From the moment she entered an associate degree program, Katie Boston-Leary knew she wanted to be an OR nurse. Teamwork, competency, and comradery define the profession and those aspects loudly appealed to her. Along the path of her career, she was fortunate enough to have mentors and supervisors who saw her potential for leadership. Eventually she earned a CNO role where she saw first-hand the racial disparities in leadership positions. This motivated her to become a career coach and actively reach out to BIPOC nurses and create networking opportunities for them explore leadership roles.

How do you define yourself as a perioperative leader?

Being innovative, able to think on my feet, and the ability to process divergent pieces of information in enormous quantities to make key decisions. As a perioperative leader, I feel it’s important to extend myself beyond the patient’s journey in the perioperative setting. It’s standard to call patients on the outpatient side, but I think it’s important to do that on the inpatient side, too. Do a round or give them a call to see how they’re doing. In the OR, it’s quite easy to feel removed because interactions are limited for the circulator, and for the surgical techs, practically non-existent. They’re so busy counting their instruments, they don’t interact. The best thing for everyone in that room is to have a relationship with the patient on the table. I like to create standards for my team that encourages them to see the patient holistically that helps elevate them beyond the body part they’re working on.

Katie Boston-Leary

PhD, MBA, MHA, RN, NEA-BC

Do you have a mantra you live or work by?

I am passionate about people, process, and product. No matter what I do, I keep those three things in sight.

Favorite or current book?

Good to Great by Jim Collins.

Current podcast?

Coaching for Leaders by Dave Stachowiak.

Have you experienced or witnessed any barriers or discrimination in the medical profession? How was it handled? How did it impact you personally and/or professionally?

Yes. Most of the surgeons are male and white. There is not enough diversity in nursing leadership. A huge part of your success as a leader in periop is for surgeons to respect you. You can be the best leader to your nurses and team, hold and manage an excellent budget, and have great relationships with everyone else. But it’s potentially dire if there is tension between a nurse leader and the surgery physician leader. You do find yourself in a constant state of having to prove yourself, especially as a black leader.

What are your concerns about racial disparities in the OR and what would you like to see changed?  

I’ve seen this scenario: Grandma is having surgery and she’s the matriarch of the family. Everyone is coming to the hospital, asking questions. But to the staff, their presence is interpreted as aggressive or having a lack of trust. Another scenario is a young person who is in the OR after having been shot and again, a large group of family and friends are in the waiting room, wanting answers. That elicits this impression of a “gang” being there, so security is called. There tends to be an occasional annoyance from staff or surgeons when the family has questions, particularly regarding something as important as consent. To be fair, this happens across the spectrum with all families because time is a major concern in the OR. But that dynamic occurs much more often with BIPOC families, compared to other group due to implicit biases that exist.

What advice do you have for aspiring perioperative BIPOC leaders?

You need to be confident and build on that constantly. Never feel like you’ve “made it.” Sometimes when you show up as a BIPOC woman in a leadership role, you must jump higher and go faster. It’s what’s required, and it’s hard, but it also gives you staying power. Another thing is to understand the culture of the organization you’re in. Find out where the landmines are, the history of relationships between surgeons and staff. Make yourself accessible and build trust. Know what is happening around you so that you’re not hearing about a problem from the CEO after the fact. This is for any leader, but it’s definitely more intense for BIPOCs. However, as a career coach, one of my goals is to help people understand that if you’re not careful, work can become your entire world. I was lucky in that I had a support system with my family that helped me raise my son, who is a successful dentist now. But I shudder to think of where he would be today as a black male if not for that support.

We have seen that the catastrophic effect of COVID-19 has disproportionately affected BIPOC communities. What can be done in the short-term to best combat this situation? Long-term?

There is a reckoning that must happen in healthcare and within healthcare organizations. For years we’ve talked about social determinants of health, but we’ve never really put that in context of systemic and structural racism. I believe a huge part of addressing these issues, and not just with COVID, is that the workforce in these healthcare institutions need to mimic the communities they serve as much as possible. They need to actively recruit people and not just hope a BIPOC professional walks through their doors. In my experience as a BIPOC CNO, the higher up the ladder you go, the less diversity exists. Organizations need to be inclusive. Diversity is an invitation for people to come to your party and inclusivity is that once they’re there, invite them to dance.

What organizations should current and future BIPOC healthcare professionals be aware of or participate with?

National Black Nurses Association (NBNA) is great. Their leadership is awesome. But also expose yourself to organizations that are outside of healthcare because it helps to round out your knowledge.

How can organizations such as search firms, hiring executives, and administrators contribute to helping promote and grow the professional options for potential BIPOC healthcare professionals?

I think these series of interviews that Whitman Partners is doing is a great first step. Imagery affects people. When I first started in a CNO role, I would encourage people to just call me Katie and my field processing manager said to me, “No, you need to tell people you’re the CNO. You don’t understand how important it is for people to see there is someone of color in that role.” Imagery helps people see, firsthand, what is possible, especially if they’re going through a tough time or feeling discouraged professionally.