Hill, Karen S. MSN, RN, NEA-BC, FACHE
Author Affiliation: Vice President/Nurse Executive, Administration, Central Baptist Hospital, Lexington, Kentucky.
Correspondence: Central Baptist Hospital, 1740 Nicholasville Rd, Lexington, KY 40503 (firstname.lastname@example.org).
This department highlights nursing leaders who have demonstrated the ability to inspire and lead change. This competency is seen in the ability to create, structure, and implement organizational change through strategic vision, risk taking, and effective communication. Each article showcases a project of a nurse leader who demonstrates change in a variety of environments ranging from acute care hospitals to home care and alternative practice settings. Included are several "lessons learned" applicable to multiple settings that provide insight for other nurses in executive practice.
Many nurse leaders have a positive influence on the direction of the nursing profession. After interviewing Colleen Goode, PhD, RN, FAAN, NEA-BC, I am convinced she is an underrecognized national nursing leader in the area of evidence-based practice. It is an honor to tell her story.
In 2009, Colleen retired as the vice president and chief nursing officer (CNO) at the University of Colorado Hospital. Colleen became a scholar in the concept and application of evidence in practice early on in her career and later as a student, developed a study to support the use of saline flush as an alternative to heparin. This not only had a positive patient care impact, but also is a cost-effective nursing intervention now used worldwide.
Colleen started her nursing career as a BSN graduate from the University of Iowa in 1961. At the time, Colleen was one of a small cadre of new graduate nurses educated at the bachelor's level in an era dominated by diploma graduates. Later, she completed her master's degree in nursing from Creighton University and her PhD in nursing administration from the University of Iowa. Colleen's first job was as a medical surgical nurse at the University of Iowa where she quickly advanced to nurse manager. After a move to South Dakota, she taught nursing and worked as a clinical educator. Upon returning to Iowa in 1970, Colleen began her career as a CNO in a 45-bed community hospital. This small facility provided endless opportunities for her to expand her knowledge and enhance her clinical skills in all areas including obstetrics, operating room, emergency department, education, and administration. The facility's limited resources were not viewed as a constraint but rather an opportunity to initiate significant change through creative and nontraditional approaches to her practice.
The use of creative strategies in times of resource limitations is one of the early career lessons learned by Colleen. Colleen has found that opportunities are always readily available for those innovators willing to be risk-takers. In many respects, the smaller institution provided more openness and opportunity for a creative nurse leader like Colleen than some bigger and more bureaucratic organizations would have. Colleen began studies toward her master's degree to enhance her career as a nurse leader.
Through networking with faculty, Colleen developed a friendship with a professor who taught research and evidence-based practice. This educator inspired Colleen and assisted her in applying these concepts at her small community hospital. This real-time research and evidence-based approach to clinical nursing practice came well before the concept was widely being implemented in other settings. Initially, Colleen worked with her hospital "audit" committee that was responsible for reviewing and updating policies and procedures basing revisions on traditional literature and references. Through the application of evidence in practice, Colleen led her organization to be recognized as a participating facility in the Research in Utilization in Nursing (RUN) study.1 From the original 200 participating hospitals, Colleen's facility was selected as 1 of 16 sites highlighted as a leader in the country in the clinical application of nursing research.
In continuing to maximize opportunities for her nursing staff and organization, Colleen collaborated with faculty at a liberal arts college to make a video discussing how her facility had implemented their program of evidence-based practice and highlighting policies and practices that had been changed. Later, Colleen developed an instructional video and guidebook highlighting her program and approach as a resource for nursing leaders and faculty members. Recognition of these 2 videos across the country led to invitations for national speaking engagements and consultation with others hoping to duplicate the success Colleen and her nursing staff had enjoyed. This exemplar highlights the outcomes that a committed nursing leader can achieve using a strategic approach, leadership expertise, and creation of a niche.
Based on the success of her work in evidence-based practice and to enhance her research skills, Colleen enrolled in the PhD program at the University of Iowa. At the time, Colleen had the opportunity to collaborate with Marita Titler, a clinical nurse specialist at the hospital, and other nurse leaders to further develop evidence-based applications and pilot projects. Another lesson learned is the value of clinical and educational collaboration with colleagues with a variety of perspectives. Working at the University of Iowa Hospital gave Colleen the opportunity to move into other interesting roles including interim CNO. Colleen reports that advancing her education changed her approach and thoughts to be more scholarly and systematic, thus enabling her to negotiate complex change through many systems.
From Iowa, Colleen moved to her most recent position at the University of Colorado Hospital, where she led the organization to be the 44th facility in the United States to receive Magnet recognition.
Throughout her career, Colleen has received multiple honors and awards including induction into the American Academy of Nursing and President of the Iowa Organization of Nurse Executives and recognition from the Iowa Nurses Association for her pioneering work in nursing research. One of the honors she is most proud of is the recognition of the nursing staff at the University of Colorado Hospital in winning the national Magnet Prize in 2006 for their approach and application of evidence-based practice. Colleen also supports leadership research including participation as a beta site for the University Hospital Consortium initial nurse residency program. In promoting the success and outcomes of this initiative on a national level, Colleen is currently lobbying the Center for Medicare and Medicaid Services (CMS) to support a national requirement for nursing residency similar to that already in place for physicians, pharmacists and pastoral care. In addressing the political continuum in support of this issue, Colleen is working with the Commission on Collegiate Nursing Education to develop accreditation standards for nurse residency programs.
Colleen's research during her doctoral studies led her to develop a study to test intravenous saline flush versus heparin flush. This protocol, which has now been universally implemented, was started with a clinical question looking for evidence and support. As Colleen says, "I have been a better CNO because I have broad clinical experiences, and that question came from my clinical practice. I also pride myself on listening to the staff nurses who know better than anyone what to ask." Colleen Goode is a seasoned and experienced nurse executive. Her transition from her current hospital role to new opportunities in leadership as a knowledge worker continues to benefit her own staff as she paves new trails professionally as well as the nursing profession as a whole. Through this transition, Colleen is combating what has been identified as a national issue: the exodus of nursing expertise from the workforce when only considering traditional roles as career alternatives.
Lessons learned in Colleen's nursing leadership roles include looking for mentors in everything you do. Colleen reports that mentors in her career have supported her, inspired her, and assisted in addressing developmental needs, networking contacts, and career opportunities.
Business skills are critical. Not everyone can major in business; however, all nursing leaders should be fluent in the language of business to support the case for change within clinical systems.
Continue your education as early in your career as you can. Colleen was balancing full-time work and 2 children during her early years. Although no regrets were voiced, Colleen feels that obtaining advanced education earlier would have further enhanced her career.
The size of your organization should not be a constraint to your impact. Colleen demonstrated this over again as she developed and supported evidence-based projects which had far-reaching impact beyond her organization.
Look for stars throughout your organization. Colleen prides herself on mentoring the nurse leaders who have transitioned to CNO roles. Colleen has done this successfully 3 times! Seeking out nurse leaders with talent and commitment and using skills such as coaching and mentoring for executive practice have added a new aspect of fulfillment to her career in addition to her other accomplishments. The continuity provided through this model has been good for the nursing staff from each organization and ultimately the patients. As a fitting transition to her time at the University of Colorado, one of these transitions was the person who has become the new CNO.
Don't look at the end of one role in a negative sense, but envision the possibilities of new beginnings and look for ways to invigorate your passion for the profession. Colleen is excited about this new phase in her nursing career. In preparing for her transition from her CNO role, Colleen has connected with mentors including Maggie McClure, RN, PhD, and Gail Wolfe, RN, PhD, two friends and nurse leaders who have maximized nontraditional directions in their recent careers while contributing on a national level to the nursing profession. Colleen will continue to apply her expertise in seeking out evidence to improve patient care and nursing practice regardless of her role. As Colleen so succinctly put it, "I can't leave nursing all together, but I am ready for additional challenges and to continue to make a difference in new ways."
© 2009 Lippincott Williams & Wilkins, Inc.