VCU news

By Mary Kate Brogan
School of Pharmacy

In the past decade, Alexander J. Smith has gone from student to middle school teacher to medical assistant to student, research assistant and neurosurgery care partner. It’s not indecision — every step has been guided by faith, determination and an unending drive to serve.

This week, Smith will take the next step in his journey as he graduates from Virginia Commonwealth University for a second time and continues this path, now as a nurse. He’ll take with him every lesson he’s learned along the way.

“I’m ready to use my talents, my skills to help those patients who are very, very sick and need special attention,” Smith said. “I know there will be tough days, and that’s one thing about me: I’ve learned through my life experiences that life is not going to be rainbows and candy. There’s going to be a lot of turns and twists that will test you, but it’s how we deal with those tests that’s important.”

Smith, a student in the Accelerated B.S. in Nursing program in the School of Nursing, first came to VCU in 2011. As a sophomore, he joined the Academic Scholars Program in Real Environments, where his passion for serving the community grew. He still provides meals to people without housing and teaches Sunday school to children at his parish.

The same year, Smith joined his father, who makes prosthetics for a living, on a trip to the Philippines with Montero Medical Missions, based in Smith’s hometown of Chesapeake, Virginia. The younger Smith was there to document the trip, but he learned far more about the impact that giving someone the resources to manage their own health could make.

“They don’t go in there and try to do some quick fixes and quick changes and then leave because the problem with that is that you have not given the population the tools to help themselves,” Smith said. “Rather, what they’ve done is create self-sustaining infrastructure so that the population in the Philippines can treat themselves and work for themselves.”

In 2015, Smith graduated with a B.S. in biology from the College of Humanities and Sciences and minors in chemistry and social work. He accepted a job with Teach for America that summer and moved to Baton Rouge, Louisiana, where he taught middle school science.

“My goal was not to go there and change as many state test scores as possible, but rather to show one or two, or as many children as I can, the value of education and the value of perseverance,” Smith said. “If I can show them that they can do it themselves, then the coal is in the train, and they are up and running.”

Smith also was teaching the teachers. As a social justice facilitator, he helped his fellow Teach for America educators — many of them new to teaching low-income, high-risk students — gain greater self-awareness about their own biases and work through those preconceived notions to be the best teachers they could be.

Smith continued to strive to do right by his students, even when it felt impossible. In his first year teaching, his students faced the sudden loss of a classmate who was killed in a shooting. While other teachers tried to go about the day as usual, Smith gave students time to work through it in class by practicing deep-breathing techniques and encouraging talk therapy with friends and family.

“I tried to empower them to get past that emotional barrier so that they can eventually get past the loss of their friend and get back to some form of normalcy,” Smith said. “Maybe later, when other things happen in their life, they’ll have the skills and coping mechanisms that we worked on to get past it as well.”

Only years later, as a nursing student, did he realize the same techniques he’d shared with his students were ones he would work through with patients who were experiencing hardships.

After two years of teaching, he knew the field of medicine was calling to him. He returned to Chesapeake, where he began working as a medical assistant at a gastroenterology practice. He explored many aspects of what it was like caring for patients with a team, which ultimately guided him toward nursing. Since he’d already earned a bachelor’s degree, Smith enrolled in the five-semester Accelerated B.S. in Nursing program at VCU in May 2019.

During Smith’s first semester, he had a health assessment class with Ingrid Pretzer-Aboff, Ph.D., an associate professor and senior nurse researcher in the School of Nursing. Smith sat at the front and asked great questions, Pretzer-Aboff noticed, so she asked him one day if he was interested in research. “He jumped at the chance,” she said.

Pretzer-Aboff brought Smith into her lab, where she and her team study the movements of patients with Parkinson’s disease who experience a phenomenon where their bodies sometimes stop suddenly midstride. Without physical support or a method to stop this freezing of gait, they can fall and sustain injuries as a result.

As a research assistant at the lab, Smith had two very different roles: managing video archives of research participants’ walking sessions and acting as a spotter to support patients when they experienced freezing of gait. He excelled at both.

“In the research setting, he really does exceedingly well bonding with the patients,” Pretzer-Aboff said. “He can relate and he has a great rapport with every single one of them. … He’s been a really strong member of our research team.”

Working in the lab has taught Smith lessons about patient autonomy — a concept he’s learned about in nursing classes — where health professionals are encouraged to give patients the ability to make their own health-related decisions.

“Although that patient population has had so much taken away from them as far as their body function and mobility, during those sessions in the walks, I want to allow them to do as much as they can for themselves,” Smith said. “For example, just little things like saying, ‘How much assistance do you need putting on your shoes?’ rather than taking away their autonomy and jumping in without asking.”

Watching Smith’s initiative inspired Pretzer-Aboff to nominate him for the School of Nursing’s Lynn Bell Undergraduate Scholarship of Sigma Theta Tau, which he won.

Smith brought his experience to teams beyond Pretzer-Aboff’s with a unique on-campus job that gave him invaluable experience: Taking on a role as a neurosurgery care partner at VCU Health. Working with patients who have illnesses of the spinal cord and brain, Smith has learned to sense when a patient is confused or nervous to ask questions.

“During my care partner experiences, as well as my clinical experiences, I have learned to advocate for my patients no matter what,” Smith said. “If I have a gut feeling that my patients have more questions, I will speak up and inform the medical team. I treat every patient as I would my own family. I think to myself in hard situations, ‘What would I do if this was my grandmother in the hospital bed in front of me?’ This helps me practice empathy, which is so important in our profession as a nurse.”

It’s a practice that will serve him well in his new role after he graduates on Saturday. Smith has accepted a position in the neuroscience intensive care unit at Duke University Hospital, caring for patients who require a high level of nursing care. Smith said he is grateful that the team there saw such promise in him, especially right out of school, but his faith and the lessons he’s learned will guide him as he starts his new career. Pretzer-Aboff said she knows Smith is going to be successful.

“He had a lot of different experiences before he came to the School of Nursing through education and working with different populations,” Pretzer-Aboff said. “These experiences bring him a maturity and perspective that will serve him well in the future.”