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University of Missouri

Trailblazer

Mizzou alumna Winnie Fritz has always gone where there was no path and left a trail.

Winnie Fritz in helicopter cockpit

By age 25, Winnie Fritz flew this Cessna aircraft over the Dead Sea in the Jordan Valley, on the Israel-Jordan border. For 17 years, Fritz worked in Jordan, first as nursing school dean and then as clinical operations officer of a 28-hospital system. Photo courtesy Winnie Fritz.

Winnie Fritz was her father’s farmhand at 6, a unit commanding officer in the U.S. Army at 22, a nurse to presidents and kings at 23, and the clinical operating officer of an international health system at 31. A 1968 graduate of the Sinclair School of Nursing, Fritz is a leader and a fighter, a traveler and a teacher, an explorer and an inventor. In 2014, the Mizzou Alumni Association honored Fritz with a Faculty-Alumni Award, and in 2015, the nursing school awarded her a citation of merit. A pioneer in her field, Fritz has always gone where there was no path and left a trail.

When Winnie Fritz walked into her patient’s room and saw he was out of bed, futzing with a ham radio, she gave him a good scolding. Earlier that day he had been rushed to the hospital with chest pains. He was supposed to be resting in bed, and Fritz had no qualms about telling him so.

“Do you know whom you’re talking to?” he retorted, standing tall over Fritz’s petite 5-foot-5-inch frame.

“Yes, sir, with great respect, but I have seven more patients just like you,” replied a feisty Fritz.

At the ostensibly tender age of 25, Fritz already had risen to nurse manager of the presidential suite at Walter Reed Army Medical Center, in Washington, D.C., where she cared for plenty of VIP patients. She had treated the likes of Richard Nixon and Mamie Eisenhower, all manner of military brass, and foreign heads of state. She had seen them all in low moments. She had a job to do, and, anyway, it was not in her nature to be cowed.

The man standing in front of her didn’t intimidate her. “Sir, for your safety, you need to get back in bed,” she asserted.

By executing that bit of business as usual, Fritz joined the small group of people who ever said no to King Hussein bin Talal of Jordan.

The moment changed her life. She had not only disarmed him and repositioned him into a more healing posture, but she had also won him as an ally who would help launch her career as a health care pioneer in Jordan and leader in the United States.

Fritz Farms
Fritz grew up on Fritz Farms in Jerseyville, Illinois. Seven generations of Fritzes have lived on the land, including her brother, who still lives in the farmhouse built by their grandfather in 1927. All have been powered by a combination of teamwork and ingenuity, captured in the family mantra: “Go where there is no path, and leave a trail.”

Fritz was 3 years old when her brother was born. With her mother preoccupied, Fritz’s father took the toddler for her first experiences working on the farm. At age 4, she rumbled through the fields, steering a John Deere tractor from her father’s lap. At 5, she learned how to brake. By 6, she knew how to shift. “Now that you can drive your own tractor,” her father said, “I can plow, and you can come behind me and help.”

Six-year-old Fritz with family

A 6-year-old Fritz in 1952 poses with her parents and her younger brother on the family farm in Jerseyville, Illinois. Photo courtesy Winnie Fritz.

Of all of her farm chores, Fritz liked caring for the animals the most. When 500-pound sows delivered piglets, Fritz helped clean them and get them under heat lamps. She performed her first suturing not as a nurse in a hospital but as a farmhand in a bed of hay.

She contemplated becoming a veterinarian, but whenever the family had to put down an animal, Fritz struggled emotionally. She decided to become a nurse so she could explain to her patients what she was doing and why she was doing it.

When she discussed her college plans with her high school counselor, he expressed concerns about her future. “Well, you know, I’m not sure you’re college material,” he told her. 1 That puzzled Fritz, whose mother and grandmother were college graduates. She was going to college, too.

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She knew her parents would be stressed to provide money for both tuition and a new combine harvester, so the farm girl enrolled in the U.S. Army Student Nurse Program at the University of Missouri. In return for financial assistance for the final two years of school, Fritz owed three years of service.

The United States was ramping up its involvement in the Vietnam War. By the end of 1964, the number of U.S. troops deployed to Vietnam stood at 23,300, up from 3,200 in 1961. Fritz’s father was nervous. “He was worried I’d come home swearing like a sailor,” Fritz recalls. “I laughed and said, ‘Daddy, I’m not going into the Navy. I’m going into the Army. I’m going to come home swearing like a soldier.’ ”

Winnie Fritz in 1969

Fritz hosts her first equipment fair in 1969 — something she’s done many times since — at Fort Rucker, in Dale County, Alabama. To reduce wastefulness, Fritz put a price tag on each item used in the post’s hospital. “I don’t know how I ever thought to do this at this age,” Fritz says, “but I thought we were wasting supplies. Don’t you have any idea how expensive these things are?” Now everybody knew not to kick around the vital sign machine that cost $1,500 and to use paper towels instead of a sterile wipe when they could. Photo courtesy Winnie Fritz.

Marching Orders
Fritz played the clarinet in Marching Mizzou and participated in the MU Baptist Student Union. In her free time, she and her friends rode motorcycles across the Missouri countryside.

But she spent most of her time trying to meet the expectations of one of her clinical instructors at University Hospital, Eleanor Poundstone Van Natta, BSN ’56. “She was stern; she was firm,” Fritz says. “I was not afraid of her, but oh, my gosh, did I respect her.” Every night, Fritz reviewed the status of her patients and her plans for their care so when she arrived at the hospital at 4:30 a.m. she would be ready for Van Natta’s barrage of what-if questions.

During one of her first shifts on obstetrics rotation, Fritz cared for a young pregnant woman expecting her third child. It was a high-risk pregnancy, so Fritz prepared for Van Natta to ask those what-if questions: What if the patient’s blood pressure changes? What if she begins to bleed? But Van Natta threw Fritz a curveball. “OK, what are you going to do when you now have two lives in your hands and the fetal heart tones suddenly change?”

Fritz froze. She was so concerned about her adult patient she forgot to focus on her second patient — the baby. She quickly reorganized her thoughts and came up with a plan. “But no matter what you said, Van Natta always asked another what-if question,” Fritz says. From Van Natta, Fritz learned how to think critically, how to adjust to moving targets and how to explain her actions. 2

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By the end of 1967, the U.S. had deployed more than 485,600 troops to Vietnam, and Gen. William Westmoreland was requesting more. Proving her guidance counselor wrong, Fritz completed her coursework a semester early.

After basic training at Fort Sam Houston in Texas and Fort Rucker in Alabama, Fritz received her orders to deploy to Vietnam in August 1969. She was told to arrive in her class “A” Army Service Uniform: a green-and-white seersucker skirt and blouse, pantyhose and black shoes with a 1-inch heel. “I’m supposed to go to Vietnam in pantyhose?” she asked, incredulously.

Fritz was the commanding officer on the flight to Vietnam. At 22 years old, she was the oldest person on the plane, the highest-ranking officer and the only woman. 3 When they deplaned, an infantry colonel advised her to have two priorities while serving in Vietnam: “Your first is to save your own butt. Don’t take crazy risks. Your second is to save as many other butts as you can. The rest, Ma’am, is all crap.” 4

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Fritz receiving medal

Col. Cochrane awards Capt. Winnie Fritz with her second U.S. Army commendation medal in 1970. Photo courtesy Winnie Fritz.

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Fritz spent the next year surviving, saving lives and witnessing the loss of lives. She spent some days in surgical and field hospitals made of galvanized tin and slab concrete, others flying to villages on medical civic action program missions to evacuate and care for military personnel and civilians. During her tour of duty, she witnessed unspeakable horrors that cut to her seemingly unflappable core. “I was prepared for death,” Fritz says. “But I was not prepared for mutilation.”

Toward the end of her tour, Fritz was injured and left Vietnam on a stretcher. While her physical injuries were healing at Water Reed, Fritz often spoke of her emotional injuries. She and countless other infantry soldiers and nurses who had served in Vietnam became research subjects at a Harvard psychophysiology lab in an ongoing study on what would become known as post-traumatic stress disorder (PTSD). Nearly 10,000 miles away she could still picture her dismembered comrades, smell burning flesh and hear the cries of South Vietnamese villagers.

During a trip home to the farm, Fritz’s father cried and commented that she seemed different. “You were always my little girl who cried when a baby pig died. What did they do to you?” he asked.

When her physical injuries healed and she was able to work again, Fritz requested a night shift in the intensive care unit at Water Reed. She didn’t want to talk to anybody about Vietnam.

“I was a very efficient nurse. I could do anything,” Fritz says. “But I had a Plexiglas plate under my skin. We could talk, but I was never going to form a warm relationship with you because I could lose you, and I wasn’t going to go through more loss.”

Fritz participated in the long-term study, benefiting from biofeedback, counseling and learning to form relationships again following her tour in Vietnam. Eventually, emotional healing came, too, and the glass cracked. “I cried easily for three years,” she says. “And that was OK. I learned that feeling and crying is better than not feeling.”

Fritz received a Bronze Star for her work in Vietnam and was promoted to manager of the presidential suite. With a patient population of accomplished national and world leaders, she embarked on her own research project. At the right time, she asked each patient, from Sen. William Proxmire to Gen. Omar Bradley, one question: “If I were to mature into an effective leader, what one lesson about leadership would you want me to learn?” 5

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By the time the king of Jordan came into her care, she had learned from enough presidents, generals and senators to resist backing down. Without hesitating, she directed Hussein to get back in bed. And he was impressed. He had heard enough “Yes, sirs.” 6

During Hussein’s weeklong hospital stay, the two bonded over ham radios (Hussein was a life member of the American Radio Relay League), aviation (Hussein, like Fritz, was a trained pilot) and motorcycles (Hussein collected them).

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Hussein observed that Fritz was not only a competent nurse leader but also a critical thinker. “The health care system in Jordan does not provide care like the care you gave me,” he told her. “I want you to come and make it work like that.”

Fritz was intrigued. “I like those kinds of challenges,” she says. “If somebody says a hospital has issues with clinical quality, is in the red financially and the community doesn’t hold the hospital in high regard, I like that challenge.”

So she agreed to go serve in Jordan’s health care system — but she had some requests of her own first.

Jordan Journey
In 1977, Fritz was working on her master’s degree, courtesy of the GI Bill, at the University of Maryland. Before she moved to Jordan, she wanted to finish her coursework and study five new topics: the Arabic language, Islam, Middle East history and culture, Arabic cooking and Arabic dancing.

“In the military we have this expression: ‘Prior planning prevents piss-poor performance,’ ” Fritz says. “I was going to be alone over there. There were things I needed to do to prepare myself.”

For a year, Fritz spent evenings studying with faculty who usually prepared Foreign Service officers. She spent many evenings at her Arabic instructor’s house speaking the language, cooking dinner with his wife and dancing with his daughter.

Fritz arrived in Jordan in 1978 confident she could make it on her own. Hussein wanted her to immediately begin her work in the Jordan health care system by starting work within the hospitals. But Fritz chose not to tackle the hospitals until she had overhauled the schools that trained the nurses and doctors. And she chose not to do that until she understood the health needs of the Jordanian population, which included about 65,000 Bedouins moving about the desert with their tents and livestock.

Fritz in Jordan

Fritz sits with a Bedouin woman in Jordan. In the late 1970s, Fritz conducted a health assessment of Jordanian Bedouins to understand their health care needs. She used the information to better prevent or reduce major community health problems in Jordan. Photo courtesy Winnie Fritz.

She launched her research, traveling throughout Jordan’s desert to complete a health assessment of the Bedouin families 7, learning they had tuberculosis and hepatitis, as well as a higher than average infant mortality rate.

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Armed with a better idea of the major community health problems and how they could be prevented or reduced, Fritz focused on curriculum development in three nursing schools. She worked to develop faculty, and with them, she set about transforming the students from nurses with technical skills to health care providers with critical-thinking skills. 8

Fritz served three years as the dean of a Jordanian nursing school before she accepted Hussein’s offer to become one of two clinical operations officers of the 28-hospital system. She spent nearly 17 years working in Jordan, leading strategic planning and operations in the hospital system, designing and managing facilities construction and renovations, spearheading clinical quality-improvement work, and writing national legislation.

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Fritz rests in a Black Hawk helicopter with her team after a long day of conducting hospital assessments. On this trip in 1985, she brought along Fakri Malkawi, a photographer, and Mohommed Atta, a hospital administrator.  Photo courtesy Winnie Fritz.

Fritz rests in a Black Hawk helicopter with her team after a long day of conducting hospital assessments. On this trip in 1985, she brought along Fakri Malkawi, a photographer, and Mohommed Atta, a hospital administrator. Photo courtesy Winnie Fritz.

Fritz started each comprehensive assessment of a hosptial with a bird’s-eye view of the situation. She requested a helicopter, a structural engineer, a hospital administrator and a photographer to help her paint a complete picture. Fritz and her team worked from north to south, from 3,000 feet above each hospital to inside every bathroom. She evaluated the perimeter fencing, the emergency entrance and parking. She assessed the water tanks and the roof. She flushed every toilet, cooked in every kitchen and washed a load of linens in every laundry room.

It took months. After she completed her assessment, she presented her findings to Hussein and, to her surprise, his Cabinet. During her assessment, Fritz had discovered one of Hussein’s Cabinet members had diverted money earmarked for a clinic to his family farm. She was prepared to show Hussein that information but wasn’t expecting the Cabinet member to be at the table when she did.

As she revealed her findings, Hussein grew quiet, Fritz says. “He had an expression in his eyebrows when he was moving to anger, and he would become very quiet. We went a full three hours, and he never said a word.”

At the end of the presentation, Hussein dismissed the Cabinet and asked Fritz to follow him and his aide-de-camp into his office. The aide walked over with a padded satin box, and Hussein opened it to reveal his Medal of Honor.

“He put it around my neck and said, ‘Thank you for loving us enough to tell the truth,’ ” Fritz says.

King Hussein bin Talal of Jordan presents Fritz with his Medal of Honor medallion for her work assessing the 28-hospital system.  Photo courtesy Winnie Fritz.

King Hussein bin Talal of Jordan presents Fritz with his Medal of Honor medallion for her work assessing the 28-hospital system. Photo courtesy Winnie Fritz.

Cultivating Change
In 1989, Fritz moved back to the U.S. to be closer to her aging parents.

Since returning to the states, she has devoted herself to improving not only U.S. health care systems, serving as CEO, chief clinical officer or chief nurse in five U.S. hospitals, but also international hospitals and care providers in the United Kingdom, in India, in the Philippines and throughout the Middle East.

In Tucson, Arizona, where she was CEO of Carondelet St. Mary’s Hospital and Holy Cross Hospital, she noticed numerous readmissions of homeless veterans, many from the Vietnam era, who were living beneath bridges. Instead of moving them into shelters, which Fritz knew could be difficult for veterans suffering from PTSD, she thought back to her years providing care to the nomadic Bedouins in Jordan and decided to take the health care to the veterans. She purchased a $36,000 RV, outfitted it with everything needed to provide quality health care, and staffed it with a nurse practitioner and a patient care tech who started making routine rounds to the viaducts.

More important than the health care Fritz provided was the emotional support she extended to the veterans. After returning from Vietnam, Fritz could have easily turned to drugs and alcohol to cope with her PTSD. She could have been a homeless veteran living under a bridge.

“But I knew no matter what that my parents and my brother loved me,” she says. “Many people didn’t have that, including those people under the bridge. My message to them was, ‘I am family, and I want to take care of you. At the hospital, you have someone who is family.’ ”

Ron Marston, CEO of HCCA Management/International, calls Fritz the Energizer Bunny. “She can get on a 17-hour flight, get off and start working,” he says. But what impresses Marston most about Fritz isn’t the way she can persuade an international hospital system president to fund improvements that would help reduce hospital-acquired conditions but how she takes care of the people on the front lines.

“You see how she impacts the people who are not as well off as we are in the U.S., people who are downtrodden,” Marston says. “Some of the nurses we are developing have never used a stethoscope. Some have not been taught how to do head-to-toe assessments. If there is something she can help a nurse with, such as purchase a textbook, she does that at her own expense.” 9

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During an interview for the CEO job at a U.S. hospital, the chief of staff asked Fritz a personal question: “I find you hard to read. You come in early and leave late. You’ve learned all of our names. You’re always in a good mood. We’re waiting for the other shoe to drop. Don’t you ever get angry?”

Fritz let him in on her secret.

“There is this tape that plays in my head at least once a day,” Fritz told him. “Is this as bad as Vietnam? And so far, the answer has always been heck no.” 10

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In October 2014, the Mizzou Alumni Association honored Fritz with a Faculty-Alumni Award. In May 2015, the Sinclair School of Nursing awarded her a citation of merit. Fritz returned to Columbia and spoke with the doctoral students in the nursing school. In these talks, she spoke often of Van Natta, whom she credits with teaching her the critical-thinking skills that carried her from the Vietnam War to today. 11

Now Fritz lives in Surprise, Arizona, where she is the senior vice president of operations and clinical services for HCCA Management. “Yesterday I was working on a project related to a new hospital in Nigeria and a staffing plan for a clinic in Saudi Arabia. I’ll spend the last couple weeks this month at a hospital in Baltimore, Maryland. Another project in Jordan is also on the to-do list.”

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Winnie Fritz portrait

Fritz, BSN ’68, is the senior vice president of operations and clinical services for HCCA Management. The Mizzou Alumni Association honored Fritz with a Faculty-Alumni Award in October 2014. Photo by Rob Hill.

Often people tell Fritz that she’s lucky for all of the experiences she’s had. The first time it happened, it stumped her a little. It was luck that she was born to parents who encouraged her to be a trailblazer. But as for the rest, that wasn’t luck.

Every step along the way — from signing up to be an Army student nurse to taking a job in the Middle East to interviewing to be a CEO — people have told Fritz that she’s out of her mind.

The way Fritz sees it, she was just saying yes. She was asking herself what if. She was going where there was no path and leaving a trail.