Within the first year as CNO, you described a vision for the Department of Nursing: excellent care to patients and families, with the best staff, in the safest environment. Why did the department need a vision?

We began an intentional journey together five years ago. During my first year, I spent many hours talking to nurses at the bedside, finding out what it means to them to be a nurse in the Department of Nursing at Brigham and Women’s Hospital. From those conversations, I heard how proud nurses are to work here, how important it is for them to give excellent care to patients and families and how important it is for them to feel connected to their leaders. Our vision came from the messages I received from BWH nurses. Our vision unites all BWH nurses in our purpose, which is to provide excellent care to patients and their families. Our vision guides the Department of Nursing’s journey; it charts our course. Everything we have done in the last five years was based on our vision.

You have talked a lot about the importance of the voice of the nurse. How did you stay connected to nurses and ensure that their input helped to guide the work?

The voice of the nurse has been a guiding principle for me and for nursing leadership. Caring for patients is the central work of nurses and nursing. Clinical nurses are important advisors on patient care and the practice environment because they are the ones taking care of the patients. What better way to inform and shape decisions than to ask them? I sought out as many opportunities as possible to get to know nurses at the bedside in many different areas of the hospital. I have held many focus groups over the years, which allowed me to spend time talking with different groups of nurses about the issues that are important to them, about what patient care looks like where they work and what they need in order to provide the best care imaginable.

What has resulted from those conversations?

We are working to ensure that the Department of Nursing is advancing professional nursing practice so that patients are receiving the best care. Our work is about creating a professional practice model that continually enables nurses to advance their practice and improve patient care as a result.

Another important principle for me has been to ensure that no nurse feels “alone” in his or her practice. This means that nurses know there are resources, including their leaders, that are accessible and available to help them think through a patient care problem. We also want to make sure that nurses realize they are members of a larger community of nurses at BWH. Though we are each specialized in what we do, we can learn a great deal from each other.

What do you hope nurses will keep in mind as they continue this journey?

Ask yourselves, what do you want patients and families to experience from the nurses at BWH? What do you want your colleagues at BWH and nurses across the country to know about our practice? And finally, what does it mean to you to be a BWH nurse?

What does it mean to have a professional practice environment?

In a professional practice environment, nurses and nursing practice will grow and flourish. Through the process of Finding and Defining the Good, nurses who are known for their excellent nursing practice were asked to describe what excellent care looks like and how they make a difference to patients. They described the foundation of our practice: their relationship with patients and their families. We have learned much about what excellent practice looks like from these nurses. We want to extend this nursing excellence to benefit all patients and nurses so that we reliably provide excellent care to patients. I want to be confident that if any member of our families is admitted to BWH, they will receive the same excellent care from every nurse on any unit at any time.

What are your hopes going forward for the Department of Nursing?

I am confident that the work we have started together will continue. The Department of Nursing’s next steps include translating what we learned through the process of Defining the Good into practice across the hospital to improve patient outcomes (Extending the Good). It is important to continue to focus on understanding diversity and ensuring that our nurses reflect the diversity of our patients on such demographics as age, culture, ethnicity and sexual orientation. Reliability in our practice is very important—every patient should be able to expect one standard of nursing practice, regardless of unit or clinic.

Under the interim leadership of Trish Gibbons, DNSc, RN, this work will continue to be supported and developed. Clinical nurses and nursing leaders throughout the department will continue to drive this work and continue to strengthen the Department of Nursing with their contributions going forward. Our committees of staff nurses and our nursing leaders will ensure the Department of Nursing concentrates on areas that are key to supporting nurses in providing the best care to patients and families.

I hope that nurses are as proud as I am of the work they have accomplished already and feel energized to build upon this strong foundation.

As you think ahead to your new role as COO, what would you like the BWH community to know?

As chief nursing officer, I have been able to focus on each aspect of our hospital’s mission in a discipline-specific way. I see this new role as a wonderful extension of that work. I now have the privilege to collaborate with staff and leadership throughout the institution to achieve the mission that is so important to all of us: providing the best and safest care to patients and families, generating new knowledge through research, training our future care providers and extending our services to the broader community.

As you reflect on your time as chief nurse, what were some of the best moments for you personally?

My best moments were always when I could be with clinical nurses, listening to them talk about caring for their patients. I loved watching nurses grow and develop in their practice, and especially to see the enthusiasm that radiates from them when they have influenced decisions that shape the practice environment and improve patient care. I am filled with a tremendous sense of pride when I read letters from patients and their families praising their nurses for their compassion, their support and the knowledge they used to provide care to patients during one of the most vulnerable times in their patients’ lives. I am so proud of how nurses are contributing to this institution and to our local and global communities. Serving as your chief nurse has truly been the role of a lifetime. I am, and always will be, proud to be a BWH nurse.