepted: August 2006
Since the Journal of Obstetric, Gynecologic, and Neonatal Nursing’s inception 35 years ago, childbearing practices have changed considerably. Electronic fetal monitoring was relatively new in 1971 and offered hope that poor perinatal outcomes could be reduced if not eliminated. Episiotomies were standard practice; few certified nurse-midwives were available to care for childbearing women. Prepared childbirth was gaining momentum, as it offered women control in childbirth in opposition to medicated labors and birth with forceps following spinal or general anesthesia. Cesarean delivery and labor epidural analgesia were far more infrequent than they currently are; an elective cesarean delivery was inconceivable. As multiple interventions and procedures have become routine in childbirth, costs, potential adverse effects, and unintended consequences have multiplied. In reflecting on the lack of evidence to support
many medical procedures during childbirth and the strong evidence for intensive labor support, a nurse leader recently asked, “where are the voices for change … (for) less overtreatment and far more support” (Albers, 2005, p. 68). For more than 35 years, Dr. Sharron Smith Humenick was a tireless and passionate voice for normal birth and supportive care for women and their babies. She devoted her life to providing women with adequate support for both a natural, empowering birth and successful breastfeeding. Lessons from her life’s work can inspire nurses in our specialty. For new nurses, Dr. Humenick’s work provides guidance for an effective and productive professional career. For the majority of nurses in the aging workforce, Dr. Humenick was a model, a leader who mentored and shared her passion so that others could carry on the work she began. Dr. Humenick devoted her time and energy to educating others, conducting research, affecting policy, and mentoring others to share her passion and focus for promoting health of mothers and infants through normal birth and breastfeeding.
T
he work of this nursing leader can inspire novice and expert nurses for a productive and effective career.
Dr. Humenick’s devotion to promoting normal and empowered childbirth and breastfeeding grew from her belief that birthing experiences are important
© 2006, AWHONN, the Association of Women’s Health, Obstetric and Neonatal Nurses
JOGNN 681
to personal development. Experiences that are challenging can be strengthening. Women who find inner strength during normal childbirth are better able to meet the challenges of parenting. To meet the challenge of normal birth, women must be well supported. To this end, Dr. Humenick devoted herself to preparing both families and nurses for normal birth. As both a childbirth educator and one who prepared childbirth educators, she was actively involved for more than 35 years in preparing families for birth and educating nurses on the value of labor support. The evidence strongly suggests the value of being prepared for childbirth (Humenick & Howell, 2003) and the value of labor support (Hodnett, Gates, Hofmeyr, & Sakala, 2003; Kardong-Edgren, 2001). In response to this, Dr. Humenick asked, “how much more research do we need”? (S. Humenick, personal communication, April 21, 2006). Knowing that women need support in labor, she provided education on effective labor support husbands, support persons, and nurses. Additionally, she served as the editor in chief of The Journal of Perinatal Education for the last 10 years and wrote numerous books for practicing nurses, four of which received the prestigious American Journal of Nursing (AJN) Book of the Year award. All these activities focused on her commitment to support families in normal childbirth and breastfeeding. In addition to her work as an educator, Dr. Humenick focused her research on promoting the health of women and children through breastfeeding. Her research on the measurement of human milk maturation and the clinical problem of insufficient milk syndrome has been recognized internationally. As an early investigator of lactation and the recipient of two grants from the National Institute of Nursing Research, Dr. Humenick conducted important research that provided early practice knowledge for lactation consultants and nurses.
T
o meet the challenge of normal birth, women must be supported by nurses and families who are prepared for this role.
Dr. Humenick’s influential work provided her opportunity to influence public policy, especially in the area of human lactation. She actively supported breastfeeding in her workplace and at the state, national, and international levels. On the campus where she taught, she established a breastfeeding/lactation station for breastfeeding mothers, whether they were students or faculty. She testified before the Virginia legislature was invited to appear before Congress, gave presentations nationally and internationally, 682 JOGNN
and served as a representative from the Breastfeeding Expert Panel of the American Academy of Nursing to the U.S. Breastfeeding Committee. Finally, Dr. Humenick was a mentor to many who shared an interest in normal birth and breastfeeding. Because she was very clear about her focus, she poured her time and energy into those who shared her vision. As a busy and accomplished nurse educator, editor, and researcher, she had many demands. When asked to give time and energy to someone who shared her passion, this request “always goes to the top of the list” (S. Humenick, personal communication, April 21, 2006). Mentoring requires a great deal of time but Dr. Humenick found that in mentoring she was able to encourage others to accomplish many things. “Do good work and support others to do good work” drove her commitment to mentoring (S. Humenick, personal communication). Dr. Pamela Hill is one recipient of Dr. Humenick’s mentoring. When Hill learned of Humenick’s work (1987) on the milk maturation index, Hill contacted Dr. Humenick, who provided “the life jacket needed for survival” in her career (P. Hill, personal communication, April 7, 2006). The two worked in different areas of the country and arranged several meetings. They met at a conference they both attended and at a restaurant when Dr. Humenick was driving with her family on a vacation through the state where Hill lived, and they finally worked in Dr. Humenick’s basement to write a grant to study insufficient milk supply. Hill recognizes Dr. Humenick’s “generosity, wisdom and willingness to share” as a mentor that was the launch of her research trajectory (P. Hill, personal communication, April 7, 2006). The grant was funded, and their collaborative work provided practicing nurses information about insufficient milk supply and breast engorgement (Hill & Humenick, 1989, 1994, 1996). Dr. Humenick’s work as a mentor provided the personal fulfillment of meeting others and establishing friendships with those who shared her vision.
N
urses with a passion should be knowledgeable of the research continually maintain skills that support their passion.
Many lessons can be learned from Dr. Humenick’s successful career in advocating for normal birth and breastfeeding. First, nurses should be clear about their passion in nursing. Dr. Humenick focused her work on her passion and did not deviate from it. While Dr. Humenick worked Volume 35, Number 6
to support normal birth, she recognized that interventions, such as labor epidurals are available and part of the health care system. She advised nurses not to advocate for unnecessary interventions. She used the analogy that during a marathon, a sag wagon is always available; however, those who support the runner do not encourage the runner to climb immediately into the sag wagon. Nurses can encourage women to have a normal birth, providing them with supportive and creative nursing care to facilitate labor and meet its demands. Second, nurses with a passion should be knowledgeable of the research in the area and continually maintain skills that support their passion. Dr. Humenick demonstrated this in her continuing work with nurses, childbirth educators, and parents. Third, think long term and not short term. Early promises of continuous electronic fetal monitoring (CEFM) reducing negative fetal outcomes diminished when later research suggested primarily an increase in cesarean delivery and operative vaginal delivery with CEFM (Priddy, 2004). Likewise, Dr. Humenick suggested that we do not know the long-term effects of elective cesareans and labor epidurals on women and their families. What is lost in the long term with these interventions is the empowerment of a normal birth. Last, Dr. Humenick advised that nurses should work toward something positive. This work is good for the soul and provides personal gain in satisfaction and networking with others. I honor Dr. Sharron Humenick’s memory for her work during the last 35 years to promote normal birth and breastfeeding and the lessons she taught many through her passion for nursing care of women. Mothers, babies and nurses have lost an exemplary author, researcher, mentor and advocate. We will all miss her.
November/December 2006
REFERENCES Albers, L. L. (2005). Overtreatment of normal childbirth in U.S. hospitals. Birth, 32, 67–68. Hill, P., & Humenick, S. (1989). Insufficient milk supply: Exploration of a concept. Image: The Journal of Nursing Scholarship, 21, 145–148. Hill, P., & Humenick, S. (1994). The occurrence of breast engorgement. Journal of Human Lactation, 10, 87–93. Hill, P., & Humenick, S. (1996). Development of the H & H lactation scale. Nursing Research, 45, 136–140. Hodnett, E., Gates, S, Hofmeyr, G. J., & Sakala, C. (2003). Continuous support for women during childbirth. In The Cochrane Library (Issue 3). Oxford, England: Update Software. Humenick, S. (1987). The clinical significance of breast milk maturation rates. Birth, 14, 174–181. Humenick, S., & Howell, O. (2003). Perinatal experiences: The association of stress, childbearing, breastfeeding and early mothering. Journal of Perinatal Education, 12, 16–39. Kardong-Edgren, S. (2001). Using evidence-based practice to improve intrapartum care. Journal of Obstetric, Gynecologic, and Neonatal Nursing, 30, 371–375. Priddy, K. (2004). Is there logic behind fetal monitoring? Journal of Obstetric, Gynecologic, and Neonatal Nursing, 33, 550–553. Mary Ann Stark, PhD, RNC, is an assistant professor at Western Michigan University, Bronson School of Nursing, Kalamazoo. Address for correspondence: Mary Ann Stark, PhD, RNC, Western Michigan University, Bronson School of Nursing, 8379 Phoebe Street, Kalamazoo, MI 49009. E-mail: mary.stark@ wmch.edu
JOGNN 683