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Joyce C. Clifford, former Beth Israel Hospital Chief Nurse, passes away

Credited with developing "primary nursing" model

BOSTON -- Joyce C. Clifford, a former Senior Vice President and Nurse-in-Chief of Boston's Beth Israel Hospital, who was credited with developing the "primary nursing" model where an individual nurse cares for a particular patient throughout a hospital stay, has died.

Clifford, who advocated for the full professionalization of the nursing role through decentralized decision-making, 24-hour accountability for care, and full collaboration with other disciplines, was 76.

"My wife loved the Beth Israel Hospital," said Lawrence Clifford, PhD, her husband of 44 years. "She loved everyone there because the hospital oriented itself to the most important task and objective of a hospital and that was caring for patients. Its reputation was built on that principle."

"Joyce knew the importance of the environment in which care is delivered," said Trish Gibbons, RN, DNSc, former Vice President for Nursing. "Joyce understood that excellence required a commitment from all care providers and hospital administration and she worked at the executive level to assure this outcome. Joyce demonstrated that scholarly nursing practice could exist in hospitals and that patients and families had a right to expect nursing care that was personalized. Through her leadership BI became a magnet for nurses who wanted to practice professionally and a model for hospitals across the country."

Many of today's nursing leaders practiced under Joyce's leadership.

"I started my nursing career at Beth Israel in the 1980's - a time when Joyce Clifford's work to establish primary nursing and a professional practice environment for nurses was in full bloom," said Marsha Maurer, RN, Senior Vice President of Patient Care Services and Nurse-in-Chief. "That work truly changed the fabric of nursing practice, both at Beth Israel and around the world. It was a huge advancement for both the profession and for patient care. I was honored to be able to celebrate Joyce's legacy by establishing the Joyce C. Clifford Seminars in Nursing last year. The annual seminar will ensure that her passion for leadership in patient care, research, and scholarship will live on."

Designed as an educational and networking seminar, the event gives practicing clinical nurses the opportunity to interact with nursing leaders and colleagues around topics of importance to practice. This year's Seminar will take place Nov. 30 and include a keynote address by Terry Fulmer, PhD, RN, FAAN, Dean of the Bouvé College of Health Sciences at Northeastern University, who practiced as a floor nurse and initiated the Geriatric Resource Nurse model at Beth Israel Hospital under Joyce.

Click here to watch a video about Clifford, her legacy, and the seminar named in her honor.

"First in the nation to institute primary nursing throughout the hospital, Joyce Clifford, RN, strengthened the professionalism and scholarship of nursing to levels matching those of the medical specialties," said Mitchell T. Rabkin, MD, Distinguished Scholar at the Carl J. Shapiro Institute for Education and Research. "Moving her staff from nursing station desks to the patient's bedside, she empowered nurses to become true professional colleagues of their patients' doctors. At Beth Israel Hospital, the nurse could then remain working at the bedside providing hands-on care and know that she would advance in stature and salary; no longer would she have to move to an administrative role to grow in the profession."

"Like their medical colleagues, they did research, presented at national meetings and as they gained experience, served as specialty consultants to others on staff confronted with challenging issues of nursing and medical care. The notion of "scut work" disappeared, since every hands-on contact with patients gave the opportunity to learn more of the patient's understanding of the illness and ability to cope, and to observe more often and more closely the patient's clinical status, look for bed sores and other signs of trouble, and make the patient more comfortable. Sharing with physicians their gains in understanding and awareness made for unsurpassed patient care. Knowledge of Joyce Clifford's contribution to Beth Israel spread throughout Boston to become nation-wide and beyond. Many who have worked with her are today leading nursing practice or education around the globe. Her positive impact for the care of patients will remain a lasting legacy and a tribute to her exceptional accomplishments."

Clifford was President and CEO of The Institute for Nursing Healthcare Leadership (INHL), representing the Consortium of Harvard-Affiliated Nursing Services (CHANS). She served as Senior Vice President and Nurse-in-Chief at the former Beth Israel Hospital for more than 25 years and held appointments as Lecturer at Harvard Medical School and a Visiting Scholar at Boston College School of Nursing.

"The Consortium has been privileged to support the INHL under Joyce's leadership for many years," said Eileen M. Sporing, MSN, RN, FAAN, Chief Nursing Officer and Senior Vice President at Children's Hospital, and current CHANS President. "Joyce was renowned throughout the world for her many contributions to nursing and nursing leadership."

Many current and former BIDMC nurses remembered their colleague, friend and teacher.

"Joyce mentored generations of nurses to be leaders for patient care," said Susan Burns-Tisdale, RN, former Vice President for Nursing. "Whether in a clinical or an administrative role, nurses learned that the needs of the patient and family must remain primary in all decision making. It created absolute clarity."

Clifford received her diploma in nursing from The Hospital of St. Raphael School of Nursing in 1956. She received her BSN from St. Anselm College in Manchester, NH, her masters in nursing from the University of Alabama and a doctorate in Health Planning and Policy Analysis at the Heller School of Brandeis University.

She was a fellow of the American Academy of Nursing and a former President of the American Organization of Nurse Executives. She was a member of the Board of Trustees of the American Hospital Association from 1991-1994. In addition, she was a trustee for her alma mater, St. Anselm College, and was the first nurse to be a member of the Harvard Medical School's Admissions Committee.

Widely recognized for her contributions to nursing, Clifford received numerous awards. Most recently, she was awarded the Living Legend in Massachusetts Nursing by the Massachusetts Association of Registered Nurses in 2007, named a "Living Legend" by the American Academy of Nursing in 2005. She was a member of the charter class of the Johnson and Johnson-Wharton Fellows Program in Management for nurses; served as a Commissioner on the National Commission on Nursing in 1988; and, in 1995, was a member of the committee on the Adequacy of Nurse Staffing of the Institute of Medicine. She has served on the Robert Wood Johnson (RWJ)-sponsored council on Economic Impact of Health System Change and was a member of the National Advisory Committee of the RWJ Executive Nurse Fellows Program.

Clifford is regularly described as the architect of nursing's professional practice model - a model that has been recognized nationally and internationally in hospital and in out-patient/community services.

This practice model has been studied and emulated by nurses and health administrators around the world including: Australia, New Zealand, Israel, England, Scotland, Germany, Netherlands, Kenya, Thailand, China, Saudi Arabia, Japan, and all of the Scandinavian countries. Her leadership has been was also recognized with the Award of Honor of the American Hospital Association (1990), the National Nurse Executive Leadership Award of the American Organization of Nurse Executives (1996), three honorary degrees, the Lifetime Achievement Award of the American Organization of Nurse Executives (2003), and the AACN-Marguerite Rodgers Kinney Award for a Distinguished Career of the American Association of Critical-Care Nurses (2004).

She held leadership positions on many boards and special programs, including the American Journal of Nursing Publishing Company (board chair), the American Hospital Association, the Institute of Medicine's Committee on the Adequacy of Nurse Staffing, The Council on the Economic Impact of Health Care Reform, Strengthening Hospital Nursing Program (RWJ/Pew), and The RWJ Executive Nurse Fellowship Program. Her book Restructuring: The Impact of Hospital Organization on Nursing Leadership was frequently cited in the 2004 IOM report on patient safety. She was co-editor with Kathy J. Horvath, PhD, RN, of the book Advancing Professional Nursing Practice: Innovations at Boston's Beth Israel Hospital.

Clifford's past nursing experiences include multiple nursing positions in service and education and both active and reserve duty in the U.S. Air Force Nurse Corps where she achieved the rank of major.

Funeral services are being arranged by Gormley Funeral Service in West Roxbury where a wake will be held Thursday, Oct. 27, from 3 to 8 p.m. The funeral mass will be held at St. Theresa's in West Roxbury at 10 a.m. on Friday, Oct. 28, followed by burial at the Massachusetts National Cemetery in Bourne.

BIDMC flags will be lowered to half-staff in Joyce's honor on Monday and Tuesday, Oct. 24-25.

Materials from the Ruth and David Freiman Archives at Beth Israel Deaconess Medical Center were used in preparing this message.