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Canada Formidable nursing leader Dorothy Wylie inspired others

Dorothy Wylie pressed forth with innovative ideas that came into fashion years later, including patient-centred care.

Courtesy of Wylie family

It was 1971 and a young nurse named Susan Smith was looking after a ward full of seriously ill patients – people on dialysis and with gastrointestinal bleeding – at Toronto's Sunnybrook Hospital. With just one registered nursing assistant to help her, Ms. Smith was overwhelmed and called down to the nurse supervisor.

The supervisor suggested she come down to talk, but Ms. Smith, knowing that stepping off the ward would be unsafe and against hospital policy, hung up in a rage. Five minutes later, a formidable woman appeared in front of her saying, "I understand you have a problem up here."

It was Dorothy Wylie, the newly hired assistant executive director of patient care. A person of such a high position, in that era, would normally never set foot on a ward. Ms. Smith thought she'd get a tongue lashing. Instead, Ms. Wylie listened to her concerns and a registered nurse from another floor soon arrived to help.

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The moment inspired Ms. Smith to become a nurse leader herself – a career path for which Ms. Wylie mentored her.

Ms. Wylie's no-nonsense, get-it-done approach changed nurse leadership in Canada and garnered her a loyal following. Ms. Wylie, who died of renal failure on Aug. 13 at the age of 86, had a varied career as a nurse, nursing administrator and educator who was known for her intelligence, forward thinking and often blunt pragmatism.

For nearly a decade, starting in 1978, she served as vice-president of nursing at the 1,000-bed Toronto General Hospital, the largest hospital in the country at the time. She played a key role in the launch of two important organizations in nurse leadership: the Ontario Provincial Nurse Administrators' Interest Group and the Journal of Nursing Administration (now known as the Canadian Journal of Nursing Leadership). In 2001, three of the women she mentored founded the Dorothy Wylie Health Leaders Institute, which offers leadership education for nurses.

Throughout her career, she pressed forth with innovative ideas that came into fashion years later. As a nurse leader in the 1970s and eighties, she was an early proponent of patient-centred care, which gives priority to the patient experience rather than what works best for the health-care system. During her tenure at large Ontario hospitals, she insisted nurse leaders participate in high-level decision-making conversations, putting nurses in what many now see as their proper place in health-care leadership.

At the University of Toronto, she founded one of the country's first master's degrees in nursing administration. As a teacher, she experimented with so-called experiential learning, which favours hands-on projects over lectures. "She was on the cutting edge of New Age learning," says Judith Skelton-Green, a nurse and educator who co-founded the institute named for Ms. Wylie.

Ms. Wylie had a huge impact as a mentor. "The women that she first brought into her fold at the General are probably the most successful group of women leaders in the country," says Mike Villeneuve, a former student of Ms. Wylie who now lectures in nursing at U of T.

She was often blunt but always wise. "She had an amazing way of cutting to the chase. Here's what the issue is, and let's get on with it," says Ms. Smith, who went on to serve in several senior roles at Hamilton Health Sciences Corporation.

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For instance, when Mr. Villeneuve once lost his job, she said, "Is this the first time you've ever been fired?" When he said yes, she replied: "Rookie." When she found out they gave him a severance package, she said, "So what's the problem? You have six months off. They were tired of you, you were tired of them. They did you a favour."

Dorothy Muriel Wylie was born on Aug. 15, 1929, in Toronto, the only child of Muriel Margaret (née Whitehead) and Irvine Wylie, who was a firefighter and fire chief. At age 18, young Dorothy could not wait to start nursing school, but most institutions required students be at least 19. Against her Protestant parents' wishes, she enrolled in the St. Michael's Hospital School of Nursing – a Catholic organization – and graduated with a diploma in 1950.

She worked for a few years as a nurse then moved to do a bachelor of science degree in nursing at New York University, which she completed in 1964. She stayed in the U.S. for a while, eventually becoming head nurse of the recovery room at Cornell Medical Centre. She then did her master's in nursing administration at Cornell, finishing in 1969 – a time when few nurses did graduate work.

She returned to Canada to be closer to her parents and to avoid having to become an American citizen. An animal lover, she brought with her a beagle named Victoria, the dam of many litters of pups that were used for experiments at Cornell.

In the 1970s, Ms. Wylie took on leadership roles at Scarborough Centenary Hospital, Sunnybrook and the Registered Nurses Association of Ontario (RNAO). She joined Toronto General in 1979 and held that post until 1987.

At the General, she made the unpopular move of hiring clinical nurse specialists – nurses with specialized skills backed by a master's degree – an unusual qualification at the time. Ms. Wylie told the nursing publication Longwoods in 2003: "Every change causes some commotion. I think I had a reputation that if I was coming to your place, there was going to be some kind of change going on."

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As a manager of nurses, she was all fairness and common sense. One young nurse washing a patient's hair was told that she needed a doctor's order. She went to Ms. Wylie to find out if this was true and her blunt reply was: "Absolutely not. And if anyone says you do, you send them to me."

During those years, she lived in a tiny apartment at the top of the Sutton Place Hotel from Monday to Friday and went home to be with her parents, who lived in the north part of the city, on weekends. Outside of her day job, she acted as president of the College of Nurses of Ontario for two years. In 1985, she completed her master's of science in human-resources development at American University in Washington D.C., which involved two years of commuting to the U.S. one weekend a month.

Ms. Wylie then did health-care consulting and worked in academia. She was named a fellow at Ryerson in 1982, taught at the University of Manitoba and became an associate professor at U of T in 1989.

Seeing a gap in support for nursing leaders, she founded the Ontario Provincial Nurse Administrators' Interest Group and sought input, leadership and members from government, education and health-care organizations.

"She was very progressive in two ways: to take the chance of bringing people together to have a collective voice, and the other was to bring nurses from different sectors together," says Gail Donner, the former dean of the U of T Faculty of Nursing. In 1998, the group merged with the Ontario Nurse Executives and became the Nursing Leadership Network of Ontario. It is now part of the RNAO and has 1,600 members.

She retired from teaching in 1994 but remained active in her field. When her colleagues created the institute in her name in 2001, she first said, "Usually when someone names something after you, you're dead." Ms. Skelton-Green sensed Ms. Wylie needed reassurance about the organization's aim. After filling in her mentor on its broader ambitions and commitment to approaches such as experiential learning, Ms. Wylie assented and was deeply proud of the group.

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For the last several years of her life Ms. Wylie was living with chronic renal failure, and eventually agreed to dialysis. As her overall health declined, however, she decided to cease dialysis last summer. Her friend Ms. Skelton-Green suspected this would happen when Ms. Wylie said, in her straightforward way: "You know, I'm not having much fun."

She never married, devoting herself to her career and her parents. Before her father's death in 2002, he moved to a long-term care facility, but she visited him nearly every day. She remained close to her cousins. Her second cousin, Heather Whyte, recalls weekends at the Wylie family cottage where Ms. Wylie would get into political discussions with Ms. Whyte's father, a banker. "She'd never back down," Ms. Whyte says. When he was hit by a drunk driver, Ms. Wylie was right there in the hospital, providing support.

This original leader of nursing leaders was known for her loyalty, sense of humour, intelligence and her ability to raise a dramatic eyebrow when something was not quite right. "Oh, she had an eyebrow," Mr. Villeneuve says. "She never let the absurd or ridiculous come and pass."

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