1. Edmonson, Cole

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The following manuscript is the winning Visionary Leader 2008 entry submitted to Nursing Management by the staffs of Medical City Dallas Hospital and Medical City Children's Hospital, Dallas, Tex., in recognition of Cole Edmonson, RN, MS, FACHE, NEA-BC, vice president and chief nurse executive. Cole was formally recognized for his achievements during the opening ceremony of Congress2008, September 29, in Las Vegas, Nev. There, he received the award, sponsored this year by B.E. Smith.

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Cole Edmonson exemplifies the definition "Visionary Leader." When we received the e-mail to nurse leaders in the organization reminding us to nominate one of our colleagues for this prestigious award, a number of us realized that he is the one among us who best represents the qualities and characteristics described in the nomination information. He has such incredible passion for the "art and science" of nursing. From "nursing as caring," the framework that supports our professional model of care, to the "conduct and utilization of research"-the framework that supports our evidence-based practice and research program-he connects the art and creativity in nursing with evidence-based care, scientific inquiry, and data-driven decision making. He is respected by those of us who report to him and all who know him, including nurses, physicians, administrators, and allied health team members.


Edmonson epitomizes a successful career path as a nurse leader, and though he was promoted to his current position as vice president (VP) and chief nurse executive (CNE) just 18 months ago, he has made an indelible impression and significant impact on the organization and has many professional accomplishments to his credit. He served as an Associate Administrator and Magnet Project Director and was part of a strong chief nurse officer (CNO) succession plan prior to being promoted to his current position as VP and CNE. In his previous role, Edmonson led Medical City and Medical City Children's Hospital to Magnet designation in 2003 and more recently as CNO led the organization to Magnet redesignation in 2008. Cole has strong beliefs in the values that nursing excellence brings to an organization, and Medical City was the first organization in this large urban area to achieve Magnet designation and the first in this area to also join an elite group of organizations nationally in achieving Magnet redesignation.


Edmonson has incredible vision for nursing and holds both leaders and direct care nurses to high standards, while at the same time challenging them to pursue their dreams and achieve healthy work/life balance. He is a compassionate leader with a great sense of humor. From the moment nurses enter the organization during orientation, he dialogues with them and makes himself available to listen to their ideas and concerns. He seeks their opinions when making decisions that affect them. He has an open door policy and lives the value of being approachable and accessible to nurses at all levels of the organization. He makes administrative rounds in patient care areas and spends time on a rotating basis in these areas throughout the organization, following nurses around and listening to their success stories as well as their concerns and suggestions for improving their work environments. He serves as a strong example in the art of relationship-building. He forges relationships with nurse leaders in the community and across the nation by making contact with them via e-mail, phone, and face-to-face. He invites new CNOs to lunch as a means of networking, building relationships with them, and offering his support whether they are new to the CNO role or new to the area. He is working to connect leaders from local chapters/districts of the organization of nurse executives with those from Texas Nurses Association in order to define common ground and strengthen relationships at a time when nurses need to come together around important legislative and professional issues that impact patient outcomes and nurses' work environments.


Nurses are not alone in valuing Cole's leadership. During our last Magnet site visit, it was gratifying to hear the responses from diverse organizational leaders in the room when the Magnet appraiser asked members of the executive team, physicians, board members, and nurse leaders to state in one word their views of the CNO as a leader. The words they chose to describe his leadership ranged from "compassionate" to "visionary." The descriptors flowed freely from the entire leadership group assembled, and not one person in the room hesitated as each one spoke of his strengths as a leader and member of the executive team. The striking group consensus was that he made a seamless transition into the CNO role and has become a remarkable and well-respected leader in a very short period of time.


Edmonson is also respected by his colleagues in the nursing community. He serves as the President-elect of the North Texas Chapter of the Organization of Nurse Executives, a Chapter he played a pivotal role in establishing locally. He is also actively involved in the local District of Texas Nurses Association, served as Chair of the Nominating Committee, and was awarded "Nurse of the Year" at this year's awards celebration. He is actively involved in the American Organization of Nurse Executives and served on the Patient Safety and Quality Committee. He has a strong commitment to professionalism and leads by example through achieving certification as a Board Certified Nurse Executive Advanced through the American Nurses Credentialing Center and also as a Fellow of the American College of Healthcare Executives. He is requiring all nurse leaders at the manager level and above to achieve certification by the end of 2008, and for those who are not yet Masters-prepared he has worked with them to develop plans for pursuing additional education.


Early in his tenure as CNO he established a Center for Nurse Excellence with a strong commitment to achieving excellence in nursing through education, research, holistic self-care, and creativity. He developed the vision for the Nursing Research and Evidence-based Practice (EBP) Program, and led an effort to cohost an annual Research/EBP Day that is now in its second year. Each year the program includes a nationally known keynote speaker, local speakers, and a poster session. He also established the first annual Research Fellowship and Competition. There were nine applicants for the 2008 fellowship, and the top three award-winning principal investigators received a monetary award and will also receive paid hours to assist in accomplishing their research projects.


He has been instrumental in forging new relationships with academic partners in the community to take the Research/EBP Program to the next level and to also establish a "Grow Your Own" Associate Degree Program. Employees from the organization will receive on-site instruction and clinical experiences, and the organization will cover all their tuition, books, and fees. Upon completion, these new graduates will then fulfill commitments to stay and work as nurses in the organization for at least 2 years. He has worked with organizational leaders to allocate both fiscal and human resources to ensure the success of this program and increase our nursing workforce by helping loyal allied health employees pursue their professional goals. He constantly explores creative ways of growing and sustaining a strong nursing workforce in an urban environment with tough competition for limited nursing resources.


Edmonson has a strong commitment to participative leadership. He has sustained and evolved a model of shared governance that empowers direct care nurses to lead patient care and professional practice initiatives. These council members' efforts impact both patient outcomes and the nursing work environment. Following Magnet redesignation, several nurses and allied health team members participated in spontaneous interviews regarding their perceptions of what being Magnet-redesignated meant to them. One of the nurses talked about the incredible degree of autonomy in her professional practice here, while others spoke of being given a "voice" and control over decisions that impacted their practice. His collaborative, transparent leadership style engages nurses and team members at all levels to get involved in unit-based and organization-wide councils and committees, while at the same time challenging them to use data and "best practice" evidence in making decisions. He involves clinical leaders and direct care staff from nursing and allied health in organizational committees and councils in order to gain their input and empower them to constantly evaluate and address nurses' work environments and performance improvement issues and initiatives.


Edmonson serves as a mentor to other organizations on the Magnet journey and speaks at local, regional, and national conferences on topics such as Magnet designation and EBP. He recently supported cohosting a national "Journey to Nursing Excellence and Magnet Recognition" workshop and provided the CNO perspective regarding the journey to Magnet designation and redesignation for workshop participants. Many workshop participants expressed their appreciation for his presence over the 2-day event and were amazed that he took time from his busy schedule to attend the conference in addition to delivering his presentation. He networked with participants and answered their questions regarding Magnet designation, giving each person he encountered the same special attention he affords nurses from within the organization with whom he dialogues every day. He lives and breathes "collegiality" in all his relationships with nurses, from the bedside to the boardroom. He creates an environment of engagement and inquiry that fosters nurses' satisfaction and promotes their professional growth. In addition, he creates an environment that welcomes students and personally sets an example by mentoring students from graduate programs in nursing and healthcare administration. He recently hired one of his former students from a local program in nursing administration and is working closely with her to further define her career path, while supporting and challenging her to pursue and achieve her career goals.


His incredible leadership talents have also contributed to a number of initiatives that influence patients' outcomes and nurses' work environments. He has encouraged and empowered nurse leaders to create Centers of Excellence and provided fiscal and human resource allocations to ensure that these patient care initiatives are successful. Such efforts have included a Bariatric Center of Excellence, a Cord Blood Donation Center, a Cancer Resource Center, and an accredited Chest Pain Center. He serves as an advocate for patients and nurses with the Executive Team to ensure the provision of financial resources that improve nurses' work environments such as bedside proximity cabinets and computers, technological advances, a bed tracking system, an equipment tracking system, computer-based resources for accessing scientific literature and practice standards, and equipment for safe patient moving and handling.


He also led an initiative to implement a revision in the Nursing Career Enhancement Model that would better meet the needs of the hospitals in this division and provide consistent ways to approach professional development for nurses. The model provides a foundation that includes career paths and establishes related milestones aimed at helping nurses achieve their professional goals in clinical, education, and leadership realms. The organization has a strong history of retention and long-term employment for nurses. As an indicator of his effectiveness, employee satisfaction scores reflect consistent improvement from 2006 to 2008 (from 81% in 2006 to 86% in 2008). Despite high turnover rates in this competitive market, our turnover rate has also steadily declined under his leadership (from 19.8% in 2001 to 12.1% in 2007). Many organizations, however, struggle to keep new graduate nurses engaged and often have difficulty assisting these new nurses to establish career paths that enable them to seek professional opportunities within the organization rather than pursue outside opportunities. Cole is always seeking new and creative methods for attracting and retaining the best and brightest nursing talent, and this new and improved Career Enhancement Model is one such strategy to recruit and keep nurses, whether they are new graduates or seasoned employees, by offering and promoting career paths that meet the diverse generational needs of the current nursing workforce and last a lifetime.


Edmonson is a humble leader who is often taken aback when colleagues recognize him for his talents and contributions to nursing. As he receives praise, recognition, and awards from others he always expresses gratitude to the team of nurses with whom he works and states that without them such awards would not have been possible. He is the most exceptional nurse leader at giving recognition to others for their accomplishments and ensures that he begins every clinical leadership meeting with kudos for direct care nurses and nurse leaders who have made a difference in patients' lives, improved nurses' work environments, or made significant professional contributions. He constantly writes positive e-mails; sends handwritten notes of thanks and praise; gives gifts, kudos, and "City Lights" awards to recognize important contributions; and at times makes personal phone calls or unannounced visits to provide support, encouragement, and praise to nurses in the midst of their efforts to make a difference in the lives of patients and families, their peers, or the profession. Most recently at our Excellence Awards ceremony during Nurses' Week, he established a new tradition of recognizing nurses who died within the past year by memorializing them before their peers and providing a framed picture and story for each nurse to place in their units, so staff in years to come would know of these nurses' important contributions to the fabric of nursing in our organization. He communicates every notice regarding nominating nurses for excellence awards to nurse leaders in the organization and follows up to make sure that we never miss an opportunity to recognize our nurses for their accomplishments. He writes a monthly newsletter to keep nurses informed about changes and also uses this format to recognize nurses' and allied health team members' accomplishments. He employs a variety of communication strategies to ensure that nurses at all levels of the organization stay informed.


In summary, Cole Edmonson represents all that is BEST about nursing. In his passion for excellence, he inspires and challenges others to:


* provide patient/family-centered care that meets the needs of diverse populations;


* create and sustain safe, healthy environments for patients and nurses;


* define their career paths, grow professionally, and accomplish both personal and professional goals; and


* achieve healthy life/work balance.



He is a visionary leader that leads by example. He holds nurses to the same high standards he sets for himself. He is a force of calm in the midst of chaos and a voice of reason in the midst of conflict. He listens to a broad range of views, welcomes input at all levels, and respects diverse styles. He leads nurses from four generations and is respected by nurses from the youngest to the most seasoned. He is passionate about nursing and skillfully blends its art and science into every aspect of the organization's care delivery models, professional practice standards, career paths, and nursing work environments.


He is a talented, compassionate, caring, wise, and visionary nurse leader. He is driven to achieve excellence; he excels at all he does; and he inspires those around him to do the same. The Medical City and Medical City Children's Hospital teams cannot think of a more deserving "Visionary Leader" for 2008 than Cole Edmonson.