45 Minutes with Rose Constantino, RN, Ph.D, JD, FAAN, FACFE

By Jerome Babate /Joseph Andrew Pepito

In 1962, Rose graduated with her BSN degree from Philippine Union College in Manila now the Adventist University of the Philippines in Silang, Cavite. In 1971 she completed her Masters in Nursing (MN) degree from the University of Pittsburgh School of Nursing, her PhD from the University of Pittsburgh in 1979 and her Juris Doctor (JD) from Duquesne University in 1984. She is a fellow of both the American Academy of Nursing and the American College of Forensic Examiners.

Her journey is long and fraught with challenges and opportunities. Join us in this conversation with Dr. Constantino, Associate Professor at the University of Pittsburgh School of Nursing.

Internationally, you are regarded as one the leading researchers of “Intimate Partner Violence”. What are some of the exciting new developments in this area? I mean the area of research that you have placed time, effort, and talents by integrating your legal background with nursing practice?

RC: Jerome, I am so proud and thankful for your leadership in taking on the international nursing blog site (Global Pinoy Nursing News) to inform, engage, and empower the global Filipino nursing
community. The area of Intimate Partner Violence (IPV) has been in the limelight lately due to reported incidents of IPV among celebrities and sports personalities in the U. S. where they have been aired unabridged by the media. When we say “IPV” we mean any act of coercion, abuse and violence including verbal, emotional, physical, sexual, and stalking perpetrated by a partner toward the other. Research on IPV has been lagging behind other areas of health, disease and social concerns due to our inability to comprehend the multi-dimensional etiology, dynamics, consequences, and strategies to end IPV. On the issue of etiology, the age old debate whether it is nature or nurture goes on. Are perpetrators of IPV born already and endowed with the inclination to be coercive, abusive or violent? Or are perpetrators of IPV nurtured and learned in acts of coercion, abuse and violence? On the issue of dynamics--does it take the right/wrong partner to trigger or evoke abusive, coercive and violent behavior or no matter who the perpetrator is partnered with, IPV will inevitably occur? On the issue of consequences, once IPV is stopped or the IPV survivor leaves the perpetrator or the perpetrator is incarcerated, is the problem solved?

Research has shown that IPV affects social, mental, and physical health and is a major source of
morbidity and mortality in the U. S. and globally albeit grossly underreported. The costs to IPV in terms of survivors’ physical, mental, economic, and social well-being are enormous in the U. S. alone. One of the physical consequences of IPV that I and my colleagues are exploring is Cardiovascular Disease (CVD) risk factors in IPV. Results of Thurston and others’ (2014) research indicated that a history of childhood sexual abuse was associated with higher intima media thickness in midlife women controlling for standard CVD risk factors and other confounders. Interestingly, they are not alone, Scott-Storey (2013) strongly suggest that experiencing IPV is a gendered risk factor for CVD. We are exploring ways to help midlife women in IPV understand that subclinical CVD and CVD risk factors are preventable. We are using online and social media as a mode of delivering our intervention. On the issue of prevention and intervention, should we start intervening in kindergarten, elementary, junior or senior high, college, workplaces or in homes? Although researchers have been through these issues before, new barriers and opportunities arise and the potential for innovation is great. These new developments make work, learning, teaching, research and practice exciting.

I was fortunate to read a few chapters of your FA Davis published book. Can you tell us about this Forensic Nursing book that was published in 2013?

RC: As senior editor of Constantino, R. E., Crane, P. A. and Young, S. E. (2013). Forensic Nursing:
Evidence-Based Principles and Practice, Philadelphia: FA Davis Company, I co-authored the first 3
chapters of the 20 chapters and authored Chapter 4: The Anatomy and Physiology of a Lawsuit for the Forensic Nurse. I continue to disseminate its content in my lectures and presentations. I teach a 3-credit course NUR 2820: Principles and Practice of Forensic Nursing and Legal Nurse Consulting as a Hybrid (Onsite and Online) course. This course provides knowledge in areas of the law; the process of a lawsuit; and ethical, legal, and social issues (ELSI) related to forensic nursing (FN). Approaches and methods in legal nurse consulting and forensic nursing are discussed including but not limited to screening cases, analyzing health professional malpractice cases, performing medical records review and examination, quality assurance and risk management, preparing effective written and verbal reports and abstracts, and preparing for testifying as an expert witness.

The concept of Interprofessional Collaboration (IPC) in education and practice for the health professions are discussed in the NUR1820 hybrid course. IPC will be a new content/chapter in the book for future editions. In the fall of 2013, a delegation of faculty members from Japan came to visit us at the University of Pittsburgh School of Nursing seeking to discuss among other things the process of translating the book into Japanese. In collaboration with F. A. Davis publishers and an international publishing company, it was planned to complete the translation by March 2015.
The book has provided all of its authors and chapter contributors ample opportunity to amplify their respective chapters through consultations, presentations, workshops, and lectures. The book embodies the principle that forensic nursing is taught, learned and practiced through critical appraisal of the evidence as it is collected, evaluated, recorded and submitted through a “chain of custody”. Evidence collected by the nurse from the patient’s body or from the scene of the crime may be the only evidence available to identify the perpetrator or the cause of the injury. The book provides its users case studies to invoke critical appraisal of evidence. The online/electronic Instructor’s Guide ancillary portion of the book which is accessible online is a rich resource and guide in teaching and learning forensic nursing.

Tell us about your academic engagement (visiting professor, keynote speaker, awards sponsor) in the Philippines.

RC: Through Jerome Babate’s vision and passion to transform evidence-based nursing practice through research in the Philippines, I collaborated with Beta Nu Delta in sponsoring research and practice-based awards to qualifying nurses in the Philippines. This was the first project in the Philippines that was listed in the ICN database. I sponsored 3 awards to enhance nursing research by honoring and awarding new/young or seasoned nurse researchers through GIFTs (Grant It First): 1) A Nursing Research Grant awarded to a clinical nurse researcher, 2) Nurse Fellows Award-provides support to speakers/lecturers in nursing research at educational events, symposia, convocations, and other special nursing events, and 3) Visiting Nurse Scholar-awarded to a PhD prepared nurse researcher from another university.

In 2011, I was invited as a Keynote Speaker for the First Cebu International Nursing Conference which was organized by Cebu Normal University. In Spring of 2014, I was invited as a visiting professor to the graduate school of Cebu Doctors’ University to teach two 3-credit courses to its first class of PhD students: 1) Philosophy of Science and the Art of Caring which aims to bring the graduate student to a milieu where nursing science and the art of caring are intertwined in one discipline-Nursing and 2) Ethics in Interprofessional Collaboration (IPC) which aims to introduce the PhD student in ELSI (Ethical, Legal, and Sociocultural Issues) in IPC and the core competencies of IPC which are Values/Ethics; Roles and Responsibilities; Communication; Teams and Teamwork as outlined by the 2011 Expert Panel in Interprofessional Collaborative Practice Report. These experiences physically, emotionally and spiritually transport and transform me back to the Philippines -- like reliving the first 23 years of my life. Indeed it is worth living and reliving it over and over again.

Is there an advice that you can give to the millions of Filipino nurses around the world?

RC: Yes, I wish there’s room and time to include them here because I have lots to say. However, I am respectful of the human tendency toward boredom and agitation to speakers or writers who forget the dynamics of the human way thinking, feeling and behaving. Therefore, I will cut this paragraph down to basics. Wherever fate or destiny leads you, you must give back and return to your roots. Whether you have accumulated wealth, talent or wisdom, give back some of it to your Alma Mater, hometown, church or organization in the Philippines. After all is said and done what matters in the end is family, the relationships you built and cherished, the respect and fairness you gave to others, and the promises you made and kept. It does not matter how much money you have, how much land you own, how many houses you own, how many awards and honors you have received, and how many degrees you have after your name. All of them are “fluff”. No one will remember them.
In the Bible, in the book of Matthew chapter 25, verses 34-40 allow me to paraphrase the drama that will unfold when the son of God will judge the inhabitants of the earth. To those on His right hand, he welcomes, blesses, and invites the righteous to inherit the kingdom prepared for them from the foundation of the world. Then He says the most puzzling thing to the righteous, “I was hungry and you gave me food, I was thirsty and you gave me drink, I was homeless and you gave me shelter, I was cold and you gave me warm clothing, I was sick and you cared for me, I was lonely and you comforted me, I was in prison and you visited me. ”Then the righteous, still puzzled will seek clarification “When did we ever see you hungry and feed you, thirsty and give you drink, homeless and give you shelter, cold and give you clothing, sick and care for you, lonely and comfort you, in prison and visit you”. Then the King will reply in the most awesome, omniscient, omnipresent and omnipotent tone, whenever you did one of these things to one of the least and marginalized of all my children, you did it to me”. Therefore give back! Thank you.