This article is part of a captivating series on Sigma members who have recently achieved one of the highest honors in the field of nursing research: induction into Sigma’s International Nurse Researcher Hall of Fame.
I began my nursing career at a safety nurse hospital in 1992 as a student nurse (or nurse assistant). During my baccalaureate training, I was competitively selected twice to participate in a summer research program, and both times, Dr. Joan Austin mentored me. She even employed me as a research assistant after I completed the summer programs. Upon employment, I worked on the medical-surgical floor, and when I graduated with my BSN, my manager created a position for me as a staff nurse. I worked there until 1999 when I went back to get my Master of Science in Nursing (MSN), at the suggestion of my academic mentor, Joan.
It was natural that I would focus on child mental health—both because my undergraduate research was focused on child adaptation to chronic conditions including epilepsy, and because Joan was a psychiatric mental health nurse. During my educational training, I continued to work part-time in a psychiatric unit. This is where I met Margie Payne—an incredible visionary nurse leader. She integrated psychiatric and mental healthcare across primary care settings - before it even became a thing! When I graduated with my master’s degree, I was honored that Margie offered me a job as a Clinical Nurse Manager for a child and adolescent mental health program.
During my tenure as a board-certified Clinical Nurse Specialist, I was struck by two observations. First, my young patients dropped out of care without completing treatment. Second, many of them had psychosocial issues which either caused or fueled their mental health conditions. Many parents or family caregivers were also suffering—either from their own mental health challenges, stress, or the burden of caregiving for their children with mental health disorders. However, the resources were inadequate to fully support caregiver and family needs.
To address treatment dropout, I began sending letters to the child’s primary care provider (PCP) after the initial appointment with the child, with the intent to discharge the child back to the PCP for medication management once symptoms were stable. So, the topic of discharge was presented on day one. To say “you will not be in treatment forever” inspired hope, a reminder that there is light at the end of this tunnel. Given my record of collaboration with PCPs, when the opportunity came around, I put in my application to serve as the lead APRN: To launch an integrated behavioral and primary health care program across four large community health centers (primary care settings) and a juvenile detention center.
In this role, I collaborated with people from multiple disciplines and led the integration of mental health and physical health records. I laid the groundwork for the designation of our centers as federally qualified health centers, which brought in much-needed federal funds to serve patients. The program is now fully integrated across the health systems, leading to early diagnosis and treatment of mental health conditions, increasing access, and reducing stigma for affected populations.
To address the issue of adequate programming for families, I navigated my way back to school to pursue a PhD. I focused on the issue of addressing both the child's and family's needs, leveraging inherent strengths to enhance treatment engagement and outcomes. I assumed that I would return to practice after graduation, but that was not to be! My dean, Marion Broome, at the time, encouraged me to explore all of my options, and after much consideration, I chose academia.
Now, 12 years later, I am the Gorden Keller Professor of Nursing (tenured), Senior Associate Dean of Research, and the Director of the PhD program at the University of South Florida in Tampa, Florida, USA. I have established and sustained an impactful program of research focused on the mental healthcare of children, especially those with disruptive, impulsive, and conduct disorders (DICs) and their family caregivers. I have also conducted research on alcohol and substance use treatment. In 2020, I launched a program of research addressing global inequities in mental health treatment with special emphasis on low- and middle-income countries.
Addressing psychosocial determinants of health requires societal level or policy changes. Therefore, my service portfolio has been quite diverse. Thanks to my mentors at various nursing and interdisciplinary health organizations, I was mentored up the leadership chain in a safe, nurturing, and inclusive environment. I have been able to offer my unique perspective and inform/influence mental health policy across local and global communities. I am proud to have dedicated my career to improving the mental health and well-being of children and their families through research, education of the next generation of nurse clinicians and scientists, and service at all levels.
That being said, I believe very much in the African proverb, which says, “It takes a village!” I would not be who I am today without so many mentors and nurse leaders across practice and academia who paved the way, believed in me, and supported me—and continue to do so even now. I honor them by paying it forward.
I honor my patients, research participants, and collaborators for their generosity of time and cheer!
Ukamaka M. Oruche, PhD, RN, PMHCNS-BC, FAAN, is the Gordon Keller Professor, Senior Associate Dean of Research, and the Director of the PhD program at the University of South Florida. She is a member of Sigma’s Alpha Chapter.