A Trailblazing Nurse and Attorney Reflects on Her Career

Margaret “Meg” Robins Garrett, founding member of the American Association of Nurse Attorneys, grew up during an era when most women who worked were nurses, teachers or administrative assistants. From an early age, the vice president of risk management and chief legal counsel for the Johns Hopkins Health System says she knew she “wanted to help people.”

For the past 33 years, Garrett has been responsible for designing, implementing and overseeing all aspects of the Johns Hopkins Health System Risk Management Program/Department. This includes six hospitals, Johns Hopkins Home Care and Johns Hopkins Community Physicians, as well as long-term care facilities, international hospitals and numerous clinics.

Now, as Garrett prepares to retire in June, she reflects on what she considers a transformative career.

“Becoming a nurse seemed like a natural fit for me,” says Garrett. Her Irish mother served as a nurse in London during World War II, where her parents met. After the war, they married and raised their family in central Pennsylvania.

A 1972 Villanova University College of Nursing graduate, Garrett joined the Navy and volunteered to serve during the Vietnam War. At one point during her six years of service, she was tasked with overseeing an orthopedic unit at a Boston military hospital. Many of the patients were amputees with multiple co-morbidities, including serious infections.

“It was a big, open ward,” Garrett recalls. “Rehab didn’t exist, and patients spent at least a year in the hospital.” But what intrigued her most were the psychiatric aspects of care. “That was the beginning of what we now know as PTSD [post-traumatic stress disorder].”

While stationed in Charleston, South Carolina, she earned a master’s degree in counseling and education from The Citadel and worked as a psychiatric nurse at Naval Hospital. Two years later, she married the late South Carolina native William Garrett, a Navy Medical Corps physician.

The family moved to Baltimore, where her husband established a practice in rehabilitation medicine. In 1983, she earned a law degree from the University of Maryland Carey School of Law.

With four children under 6 years of age, she was not looking for a job when the Johns Hopkins Legal Department contacted her about a new legal position they had established. “When I put together all three of my degrees — in nursing, education and law — Hopkins was the ideal place for me to utilize all that knowledge,” she says.

Garrett began her career as a nurse attorney at Johns Hopkins in May 1986. She was responsible for nurse orientation and teaching nurses about the law, and introduced the 24/7 on-call legal hotline, which ensures that issues and events can be reported and addressed quickly.

When she joined the hospital, recalls Garrett, “health care was changing fast. Laws and regulations were becoming necessary, and health care providers didn’t understand them.” She has taught risk management and the law to physicians and nurses for more than 30 years.

Garrett would go on to play a pivotal role in the design, implementation and oversight of all aspects of risk management across Johns Hopkins Medicine. In addition, she developed an integrated approach to risk management and patient safety throughout the organization. She has been actively involved with the Johns Hopkins Ethics Committee and has provided both legal and ethical counseling during her tenure.

And, always a teacher, Garrett has helped to explain the intricacies of health care law to more than 200 law students. She has been an active supporter and adviser to the Health Law Section at the University of Maryland law school and is adjunct faculty at the Johns Hopkins University School of Nursing.

Looking back, Garrett says the rigorous training from her time in the military positioned her to take on many different roles. “I feel like I’m a competent leader,” she says. “I have to make decisions but need to be empathetic and listen well.”

“Patients should always be at the center of our universe,” adds Garrett. “I’ve always been an advocate for them, whether as a clinician or in my role as legal counsel or risk manager.”

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