Bette Keltner Jacobs

Dean of Georgetown University Schools of Nursing and Health Studies

BetteKeltner In 1999 Bette Keltner Jacobs, Cherokee, PhD, RN, became dean of Georgetown School of Nursing. Since that time, under her effective leadership, the School of Nursing has become the School of Nursing and Health Studies (NHS). Within this expanded school, in addition to the department of nursing, there are departments in health systems administration, human science and international health. Jacobs has recruited well-regarded scholars and greatly increased the school's portfolio. NHS faculty members pursue such diverse areas of inquiry as HIV/AIDS, childhood development, health care access, and population health.

Jacobs has also overseen significant improvements in the school's facilities, including the creation of the Discovery Center that is used by students and faculty for biomedical laboratory teaching and investigator-initiated molecular and cell biology research. Nursing, which includes both undergraduate and graduate programs, is now only 25 percent of the focus of the school, so while Jacobs provides overall leadership in the school, the chair of the department of nursing provides most of the leadership in nursing.

Recently, the school launched the Linda and Timothy
O’Neill Institute for National and Global Health Law. The institute, which was co-founded with colleagues at Georgetown University Law Center, brings together law, scholarship and policy. The vision for the institute is built on the proposition that the law has been, and will remain, a fundamental tool for solving critical health problems in our global, national, and local communities.

The following article, which was published when Jacobs became Dean of the School of Nursing, is still relevant because it focuses on her journey and her advice to students. When the article was published, the dean was known as Dr. Bette Keltner, so she was referred to as Dr. Keltner in that article. In 2008, Keltner married Joseph Jacobs, MD, who is a member both of the St. Regis Mohawk Tribe in Upstate New York and the Kahnawake Tribe in Quebec, Canada. Now the dean is known as Dr. Bette Jacobs.

Dean of Georgetown University School of Nursing

In August 1999, Bette Rusk Keltner, Cherokee, PhD, RN, was named dean of the prestigious Georgetown School of Nursing. She is one of the first American Indians to serve as dean of a nursing school. What path did Dr. Keltner take on her way to this position of great honor and responsibility? How has her path been linked to her American Indian roots?

In high school Keltner did well in the sciences, but she did not have help in choosing and pursuing a career. The local junior college catalog was her “map” which led her to nursing. “I didn’t have aspirations at that point to go into a bachelor’s program or a PhD program or be a vice president or be a dean,” says Keltner.

After being licensed as a registered nurse and practicing for a few years, Keltner made the difficult decision to leave her home in the San Francisco Bay area and pursue her bachelor's of science (BS) degree in nursing at California State University in Fresno. “It was a couple of hours away, but it felt very far because I had never been far away from home. Considering how much I’ve traveled now, that seems funny. But then it was like going to a different world.”

Keltner received her BS, worked as a hospital staff nurse, earned her master's of science in public health at California State University, and then begin working as a public health nurse. During this time she gave birth to two daughters, so she had the added responsibilities of a young mother.

Keltner’s academic career started in 1981 when she joined the California State College as assistant professor. A few years later she began her studies at the University of Texas, which awarded her a PhD in 1985. By then she was the mother of three children and had begun doing research, writing scholarly papers, and making presentations in areas that she has continued to pursue, including child, maternal, and family health and the special issues of mothers and children with developmental disabilities. These interests, she says, were kindled while she was working with families as a public health nurse.

“Developmental disability and poverty often go hand in hand,” she says. “It’s like a double whammy, and it perpetuates itself intergenerationally. When you have high rates of disability, particularly mental disabilities, it’s hard to pass on the strengths and vibrancy of a culture. People with these disabilities can teach important lessons of patience and reality but, for example, they won’t remember the historical stories and legends that serve as guides.”

While developmental disabilities affect people from all backgrounds, Keltner says that such disabilities “are over-represented among families who have been deprived for generations of basic needs”. Indian reservations are the most economically impoverished areas in the United States. While Indians have “impressive reservoirs of strength” and have coped in the face of great adversity, “they have endured high rates of disorders associated with social stress”.

In 1990 Keltner returned to California State University where in 1990 she was promoted to full professor with tenure. For one year she served as Acting Associate Dean of Graduate Studies and Research. Then in 1994 she became a professor in the School of Public Health at the University of Alabama in Birmingham where she served as Associate Director of Applied Research.

Keltner continued examining the relationship between cultural factors and health, and she continued paying special attention to the challenges facing Indian people. This is reflected in a $1,598,000 grant from the National Institutes of Health for a project entitled “American Indian Families and Adaptation.” It is also reflected in her active involvement in the National Alaska Native American Nurses Association. For the past three years, Keltner has been president of this organization that she calls a “jewel”.

Keltner’s career path has not been linear. In 1997 she became the Assistant Vice President of Administration, Medical and Health Services at Honda of America in Ohio. “I used to say that you never know where a public health nurse will end up,” says Keltner. “I was used to working in migrant camps and going into clinics and schools. Then I ended up in a company with hard hats and steel-toed shoes. Even that surprised me.”

Now as Dean of Georgetown’s School of Nursing, Keltner continues her advocacy of the underserved. She feels that nurses have unique opportunities to help design cost-effective, efficient ways of providing high-quality care to all people. Towards that end, she says, “I hope I can help the nursing school grow in its responsibilities to educate nurses and to grow a good research program that will make a difference.”


What is Keltner’s advice to readers who want to consider a career in nursing? “Nursing can provide a lifetime of challenge and opportunity, but as with any other path, you need to do your very best and to give back to the people who have brought you to this place.

“Consider the many opportunities that are available for nurses, she recommends. “Within the scope of a single nurse’s practice, you can do wonderful things, but you’re limited to just those people that you physically meet. If one has a position in education or policy or administration, particularly if it’s in a domain that charts priorities or channels funding streams, the impact that you can have can be much greater.”

Keltner recommends thinking big. She admits that as a young woman, “I probably would have fled if I had thought about myself giving speeches in front of large groups or working as a vice president or a dean.” But with each job that she did well, she built her own self-confidence. And others, who respected and admired her work, gave her new challenges and opportunities. “When we are 17 there are lots of things that we can’t imagine doing that actually we wind up doing pretty well.”

For readers who want to consider going into leadership positions in nursing and health care, Dr. Keltner recommends going to an elite school, such as Georgetown, “where students are expected to go on to do exceptional things” and where there is an infrastructure that opens doors to the best graduate schools and to high-level jobs.

Dr. Keltner has been and continues to be a leader in health care and health professions education. She is an excellent role model for people who are willing to take risks and to pursue worthy goals
This article was originally published in the Winter 2000 issue of Winds of Change. (The cover artist is Ben Shorty, Navajo.)

Update 2010

In 2008 Keltner married Joseph Jacobs, M.D. Dr. Joseph Jacobs is a graduate of Columbia University, Yale Medical School, and Wharton, the business school of the University of Pennsylvania. Jacobs is currently serving as Associate Medical Director for Abbott Molecular. He was the first director of the office of alternative medicine at the National Institutes of Health. Over the years he has been very active in the
Association of American Indian Physicians and served as its president.

For updates on Dr. Bette Jacobs, see her page at