Looking Back and Moving Forwards
"… the final test of a leader is to leave behind the conviction and will to carry on …" – Walter Lippmann
January always gives one pause for reflection on events of the year past – the good and the bad, the successes and failures, the gains and losses. On the world stage, we have witnessed many notable events in 2016 – national uprisings, warring factions, thousands seeking refuge, mass shootings and terror attacks, precarious economies, and divisive referendums and elections. Closer to home, in Canada and in the realm of healthcare, debate and deliberation continues about assisted suicide, the legalization of marijuana, safe injection centres, escalating suicide rates among aboriginal youth and a new health accord. Despite the unfolding of many controversial issues, ours remains a largely a peaceful nation and among the most fortunate in the world.
The year was also marked by the deaths of many renowned public figures: Castro, Prince, Bowie, Ali, Princess Leia, Howe and Toffler are among the dozens of people who have left us with indelible yet diverse traces of notoriety. Canadian nursing has lost significant, long-time contributors to the profession over the past year too, including Harriet "Hallie" Sloan, T.R. "Jerry" Gerow, Sister Simone Roach, Dorothy Wylie, Heather K. Spence Laschinger and Kathleen King. In honour of their memory, I want to offer a few words about each of these amazing nurses. Although I can hardly do them justice in a few sentences, you can follow the links below to understand more of their rich legacy to Canadian nursing.
Harriet "Hallie" Sloan (1917–January 21, 2016) had a long career in the Canadian military and was ahead of her time as she advocated for male nurses in the military. Ending her career as a Lieutenant-Colonel, she made numerous contributions to the advancement of military nursing. A decorated veteran, in 2004, Hallie received the Order of Canada for her outstanding leadership and for advancing military nursing and patient care. (To read more about her contributions, go to: http://cnf-fiic.ca/harriet-hallie-j-sloan-c-m-c-d-r-n-1917-2016/.)
Thora Rebecca "Jerry" Gerow (1919–January 28, 2016) founded the Nurse Practitioner Association of Ontario (NPAO) Interest Group in 1973. Regarded as a "trailblazer," she was a long-time policy and practice advocate and an influential voice for advanced nursing practice roles. In 2005, she was honoured with NPAO's Lifetime Achievement Award, and in 2012 she was awarded the Queen's Diamond Jubilee Medal for her lifelong commitment to the delivery of healthcare and the education of nurses. (To read more about her contributions, go to: http://rnao.ca/news/memoriam-jerry-gerow-1919-2016.)
Sister Simone Roach (1922–July 2, 2016) is credited with developing Canadian nursing's first code of ethics. She is also known for her theory of caring, in which she identified the "6 C's of nursing": caring, compassion, commitment, conscience, confidence and comportment (Roach, 2002); she later added creativity to the list. In 2010, she became a member of the Order of Canada for her dedication to improving patient care in Canada as well as her work in nursing education and ethics. (To read more about her contributions go to: http://www.theglobeandmail.com/news/national/nursing-pioneer-sister-simone-roach-created-theory-of-caring/article30930516/.)
Dorothy Wylie (1929–August 13, 2016) was "known for her intelligence, forward thinking and often blunt pragmatism"(see The Globe & Mail link below). She was profiled in the 29(2) issue of the Canadian Journal of Nursing Leadership (see: http://www.longwoods.com/publications/nursing-leadership/24654), in which colleagues, former students and those benefitting from her legacy through their participation in the Dorothy Wylie Institute for Healthcare Leadership proffered many testimonials and tributes to her leadership. She taught me too, and I like to think it shows just a little. Incidentally, she was key to the launch of the Canadian Journal of Nursing Leadership precursor, the Canadian Journal of Nursing Administration, and was the Editor from 1993 to 2003. (To read more about her contributions go to: http://www.theglobeandmail.com/news/national/formidable-nursing-leader-dorothy-wylie-inspired-others/article31780823/.)
Heather K. Spence Laschinger's (1945–October 29, 2016) death was a huge loss to the nursing research community. A long-standing, highly regarded member of the Arthur Labatt School of Nursing at Western University in London, Ontario, she was a major contributor to expanding our understanding of workplace empowerment, new graduate nurse transition and healthcare leadership. In this issue, Dr. Carol A. Wong (2016: pp. 13–18) provides further details of Dr. Spence Laschinger's important work in a tribute to her friend and colleague.
Kathleen King (1925–November 29, 2016) was instrumental in the launch of the Master of Nursing Program at the University of Toronto in 1970. A long-time and committed educator in the Faculty of Nursing, she served as Dean from 1972 to 1979 and saw numerous advancements in nursing education during her career. She was gracious and witty, and I was fortunate to have her as my advisor during my masters program in the late 1980s. (To read more about her contributions go to: https://bloomberg.nursing.utoronto.ca/news/memoriam-kathleen-king.)
Whether as students, nurses or citizens, we have all reaped the benefits of the collective influence of these leaders in nursing and healthcare. There were likely many other colleagues, perhaps less known on the national stage, lost to the profession in 2016, so let us also recognize and applaud their contributions.
Moving into 2017, we are embarking on a significant celebration, that of our great country's sesquicentennial: hard to believe I was around for the centennial, but I was a mere child at the time. On another celebratory note, this is the thirtieth anniversary of the Canadian Journal of Nursing Leadership – in the traditional sense, a milestone which should be marked by gifts of pearls or, in modern-day terms, recognized by diamonds. I am not sure but I think these are to be directed to the Editor-in-Chief – either will do! All kidding aside, I expect that in the literary sense, the papers lined up for 2017 will be filled with pearls of wisdom, including those found in this issue.
Collectively, our contributors in this issue focus on strategies to optimize nursing roles, influence and engagement within specific care settings, organizations and the healthcare system.
In a qualitative descriptive study, Yuille et al. (2016) examine registered nurses' perspectives on the optimization of nursing roles in the delivery of cancer survivorship care within primary care settings. Study participants highlighted gaps in the current approaches to the care of cancer survivors and identified various untapped opportunities for future role enhancements.
Situated in a large Saudi tertiary hospital, Alammar and colleagues (2016) describe their examination of factors predicting nurses' job involvement. Overall, they found that high organizational commitment enhances job involvement, which may lead to more organizational stability and effectiveness.
"If we truly want a culture of safety in healthcare and protect our patients from harm, the successful implementation of a just culture is the crucial first step" (Freeman et al. 2016, p. 44). Freeman et al. (2016) explore the perceptions of nurse managers related to the development of personal competencies to enable them to effectively implement a just culture on their units. Their findings indicate the criticality of a multi-faceted educational approach, providing managers with a new set of competencies to facilitate the complex implementation of a just culture.
In a systematic inquiry into the methods and messages developed by national nursing organizations to communicate their policy agendas and strategies used for member and public engagement, Whyte and Duncan (2016) highlight the need for a policy research agenda to strengthen our knowledge of political advocacy. Furthermore, they identify the need to understand how patterns of engagement affect nursing's influence on Canadian healthcare.
As we embark on the inevitable leadership challenges of 2017, in nursing and elsewhere, let us be thankful for the strength of our past leaders and those among us today. And, in their honour, let us remain staunch in the conviction that our cooperative efforts will continue moving us forward for the sake of nursing and the health and well-being of Canadians – carry on!
Lynn M. Nagle, RN, PhD, FAAN
Lawrence S. Bloomberg Faculty of Nursing
University of Toronto
Alammar, K, M. Alamrani, S. Alqahtani and M. Ahmad. 2016. "Organizational Commitment and Nurses Characteristics as Predictors of Job Involvement." Canadian Journal of Nursing Leadership 29(4): 59–69. doi:10.12927/cjnl.2016.24983.
Freeman M., L.A. Morrow, M. Cameron and K. McCullough. 2016. "Implementing a Just Culture: Perceptions of Nurse Managers of Required Knowledge, Skills and Attitudes." Canadian Journal of Nursing Leadership 29(4): 35–45. doi:10.12927/cjnl.2016.24985.
Roach, S. 2002. Caring: The Human Mode of Being, 2nd ed. Ottawa, ON: Canadian Hospital Association Press.
Whyte, N.B. and S.M. Duncan. 2016. "Engaging Nursing Voice and Presence During the Federal Election Campaign 2015." Canadian Journal of Nursing Leadership 29(4): 19–34. doi:10.12927/cjnl.2016.24986.
Wong, C.A. 2016. "Tribute to Dr. Heather K. Spence Laschinger." Canadian Journal of Nursing Leadership 29(4): 13–18. doi:10.12927/cjnl.2016.24987.
Yuille, L., D. Bryant-Lukosius, R. Valaitis and L. Dolovich. 2016. "Optimizing Registered Nurse Roles in the Delivery of Cancer Survivorship Care within Primary Care Settings." Canadian Journal of Nursing Leadership 29(4): 46–58. doi:10.12927/cjnl.2016.24984.
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