Rosamond Gabrielson was the Director of Nursing Vanderbilt University Medical Center from 1976-1988.
“Gabe,” as she was commonly called, came to Vanderbilt University Medical Center as the Director of Nursing after completion of her tenure as President of the American Nurses Association, a position that she held from 1972 to 1976. Her advocacy of the bedside nurses’ role started long before her arrival at Vanderbilt. One of her research studies explored the role that nurses had with physicians. She studied nurses’ actions with regard to verbal orders for medications and found that 21 out of 22 nurses followed physicians’ orders to give a medication that didn’t exist. Nurses were blindly following orders without question. She urged nurses to challenge these relationships and strive for collaborative practice. She brought this vision and passion for nursing practice and staff nurses to Vanderbilt.
She challenged her nursing leadership team to seek the input of bedside nurses asking frequently “What do the staff nurses think?” She wasn’t afraid of visionaries, people wanting to try new ideas. Prior to Vanderbilt establishing a credentialing process for Nurse Practitioners, Gabe saw the value in maintaining the patient’s continuity of care by permitting the Nurse Practitioners to see their admitted patients. Gabe challenged two Associate Directors, Adrienne Ames and Frances Carson, to form a group to define a structure around the nursing process. The Vanderbilt model of Shared Governance and the Nursing Bylaws unfolded from this work.
Early in Gabe’s tenure the hospital’s pharmacy wasn’t open 24 hours a day, which led to nurses filling prescriptions after hours. She recognized the potential safety issues with this practice, pushed and got it changed. She recognized that nurses couldn’t competently float to alternative clinical areas; she stood firm on this notion and from this came self-containment. Gabe wanted to validate the role of the nurse in a patient’s care. She consulted Marie Manthey. The results was a shift in the model of nursing practice to primary nursing with an emphasis of the nurse being as important a member of the Health Care Team as any other discipline.