Credited for pioneering the U.S. hospice movement, Florence Wald made immense contributions in the field of Nursing (Cynthia, 2011). Born in 1917 as Florence Sophie, in New York, Wald spent many months in a hospital during her childhood because she had a chronic respiratory ailment. Florence decided to pursue nursing career because of her childhood hospitalization experience. She attended Mount Holyoke College, where she received a B.A. in 1938. Wald also studied at Yale School of Nursing, where she received an M.N. in the year 1941 (Deborah, 2009). She later furthered her studies in the field of nursing by getting her second masters degree in Mental Nursing from Yale University. Wald began her nursing career with the New York Visiting Nurse Service before accepting a position at Rutgers University to teach psychiatric nursing. She equally served as Dean of Yale School of Nursing Faculty. The care for terminally ill or the dying moved to hospitals from being home-based after the Second World War (Beth, 2007). This paper, therefore, examines the constructs of Florence Wald’s transformational and visionary leadership in relation to nursing and hospice care.
Brief overview of the nurse leader
The interest of Florence Wald in the care for dying or terminally ill individuals piqued, when she attended a lecture in 1963, presented by Cecily Saunders (English physician) (Cynthia, 2011). Cecily Saunders was an innovator and founder of London’s “St. Chirstopher’s Hospice”. It is important to note that this was the first purpose built-hospice in the world. Wald made great contribution in the field of nursing by pioneering the introduction of hospice movement in America. This illustrates her leadership abilities that enabled her to make significant and lasting impact in America’s nursing profession. Wald equally became one of the members of National Women’s Hall Fame. Wald’s work enhanced the interest of both the public and professionals in hospice, thus, leading to the opening of nearly three thousand hospice facilities in U.S. within a period of fifteen years (Robert, 2006). Through extensive studies and research, Wald examined the need and readiness for change in palliative/hospice care. By creating or establishing a multi-disciplinary team to help her with the opening of Connecticut hospice, Wald demonstrated the importance of collaboration and teamwork in leadership (Cynthia, 2011). This paper focuses on Florence Wald because of her leadership credentials as a visionary and the pioneer of hospice movement. She was courageous and demonstrated perseverance in establishing new frontier palliative/hospice care in America.
The unique contribution(s) this leader made to the nursing profession and/or nursing practice
Florence Wald is responsible for the introduction of hospice movement in America from England after she established the first hospice unit in America in the year 1971 in Bradford, Connecticut (Cynthia, 2011). The hospice unit established by Florence Wald served as a model for hospice-care both in the U.S.A and abroad. She equally helped reshape the nursing education and training to focus on both patients as well as their families, thus, changing how people perceived the care provided for dying people in America. Under the influence of Florence Wald, the United States witnessed the growth of hospice movement to about a thousand hospices within less than fifteen years since the opening of the first one in 1971 ( Beth, 2007). Her unique contributions in the field of palliative care earned her the “Living Legend” title in Washington D.C. and her subsequent induction into National Women’s Hall of Fame (Robert, 2006).
As the Dean of Yale School of Nursing, Wald focused her efforts on revamping nursing education and orienting it to focus on both patients and their families (Beth, 2007). In this case, the care or medical interventions should equally involve the participation of the patients as well as their families. Wald’s was able to effect the change, in part because the moment was right, as there were various social movements in the U.S. in 1960’s. Women were agitating and demanding for opportunities and equal rights, thus, affecting the relation between doctors and nurses. This was important because the doctors were predominantly men, while the nurses were predominantly women, hence the women movement promised to lower the gender barrier (Stephen, 2009). It is important to note that lectures by Wald on palliative/ hospice care across United States played a significant role, attracting attention to hospice care. In her lecture at Yale to medical students, Wald informed the students about providing care to dying patients that entails focusing or relieving or easing the suffering and pain of the patients during their final days (Howard, 2006). According to Wald, such approach would enable the families as well as the patients to focus on their relationship as well as prepare for the death.
The characteristics Wald employs to meet health care needs of individuals, families
In her advocacy work, Florence organized several educational conferences that sought to elevate and improve the consciousness of the community in relation to palliative care, thus, creating a shared vision and understanding on the need to improve palliative care (Howard, 2006). Florence Wald organized a team comprised of nurses, doctors and clergy to examine the needs of terminally ill patients. The interdisciplinary team helped in the opening of the America’s first hospice. Wald traveled extensively visiting Connecticut prisons, conducting a research pertaining to palliative care, a project sponsored by National Prison Hospice Association, where she served as a member of the board of directors (Beth, 2007). Her work in the prisons involved trying to find ways that would make incarcerated prisoners access hospice/ palliative care within the prison system.
The project envisioned a situation, where inmates would serve as hospice volunteers to their terminally ill or dying counterparts. She equally identified training as an important tool for preparing the hospice volunteer for the task, helping in providing palliative care in prisons (Cynthia, 2011). The hospice model of dignity and compassion led to the training of a number of inmates since the inception of the program that serves correctional facilities in Connecticut. Medicaid began financing or paying for care, offered in hospice, thus, resulting in a sharp surge in the number of hospice facilities in the United States. At the time of Florence Wald’s death in 2008, the United States had nearly three thousand hospice programs providing service to nearly nine hundred thousand patients on an annual basis (Deborah, 2009).
The specific barriers, obstacles, or circumstances that precipitated or influenced the leader’s decision to address the situation that led to the change
Before the introduction of hospice movement in America, hospitals strongly focused their efforts on curing diseases but the hospitals were unable to cure the terminally ill and this challenged their mission (Deborah, 2009). At that time, health institutions could use technology for resuscitation, ventilation and defibrillation purposes; nurses and physicians operated in a medical model and system that considered dying patients an indication of failure, hence, the medical facilities such as hospitals tended to place the dying patients towards the end of the hall.
The doctors spent much of their time and efforts trying to treat or cure dying patients and whenever patients asked questions concerning their failed treatments, the doctors would evade the questions and rebuff the nurses whenever they tried intervening on the patient’s behalf (Cynthia, 2011). This way, nurses began to appreciate the significance of patients’ feelings and thoughts in relation to the care they are receiving and participating in making decisions. However, nurses were unable to make meaningful intervention in helping alleviate the dying patients suffering (Deborah, 2009). In this case, the patients continued suffering through un-ending ineffective treatments. One of the challenges Wald experienced was the division and disagreements within the board that was responsible for the running of Connecticut, with some board members questioning her vision for pertaining to the hospice program. This forced Florence Wald to resign shortly after the opening of the hospice facility.
The impact Wald’s contribution will have on future generations of nurses
Future nursing leaders will use the work of Florence Wald in the field of nursing, especially hospice/palliative care by building upon the shared values, thus, promoting momentum and providing direction critical to sustaining the change and progress in palliative care (Robert, 2006). In this case, future transformational nursing leaders will appreciate the need to build consensus, concerning a vision before beginning the process of executing meaningful change by seeking partnership and collaboration with a diverse range of stakeholders as this helps encourage and facilitate the broad ownership of the initiative/cause. By working together, nursing leaders are able to elevate consciousness of their respective work groups, thus, assisting the direct purposeful change by creating and sustaining value-based cultures of inquiring information (Beth, 2007). This implies that decisions will rely on evidence and reliable information, thus, supporting successful outcomes. In her work, Florence Wald achieved this by carrying out research projects in relation to palliative care (Beth, 2007). The future generation of nurses will equally face the medical and nursing challenges of their time by seeking better solutions and executing meaningful change that will improve various aspects of nursing. The changes to the nursing curricula, spearheaded by Florence Wald, when she was serving as Dean Yale School of Nursing in which she emphasized the need to involve both the patients as well as their respective families in the patient’s care, significantly defined how future nurses would provide care to patients (Cynthia, (2011).
Wald’s contribution, including how she propelled the change, which impacts you from a personal and professional perspective: knowledge, values, and beliefs.
Florence Wald was caring leader and demonstrated a strong commitment to her cause and this enabled her to spearhead meaningful change in the field of palliative care (Cynthia, 2011). She based her leadership on the reverence and respect for the value of human life. Her courage and dedication to provide care for the dying inspires me to make meaningful contribution to the society. Her perseverance in the face of challenges and difficulty motivates to remain committed to my profession despite the challenges. She helped bring the significant change in this sector by educating care providers on the need to provide quality care for the terminally ill (Beth, 2007). In this, I learn that an individual can make great impact in the society and bring about positive change. She acquired proper education in the field of nursing, thus, preparing herself for the great task of bringing change in the field of nursing. It makes me appreciate the role of education and training as a means of acquiring necessary skills and knowledge. In order to realize her vision, Florence conducted extensive research projects that improved her knowledge on the subject of palliative care. Through research, one is able to acquire proper information that is relevant for better job performance (Cynthia, 2011). By creating a multidisciplinary team to find out the needs of the drying or terminally ill persons, Florence Wald demonstrated the importance of teamwork.
In conclusion, it is important to note that Florence Wald is an outstanding world leader in the field of nursing and a champion in palliative care or care for the dying. As visionary leader, Wald pioneered the U.S. hospice movement by opening the Connecticut hospice facility in 1971. It was the first of its kind in the United States. Her work won her the “Living Legend” title that she received as honor in Washington D.C. Wald was transformational leader who played a significant role in changing care for terminally ill or the dying in U.S. She organized community leaders, doctors, nurses and clergy to develop synergy and vision pertaining to palliative care. She led the group to conceptualize, develop/build and successfully open America’s first hospice facility. Florence envisioned the importance and need of maximizing quality of life to individuals who are terminally ill. She was, therefore, a transformational leader who brought meaningful change in palliative /hospice care.
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