The following manuscript is the winning Visionary Leader 2006 entry submitted to Nursing Management by the staff of Moses Cone Health System, Greensboro, N.C., in recognition of Joan Wessman, chief nurse officer at the organization. Joan was formally recognized for her achievements during the opening ceremony of Congress2006, October 15, in Philadelphia, Pa., during which she received the award, sponsored this year by B.E. Smith.


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WHEN THINKING of a nurse who emanates such pride in the nursing profession, Joan Wessman, RN, MS, CNO, comes to mind. As the chief nurse officer of the Moses Cone Health System, her thoughts, actions, words, and deeds constantly surround nursing and the delivery of quality patient care. She presents herself in a very accomplished manner. Colleagues, physicians, and staff respect her. Professionalism and nursing autonomy are supported through a shared governance model under her leadership. Joan promotes continuing education among her staff and has maintained that all nursing directors within the system be master's prepared. She encourages collegial support and ardently represents nursing's vision at the executive level with research-based knowledge and accuracy. Joan believes in the potential of her staff and supports them through mistakes and successes, as she knows this is the method in which learning occurs. She is a champion of synergistic teams, as evidenced by the five-hospital health system obtaining American Nurses Credentialing Center Magnet certification under her leadership.

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Joan possesses the quintessential qualities of a professional nurse leader: the capacity to create vision, willingness to take responsibility, enjoyment of the thrill of a challenge, and most importantly, recognition of the importance of what nurses do-care for patients. She is a teacher and mentor to others, sharing her knowledge in all areas of practice. Her position requires her to have a mental toughness, but at the same time, she embodies the humanity of her job, supporting nurses by offering one-on-one time to discuss concerns they have. Almost a year ago, the Moses Cone Health System went through a dress code policy change via shared governance for the betterment of patient care in identifying the nurse. As expected, many nurses were frustrated with this change. Instead of their concerns falling on deaf ears, Joan opened her door and had one-on-one meetings with any nurse who wished to discuss this change. Based on the feedback received and presented to the Shared Governance Council, two colors became permissible instead of the original "white only." Nurses more readily embraced this, as it allowed some flexibility and individuality within the policy.


Joan is personally and professionally charged in promoting the nursing profession. She is an advocate of professional practice, as evidenced by the research projects in which she has participated. She has had the honor of having much of her research published.


Joan upholds the characteristics of integrity, accountability, and honesty in various ways. One such way she holds herself accountable and displays her integrity is the "new tradition" she designed. Joan started a new tradition upon completion of her first year and now annually presents to the entire health system the "State of Nursing Address." During this presentation, she celebrates the accomplishments of the prior fiscal year, reflects on goals not achieved, and shares plans for the new year. She presents the "State of Nursing Address" at all campuses at various times. It is even taped for those who are unable to attend. Nurses, systemwide, have commented as to how the presentation realizes the magnitude of what they've done under her leadership during the year. A few of these include:


[white diamond suit] Magnet designations for all five hospitals in the health system


[white diamond suit] implementation of new technology: computers on wheels, Nursing E-chart Committee to provide guidance as we upgrade our documentation system, information system upgrade in the emergency departments, software for surgical services, patient care organizer developed, standardization of defibrillators across all campuses, Safety Zone Portal fully implemented, and bed-tracking/staffing/productivity systems selected


[white diamond suit] improvement in clinical outcomes: pressure ulcer prevalence below 4.7%, falls well below our goal of 3.6 per 1,000 patient days, and restraint use reduced in both critical care and medical/surgical units


[white diamond suit] investigations of alternative care delivery models and experimentation with a new orientation model.



Joan delivers open, honest, and direct responses to problems and challenges faced within nursing. Her responses are very direct and honest but without personalization. Her goal is for the health system to become the best place to practice nursing. She strongly supports nurses fully utilizing the scope of nursing practice and keeps her license up-to-date at all times. She fiercely displays commitment to patients, families, and colleagues. She advocates for the nurse caring for the patients, and rounds daily on patients and staff to see that their needs are met. Her expectations are that all patients and families receive the care we would want for our loved ones. She has been instrumental in supporting and "pushing through" many valuable patient-centered initiatives this past year. One such initiative, is the approval to implement a safe patient handling program that includes the purchase of "no lift" equipment. This is not only a positive patient-safety initiative, but also a proactive initiative that supports retention of our older nurses.


Another initiative that resulted in positive patient outcomes and that supports retention is the revised relief policy. Joan coordinated the committee that designed this new policy, which resulted in a 35% increase in relief staff working. This initiative increased nurses at the bedside, which supports improved patient care and increased retention. Joan also participated and facilitated multiple quality initiatives to include Six Sigma and PDCA projects, development of the rapid response team, and revisions of the new suicide policy. She is always discovering and implementing unique means to support nursing. Knowing the future of nursing, and anticipating the looming nursing shortage, Joan presented to the executive leadership the great need for a nurse retention position within the system. Her desire was for this individual to focus on the needs of the nurses so they could be supported and retained. During the past year, this retention position has supported 102 nurses with a 75% retention success rate. Another display of patient commitment is via improved patient throughput and length of stay. Joan was an active supporter of the Patient Throughput Committee and decreased length of stay initiatives. She supported the use of dry wipe boards to display the patient's anticipated discharge date, thereby encouraging the entire multidisciplinary team to work on focused aspects of the patient care that would assist the individual to meet his or her discharge date. Another important accomplishment is that, under her leadership, nursing was able to provide uninterrupted, quality patient care despite construction going on at multiple campuses.


Growing others is a strong desire of Joan Wessman. She is constantly encouraging and supporting her colleagues and staff to continue advanced education preparation, as well as participating in research projects and publications. She recognizes that nurse certification plays a key role in patient outcomes and safety. This past year Joan supported reimbursement for nurses passing specialty certification exams. This initiative resulted in the increase of the number of specialty certified nurses by 15%. She also endorsed nursing research fervently, and a very active nursing research agenda was realized throughout the system to include work on RN satisfaction, patient satisfaction, fatigue after myocardial infarction, sleep surfaces studies, and health and safety outcomes. Under Joan's leadership, 526 nurses participated in research, 43 nurses published, 241 nurses presented at symposiums, and 695 nurses belong to national organizations. As mentioned earlier, Joan has been extensively involved in research and publications as well, a grand display of leading by example. She collaborates closely with our local schools of nursing. Clinical supervision for students from UNCG, GTCC, NC A & T State University, and RCC was provided to allow these schools to increase enrollment. Additionally, she has supported commitment from our clinical nurse specialists to assist in the clinical orientation of these students. This past year, this system welcomed 339 first-year nursing students. Another display of Joan's desire to see others grow is her continued support of the new graduate orientation program. Joan meets with each new group, hears their concerns, and actively addresses them. Many new graduates have commented on how approachable, understanding, and caring she is. She also remarked to staff recently, "Please help make these new colleagues feel supported as they begin their nursing careers. Our 'caring' extends to each other, as well as our patients. I have personally promised these nurses that we will do all we can to help them be successful in their new role."


Joan is always full of energy and full of praise for those delivering quality patient care or those who have successfully reached a milestone such as advanced education, certification, or successful publication of research. She is a strong advocate and constantly boasts about the care delivered by the staff that reports to her. Joan is also very humbled by the care provided. She told staff, "I feel blessed to be your chief nurse officer." Her strong passion for nursing emanates from her at all times, whether addressing nurses, executive staff, or patients and families. A phrase she has coined is "caring, competence, celebration." She encourages all who surround her to celebrate in the caring and competence of nursing. This slogan has become a motivator for our staff and is recognized on many of nursing's promotional and celebratory communications. Joan has made a difference to overall practice setting outcomes through her own research, publications, and speaking contributions, and by supporting her colleagues and staff toward higher educational preparation, research, and publications. She also demonstrates her love of nursing through the many active positions she holds on multiple nursing organizations, such as the NC Advisory Board, AONE, and VHA, just to name a few.


Joan's philosophy about nursing leadership is best summed up by a quote from Florence Nightingale: "Let whoever is in charge keep this simple question in her head, not how can I always do this right thing myself, but how can I provide for the right thing to be always done?" Joan Wessman embodies the quintessential characteristics of a balanced nurse leader: firm yet fair in her dealings, inspirational to those around her to do their personal best, and most importantly, a patient- centered decision maker.