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  1. Section Editor(s): Brown, Barbara J. MSN, EdD, RN, FNAP, FAAN

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Emerging Leaders

"Emerging Leaders" is a most forward-looking, successor planning, and mentoring topic, as I look back on more than 37 years as founder and Editor-in-Chief of Nursing Administration Quarterly (NAQ). Key leaders for this issue are Linda Burnes Bolton, Vice President for Nursing, Chief Nursing Officer, and Director of Nursing Research, Cedars-Sinai Medical Center, Los Angeles, California, and Tim Porter O'Grady, Senior Partner, Tim Porter O' Grady Associates, Inc, Atlanta, Georgia, who are serving as Guest Issue Coeditors for this issue. Linda suggested that NAQ focus on new nurse leaders, and Tim readily offered to join her. What a team of NAQ board members, whom I am forever indebted to and shall miss, as this is my last issue as Editor-in-Chief. Tim and Linda are certainly experts in developing new nurse leaders. Tim Porter-O'Grady was appointed Clinical Professor and Leadership Scholar at Ohio State University, College of Nursing, in fall 2012. Many colleagues and friends have urged me to share my nursing history, passion, and career story in this, my last editorial.


It is with mixed emotions that I leave these energizing, thought-provoking, and always challenging years of my nursing career, which began in 1955 when I graduated from Marquette University College of Nursing with a BSN degree. Following a few years of nursing practice, teaching, and continuing to take courses in Ward Management and Teaching, and Test and Measurements (required at that time by the Wisconsin State Board of Nursing, to teach), I was awarded a Federal Nurse Traineeship to attend Marquette University for my master's degree. With 3 children (ages 3, 1.5, and a newborn), I was able to complete my MSN degree in 1 year, in 1960. My passion for nursing increased, and I taught at Marquette University only to be expecting number 4, so I took a short 6-month break but was called to teach at Milwaukee County Hospital School of Nursing. Faculty shortage was as great then as it is today. After teaching medical-surgical, nursing, obstetrics/gynecological nursing, and nursing leadership followed by being Assistant Director of Nursing at Milwaukee County Hospital, and adding 2 more sons to my family, now 6 (2 daughters and 4 sons) under 10 years, I decided to pursue my doctorate in Administration at Marquette University, graduating in 1970 with a Residency in Hospital Administration at Milwaukee County Hospital/Medical College of Wisconsin. At that time, I was an emerging leader in nursing with 6 children, and academia was calling. I accepted the challenge of Chairman of Nursing at Alverno College, School of Nursing, Milwaukee, Wisconsin, and was able to lead it through 2 accreditations successfully (National League of Nursing and Wisconsin State Board of Nursing) in 1970. After initiating an RNB/credit by examination program for associate diploma nurses and diploma graduates, which attracted nurses from as far away as Florida, I left Alverno College to teach and do research at the University of Wisconsin/Milwaukee. I had also formed my consultancy, Hospital Administrative Assessment Profile, Inc, based on my doctoral dissertation. In 1973, as I was serving on the Governor's Task Force for Health Planning and Policy, hospital administration beckoned with a challenge to create a "professional practice environment." Walter Harden, CEO at the then Doctor's Hospital, said: "Put your money where your mouth is and change an ordinary community hospital and nursing home into what you teach in nursing." Thus, began the rest of my career, changing practice environments as Administrator for Patient Care at Family Hospital and Nursing Home, Milwaukee, Wisconsin. (The name changed to Family after my first year, as we developed our family-centered care model and philosophy.) I was awarded a National Institutes of Health grant to establish the Sexual Assault Treatment Center at Family Hospital, which became a model for the country. It exists today as the Greater Milwaukee Area Family Violence Treatment Center.


As I was also teaching one graduate course in nursing administration each semester at Marquette University, I initiated NAQ in 1975 with Aspen Publishers, using Administrative Science Quarterly and Harvard Business Review, as models for nursing leadership. I never suspected it would be my passion for so many years, as well as so many nursing leadership opportunities. In 1977, I was invited to become a Fellow in the American Academy of Nursing, a very special honor, and certainly immersed me with nationally respected nurse leaders, including Rheba DeTornyay, Dean of Nursing, at the University of Washington.


A move to Seattle placed me at the University of Washington, teaching graduate courses in health care administration and nursing administration, only to be selected as Associate Administrator for Virginia Mason Hospital and another challenge changing the nursing practice environment from one of team nursing to primary nursing and collaborative practice models with nurse practitioners and reimbursement for nursing services. Virginia Mason Hospital was also designated a Magnet hospital in the American Academy of Nursing study. (Both Family Hospital and Virginia Mason Hospital were designated original Magnet hospitals in the first study by the American Academy of Nursing, 1983.)


In 1987, when my youngest son was 21, I accepted another challenge to change the practice environment as Associate Executive Director at the King Faisal Specialist Hospital and Research Centre in Riyadh, Saudi Arabia. Challenges of cultural diversity, Islamic law, and an extreme male-dominated society tested leadership skills and practices that led to past successes, far beyond prior experiences. I recall in the 1970s and 1980s, when I was the first nurse executive to be included in executive board meetings and medical executive meetings, when doctors (all male) and administrators did not openly welcome a nurse leader at the boardroom table.


I now was the only woman amid Arab executives with a 2000 nursing staff from more than 40 different countries. I soon realized I had to find a way to develop a strategic plan for change and negotiate in an entirely unique manner. Fortunately, it was possible to garner a strong nursing leadership team from within the King Faisal Specialist Hospital staff and recruit colleagues to enable a transformation to a sound professional practice environment including nursing research and education and utilization of advanced practice nurses. We were also able to develop distance learning programs so that international nurses could earn master's and bachelor's degrees while working in Saudi Arabia, as well as certification programs for clinical excellence. Then came the Gulf War and so many nurses left that we rapidly downsized and were able to welcome the 217th from Ft. Sam Houston to set up an emergency medical evacuation hospital. I was chief warden for more than 1000 US citizens and had my NBC (nuclear biological chemical) suit, as did my management team. After the war was over, it was time to return to the United States in summer 1991 and my family, now 13 grandchildren and 3 great grandchildren.


During all these years, many of the NAQ editorials reflected administrative leadership challenges, including the Gulf War and the loss of my youngest daughter to cancer of the esophagus in 2007. (Readers who are interested may retrieve past editorials at the http://NAQjournal.com Web site). My time has come to pave the way for "emerging nurse leaders" in nursing journalism, and as I turn the editorial responsibilities over to Kathy Sanford, Associate Editor, I was asked to share messages from the NAQ board. I chose one from Roy Simpson:


Wow, retiring from editing! I am awestruck or is it moon struck as Cher or whatever-the world is changing right before our eyes, and Barb, you know all the board sends lots of love and hugs, but most of all we thank you for adding to the literature at a time when there was no topically focused journal in nursing. There was such limited research and not one word of nursing informatics was in writing for a new competency in administration. The topically focused journal was so revolutionary in structure for those of us that remember or refuse to admit we remember those days. We read about your family all these years-those of us that knew you picked up on the innuendos in your editorials-and we were with you in the loss of your Andi-our hands tied with only the ability to tell you we cared and loved you.


Your spontaneity, ability to move right on through the "stuff" and get the work done is a bar of excellence-clearly an exemplar in publishing and administration. You are an icon, Barb, one who regardless of noticing all our warts, blisters, and moles in our writing, you always made us feel like we could write. No matter what we had to say, you felt there was a way to say it to message our profession, the leadership.


Roy wrote so much more, as did many other colleagues on the NAQ board, so I now say farewell in this last editorial and choose to continue a professional and personal life journey wherever I may find need: speaking, consulting, writing, teaching, and always my family and skiing in Colorado.


God bless each and every nurse leader, all nurses, and live life to the fullest every day, caring for yourself and others. Be forever proud to say: "I AM A Nurse." and I can do it! Keep in touch naqbb@aol.com


-Barbara J. Brown, MSN, EdD, RN, FNAP, FAAN




Nursing Administration Quarterly