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The Nurse’s Way

Patricia Flatley Brennan, GNu’79, RN, PhD, is part nurse, part engineer, part information architect — and total innovator. A graduate of Penn Nursing’s Psychiatric-Mental Health Program, she also holds a PhD in industrial engineering from the University of Wisconsin-Madison. Combining a diverse background that spans disciplines, she has led a pioneering career in health care information systems and technology. Since 2016, Dr. Brennan has led the field as Director of the National Library of Medicine at the NIH. She serves a global audience of scientists, health professionals, and members of the public, always aiming to empower through information.
The goal? To improve public health and ensure the best possible experience in patient care.
The advantage? Her unique and invaluable perspective as a nurse.

For me, nursing is where it all began. I started my career with a BSN from the University of Delaware and then completed my MSN at Penn Nursing. I also hold a license as a registered nurse.

I think of myself as a psychiatric nurse, although I spent a few years in the mid-1970s on the 3-to-11 shift in a busy surgical shock-trauma ICU. I have also served on the faculty of nursing at Case Western Reserve and at the University of Wisconsin-Madison.

It helps to understand nursing to see why being a nurse is such a great asset in my role as director of the National Library of Medicine. To me, nursing is fundamentally the diagnosis and treatment of the human response to disease, disability, and developmental challenges.

Note that phrase “human response,” i.e., how people react to the challenges in their lives. Nurses focus on the human response, while the biomedical knowledge we have, like pathology or anatomy, helps us understand what a person is coping with and what kinds of complementary or supplementary supports are needed.

As noted nurse and author Virginia Henderson observed, nurses must actively engage with the patient to help him or her perform “those activities contributing to health or its recovery (or to a peaceful death) as he [or she] would do unaided had he [or she] the necessary strength, will, or knowledge,” with independence from the nurse the common goal. Nursing addresses the whole person and helps that person live to the fullest extent.

Along the way, nurses come to know people differently than the other clinical disciplines. And that knowledge, I’ve discovered, helps me as Library Director.

It affords me special insight into the public patrons who use our services. I can imagine a young mother using MedlinePlus in the middle of the night to figure out how to comfort a feverish child. I can anticipate the information needed by someone with a late-stage cancer diagnosis, and recognize the need to complement journal articles on treatment options with literature on comfort measures and death with dignity. And I can appreciate the challenges of navigating the health care environment, from its specialized vocabulary to its unique culture. 

A nurse’s way of knowing helps me set policies for integrating into the Library’s formal standards and language systems the terminologies that address the social and behavioral domains of health. Nurses live in those domains, as much if not more than the technical or scientific.

Perhaps most importantly, my experience as a nurse has taught me that each person has his or her own strengths, and that the Library’s resources should build upon those strengths to help the person make healthful choices, not just explain deficits.

But the benefits of being a nurse and a library director are not one-sided. Directing a library also lets me fulfill my nursing role, as I help others achieve the highest level of wellness possible.

Nurse-run: The National Library of Medicine in Bethesda, Maryland, offers physical as well as online resources.Nurse-run: The National Library of Medicine in Bethesda, Maryland, offers physical as well as online resources.As NLM director, I advocate for those in need, ensuring our literature is sufficiently inclusive. I improve patient care by guiding the fields of data science and biomedical informatics toward a future where professionals and patients interact to achieve care goals. And I model for younger nurses a career path that engages all that I am as a nurse, while collaborating meaningfully across disciplines.

Being a nurse is not a job requirement for directing the National Library of Medicine, but it is certainly an asset. Advanced education as a health professional gives me an appreciation for how complex health care is, and how important it is to engage all disciplines toward addressing that complexity.

Engaging patients as partners in care motivates me to build resources that foster full participation of people in health. And experience as a team player in psychiatric services enables me to join with my colleagues from library science, information and computer science, linguistics, medicine, and other disciplines to make the NLM the foundation of the future of health and discovery.