Finding the balance

Dean Katherine Gregory meets with Jason Luu ’24 and Sabrina Ng ’23 in CSON’s student lounge. Photograph: Lee Pellegrini.

Shortly after being named dean of the Connell School of Nursing (CSON), Katherine E. Gregory was intrigued to learn that she is the eighth person to assume the role since the school’s founding in 1947. “Eight is considered a fortuitous number in many cultures of the world,” says Gregory. “It’s a sign of good luck and a sign of balance. Coming out of the pandemic, I think we really need both for our school, and in the profession of nursing.”

While she can only hope for good luck, Gregory has a vision for the future of nursing and a diversity of experience as a clinician, scientist, and leader that make her uniquely qualified to promote a sense of balance and equanimity as she guides CSON through the time of change that lies ahead.

She succeeds Susan Gennaro, who stepped down as dean last spring after 13 years. But Gregory’s arrival to Chestnut Hill is really a return: she received a doctorate in nursing at CSON in 2005 and taught on the school’s faculty from 2006–2014.

“I’m really excited to be back in this wonderful and vibrant place,” says Gregory, seated in her Maloney Hall office at a table decorated with orchids in a vase, a welcome gift from the school. “The faculty and staff are highly engaged and we have the best students anyone could ask for.”

Using Science to Solve Problems

Kate Gregory in the NICU unit at Brigham and Women's Hospital in 2009.

In 2009, Katherine Gregory with patient in Brigham and Women's Hospital's neonatal intensive care unit.

You could say that nursing is in Gregory’s blood, as one grandmother and five of her aunts worked in the profession. Growing up in Syracuse, New York, she was a good student who enjoyed science. Every summer during junior high and high school, she donned the familiar “candy striper” pinafore and volunteered at Crouse-Irving Memorial Hospital. “I saw what nurses did at the bedside and how they took care of patients,” she recalls. “I thought that would be a great way to satisfy my love of people, but also use science to solve problems.”

After earning a bachelor’s degree in nursing from SUNY-Binghamton in 1996, Gregory got her first nursing job: the second shift in the neonatal intensive care unit (NICU) of that same hospital. Her love for the work inspired her to pursue a master’s degree in nursing administration at the University of Pennsylvania, where she had what she calls a “life-changing” discovery as a research assistant for Professor Barbara Medoff-Cooper, an expert in the care of high-risk and preterm infants. “It was the first time I saw that nurses could lead research,” Gregory says. “It made me realize that what I really wanted to do was get a Ph.D., be a scientist, and have an academic career.”

Gregory found something worth studying while working in the NICU at New England Medical Center after completing the master’s degree. More than once, she came into work to discover that a baby had developed a catastrophic gastrointestinal disease overnight. “What did I miss?” she recalls wondering. “How did we not know this baby was going to become so ill?” These questions led her to want to know more about the condition called necrotizing enterocolitis (NEC), which would soon become a focus of her research.

A Collaborative Vision for the Future of Nursing

Gregory believes tomorrow’s nurses must be prepared to fill five critical roles:

Nurses as clinicians

Assessment skills and critical thinking are essential, but tomorrow’s nurse must be ready to embrace technology and adapt to ever-changing practice environments.

Nurses as educators

Nurses will always teach other nurses, in the classroom or clinic. In addition, Gregory notes, “a huge part of our practice is teaching patients and families how to live with a chronic condition or the need for acute care.”

Nurses as scientists

“It’s about making sure nurses are developing science for practice and patient care, and doing that in an interdisciplinary and collaborative way.”

Nurses as innovators

“Nurses innovate all day long. Every patient has unique needs, and nurses must be able to modify or innovate in the moment to take care of that patient.”

Nurses as leaders

The COVID-19 pandemic highlighted the importance of nursing leadership, Gregory says. “The nurse was the person in the room with the patient. That made leadership critically important, because we had to advocate for the resources to meet not only patients’ needs, but nurses’ needs.”

A search for answers

Gregory enrolled in the doctoral program at CSON in 2002. The school’s faculty and proximity to Boston’s renowned academic medical centers were important draws, she says, as well as “the Jesuit commitment to preparing the whole person.”

Not long after arriving, she began searching for answers to her questions about NEC. A potentially fatal condition brought on by sudden inflammation in the intestines, NEC kills tissue and can produce dangerous perforations. Survivors are at risk for long-term health problems, including impaired growth and neurodevelopment. Any baby can develop NEC, but it’s far more common in preterm infants: more than 11 percent of babies born at 750 grams (about 1.65 pounds) or less are diagnosed with the condition. Gregory’s doctoral dissertation led to a 2008 Nursing Research paper that showed that premature infants who don’t receive enteral feedings of human breast milk are at significantly increased risk for the disease.

While teaching at CSON, Gregory began working in the lab of pioneering pediatric gastroenterologist W. Allan Walker at Massachusetts General Hospital. With Walker and others, she started exploring the link between NEC and the gut microbiome—the trillions of bacteria and other microorganisms that colonize the intestinal tract. The microbiome helps regulate the immune system, and uncontrolled inflammation can cause NEC.

Growing into Nursing Leadership

Crouse Irving Memorial Hospital ID badge for candy striper Katherine Gregory

Tufts Medical Center ID badge for staff nurse Katherine Gregory

University of Pennsylvania student ID of Katherine Gregory

Brigham and Women's Hospital Center of Nursing Excellence ID of Katherine Gregory

Brigham and Women's Hospital ID of Katherine Gregory

ID badges courtesy of Katherine Gregory; Photographs: Caitlin Cunningham

“One of the most important things we can do as we educate the next generation of nurses is teach them to be resilient and evolve in a changing environment.”

Katherine E. Gregory, Dean, Connell School of Nursing

Brigham and Women’s Hospital staff nurse Jean Reilly, new mother Carla Wilson, and Assistant Professor and Haley Nurse Scientist Katherine Gregory with Wilson’s daughter Alana Nelligan. Photograph: Lee Pellegrini

In 2011, Brigham and Women’s Hospital staff nurse Jean Reilly, new mother Carla Wilson, and Haley Nurse Scientist Katherine Gregory with Wilson’s daughter Alana Nelligan. Photograph: Lee Pellegrini

No two gut microbiomes are alike, and Gregory’s research explores how microbiome makeup influences inflammation and the risk for NEC. She obtained support to study babies’ biomes at Brigham and Women’s Hospital through several clinical research programs, including one started by University Trustee Kathleen Haley and her husband Steven, who named her the inaugural Haley Nurse Scientist in 2009.

Studying preterm babies’ microbiomes requires specimens, including stool samples. “I was affectionately known as the ‘poopy diaper nurse’ at Brigham and Women’s,” says Gregory, who estimates that a freezer at the medical center holds between 15,000 and 20,000 fecal, urine, blood spot, and breast milk samples she has collected for study. By analyzing those samples, Gregory and her colleagues identified a key marker of NEC: infants with high intestinal fatty acid binding protein in their urine have a significantly increased risk for developing the condition within a week.

Their current research, funded by the National Institutes of Health (NIH), analyzes the microbiomes of breast milk from mothers of preterm infants to determine how their composition is affected by factors including diet, gestational age at birth, and number of pregnancies. The next step will be looking at how the composition of human milk alters infants’ gut microbiomes. “Perhaps there’s something in the milk that optimizes intestinal biology and protects against NEC, or there’s something lacking in the milk that’s putting the baby at risk for NEC,” Gregory explains.

Departure and return

Dean Katherine Gregory gives the fall 2021 Pinnacle lecture. Photograph: Caitlin Cunningham

In 2014, she made the decision to leave CSON for a new dual role at BWH as research scientist and director of newborn care redesign, improvement, and analytics. In 2018, she was named the associate chief nursing officer for women’s and newborn health, overseeing all research and innovation for the department of nursing, as well as 600 nurses and 100 support staffers. Amid all her responsibilities, she also earned the rank of assistant professor at Harvard Medical School.

Her collaborators say she has a natural gift for lab work. “Research takes a lot of stamina, and Kate has it,” says reproductive immunologist Raina Fichorova, distinguished chair of BWH’s Department of Obstetrics and Gynecology, who mentored Gregory and is collaborating on her current NIH-funded study. “Kate is unbiased and never follows one idea just because it was her first. And she does not give up.” As she prepares students to be clinicians, educators, scientists, innovators, and leaders, Gregory is cognizant of evolving challenges around equity and access in health care. “How do we educate nurses to understand that health disparities are often a function of race and ethnicity?” she asks. “There is no reason why the courses we teach to future nurses can’t address issues such as health equity, social determinants of health, and racism.”

The COVID-19 pandemic has posed other new challenges. For example, telemedicine seems to be here to stay. “We’re going to have to teach nurses to provide virtual care,” says Gregory. In spite of these hurdles, she believes nurses can overcome any challenge through collaboration.

“Nursing is a team sport. My hope for the Connell School is that—by collaborating with one another and our colleagues across campus and throughout Boston—we will have a positive impact on human health.”

“My hope for the Connell School is that—by collaborating with one another and our colleagues across campus and throughout Boston—we will have a positive impact on human health.”