Behind every great leader is a team of dedicated and accomplished colleagues. Two individuals who have helped James Varnum—the long-time president of Mary Hitchcock Memorial Hospital—shape the culture of DHMC are Nancy Formella and Paul Gardent.

The senior nurse executive at DHMC since 1999, Formella will become acting president of MHMH when Varnum retires at the end of April. She brings to the position 31 years of experience as a staff nurse, a clinical nurse specialist, and a nursing director and executive. During much of her career, she held leadership positions in nursing at various Mayo-affiliated hospitals—known for their quality and efficiency. At DHMC, Formella has worked to advance professional nursing education, practice, research, and training. In 2003, she successfully led an effort to obtain Magnet Status for DHMC—a designation bestowed by the American Nurses Credentialing Center to recognize excellence in patient care, employee satisfaction, and workplace safety. In 2004, she was named Nurse Leader of the Year by the New Hampshire Nurses' Association. And in 2005, she

received an award for Nursing Management Excellence from the New Hampshire Organization of Nurse Leaders.

It is expected that Formella will lead MHMH for 12 to 18 months; she'll also be a candidate for the permanent position. "It's an extremely humbling experience," Formella said about her appointment to a local newspaper. "The nursing practice is one of the fundamental cores of what the hospital does," she continued. "Patient care is really our mission, so understanding the intricacies of patient care is really an asset."

Helping Formella make the transition into the presidency will be Paul Gardent, executive vice president of MHMH and of the Dartmouth-Hitchcock Clinic. Gardent, who came to DHMC in 1979, has been Varnum's chief deputy. A graduate of Dartmouth's Tuck School of Business and a certified public accountant, Gardent has been an integral component in the leadership, growth, and stability of DHMC. Gardent's dedication to and love for the operations end of management allowed Varnum to focus more intensely on outreach initiatives like the Dartmouth Hitchcock Alliance, mentioned here. "We complemented each other in that way," says Gardent. Their relationship was always "steady" and "constant," he adds, thanks to their common values of respect, collaboration, and partnership.

Just five years younger than Varnum, Gardent plans to step down from his

position within the next year. "For 27 years, I've been pretty well consumed by the work here," he says, "and would like some time to do some other things. I don't know exactly what those things will be," he admits, but he hopes that among them will be getting more involved with health-care improvement and medical education through DMS and Tuck.

Leaving his post at DHMC "is sort of sad," he says. "I love the people here and I love the relationships." But he felt the time was right to move on. "I think Jim should be very proud of what's been built, not just in the Medical Center but in the region," Gardent emphasizes. "I certainly share some sense of pride there and feel good about it."

But the pride belongs to all the employees of DHMC, he adds. "They come to the work here with a real sense of wanting to help others. Jim's and my role has been to support that and encourage that."

In the coming months, Formella will take over that role—supporting, encouraging, and shepherding the organization into a new era.