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Black Women in Periop Leadership: A Lot of Magic in One Place

February 9, 2023


Black Women in Periop Leadership: A Lot of Magic in One Place

Black women in periop leadership.

It’s no secret that women and minorities are underrepresented in executive leadership in the healthcare industry. For them, the path upward isn’t always straightforward or even clear. It’s a mix of personal ambition, leaders noticing and nurturing potential, and the right fit between leader and organization. 

Perioperative leaders Dr. Katie Boston-Leary, Keeli Stith, and Dr. Edna Gilliam sat for a mini-roundtable to talk about climbing the perioperative leadership ladder as women of color, the importance of mentoring, and how members of the C-suite can ensure those with leadership potential get their shot.  

All three women were guests on our panel, “The Inclusive OR: Roles and Goals for Creating a Diverse Team,” at the 2021 OR Manager Conference and are winners of Whitman Partner’s recognition award, BIPOC Perioperative Leaders to Know

Q: How can healthcare organizations go beyond abstract statements on diversity, equity, inclusion, and belonging (DEIB) and create structures to support solid objectives that can be met?

Gilliam: Many organizations and healthcare teams are still struggling with just being able to have the conversation. They’re still struggling to understand the importance of DEIB work and how it impacts our patients. There is still a lot of work to do before we can even get to the point of implementation.  

Stith: What I see across other health systems is a lot of conversation, resource support, and attention around health equity and health inequity. But I agree with Edna that some steps have been missed [in DEIB work], and healthcare executives, leaders, and boards need to get back on our strategic plans.  

Boston-Leary: Many direct care nurses say they don’t feel that DEIB initiatives have taken hold. There has been an increase in DEIB roles, but there has been limited publication of outcomes that indicate meaningful impact. Some of the focus has waned, and there is starting to be some turnover or elimination of DEIB officer roles in institutions. 

The conversation is shifting to health equity because it’s relatively easy to discuss from an outcomes perspective. We must get to a place where discomfort is equally distributed and addressed. Think about the discomfort POC feel walking into spaces where we’re alone or not well represented. There is this dynamic at play where you’re the only one, and you must carry that weight of managing a conversation that pertains to people of color. That impacts how discussions are advanced. Some charge ahead; others will bite their tongues, given the risk.

Q: Paint a picture for staff nurses of color who want to pursue manager, director, and VP positions? 

Gilliam: Do your research on the organization. As much as they’re interviewing you, you’re interviewing them. Ask questions around DEIB and see what kind of responses you get. Develop a network like the one Keeli, Katie, and I have. We bounce things off each other all the time. When Keeli was going through her interview process, she was reaching out to us and asking, “What kinds of things should I focus on? What kind of things should I talk about?” 

Stith: Nursing leadership is a dying breed. There isn’t a lot of interest in going into management anymore. One reason is the salary difference. Many of our frontline nurses make more than our managers, and many of our traveling nurses make more than our executives. We need to start to be very mindful. If you’re reading this and you’re a nurse leader with influence, and you see a person of color that might have what it takes, pick them out. We need to start recruiting and having intentional conversations with nurses. As a nurse, I used to be afraid to say that I wanted to be a nurse manager. I didn’t want to tell everybody I wanted to be the director. You need to have that confidence to call out what you want. When people start to recognize that this is what you are and what you’re going after, there will always be somebody around that’s going to support you. LinkedIn is a good way to get yourself connected. There is NAHSE (National Association of Health Services Executives) and DNPs of Color. These groups will help to build your networks. 

Boston-Leary: You need to build social capital. Building social capital doesn’t necessarily mean that you must only have people of color in your orbit. It should be diverse in terms of racial makeup and roles. You should have a peer that can be the soundboard you can trust. Then someone in a junior role that you’re mentoring because that nets bi-directional growth and development. You should have a strong relationship with your manager or your boss. Adding a mentor who gives you advice on continuing to move up and spread your influence. Having a coach, paid or unpaid, will continue to help your growth and development. You need to have a sponsor, someone with power and influence in your institution who can speak on your behalf and offer your name when you’re not in the room. 

Finally, have a loving critic. This is a term I stumbled on, and the key here is to have someone in your corner that will always tell you like it is. One example is Oprah. Her loving critic is Gail. You would see them on videos getting ready for award shows, and Gail would tell her, “Please put some lotion on your elbows.” She can say that, but someone in a different position might not feel empowered to speak up. So, we need someone to tell us we need lotion on our elbows, we have food in our teeth, or even tell us if we did not present ourselves well. When we think we’re the best thing since sliced bread, we need someone in our orbit that can give it to us straight. It keeps us grounded.

Q: How can people of color prepare themselves for C-suite/executive positions?

Stith: It’s 80% relationships and 20% work. Edna and I pride ourselves on being able to walk into a room and talk to anybody. If you can talk to frontline staff, non-nursing staff, and non-nursing leaders and have influence, that is key to taking on an executive or a C-Suite role. You need to be able to connect with everybody. Work on your relationship skills, your communication skills, and your brand. What do you stand for? My brand is that I love to talk to anybody about diversity, equity, inclusion, and belonging. I love to talk about nursing mentorship. When you know what you stand for, you can start to find how you can lead and influence the things that you value and care for, which will propel you to that success.  

Gilliam: Going back to Keeli’s earlier point, say what you want. If you want to be a CNO, you need to say that. Another issue is to address impostor syndrome, right? Because you have to see yourself there. So often, that impostor syndrome sinks in, and you’re just like, I can’t do that. 

But why can’t you? Or, why me? Well, why not me? We need to address that in ourselves. 

Dr. Boston Leary referred us to the AMN Healthcare CNO Academy. This program had like-minded individuals, and some were CNOs. So, if your journey is to move up the ranks, surround yourself with like-minded people and find programs like that. Find out what it’s like directly from a CNO, CEO, or COO.  

Q: What does mentoring look like coming from someone in the C-suite?

Boston-Leary: We need more of that. That’s where that sponsorship piece comes in. People in the C-suite are very influential, right? They control the purse strings. They develop strategic plans and approve projects. Individuals in those positions must look for potential in people. Call on leaders to take on some of these projects that are more organizational and broader in terms of impact. That’s how you help others grow, and when the opportunities do come for them to be in C-suite roles, you’ve seen what they can do at a broader level. 

Gilliam: I had a lot of discussions with my former CNO about my path and what I was interested in. Because perioperative services is very specialized, I was concerned about being pigeonholed. She suggested we talk about other things I am interested in and how I could get involved in those projects. I appreciated that because it allowed me to see the world outside of perioperative services. She was very supportive of my attending the CNO Academy, and the organization provided the resources for me to do that. If you see someone with potential, you need to tap them on the shoulder and have discussions. Support them through their journey.  

Stith: The subject of my thesis draws on my personal experience in nursing and wanting to be a leader but not having an ally or a nursing leader to take me under their wing. There is not much literature about black and brown mentorship programs for nurses trying to advance their careers. My goal is to get that published. Being in a healthcare executive position now, I can influence that and hopefully hardwire that into the healthcare system I’m in.  

When you look around the room, at conferences, at workshops, there is a lack of presence of people of color. Let’s just call it out. We need to meet and match what our community at large looks like. Our communities, neighborhoods, and suburban families are becoming more diverse. That influence needs to come from both the frontline and the executive level to help direct initiatives, change, and drive innovation with a diverse lens in mind. So, for me, those pillars are mentoring, seeing potential in people who may not have opportunities, and then making sure we match what our communities are like.  

Q: Are there any yellow alerts that signal moving up to CEO, COO or CNO may not be a good move?

Boston-Leary: That’s hard to say because that may be your only internal shot. When your number is called to step up, it’s hard to say no. When I took my first CNO job, I was given the opportunity to be an interim. I had no idea what I was getting into, but I felt a sense of duty to take it and help keep the organization in a steady state. 

Ask yourself: do you have the capacity to take on such a responsibility? Your personal life will significantly change. Meetings will be earlier and later in the day. When I went to church on Sundays, I would sit at the end of the pew so that I’m not disrupting people if I had to step out when my phone went off. I found that I was constantly checking my phone. Which isn’t a good thing, right? But sometimes, that is what those jobs require.  

The only time I’ll say not explore it is if it will upend your personal life. That is your center. But otherwise, pursue it if you think it will help you grow, learn, and succeed. Find out what your resources are that will help you in the role. Be clear about your priorities, and make sure everything is mutually agreed upon. This is important because when you’re approached for a role like this, especially when you’re a person of color, you’re the lifeline. You want to go into this with your eyes wide open. Make sure expectations are clear and achievable. Talking about what can be achieved in smaller increments versus key results is tremendous. 

Katie Boston-Leary, PhD, MBA, MHA, RN, NEA-BC, CCTP is the director of nursing programs at the American Nurses Association and an adjunct professor at the University of Maryland School of Nursing in Baltimore. 

Keeli Stith, MSN, RN, PHC-NP, NEA-BC, is the Senior Director of Operations at Dublin Methodist and Grady Memorial Hospitals at Ohio Health. She is a DNP candidate at The Ohio State University.  

Edna Gilliam, DNP, MBA, RN, CNOR, is the Assistant Vice President of Perioperative Services and SPD at Nemours Children’s Health. 

For more information about AMN Healthcare’s CNO Academy, email 

Book Recs from Keeli:

I’m Not Yelling: A Black Woman’s Guide to Navigating the Workplace by Elizabeth Leiba 

Inclusion on Purpose: An Intersectional Approach to Creating a Culture of Belonging at Work by Ruchika Tulshyan