Abstract

The scene: Toronto, late 1940s. An ambitious 18-year-old was ready to begin her nursing career, even though her father would have preferred her to do secretarial work. The problem was that the two hospitals to which she applied accepted nursing students at age 19, and she didn't want to wait. Undeterred, the young woman further aggrieved her staunch Protestant family by enrolling at the Catholic St. Michael's Hospital.

That woman was Dorothy Wylie, who has just completed a 10-year stint as editor of the Canadian Journal of Nursing Leadership. Wylie has been described as one of Canada's top nurse leaders. She has held senior nursing positions at two large teaching hospitals in Toronto, served as President of the College of Nurses of Ontario, and was named a Fellow of Ryerson University for her work in promoting excellence in nursing practice.

Her lasting influence, however, lies with the people she has helped and the practices she has changed. Wylie has mentored hundreds of nurses, co-founded a journal and pushed the boundaries of what nurses can do. All those who speak of her do so in terms of the leadership values she believes in: mentoring, team-building, education and advocacy.

"I think she's been a mentor to 90% of nurse leaders in Ontario," says Gail Donner, who has known Wylie for more than 25 years. "She's been a mentor to me, as well as a colleague." Donner, who is Professor Emeritus of Nursing at the University of Toronto and a partner with donnerwheeler Career Development Consultants, says Wylie has a knack for getting to the heart of an issue: "She's like my Senate - my house of sober second thought." Indeed, she adds, Wylie has rekindled the commitment to nursing in many who have been discouraged and have considered quitting the profession.

Linda O'Brien-Pallas, a former student who holds the Chair in Nursing Health Resources at the Canadian Health Services Research Foundation and Canadian Institute of Health, says, "She taught all of us to take risks, but to take them in an informed fashion … She created opportunities for me to succeed and never asked for anything in return."

Reflecting on her own career, Wylie says, "I enjoyed people and I enjoyed mentoring … I really liked people to come see me - to me it was important. Seeing people grow and develop is the most satisfying thing for a leader."

Wylie's role as mentor has led to long-term friendships. She and five others, including Donner, meet for dinner regularly. Among the group is Susan Smith, who met Wylie under what could have been tense circumstances. In 1971, Smith was early in her career, working an evening shift at Sunnybrook Medical Centre in Toronto. Her patients were seriously ill and she was understaffed. When she called her nursing supervisor to complain, she was told to come and talk about it. Unwilling to leave her patients, a frustrated Smith hung up on the supervisor. Five minutes later, the hospital's new Assistant Executive Director - Wylie - showed up. "She listened to me and my concerns, and I got my help," says Smith. Soon after that first meeting, Smith was promoted to head nurse on that unit.

"She guided my career for many years after that," says Smith, who recently retired as Vice-President of Patient Care at Hamilton Health Sciences Corporation. While at Sunnybrook, Wylie encouraged Smith to complete a master's degree.

The nursing world was far different when Wylie began her career. Back at St. Michael's Hospital, nursing students all lived in residence and worked together.

"When we were trained in hospitals, you had collegiality develop because you were with the same people throughout," she says. "I don't think there's the same degree of collegiality today … I'm not recommending we go back to that, because it was slave labour," she chuckles. But the sense of teamwork from that experience was something she carried through her career.

Gail Paech, now Assistant Deputy Minister in Ontario's Ministry of Health and Long-Term Care, worked for Wylie at Toronto General Hospital. Wylie was Vice-President of Nursing at the hospital from 1978 to 1987. Under Wylie's direction, the senior nursing staff would meet off-site regularly for lunch to discuss common issues at work. "[The lunches] enabled us to step out of the work environment," says Paech. "There was great team-building on that team." Wylie was also a great supporter of professional development, she says.

Education has also been a personal focus for Wylie. After completing her nursing diploma in 1950, she returned to school four times. Over the years, she earned three degrees. In the 1960s, her studies led her to New York City. She received her baccalaureate degree in nursing in 1964, and then a master of arts in nursing in 1968, while she worked as head nurse of the recovery room at Cornell Medical Centre. She returned to Canada after nine years because she would have had to become an American.

Later, while she was Vice-President of Nursing at Toronto General Hospital, she did a master's program in human resources at American University in Washington DC, commuting one weekend a month for two years.

"In some of these senior positions, it's important to step back once in a while," says Wylie. "I think you can get so caught up in it all that you lose sight of where you are going." She finished this degree in 1985.

Her involvement with the College of Nurses of Ontario also enabled her to see the broader picture. She served as president of the College from 1979 to 1981. During this time, the process of developing standards of practice for registered nurses began. Although her education and involvement with the College undoubtedly contributed to her success as a nurse leader, Wylie also has an innate sense of leadership.

"She wasn't bound by traditional structure. She built her organization around people," says Bill Louth, formerly Chief Financial Officer and Administrator at Toronto General, who worked with Wylie in the 1970s and 1980s.

"Those were pretty dynamic years," says Louth. At the time, there was a push to reduce lengths of stay and shift to ambulatory care. In addition, there were several challenging projects at the hospital, including the opening of a new wing and the merging of Toronto General with Toronto Western Hospital. Wylie was a constant advocate for greater recognition of patients and nurses. "She would put forth her view very effectively, without being combative - she was a gentle person," says Louth. "She didn't just sit in her office, she mingled well with staff."

Wylie has also pushed the boundaries of nurses' roles. When she was at Sunnybrook, she introduced the role of clinical nurse specialist, which ruffled some feathers. "Every change causes some commotion. I think I had a reputation that if I was coming to your place, there was going to be some kind of change going on," says Wylie.

Following the merger at Toronto General in 1987, Wylie retired from hospital nursing administration. The nursing staff threw a huge farewell party for her. Each of the four nursing directorates did a skit about Wylie.

"At the end of it, everyone came and hugged me," she says. "And we all were all crying. It was something you would never forget."
For Wylie, "retirement" marked a new chapter in her career, as she became a healthcare consultant. She also moved into academia part-time as a professor, first at the University of Manitoba and then at the University of Toronto. Dorothy Pringle, who came to the University of Toronto in 1988, capitalized on the opportunity to use Wylie's skills. At the time, the nursing faculty didn't have an administrative specialty for nursing.

"We were not preparing administrative leaders," says Pringle, who is the current editor of the Canadian Journal of Nursing Leadership. "I asked her to develop a master's program and teach two courses. Now administration is our strongest area."

Shortly before Wylie left Toronto General, Jan Dick, a colleague in Winnipeg, was launching the Canadian Journal of Nursing Administration.

"It was her idea to have a journal, and it took her quite a while to get it going," says Wylie. "There wasn't much Canadian nursing literature. We relied on American literature. We felt it was important to have Canadian work available and for nurses in Canada to share more of what they were doing."

Wylie joined Dick as assistant editor of the journal. When Dick fell ill with cancer, Wylie took over as editor and carried on after Dick's death in 1993. The journal has grown over the years, and it underwent a name change three years ago to the Canadian Journal of Nursing Leadership, to broaden its scope. "I think she [Dick] would be proud of the journal, and I think it has even a greater future," says Wylie.

Reflecting on the situation of nurse leaders today, Wylie is saddened by the impact of healthcare cutbacks on nursing.

"It's hard to be a leader today because of the rate of change and the emphasis on cost-cutting," she says. There are fewer opportunities to empower nurses. On the other hand, nurses are better educated, enabling them to take on different kinds of roles, a change that Wylie feels is wonderful for the profession. However, she thinks the work is much more intense than in the past, with nurses dealing with patients who are more ill, and a higher level of technology. And some of the values she cherishes have been sacrificed along the way.

"There's a lack of mentoring in nursing because of the time pressures, and also because of some of the changes in organizational structures," she says. "Nurse managers are managing huge numbers of people. They don't have the mentors they need, and consequently the staff nurses don't, either."

Mentors create leaders, and the lack of mentoring makes developing new leaders difficult. One solution is an annual one-week Nursing Leadership Institute that is, fittingly, named in Dorothy Wylie's honour.

"It was a combination of people who had been connected with her over the years who chose the name," says Beverley Simpson, a former master's student under Wylie, who now helps run the institute as a consultant in organizational development. Wylie was selected because of her activities in supporting nursing leadership in Canada, Simpson says.

A principle behind the institute is that two people from the same organization attend, and one must be in a position to mentor the other. "It's the beginning of trying to set up that kind of relationship, and hopefully it will spread throughout the hospital," says Wylie, who also sits on the institute's advisory committee. Along with the Ryerson fellowship in 1982, Wylie says one of the most satisfying moments in her career was to have the institute named after her. "It's satisfying and scary because usually you have to die before something is named for you," she jokes.

Although Wylie has now retired from her editorship at the Canadian Journal of Nursing Leadership, her involvement in the nursing profession is far from over. For the past four years, she has been involved with the Registered Nurses Foundation, a fundraising body that raises money for nursing students.

Pringle, summing up Wylie's contribution to nursing, called it "a legacy … beyond the enormous influence she has had on our current stable of leaders is the graduate program in nursing administration. It is attracting and preparing our next generation, and with luck, it will go on forever."

CAREER HIGHLIGHTS
1950 RN Diploma, St. Michael's Hospital
1964 BScN, New York University
1969 MA in Nursing Administration, Columbia University
1971-76 Assistant Executive Director of Patient Care, Sunnybrook Medical Centre
1976-78 Director of the Nursing Division of the Registered Nurses Association of Ontario (RNAO)
1978-87 Vice-President of Nursing, Toronto General Hospital
1979-81 President, RNAO
1982 Fellow, Ryerson Polytechnical Institute, Toronto, for recognition of outstanding work in promoting excellence in nursing
1985 MSc in Human Resource Development from American University, Washington, DC
1987 Co-founder and assistant editor of Journal of Nursing Administration with Jan Dick
1988 Honorary life membership, RNAO
1989-94 Associate Professor, Faculty of Nursing, University of Toronto
1992 RNAO scholarship named after Wylie in recognition of founding the provincial nurse administrators' group