Katie Boston-Leary: 5 Things We Must Do To Improve the US Healthcare System
An Interview With Luke Kervin
Leaders — Moral leadership principles must be at the center of how we all lead our teams today. Moral Leadership has been defined as the capacity to exert influence and effect change by leading self, then others towards specific goals, guided by universal moral principles. Values and ethics are what we all have to fall back on during times of uncertainty and volatility. Trust must be rebuilt as it has been broken and eroded over the past few years. Let everyone know your values and live them every day in everything that you do. It’s a tough time to lead but remember, to whom much is given, much is required. Also remember followership is as important as leadership!
As a part of our interview series called “5 Things We Must Do To Improve the US Healthcare System”, I had the pleasure to interview Katie Boston-Leary.
Boston-Leary is the Director of Nursing Programs at the American Nurses Association overseeing the Nursing Practice and Work Environment Division and Healthy Nurse Healthy Nation. She is also the Co-Lead for Project Firstline, a multi-million-dollar grant collaborative with the CDC for training on Infection Prevention and Control. As a Chief Nursing Officer and Senior Executive, Katie has led organizations to obtain numerous accolades for quality and safety including an ANCC Pathway to Excellence designation and to win the coveted annual ANCC Pathway to Excellence award in 2017. Katie also leads a non-profit, The Reach Initiative, LLC, that provides executive coaching to healthcare leaders with a focus on providing pro bono services to BIPOC nurses. She redesigned the Nurse Leadership Institute at the University of Maryland with an embedded coaching program Katie is an Adjunct Professor at the University of Maryland School of Nursing and the School of Nursing at Case Western Reserve University. She is a board member on St. Johns University Health Programs, George Washington University Women in Business Program and an editorial advisory board member with Web/MD Medscape.
She was recently identified August 2019 Health Leaders Journal as “One of Five Chief Nursing Officers Changing Healthcare”. Her most recent research was a qualitative study on nurses’ perceptions of power dynamics in the hospital setting. She is a well-known speaker nationally and internationally with many publications and podcast guest invitations. She completed her PhD at Walden University in Health Services, obtained a dual degree MBA and MHA from the University of Maryland Global Campus and her bachelor’s degree in nursing from Bowie State University in Maryland. She is a board-certified Nurse Executive and obtained a nurse executive leadership certificate from Wharton School of Business at the University of Pennsylvania. She has been interviewed for stories in numerous print, online and televised media outlets namely CNBC, NY Times, Cheddar TV, HR Maximizer and Bloomberg News. She recently co-authored an article titled, The US COVID‐19 Crisis: Facts, Science and Solidarity, which was published in the International Nursing Review (INR), the official journal of the International Council of Nurses (ICN).
Thank you so much for joining us in this interview series! Before we dive into our interview, our readers would like to get to know you a bit. Can you tell us a bit about your backstory and a bit about what brought you to this specific career path?
I had a unconventional start to my nursing career. Let’s just say I thought I would be following in my dad’s footsteps with being an accountant. After graduating high school, giving a cousin a ride to an interview at a local nursing home really was the start of my career in healthcare as a nursing assistant. Then, an opportunity to attend a county sponsored program at a community college was presented to me, I reluctantly went to the information fair on a dare to get a pamphlet for myself and my peers. I had to move to the shortest career line because I was running late to go to work that day and that happened to be the line for the RN program. That’s really how I became a RN and I haven’t looked back since!
Can you share the most interesting story that happened to you since you began your career?
The most interesting story was developing an airport check in approach as part of my innovation project for a leadership program at a hospital that I was working in and it was actually implemented! We trialed an online form process for patients prior to surgery, texting from the operating room and having an electronic status board to provide visual updates to families in the waiting room. It really helped me see how we can take lessons from other industries to make healthcare better! I actually ran into a family member who we trialed the text update option with almost a year later and how much that made a difference for her and her family that day!
Can you share a story about the funniest mistake you made when you were first starting? Can you tell us what lesson you learned from that?
Oh there are so many! And, I am the first to laugh at myself when those moments occur. I remember as an Operating Room nurse, I didn’t know the names of the instruments the surgeon was asking for and I was relegated to the processing room to learn the instruments for a week. It was so painful and humbling! After a week, I asked the tech that was managing the room, how she would grade my work and knowledge improvement, and she replied, “I’ll give you an 8”. I was excited and then said that I was ready to go back into patient care! And then she added, well an 8 out of 50! Quite humbling! I remained there another week and really focused myself to get out of OR purgatory!
Can you please give us your favorite “Life Lesson Quote”? Can you share how that was relevant to you in your life?
I have a new one from Hannah Nicole Brown — you should be ashamed to be the only one that looks like you in any room that you’re in. That should light a fire to correct that issue to pull people up with you.
Are you working on any exciting new projects now?
Well with my work with ANA, we are working aggressively on our strategic plan to address racism in the profession; infection control to pivot from the reactive mode with the pandemic and nursing staffing. As far as my Reach Initiative work, I am constantly connecting nurses of color with free resources to add diversity and address inclusion in the healthcare C-suite. How do you think that will help people? Well back to the mantra, right? Diversity is needed in the nursing profession and then inclusion with more nurses of color feeling welcomed and waived in to join the profession. The diversity numbers in nursing are no where near where they should be so we all have our work cut out for us.
How would you define an “excellent healthcare provider”?
An excellent nurse is a healthy nurse that is physically and psychologically safe, engages in self care regularly, is up to date on evidence based practice and practicing at the top of his or her license with confidence and is constantly in search of opportunities to innovate and improve processes for patients, families and the communities they serve. I guess this can be applied to any healthcare worker.
Ok, thank you for that. Let’s now jump to the main focus of our interview. The COVID-19 pandemic has put intense pressure on the American healthcare system. Some healthcare systems were at a complete loss as to how to handle this crisis. Can you share with our readers a few examples of where we’ve seen the U.S. healthcare system struggle? How do you think we can correct these specific issues moving forward?
Of course the story was not entirely negative. Healthcare professionals were true heroes on the front lines of the crisis. The COVID vaccines are saving millions of lives. Can you share a few ways that our healthcare system really did well? If you can, please share a story or example.
Well nurses and healthcare workers still are heroes but they are worn down, tired, burned out and at a collective breaking point. Our healthcare system has managed 3–4 COVID surges over almost two years and prevented severe afflictions and saved the lives with valor, commitment and innovation. I am so proud of how nurses showed up during adversity and how we heard about nurses selflessly volunteering their time at vaccine clinics after completing their shifts. This was all due to their personal and professional investment in wanting to end this pandemic. Truly admirable!
Here is the primary question of our discussion. As a healthcare leader can you share 5 changes that need to be made to improve the overall US healthcare system? Please share a story or example for each.
I’ll give you 6!
- Improve and invest in the public health system
- Whole in government and private sector response to address the nursing staffing crisis
- Leverage technology using examples from other industries
- Address health equity by improving diversity in nurses and healthcare providers and leadership
- Legislative action to address workplace violence and abuse towards nurses and healthcare workers
- Address mental health in nurses and physicians as a priority
Let’s zoom in on this a bit deeper. How do you think we can address the problem of physician shortages?
How do you think we can address the issue of nurse diversity?
It starts in schools of nursing. Many schools of nursing are predominantly white and there needs to be more diverse faculty and attention to build more programs in inner city high schools for more vocational programs as an entry point to create more opportunities for young people to enter the field of nursing. We also need more diversity in nursing leadership with a concerted effort to build diverse teams as a key performance metric for the organization. Lastly healthcare boards of directors need to be more diverse. Organizations that provide healthcare must build healthcare teams that mimic the diversity of the community they serve.
How do you think we can address the issue of nurse burnout?
First and foremost, address the root causes of burnout. That happens with obtaining insight from nurses and working with nurses in tow to address their pain points. Resiliency training seems to be the rage but it is not a silver bullet. The environments that nurses have to practice within are quite tough and nurses know what can be done to improve processes to reduce steps, streamline work and spend more time doing things that are value-added. Nurses have been the most trusted profession for about 2 decades but they must be respected as well for all that they contribute to the healthcare industry by their organizational leaders, consumers and communities. Burnout and mental health and well-being is a priority and must be addressed at every level.
Individuals — non-nurses must respect all healthcare workers and treat them as such. Own and learn more about the importance of preventative health and wellness to keep them out of the hospital setting. More important than ever during an era of misinformation is to trust your provider and nurses to lead you to make the safe and effective decisions to stay well.
Corporations — Invest, invest invest in nurses. Nurses are the largest workforce in health care and corporations should have realized by now that a thriving economy requires a healthy workforce. Health should not be for the wealthy and it is not solely supported by employment or governmental safety net programs. Corporations can close the gap for everyone to be an engaged healthcare consumer.
Communities — must partner with healthcare organizations in efforts to build wellness programs and address health literacy deficits in the community. Communities can be the link with healthcare organizations to address health disparities and inequities.
Leaders — Moral leadership principles must be at the center of how we all lead our teams today. Moral Leadership has been defined as the capacity to exert influence and effect change by leading self, then others towards specific goals, guided by universal moral principles. Values and ethics are what we all have to fall back on during times of uncertainty and volatility. Trust must be rebuilt as it has been broken and eroded over the past few years. Let everyone know your values and live them every day in everything that you do. It’s a tough time to lead but remember, to whom much is given, much is required. Also remember followership is as important as leadership!
You are a person of great influence. If you could inspire a movement that would bring the most amount of good to the most amount of people, what would that be? You never know what your idea can trigger. :-)
I have to refer to the movement we have been building with Healthy Nurse Healthy Nation! We want nurses to engage in self love which leads to self-care as a priority. We would love to build groups and communities of health with nurses which is a focus on their physical, intellectual, emotional, social, spiritual, financial, personal and professional well-being. Nurses being role models of caring for oneself setting up the nation to follow suit.
How can our readers further follow your work online?
https://www.linkedin.com/in/katiebostonleary/
https://www.healthynursehealthynation.org/
https://www.nursingworld.org/practice-policy/work-environment/violence-incivility-bullying/
Thank you so much for these insights! This was very inspirational, and we wish you continued success in your great work.
