Profiles in Nursing

Phyllis Ethridge, Innovator of Nursing Practice

Phyllis Ethridge, RN, MSN, DSc, FAAN, CNAA, has a vision for a nurse management model of healthcare.

By Elizabeth Hanink, RN, BSN
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An HMO of nurses? Extended home visits for the chronically ill patients and clinics managed solely by nurses? It doesn’t sound like business as usual—and it isn’t. Yet because of these innovative ideas, the Fellows of the American Academy of Nurses honored Phyllis Ethridge, RN, MSN, DSc, FAAN, CNAA, as a “Living Legend” in 2007.

After transplanting herself from Massachusetts to Arizona at age 17 to attend nursing school, Ethridge worked her entire career for the Carondolet St. Mary’s Hospital in Tucson. From 1970 until her retirement in 1996, she served as the Chief Nursing Officer. Along the way, she earned a Baccalaureate and a Masters degree in Nursing from the University of Arizona, and became an expert in chronic diseases and long term care.

In 1998, Phyllis’ alma mater saluted her with an Honorary Doctorate of Science Degree for her contributions to nursing education, research, and healthcare.

What was it, other than superb time management skills, that made this mother of six so special? Admirers see a combination of traits: a holistic approach to patients, a respect for their dignity, an ability to collaborate, and her accountability with respect to both cost and quality of care. These traits, along with a clarifying vision of the future, won her international recognition.

What exactly did she do? Beginning with a plan for patient care that starts with the hospital but extends along a continuum, she established a system of nurse case management that included hospital, home, and hospice. The hospital did not simply discharge patients — instead, the nurses who knew them and their history followed and managed their care. These same nurses had, after all, a rapport with the patients and their families. Later, Etheridge created an HMO of nurses to provide community care for seniors.

When the Medicare Program sought to fund studies for redesigning reimbursement methods, Ethridge helped develop an experimental HCFA-financed Community Nursing Organization, one of four nationwide. Nurses authorized all services, including durable medical equipment, therapies, nursing care, and supplies.

According to colleagues, these efforts marked the first test of a “nurse managed model for Medicare community-based services” and also “the first test of capitated reimbursement for nurse case management.”

Each innovation was scrutinized for cost effectiveness, quality, and satisfaction. Several studies recognized the Arizona CNO as a “best practices” site. Documentation, especially about finance, can be tedious, but evidence-based change is exciting.

Ethridge did not limit herself to patient services. She is the founder of Global Nursing Exchange, now in its 20th year. An active spokesperson within the profession, she’s written on issues such as licensure versus certification for advanced practice, the need for Masters degree preparation for such practice, and the duty of nurses to be proactive in cost containment.

The American Organization of Nurse Executives awarded Phyllis its esteemed Leadership Award, and she is also the recipient of the Founders’ Award from Sigma Theta Tau International, the HCFA Community Nursing Demonstration Award, and the Magnet Hospital Award. Phyllis Ethridge is truly a legend in her own time.

Elizabeth Hanink, RN, PHN, BSN is a freelance writer in Los Angeles. She has 30 years experience in hospital and community nursing.

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