Mary Dixon was 8 years old when her grandmother, Mary Walton, had a stroke and moved in with the family. The elder woman first relied on a cane, then leg braces, then a walker, but ultimately became bedridden and required total care from Dixon’s mother, Betty Walton, her daughter-in-law.
The learning curve that care required, recalled Dixon – who served as chief nursing officer at UVA Health for the past four years and earns a Doctor of Nursing Practice degree from the School of Nursing this spring – was steep, but not weighty. Dixon remembers the era filled with fun, tenderness and laughter. When the family took car trips, for example, Dixon’s father would nestle Dixon’s grandmother on a mattress and nest of blankets in the back of their Rambler station wagon. Whenever the elder Mary needed something – a sip of water, a snack, company, or a bedpan – a young Dixon would scramble around the back, swing open the door, and hop back inside to help.
“Was it a chore? Never,” Dixon explained. “It was part of our family, and part of life.”
“A word to describe Mary is genuine, and that’s refreshing in both leadership and leaders.”Jonathan Bartels, nurse and UVA Health palliative care liaison
Later, when Dixon enrolled at Catholic University’s nursing program (“My grandmother, who died in my freshman year of college, was thrilled,” she recalled), she grew interested in fields like hospice and elder care that her peers sometimes eschewed. She tended to dying patients and families with social workers, her first exposure to interprofessional practice, a concept she would come to champion in the coming decades. As a student, Dixon offered bedside care, but also attended funerals, wrote cards and made home visits. She learned to listen intently, develop a compassionate presence, have frank conversations and probe gently when necessary. Dixon relished the expanse of her nursing education, and even watched one of the first open-heart surgeries ever done, standing rapt through the 13-hour procedure.
It was in those years that she first cultivated herself as a servant leader: being generous with her care, support and the power she increasingly held in successive roles as a nurse leader and executive, a “trait,” she said, “[she] came to live by.”
“How can you expect individuals to provide the highest level of care,” said Dixon, who now serves as special adviser to UVA Health CEO Wendy Horton, “if they don’t feel supported by your presence?”
Dixon brought that same philosophy to her nursing career, which she began as a hospice nurse on a unit at Georgetown University Hospital. By 1981, she was tapped by Inova Health System in Fairfax, where she worked for three decades, the last four years as chief nursing officer of Inova Alexandria Hospital. She led nursing operations at Baylor Scott and White Health in Dallas before arriving at UVA Health in 2017.
During the last four years, Dixon developed systems to include and elevate nurses’ voices and roles and engage them in decision-making, and took aim at nurse turnover, a perennial issue for most health systems, by encouraging education and engagement. She expanded roles for UVA’s growing number of Clinical Nurse Leader graduates throughout the hospital, mentored nursing students and frontline nurses, encouraged bedside nurses to pursue research and other creative opportunities, and distributed well over 100 DAISY Awards to recognize stellar work, always showing up in person to present them. She oversaw the hospital’s Magnet re-designation – the highest national honor for nursing practice excellence – in the midst of the pandemic in 2020, an accomplishment she calls the “highlight of [her] time at UVA.”
-25%During Dixon's tenure as CNO, voluntary turnover among nurses was reduced by nearly 1/4 between 2017 and early 2020.
“She role-models what it means to be a servant-leader,” Luella Glanzer, nursing retention program coordinator at UVA Health, said. “She prioritizes building relationships: connecting with colleagues and recognizing them for their work and effort in meaningful ways.”
“Mary is a nurse’s nurse,” added School of Nursing professor emeritus Kenneth White, Dixon’s adviser since 2017 and a palliative care nurse practitioner at UVA Health. “She puts others first, and always strives to make nurses’ jobs better, and more rewarding, no matter the challenges.”
Dixon also expanded opportunities for staff nurses with associate and diploma nursing degrees to continue their education, and for her final scholarly project, studied and evaluated UVA Health nurses’ academic progression through the School of Nursing’s RN-to-BSN program. The National Academy of Medicine recommends that hospitals strive to employ 80% baccalaureate-educated nurses, a level of training associated with higher quality care and stronger patient outcomes. Under Dixon’s leadership, with baccalaureate program director and assistant professor of nursing Tomeka Dowling as a strategic partner, 80% of UVA Health nurses now have a BSN, a figure that’s grown from 61% in 2013.
“We are at a critical moment in UVA Health history for turning this around for nursing [attrition], and we will.”Mary Dixon, UVA Health Chief Nursing Officer, 2017-2021, and a member of the DNP class of 2021
“Through our academic-practice partnership, we were able to assess the educational needs, challenges, barriers and personal motivations of working nurses,” said Dowling, who described Dixon as a forward-thinking and gracious mentor and leader. “It’s been an honor to work beside her.”
Dixon walked the educational paths she encouraged others to – what associate professor of nursing Regina DeGennaro, Dixon’s doctoral adviser, calls “generous advocacy” – enrolling in the Doctor of Nursing Practice program shortly after her 2017 arrival and, this spring, walking the Lawn as she caps a distinguished 45-year career at a time that has been “the most challenging moment ever in modern health care.” Dixon said she treasured learning alongside fellow UVA Health nurses and deepening her relationships with them.
“A word to describe Mary is genuine,” said Jonathan Bartels, a nurse, UVA Health palliative care liaison and creator of The Pause, “and that’s refreshing in both leadership and leaders.”
There are few words, Dixon said, to describe the last 60 weeks. The pandemic “has been a double-edged sword,” a moment that shone a positive light on health care workers, but exacted an enormous toll, too. “Our teams provided the highest quality of care, doing a phenomenal job, and especially when one looks at our COVID survival rate compared to national statistics, we’re truly a premier organization. Our patients and families thank our team members every day.”
And it’s not just nurses and physicians who’ve led the way, Dixon said. “It’s every single member of our team that’s done this; everyone has played a part, and everyone has been affected.”
But the hospital’s success in dealing with COVID has come at a cost, Dixon said, as many are straining under the emotional weight and grind of their jobs, the constantly evolving science, protocols and vigilance, and the agony of worry that they’ll unwittingly expose others to infection or become infected themselves.
Before the pandemic, Dixon said, voluntary turnover in UVA Health’s nursing staff had declined by nearly one-quarter between 2017 and 2020. As it has at most hospitals across the U.S., COVID-19 has increased nurses’ attrition rates.
“We are at a critical moment in UVA Health history for turning this around for nursing,” Dixon said, “and we will.”
Dixon hopes to continue to find ways to help the hospital deal with nurse turnover, though as she packs up her office, she’s still imagining what retirement might bring. Her husband Gary, who owns a restaurant in Daytona, Florida, is again preparing to reopen it. Her cohort of friends, largely vaccinated, will gather together again soon. And Dixon looks forward to finding time to enjoy the beach and read books for pleasure again, something she hasn’t done lately, given the fever and intensity of her role as UVA Health’s chief nurse executive.
With her memories of the past four years, Dixon said she’ll also keep the folder of DAISY Awards she presented to nurses that tell of the commitment, care and poise of her nursing colleagues at UVA. Even as the pandemic has devastated, it has also elevated nurses and the important roles they play, Dixon said, affirming again that those in health care must always be learning.
“That’s my favorite Florence Nightingale quote,” she said. “’Nursing is a progressive art such that to stand still is to go backwards.’ Let us never consider ourselves finished as nurses; we must be learning all of our lives.”