Pat Maguire, RN, MN, CNAA

By Laurie Fronek | April 24, 2007

After nearly 40 years in nursing and administration, mostly on the West Coast, Pat Maguire, RN, MN, CNAA, returned to New England last fall and came out of retirement to be director of nursing at Nashoba Valley Medical Center, a community hospital in Ayer, Massachusetts. She's quite glad to be back, both in the region and in nursing.

Q. What made you trek across the country from Seattle to Ayer to take this job as director of nursing?

A. I grew up in Massachusetts and lived in Wakefield for the first part of my life. I went to Lawrence Memorial Hospital School of Nursing, worked at LMH for a little bit, and then went to Boston where I spent a number of years at Beth Israel. During that time, I attended Boston College and received my undergraduate degree. I was interested in a career in nursing administration, and that's what took me to Seattle in 1980. I joined Virginia Mason Medical Center, went to the University of Washington, and got my master's in nursing administration, fully expecting to move back home to Massachusetts when I finished school. But home had become Seattle, so I stayed and worked at Virginia Mason for 24 years.

I retired after a very diverse career, having started as a staff nurse working the night shift and progressing over the years through a number of positions. I served as the chief nursing executive for about 15 years, and when I retired at the end of 2004, I was a senior vice president responsible for cancer and cardiovascular services.

I always knew that at some point I would move back to New England. The end of 2004 became the right time. I honestly thought that when I retired I was going to stay retired, that I would be very busy as a retired person and probably would not work again. However, after about six months, I got restless. There was kind of a hole for me; there was something missing, and it was my career as a nurse. So I looked at different opportunities in Boston and Eastern Massachusetts and started here at Nashoba Valley Medical Center in November.

It's a wonderful organization, and I am so honored to be part of such a distinguished team of colleagues who really focus on patients, on families, on the communities we serve, and on doing what is best for all of those entities.

Q. What are your responsibilities as director of nursing?

A. Nashoba Valley Medical Center offers ambulatory and inpatient services. I am responsible for providing leadership for the inpatient [nursing] side. We have an emergency department, an intensive care unit with six beds, and a medical/surgical floor with 51 beds. I am responsible for the personnel on those units. We work together to determine the things that we're good at and the areas where we need to improve.

I also work with the nursing supervisors to address system-wide issues, like patient flow, how we expedite patients' journeys through their hospitalization. We're also constantly looking at things that will ensure patients' safety while they are under our care. I'm responsible for the structure, the processes, the policies and procedures, how we go about doing our work, and the financial aspects of running nursing services.

Q. And how do you approach the role of director of nursing?

A. Even though my title is director of nursing and I have a lot of responsibility for the organization, I very much see myself as part of a team. We all have a unique role that we play, and at the end of the day, I want my colleagues, the team members I work with, to say, "Wow! Look what we accomplished today!" I want to facilitate their ability to achieve success on behalf of our patients and the communities we serve.

Most people who serve as a director of nursing would be in a suit or other fairly formal business attire. I generally don't do that. I am a roll-up-my-sleeves kind of gal. I want to do anything I can to help the team and learn from them. It's only through walking in their shoes that I appreciate and understand the things that they face each day. So I have scrubs on today, and I'll spend some time in the emergency department, and perhaps the inpatient units, too.

I'm fortunate because we're a small organization, so I have the opportunity to do some teaching with staff. Today, for example, I have been at orientation with a group of new employees, listening to their questions and hearing about their observations from their first couple of days. For me, this organization is the best of all worlds. I get to do a little bit in many, many different areas, and I find that very satisfying, both as a nurse and as an administrator.

Q. In your opinion, what are some of the strengths of Nashoba Valley, and what are areas where you expect to focus on improvement?

A. One of the things that I think is very exceptional here is the teamwork. We are a small organization. There are no silos. In many healthcare organizations, you see silos, politics, cumbersome methods of communicating. One thing I respect about this organization is that everybody talks to anybody they need to talk to in order to meet the patients' needs. There is not the sense that "Oh, I can't talk to that person, he's the CEO." Everybody knows each other and is on a first-name basis.

I also find that we're nimble. We respond quickly. If something needs to be done, we're able to address it thoughtfully, make a decision, and move on. An example is we're working on a program to recruit nurses to work per diem. In many organizations, creating a program like that would take 9 to 12 months. Here, we implemented a program within a couple of weeks. That's remarkable. In many organizations, there might be the will to do something like that and there might be the dollars, but getting everything put together and tying a ribbon around it would take much longer.

In terms of what I'll be working on, I really see a great opportunity to simplify, streamline, and standardize. Over time, processes become outdated and instead of stopping and doing some thoughtful review, often it's human nature to add another step, to kind of patch it up. But often that step does not add value. It's important to go back to the beginning and study things carefully.

For example, we make a work schedule for every unit every month. So if there are 20 people on a floor and we're working 24 hours a day, seven days a week to care for patients, the right number of staff have to be allocated across the days of the week and the hours of the day. Over time, this organization had evolved a rather convoluted way of creating that schedule. It was taking the manager on the unit, the payroll clerk, and a secretary well in excess of 40 hours every week to manage the process of scheduling and doing the payroll. That's a lot of time. We're working on that now, and I expect that when we're finished, instead of devoting upwards of 40 hours a week, we'll probably have it down to 10 hours a week or less, and the system will work better for everyone involved.

Q. What do you think your joining Nashoba Valley Medical Center is going to mean for the organization?

A. I am very respectful of the people who have come before me who have served in this position or similar positions. They have done extraordinary work and built a very strong foundation. I in no way want to suggest that I am the knight riding in on the white horse who is going to save the day, because that simply is not the case. I'm "chronologically gifted," so to speak. I've been in this business for a long time, and I've seen a lot. I've had the opportunity to practice in many different organizations, and I believe that I can bring things to NVMC that I have learned from other organizations. This will help us to evolve into a department of nursing that's even more distinguished than it is today.

I believe Doreen Thomas, our new chief nursing officer, and I, along with the nursing leadership team, can really take all of the energy and excitement in the organization and create something very special, both for our patients and our colleagues. We are very committed to the notion of interdisciplinary collaboration. That is, the idea that the nurses, doctors, therapists, housekeepers, people in food and nutrition services -- every single person on this team is on the same team, and that is the patient's team.

Laurie Fronek is a freelance writer who lives in Seattle and a regular contributor to On Call. She has done the interviews for On Call for the past nine years.