It wouldn't be unreasonable for Syringa Marshall-Burnett to think of slowing down. Most people in her shoes - nearly 71, with a successful career devoted to improving nursing education in the Caribbean - would be content to take life easy.

But Marshall-Burnett's days remain long and full. She is now serving her third term as president of the Senate of Jamaica. She is still a part-time senior lecturer at the University of the West Indies (UWI) School of Nursing at Mona, after retiring from 13 years as head of the program. She continues her involvement with the Nurses Association of Jamaica (NAJ) and is editor of its journal. She also does three crossword puzzles a day - "the easiest ones," she says - to keep her mind sharp.

"Her energy energizes you too," says Merel Hanson, a former chief nursing officer with the Ministry of Health in Jamaica.

This energy has contributed to major changes in the way nurses are educated in the Caribbean. When Marshall-Burnett started her career in the 1950s, nurses were trained in hospitals, and university education was unheard of. She and Dr. Mary Jane Seivwright, the previous head of the nursing school, were instrumental in securing nursing's status as an academic discipline. By the time Marshall-Burnett retired from full-time academic work, undergraduate and master's programs had been established in the West Indies, enabling nurses from the region to study closer to home.

Even as a child, growing up in a farming community in Jamaica, Marshall-Burnett knew she wanted to be a nurse. "I admired a particular aunt of mine who was a nurse and midwife," she says. Her appreciation for nurses grew with the care she received after an appendectomy. So when Marshall-Burnett turned 14, she applied to the nursing school at the Kingston Public Hospital Teaching Department. A reply came that she was too young. Finally, at age 18 she entered the RN program, which required three years of hospital- based training plus six months of midwifery training.

"My generation followed a generation of nursing educators and administrators who were outstanding, even though they didn't have degrees," she says. Nurses who wanted further education had to leave Jamaica.

After working a few years, Marshall-Burnett left in 1959 to study and see a bit of the world. At the University of Toronto, she received certificates in hospital nursing and public health nursing, and then a bachelor of nursing degree in 1967. "U of T opened a whole new world of education to me," says Marshall-Burnett, who took courses in literature, sociology and psychology. "This stimulated me, and I wanted to go on."

The seeds of her future career were planted during those years. On a trip back home, she heard that nursing studies were being introduced in a university setting. In 1966, the UWI campus at Mona had begun offering certificate programs in nursing administration and education. She met with the head of the program, but decided to continue studying abroad to gain exposure to nursing research. In 1968, Marshall-Burnett enrolled in a master's program at New York University in New York City.

Back in Jamaica, the first West Indian nurse, Seivwright, was appointed head of the School of Nursing (formerly the Department of Advanced Nursing Education) in 1971. Marshall-Burnett visited Seivwright and said she was thinking of coming back, but there were no vacancies. She completed her MA in 1972 with a double major in Adult Mental Health and Nursing Education, and was about to register in a doctoral program when Seivwright wrote, offering a one-year contract. Marshall-Burnett arrived back in Jamaica on a Saturday and started work that Monday morning. She has spent the rest of her nursing career as faculty at UWI.

Seivwright had already begun discussions for a nurse practitioner program and started laying the groundwork for a degree program. Marshall-Burnett joined these efforts. "We felt we needed to improve the level of education to improve nursing," she says. UWI is a regional university funded by 15 territories in the West Indies, a situation that posed challenges in getting funding and approvals. Just as difficult was the attitude that nursing education had no place in a university.

"It was a hard fight," says Marshall-Burnett. "There were lots of prejudices against nursing." The first key milestone was the establishment of family and paediatric nurse practitioner programs in 1977. Marshall-Burnett continued "badgering everyone" to get funding for a bachelor's program during Seivwright's sabbatical, and finally, funds came through. In 1983, the first post-RN bachelor's degree was offered. This program was designed for those who were already nurse leaders and educators. Many current faculty were Marshall-Burnett's students.

"She was very good at motivating students and facilitating learning," says Dr. Hemsley Stewart, a lecturer at Mona and former student. "She provided students with the astuteness to see and understand the political system, and break down barriers," notes Dr. Hermi Hewitt, the current head of the School of Nursing.

In her role as NAJ president, Marshall-Burnett negotiated with the government on nurses' salaries, working conditions and other issues. For example, in the 1980s, there was a need for housing for nurses who came to the city of Kingston for training. She engineered a loan that enabled a hostel to be built on the NAJ secretariat compound.

"She leads from in front," says Hanson, who served with Marshall-Burnett on the NAJ executive. "She is involved in the vision, the concept, the carrying out. Of course, she delegates, but … she always finds out what's going on." Today, Marshall-Burnett is chair of a NAJ board overseeing a home for retired nurses.

After she became head of the School of Nursing in 1989, Marshall-Burnett continued to raise the bar. One next goal was to develop a graduate program. This undertaking required her and her staff to make "learning visits" to universities in Canada, the United Kingdom, the United States and Africa.

"We put together - if I may say so - a pretty good proposal for a graduate nursing education program," she says. The breadth and depth were so thorough that the graduate school adopted this approach for other proposals. To her pleasure and surprise, the graduate program was accepted much more easily than the undergraduate degree. The master's program, established in 2001, offers specialization in such areas as administration, education and advanced practice nursing.

By now, the goals that she and Seivwright had pursued since the 1970s were coming to fruition. "We needed to get students thinking 'research' and having an investigative mind-set - not to create researchers, but to produce nurses who were better consumers of research," says Marshall-Burnett. A curriculum was developed for a basic or "generic" bachelor of science in nursing (BScN), allowing students to enter a nursing degree program directly from high school. In 2001 and 2002, she helped the chief nurses successfully lobby the ministers of health of the Caribbean Community and Common Market (CARICOM, a regional body representing 15 countries) to make the BScN the entry-level requirement for nurses in the region.

"She actually started the program before it was approved by the university," says Hewitt. "She will do things that you and I wouldn't do, and she will get them done." The program first began in 2002 as a franchise at a community college in rural Jamaica. It is now offered on three campuses, enabling broader access to nursing education. The generic baccalaureate was the final phase in moving nursing education out of the Ministry of Health and into the Ministry of Education.

Another career interest of Marshall-Burnett is examining the quality of nursing education. Since 1975, she has been evaluating nursing schools in CARICOM countries and recommending improvements. In 1993, she helped set up a regional exam to license nurses. As a result, nurses in the Caribbean can work anywhere without requiring any qualifying exams.

As a leader, she describes her style as "transformative and participative." Growing up in the British system, she was exposed to a more autocratic way of leading, but says, "I've mellowed over the years." As department head, she would engage her staff in decision-making, "but there was a time when we'd stop talking and it would be time to act."

She gave her staff opportunities to grow, says Stewart. Besides her quick wit, her resourcefulness and her ability to see things from a broad perspective, "she is a fun-loving lady, too," he adds, recalling her stories from her early nursing days. Back then, nurses had to wear stockings with seams. When she didn't have any, Marshall-Burnett would take a pen and draw a seam on her leg to look like stockings.

Since 1992, she has juggled academic work with a political career, which began with a phone call from Jamaica's prime minister. She had come to his attention during negotiations as president of the NAJ. He called to invite her to fill a vacant spot on the Senate.

"You could have knocked me down with a feather," says Marshall-Burnett. "I have a big mouth and always have an opinion. For once in my life, I was at a loss for words." She accepted the offer, starting as a backbencher and becoming deputy and then Senate president in 1995. "I like the cut-and-thrust of debate," she says. She also enjoys making pithy observations to stimulate discussions on bills. She has gained the respect of both major political parties in Jamaica in addition to balancing politics with her academic life - not an easy accomplishment.

In 2002, Marshall-Burnett retired as head of the School of Nursing. She is proud of the quality of the school's graduates and of its faculty. "Nearly every head of a nursing program, every chief nursing officer and deputy [in CARICOM] has been a graduate of our program," she says. The unit is celebrating 40 years in June, and she is confident that by 2010 there will be a doctorate program.

Her family life is enriched by her five-year-old grandson. She enjoys watching visual and performing arts as well as cricket, football and track and field. She plans to retire from the Senate in two years.

Marshall-Burnett has received many awards for her work, including a Distinguished Alumni Award from the University of Toronto in 1997 and the International Distinguished Leadership Award from the Commission on Graduates of Foreign Nursing Schools in 2001. But when asked about the most meaningful accomplishment in her career, she says, "I'm most proud of the nursing movement in the Caribbean. It's gone from strength to strength."

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