1. Cipriano, Pamela F. PhD, RN, NEA-BC, FAAN


This month in the Magnet(R) Perspectives column, Pamela F. Cipriano, PhD, RN, NEA-BC, FAAAN, new President of the American Nurses Association, discusses her priorities for the future and partnerships that are being forged to support nursing.


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It is my distinct honor to be the 35th president of the American Nurses Association (ANA). In this role, I have the exceptional opportunity to work on the issues and initiatives that are critical to advancing nursing and healthcare every day, and not just in my spare time. Being an active member of ANA has shaped my professional career. I became immersed in nursing organization work as a student when I served as president of the National Student Nurses Association and was a member of ANA's Special Task Force on Entry into Practice of the Commission on Nursing Education. I went on to serve in appointed and elected positions within ANA and 4 state nurses associations.

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I feel fortunate to have been part of ANA's rich history forging the path for our credentialing activities. Prior to the inception of the American Nurses Credentialing Center(R) (ANCC(R)), I chaired the ANA Task Force on Peer Review and the ANA Board of Certification. I served on the ANA Cabinet on Nursing Practice including the subcommittees on Quality Assurance and Coordination of Certification. It was clear that a more organized and formal mechanism was needed to address improving quality in nursing care. I was elected to the ANA Board of Directors in 1986, and it was this board in 1990 that voted to approve the recommendation that "the ANA Board of Directors establish a separately incorporated center through which ANA would serve its own credentialing programs." ANCC incorporated and became operational on January 1, 1991.


The same board had also been deliberating over the formalization of a program that would implement a review system for nursing services based on the Magnet Hospital Study by the American Academy of Nursing (AAN).1 In 1990, the board took action to initiate the Magnet Recognition Program(R) as a joint endeavor between ANA and ANCC, with development and design based on the Magnet study and using ANA's standards for practice2 and organized nursing services.


As my career developed in nursing and hospital administration, it was my goal to lead an organization to achieve Magnet(R) recognition (now referred to as designation). That goal was realized in 2006 when the University of Virginia attained its 1st designation through the strong collaboration of the Professional Nursing Staff Organization leadership and nursing management. The pride and excitement were palpable. Throughout the organization, nurses were the catalysts to improve quality of care, patient experience, work environment, multidisciplinary team work, and staff retention. Without question, the achievements of a stellar staff lifted the entire organization to focus energy and effort on excellence in every aspect of service and care delivery.


Part of the journey focused on clinical competence and exemplary performance. We had a very respectable rate of clinical certification among our staff, but that was not the case for managers. As leaders we knew we needed to increase the number of managers and directors who were certified in nursing administration. We organized a study group and helped more than a dozen nurse leaders achieve basic or advanced ANCC certification, myself included.


Over the last decade, the demand to improve quality, safety, and the patient experience has been the driver of most nurse leaders' efforts. Nurse executives could not ignore the preventable complications and deaths, knowing nursing care and more effective communication could improve these patient outcomes. We were compelled to act out of duty to our patients, as well as external regulatory pressures to improve performance.


It has been essential to understand and apply the principles of performance improvement and measurement methods. Participating in the National Database of Nursing Quality Indicators was one way to understand and act on areas needing improvement, as well as spread successful efforts. These internal efforts were exponential with the new impetus to engage in work that would bring hospital-acquired conditions to zero. Being able to use evidence to address problems such as falls, hospital-induced delirium, catheter-associated infections, and other preventable conditions was consistent with the drive for empirical outcomes.


With a great affinity for technology, most likely spurred during my time as an adult critical care clinical nurse specialist, I had the unique opportunity to serve as the Distinguished Nurse Scholar in Residence at the Institute of Medicine in 2010-2011, a program jointly sponsored by ANA, the AAN, and the American Nurses Foundation. In this role, I helped study the safety of electronic health records and devices and worked on the development of electronic quality measure criteria at the Office of the National Coordinator of Health Information Technology, part of the Department of Health and Human Services. This work underscored the intersection of nursing care as the best line of defense for patients, the importance of nursing documentation that can be captured electronically, and quality measurement that reflects patient outcomes.


As a nurse executive, it has been important to establish skills as a leader, communicator, influencer, and driver of change. Being fearless and willing to take risks has never been more important. In addition to these skills that fortify one's ability to lead an organization to excellence, being compassionate, a good listener, genuine, and an advocate for staff contribute to being a transformational leader. These are the same skills and abilities we need to lead any organization that represents nurses. As I begin the presidency of ANA, I am grateful for the rich experiences that have shaped my career. I have a deep understanding and ability to take action to improve care in clinical and administrative arenas; to influence decisions and resource allocation for a strong, well-educated nursing workforce; and to help organizations aspire and achieve Magnet-level performance. This creates the best environment for nurses, as well as the patients and families we serve.




1. McClure ML, Poulin MA, Sovie MD, Wandelt MA. Magnet Hospitals: Attraction and Retention of Professional Nurses. American Academy of Nursing Task Force on Nursing Practice in Hospitals. Kansas City, MO: American Nurses' Association; 1983. [Context Link]


2. American Nurses Association. Scope and Standards for Nurse Administrators. ANA Task Force on Standards for Organized Nursing Services, 1194-1995. Kansas City, MO: American Nurses Publishing; 1996. [Context Link]