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Journal of Social Work in End-Of-Life & Palliative CarePublication details, including instructions forauthors and subscription information:http://www.tandfonline.com/loi/wswe20

Zelda FosterJudith L. Howe PhD a b c & Louisa Daratsos LCSW d ea Mount Sinai School of Medicine , USAb VA Bronx-New York Harbor GRECC , Bronx VAMC,130 West Kingsbridge Road, Bronx, NY, 10468, USAc Consortium of New York Geriatric EducationCenters , Bronx VAMC, 130 West Kingsbridge Road,Bronx, NY, 10468, USAd VA New York Harbor Healthcare System BrooklynCampus , USAe Wurzweiler School of Social Work , YeshivaUniversity , USAPublished online: 11 Oct 2008.

To cite this article: Judith L. Howe PhD & Louisa Daratsos LCSW (2007) Zelda Foster,Journal of Social Work in End-Of-Life & Palliative Care, 3:1, 47-56, DOI: 10.1300/J457v03n01_07

To link to this article: http://dx.doi.org/10.1300/J457v03n01_07

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Zelda Foster:A Social Work

Mentor’s Legacy

Judith L. Howe, PhDLouisa Daratsos, LCSW

INTRODUCTION

For nearly her entire career, Zelda Foster provided stellar leadershipnationally and internationally in the areas of palliative and end-of-lifecare. As Chief of Social Work Service at what was then known as theBrooklyn VA, not only was she a strong advocate of the role of socialwork in health care practice, education, and research, but she was deter-mined to prepare the next generation of social work leaders to expandand intensify the scope of social work practice in service to veterans andtheir communities. She took her role of “mentor” (although early in hercareer, she may not have called herself that) very seriously throughoutin her tenure as a social work leader. Indeed, she received her own startas a mentor through her relationships with several professionals whomshe readily credited helped secure her development as a clinician, man-ager and visionary (Foster & Corless, 1999). Her efforts to mentor so-cial workers continued even more fervently after her retirement from

Judith L. Howe is Associate Professor of Geriatrics, Mount Sinai School of Medi-cine, Associate Director/Education, VA Bronx-New York Harbor GRECC, andCo-Director, Consortium of New York Geriatric Education Centers, Bronx VAMC,130 West Kingsbridge Road, Bronx, NY 10468 (Email: Judith.howe@va.gov).

Louisa Daratsos, is Psychosocial Coordinator for Oncology, VA New York HarborHealthcare System Brooklyn Campus, and Doctoral Candidate, Wurzweiler School ofSocial Work, Yeshiva University (Email: Louisa.daratsos@va.gov).

Journal of Social Work in End-of-Life & Palliative Care, Vol. 3(1) 2007Available online at http://jswel.haworthpress.com.

doi:10.1300/J457v03n01_07 47

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the Department of Veterans Affairs (VA). In this article, we discussZelda’s development of the next generation of social work leaders in theVA from the perspectives of several senior level social work managerswho had the benefit of Zelda’s formal and informal mentorship bothduring their time together in a direct chain of command and after theseindividuals were promoted to other positions in the VA system.

MENTORING

For purposes of this paper, mentoring is defined as “a helping rela-tionship between two professionals at different stages in their careerswho work together to nurture the junior professional’s development”(Schapira, Kalet, Schwartz, and Gerrity, 1992). Within business, nurs-ing, medicine and some academic disciplines, the importance of seniorpersons mentoring junior colleagues has long been recognized, withdifferent perspectives and “institutionalized” models reported in the lit-erature. A Medline search (February 13, 2007) using the keywords“mentoring in the health professions” found 599 citations, the vast ma-jority from medicine and nursing, with just eight articles referring to so-cial work mentoring, one of which was co-authored by the senior authorof this paper. The recognition of the importance of mentoring has re-sulted in articles discussing the importance of mentoring, how to createa culture of mentoring and tips for mentors and mentees in a variety ofhealth care work settings (Barker, 2006; Lee, Anzai & Curtis, 2006;Hayden, 2006).

Mentoring is also the focus of research inquiry and data analysis. A num-ber of innovative mentoring models and national mentoring programs arealso reported in the literature. For instance, mentoring is a key component ofthe John A. Hartford Foundation’s initiatives on Building Academic Geriat-ric Nursing Capacity as well as the Centers on Excellence in Geriatric Medi-cine. Mentored nursing scholars have exhibited higher levels of professionaland academic leadership development as evidenced by outcomes such aspublications, presentations and funding than counterparts who were notmentored through the program (Maas, 2006). Other mentoring models in-clude on-line mentoring such as MentorNet, an eight month longe-mentoring program which pairs students or junior investigators with men-tors from academia or industry with the goal of enhancing success of minori-ties and women (www.mentornet.net/documents/about/programs/, retrievedMarch 7, 2007). E-mentoring programs are a cornerstone of international re-

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search mentoring programs such as those found in academic nursing (Byrne &Keefe, 2002).The field of social work, however, has historically not empha-sized mentorship as a means of transmitting the necessary skills to become asocial work leader, which makes Zelda’s contribution even more remark-able. Instead, social work professional development has relied on supervi-sion as a means of deepening clinical practice, in particular, and learningleadership skills. It is inferred that the nature of the development that resultsfrom the best of supervision relationships is a practitioner who can manageclinical relationships with social work clients and can supervise more juniorcolleagues in their work with clients. In contrast, the term “mentorship” andthe results of the mentor/protégée relationships encompass a wider skill setthat includes managerial and leadership skills, community relationships andinterdepartmental collaborations.

Social work’s attention to “mentoring” has increased over the past de-cade in the recognition of the need for explicit attention to this concept, es-pecially within healthcare as the model for medical care delivery becomesmore and more rooted in business models. Moreover, social work leadersare embracing the concept of mentorship based on the benefits of high pro-file and nationally funded mentoring projects. Specifically, the John A.Hartford Foundation funded Geriatric Social Work Faculty Scholars Pro-gram, established in 1999, has developed a unique mentoring model to in-crease the social work profession’s capacity in gerontological teaching,practice, research and scholarship. Through a network of colleagues andmentors, scholars are prepared to become academic leaders, role modelsand mentors for future generations of social workers in geriatrics/gerontol-ogy (Maramaldi, Gardner, Berkman, Ireland,, D’Ambruoso, & Howe,2004). In addition, beginning with the academic year 2006-2007 the Col-lege of Palliative Care of the American Academy of Hospice and PalliativeMedicine (AAHPM) has included social workers in its program of distancementorship in palliative care and end of life research. The second author(LD) of this article is the protégée in one of the three pairs of social workmentorships in this program.

METHODOLOGY

Both authors are longtime employees of the VA and both had theprivilege of knowing Zelda. One of the authors (JH) became profession-ally associated with Zelda as a result of collaborations in healthcare so-cial work after Zelda’s retirement from the VA. The other author (LD)began her VA career as a medical social worker working under Zelda

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when Zelda was Chief of Social Work Service. The initial conceptionfor this article began when the authors read tributes about Zelda and hermany mentorship relationships, both within the VA and in the world ofpalliative and end-of-life care and social work practice. We recognizedhow many colleagues we know in our workplaces and within the greatermetropolitan New York area who are the direct beneficiaries of Zelda’swisdom, guidance and vision. We chose the qualitative method ofstudying the nature of Zelda’s mentorship with her protégées as a wayof analyzing data yielded by a small sample. Qualitative research isused when researchers want to gain a deeper understanding of the hu-man experience (Rubin & Babbie, 2005). The specific technique usedwas depth interviewing which allows for respondents to state their ownperceptions about their mentorship experience and further allows themto make their own meanings about that experience (Miller & Crabtree,2004).

We were mindful that the clinical term the profession of social workstill prefers to use is “supervisor” or “supervisory relationship” but webelieve that Zelda embraced the term “mentor” as the term became pop-ular in the literature of career development so that social workers, too,could continue to advance in their careers and could secure standing inthe health care community. Most of all, if patients were going to bebetter served with a model of professional development that was goingto help social workers learn all the necessary skills required to surviveand thrive in a demanding business model, then “mentorship” is the pre-ferred term for her work with those whom she supervised.

The authors developed a short interview schedule of open-ended,in-depth semi- structured face to face interviews which was adminis-tered to six of Zelda’s mentees. The schedule of interview questions isfound in Figure 1. The in-depth interview format is an appropriate qual-itative research design when the following four conditions exist: (1) thefocus of inquiry is well defined, (2) the respondents are selected from a“clearly defined unit,” (3) the respondents are familiar with interviewsas a means of gathering data, (4) the goal of the research is to develop“themes and narratives” (Miller & Crabtree, 2003, p.186).

Participants

We defined a mentee as a junior colleague of Zelda who was directlyor indirectly mentored by her. “Direct mentees” were defined as directlyreporting to her, and “indirect mentees” were seen as more junior col-leagues who did not report to Zelda at any time in her career, but who

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were guided and influenced by her in some way. Mentees were assuredconfidentiality and anonymity in our reporting, synthesis, and discus-sion. Today, all the respondents would be considered senior level ad-ministrators by professional standards. They each are responsible formanagement of their departments, include a range of personnel, includ-ing social workers, budgets and critical policy areas.

Judith L. Howe and Louisa Daratsos 51

FIGURE 1. Interview Tool

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Over the course of four weeks, we interviewed six mentees, threemales and three females. The initial names for the first two identifiedmembers of the sample were well known to the authors from committeework and from prior supervisory relationships. In the course of tele-phone calls and emails, and while setting up the interview schedule, aform of snowball sampling occurred as the first two respondents inde-pendently identified other social work leaders who met the inclusioncriteria for the sample. This identification also occurred after the au-thors had already determined the maximum number of interviewees forthe study. These respondents defined themselves as successful individ-uals who saw themselves as a cohort, and were able to identify otherswhom they perceived met the criteria for inclusion in the sample. Onlyone of these individuals was an indirect mentee who did not report toher at any point in her career at the VA. Another female was alreadyworking for the VA when Zelda returned to the VA as chief of the ser-vice. One female respondent was hired after completing her second yearfield work internship at the agency. The three male respondents werehired by her within at least three years of attainment of their Mastersdegrees in social work.

FINDINGS

Mentoring Phases

The literature reports on four phases of mentoring: initiation, cultivation,separation, redefinition (Kram, 1983). Here we discuss Zelda’s mentoringin the context of these four mentoring phases.

Initiation. Of the four respondents who were hired by Zelda, each re-calls that upon their being hired, they had had a sense of gratitude thatZelda recognized their potential to contribute to the work environmentthat Zelda had created within the Social Work Service and to the reputa-tion for having a department with outstanding social workers who couldrepresent the profession throughout the hospital community. The senseof gratitude and the sense of being hired to participate in a uniquely ac-tive social work department is especially striking as three of the four re-spondents who recall these feelings already had established careers inthe field and therefore had a basis of comparing qualities of social worksupervision and leadership as well as institutional cultures. Indeed, twoof the three respondents who had post-masters’ work experience hadworked in other health and mental health settings. Additionally, they

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knew of Zelda’s reputation as they had initially heard of their eventualVA positions through mutual social work professional contacts. Thus,the respondents, in some senses, could have been said to also initiatetheir professional contact with her as each individual was able to ascer-tain something about the Brooklyn VA Social Work Service and Zeldaas its Chief, prior to the hiring process. Although none of these respon-dents discussed what they recalled of Zelda’s reputation they each be-gan their answers to the opening question of the interview by sayingsome variation of “She took a chance on me.”

Cultivation. The respondents all reported that Zelda actively culti-vated all members of her department. This activity was more pro-nounced for the people who, like other respondents who were inter-viewed, were among her mentees. All reported a sense that Zelda couldvery quickly evaluate one’s potential to contribute to her vision of themission of the Social Work Service. Each of the respondents whoworked for her (n = 5) recall that Zelda had a specific method of observ-ing and preparing an individual for larger roles within the departmentand within the hospital. The department was run by committee andZelda had the opportunity to evaluate an individual’s efforts on thatcommittee either through direct observation, such as monthly staffmeetings, or through the reports of the committee chairperson or one’sdirect supervisor. The objective of the cultivation phase was to assessone’s ability to represent the department within interdepartmental com-mittees at the level of stature that Zelda envisioned that social workerscould and should occupy.

Separation. While we did not directly ask this question, Zelda main-tained relationships with the individuals she mentored who eventuallyreceived promotions which took them out of the Social Work Service.The respondents who had this experience recall the gratitude they feltwith the ongoing connection to the department as an anchor to their pro-fessional and discipline-specific identities, since for the first times intheir careers they reported to someone other than a social worker. Mostimportant, in their own words, was the continuing guidance they re-ceived in their consultations with Zelda. It was during these earlyphases of their own mid-level managerial careers where one could saythat they benefited from a traditional mentor-protégée relationship withZelda. They knew they could contact her as needed and receive guid-ance in program coordination and design, supervision, managing rela-tionships with non-social work supervisors and coworkers and anyother issue related to leadership.

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Redefinition. Upon her retirement, mentees redefined their relation-ship with Zelda. The three female respondents in this sample discussedhow their relationships with her evolved from that of a mentor/protégéeto a wise and loving friend. She remained a teacher and a leader to them,and continued to encourage them to stretch themselves professionallyand personally. Each of these women talked about Zelda and her love ofhaving fun and not taking herself too seriously while she was employedby the VA. This side of her was even more apparent to them once she re-tired as Chief and was said to extend even in her last weeks of life

MENTOR CHARACTERISTICS

Strong mentors have a desire to share experiences and knowledge,and all respondents made it a point to say that Zelda’s sharing of experi-ences and knowledge was in no way intended to promote Zelda herself.Instead, her sharing of experiences and knowledge was intended to helpher supervisees and protégées learn and grow in their positions. Each re-spondent recalls that Zelda was active in formal and informal leadershiptraining opportunities.

Several respondents recalled Zelda’s role in the VA’s national SocialWork Administrative Leadership Training (SWALT) program both asan official mentor of social workers from other VA medical centers andas an active promoter of social workers in her department whom shedeemed appropriate for selection into this prestigious training opportu-nity. Zelda’s appreciation for the SWALT program provided impetusfor some workers to consider themselves for leadership roles who maynot have imagined that they could achieve promotions within the sys-tem. Those respondents who worked for Zelda all recalled how Zeldawas instrumental in securing social workers from the department appli-cations into the program and the Brooklyn VA’s distinction as having ahigh number of its applicants accepted into the program.

Zelda also promoted critical thinking and a systems perspective inher protégées. The respondents who worked for her all recall Zelda’skeen ability to use a systems perspective in analyzing issues. She ap-proached issues with two considerations always in mind: what were thecurrent gaps in service and how could patients be best served? The goalwas always how to close the gap and, in the words of one of herprotégées, she required that her staff approach problem solving at themicro and macro levels. All the respondents remember that Zelda im-pressed upon them the importance of continuity of care and forging

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community partnerships long before these program planning modelsbecame professional standards and certainly well before the VA wasnoticed as an institution willing to look beyond its own resources tomeet patients’ service needs. Of those protégées who had the opportuni-ties to design programs, Zelda’s door was always open to them to dis-cuss the merits of a particular course of action and to think through anypotential barriers to program planning and implementation.

Strong mentors also promote disciplined work habits, understandingand patience, attention to detail, and organizational skills. All of the re-spondents commented on these attributes as demonstrated by Zelda intheir interactions with her. These qualities were noticed by them fromtheir earliest interactions with her. Once again, Zelda practiced these at-tributes of leadership in her unique style. All remarked that Zelda wasvery disciplined when it came to developing a plan to venture into a newproject or partnership. She had the discipline to analyze all aspects ofthe issues and could anticipate any barriers that may present themselvesat all phases of the planning. While she was planful, she was not neces-sarily patient with people and rules that stood in the way of achievingher desired results. All or the respondents spoke at length about Zelda’spassion for honesty, ethics and social justice. She had no tolerance fordishonesty.

If anything, Zelda taught her mentees to be prompt, detail-oriented andthoughtful but to also be prepared to enlist anyone to help achieve the inno-vations needed to improve services and to promote continuity of care. At atime when the VA as a national institution was isolated from the rest of thehelping community, Zelda encouraged her protégées to partner with local,city and state agencies to develop comprehensive medical and mentalhealth programs in HIV/AIDS, substance abuse and homelessness amongother areas of practice besides end-of-life care.

CONCLUSION

Zelda was concerned that future leaders in social work be prepared totake on the considerable tasks and challenges facing the profession inthe midst of sweeping changes in the health care field. One menteenoted that she was interested in succession planning for a number ofyears before her anticipated retirement. Her sense of legacy was notegotistical but driven by doing the right thing. As one protégée respon-dent noted, “Zelda took us from one place to another place. Now, be-cause of her we have enhanced services and a different way of thinking

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regarding end-of-life care and other services. If we just stay here, whereshe brought us, we have not served her memory. We need more Zeldasso that social work can be more effective from a professional, ratherthan a product line, base.”

The authors argue that beyond honoring Zelda with all the well-de-served tributes that have been offered since the news of her death, socialworkers interested in honoring her memory need to study her career andthe impact she has made upon those whom she mentored. Then, apply-ing the results of this research, social workers need to become activementors to social work students and junior practitioners to truly keep thespirit of her work alive.

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Byrne, M., & Keefe, M. (2002) Building research competence in nursing throughmentoring. Journal of nursing scholarship, 2002, 4th quarter, 391-396.

Foster, Z., & Corless, I. (1999) Origins: An American perspective. In Z. Foster & I.Corless, (Eds.) The Hospice Heritage: Celebrating our Future. pp. 9-13.

Hayden, J. (2006) Mentoring: Help with climbing the career ladder. Health promotionpractice. 7(3):289-292.

Kram, K. (1983) Phases of the mentor relationship. Academy of management journal.26, 608-625.

Lee, J. M., Anzai, Y. & Langlotz, C. P. (2006) Mentoring the mentors: Aligning mentorand mentee expectations. Academic radiology. 13:556-561.

Maas, M. L., Strumpf, N., Beck, C., Jennings, D., Messecar, D. & Swanson, E. (2006)Mentoring geriatric nurse scientists, educators, clinicians and leaders in the John A.Hartford Foundation Centers for Nursing Excellence. Nursing outlook, 54:183-188.

Maramaldi, P., Gardner, D., Berkman, B., Ireland, K., D’Ambruoso, S. & Howe, J.L. (2004)Mentoring new social work faculty: A gerontological perspective. Gerontology & geri-atrics education, 25(1): 89-105.

Miller, W., & Crabtree, B. (2004) Depth interviewing. In S. Hesse-Biber & P. Leavy (Eds.)Approaches to Qualitiative Research: A Reader on Theory and Practice. NewYork: Oxford University Press. pp. 185-204.

Rubin, A., & Babbie, E., (2005) Research Methods for Social Work. Belmont:CA.Brooks/Cole Thomson Learning.

Schapira, M., Kalet, A., Schwartz, M. & Gerrity, M. (1992) Mentorship in general in-ternal medicine: investment in our future. Journal of general internal medicine, 7:248-251.

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