To Love, Honor, Obey — And Study Nursing

Christine Tassone Kovner was 25 years old and a student at the University of Pennsylvania when she first laid eyes on Anthony Kovner, a professor 11 years her senior. Their shared interest in health care gave way to mutual attraction, romance, and — 11 months later — marriage.

Nearly 38 years hence, the Kovners, both professors at New York University, are as committed to health care management as they are to each other. In recent years, their work has focused on the nursing shortage in New York.

While they share a common goal — to improve the training and retention of qualified nurses — Mrs. Kovner, a professor in the College of Nursing, has taken a theoretical approach, developing research projects to address the shortage. Mr. Kovner, a professor at the Wagner School, has taken a more practical approach, and most recently started a program to train nurse managers.

Still, their work often overlaps. "I find out a lot at dinner," Mrs. Kovner said, adding that her husband will "often force me to back into the question, 'Well, what does it mean day to day?'"

Mr. Kovner said his wife is the superior scholar. "She's always making sure that whatever I say holds up from a research and logical point of view. She's my toughest critic, and I consider that a good thing," he said.

Recent studies have projected that the nationwide shortage of nurses could reach 340,000 by 2020 and 500,000 by 2025. In New York, the shortage is already becoming severe, according to a study published in May. The statewide vacancy rate for nurses was 8.8% in 2007, up from 6.38% in 2006, according to the Healthcare Association of New York State. By comparison, the overall unemployment rate in New York was 4.4% last year.

"We've been through a lot of nursing shortages, so we're very experienced," Mrs. Kovner said.

The Kovners found common ground despite coming to health care from entirely different backgrounds.

Mr. Kovner, the son of a hospital owner in New York City, was groomed early on to take over the family business. Growing up, his father and uncle owned several small, proprietary hospitals in and around the city, including the Park East and Park West Hospitals, 100-bed institutions that closed in the late 1970s.

For his doctoral dissertation at the University of Pittsburgh, Mr. Kovner wrote about the organization of nursing units in hospitals. "I wanted to be a manager, and I thought this would be a good way of learning at the frontline level," he said. After a short stint as an executive at Beth Israel Medical Center, he moved to Philadelphia to launch a health care management program at Wharton, where Mrs. Kovner was one of his students.

Meanwhile, Mrs. Kovner began her career as a clinical nurse. After graduating from Columbia University, her first job was for the city's Department of Health and Mental Hygiene, where she worked in a tuberculosis clinic and, separately, with patients suffering from venereal disease. A desire to change nursing practices arose after she labored under a rigid nurse manager. "My supervisor was just impossible, which absolutely plays into this whole 'Why do nurses leave?' idea," she said. "I just knew I could do a better job."

The daughter of a small-businessman, she found her interest in economics and nursing converging as she pursued advanced degrees, including a master's from the University of Pennsylvania's College of Nursing. "I've always been interested in the organization and delivery of care and nurses, because I think that unless we have an adequate supply of nurses deployed in the right places, people can't get good health care in this country," Mrs. Kovner said.

Their careers guided — at least geographically — by Mr. Kovner, the couple moved back to the New York area when Mr. Kovner worked as a chief executive officer at a 225-bed facility in New Jersey. In 1979, Mr. Kovner returned to academia when he joined the faculty of New York University. Mrs. Kovner followed, and after earning her doctorate and completing a post-doctoral fellowship at NYU, she became an assistant professor in the College of Nursing in 1985.

In light of the current nursing shortage, Mrs. Kovner and the NYU College of Nursing in March received an eight-year, $4.1 million grant from the Robert Wood Johnson Foundation to study changes in the careers of newly licensed registered nurses.

Meanwhile, last fall, Mr. Kovner designed and launched a graduate degree for nurse managers at the NYU Wagner School of Public Service. The degree, a Master of Science in Management with a concentration for Nurse Leadership, was designed in conjunction with New York-Presbyterian Hospital and seeks to address the nursing shortage by improving the quality of nursing management and boosting nurses' job satisfaction.

In an interview, the Kovners said their work often overlaps. During a discussion of why nurses leave their jobs, Mr. Kovner invoked his wife's research: "She said nurses generally aren't committed sufficiently to the organization. That's something I'm very interested in, that we can include in our management program," he said.

His answer prompted a swift retort: "I don't think I said they're not committed enough," she said.

"I heard you say that," he replied.

"No, I would say that nurses who are more committed are more likely to stay," she said.

"Yeah, okay," he conceded, prompting her to tell a reporter: "That's a typical exchange."

Still, the Kovners agree more than they disagree. The parents of two adult daughters, both of whom hold doctoral degrees, they stressed the important of nurse training and education. They offered a myriad of solutions to the nursing shortage, including utilizing older nurses more effectively, encouraging men to become nurses, and changing the historic role of nursing schools, which they said are seen often as less important than business and medical schools in the eyes of university leaders.

"Saying 'We have the best nursing school' doesn't cut it at the cocktail parties with the trustees in the same way," Mrs. Kovner said.

Without a silver-bullet solution, she turned back to her research, including a study of 2,220 new nurses who left their jobs. "I think there's still a lot to find out about how this stuff works together," Mrs. Kovner said.

Correction from September 24, 2008: The University of Pennsylvania School of Nursing is where Christine Kovner earned a master's degree. The school was misidentified in an article on page 6 of the September 22 New York Sun.