For the last two years, Shawana S. Moore, DNP, APRN, WHNP-BC, PNAP, FAAN, who works as the Interim MSN and DNP Program Director at Emory University’s Nell Hodgson Woodruff School of Nursing, has served as the first African American President of the National Association of Nurse Practitioners in Women’s Health (NPWH).
Minority Nurse asked Moore to reflect upon what she’s accomplished, what she’s proud of, and what still needs to be done. What follows is our interview, edited for length and clarity.
What was it like for you to be the first Black/AA President NPWH? Do you think you gave more of a voice to minorities?
I am honored to share my experience as the first African-American President of the National Association of Nurse Practitioners in Women’s Health. Serving in this role has been a tremendous privilege and a humbling experience.
When I first took office, I recognized the significance of being a trailblazer and the responsibility that came with it. Being a representative for my community and advocating for the needs and concerns of women’s health nurse practitioners across the nation has been challenging and rewarding.
Throughout my tenure, I have worked tirelessly to advance our organization’s goals and mission, ensuring that women and gender-related health remain at the forefront of healthcare discussions. I have championed initiatives that focus on equitable access to healthcare, particularly for underserved populations.
As the first Black President, I have prioritized diversity, inclusion, and equity within our organization. I believe that embracing our differences can foster a stronger and more inclusive community of nurse practitioners in women’s health. I have actively encouraged mentorship and professional development opportunities for underrepresented individuals, enabling them to thrive and excel in their careers.
In addition to these efforts, I have collaborated with other professional organizations to advocate for legislation that supports women’s health. Guided by evidence-based practice and the expertise of our members, we have successfully influenced key decisions that ultimately improve the quality of care for women across the country.
I am grateful for the support and encouragement from my colleagues, mentors, and the broader healthcare community. Together, we have made significant strides in advancing women’s health and breaking down barriers that hinder access to care.
During my tenure as the President of the National Association of Nurse Practitioners in Women’s Health, I prioritized amplifying the voices of minorities within our organization. Recognizing the importance of representation and inclusivity, I implemented several initiatives to ensure that the unique perspectives and needs of minority healthcare professionals were heard and addressed.
First, I was the Co-Chair of the inaugural committee focused on enhancing inclusivity, diversity, and equity within our association. This committee comprised representatives from various minority groups, creating a platform for open dialogue and collaboration. Through this committee, we developed strategies and initiatives to foster a more inclusive and equitable environment for all members.
Additionally, I actively sought out opportunities to engage with minority nurse practitioners and healthcare professionals by attending conferences, workshops, and events specifically tailored to their needs and interests. By actively participating in these forums, I showcased the importance of diversity within our field and provided a platform for minority voices to be uplifted and celebrated.
Moreover, I facilitated educational workshops and seminars that addressed the unique healthcare challenges faced by minority populations. By focusing on cultural competence, implicit bias, and health disparities, I equipped our members with the knowledge and tools to deliver equitable care to all women, regardless of their background or ethnicity.
Finally, I prioritized recruiting and retaining diverse nurse practitioners by meeting with WHNP students nationwide and reinvigorating our mentorship and scholarship programs. These initiatives aimed to provide support and resources to aspiring minority healthcare professionals, ensuring their success and advancement within the field of Women’s Health.
Through these efforts, I am proud to say that I made a difference in amplifying the voices of minorities within the National Association of Nurse Practitioners in Women’s Health. By fostering an inclusive and diverse environment, we not only enriched the experiences of our members but also enhanced the quality and equity of care provided to women nationwide.
How long was your term? Once it ended on December 31, 2023, how will continue to be involved in the organization?
While my time as the first Black/AA President ended, my commitment to advocating for women’s and gender-related health and promoting inclusivity, diversity, and equity in healthcare will continue. I hope my tenure has paved the way for future leaders who will further advance the field and ensure equitable and comprehensive care for all women.
The organization has developed the President’s Circle to maintain the active involvement of Past Presidents. I will actively participate in the forum. Additionally, I will support the organization in developing a maternal health series, an environmental health series, and other projects.
It has been an honor to serve as the first Black/AA President of the National Association of Nurse Practitioners in Women’s Health, and I look forward to witnessing our organization’s continued growth and progress in the years to come.
Please tell us what you believe are the most important goals you accomplished while in your role as President. How did these actions help improve the lives of nurse practitioners?
As President of the National Association of Nurse Practitioners in Women’s Health, I am proud to have accomplished several important goals that have impacted our organization.
One of the most significant achievements was ensuring equity was woven throughout our organization. Recognizing the importance of equity, I spearheaded the revisions and updates of our bylaws with a lens of equity. This initiative proved invaluable in fostering inclusivity, diversity, career advancement, skill development, and networking opportunities for our members, staff, and Board of Directors.
Another crucial goal I accomplished was expanding educational resources and professional development opportunities. Establishing partnerships with renowned institutions and experts in women’s health resulted in a wide variety of high-quality educational materials, webinars, and conferences. These resources enhanced our members’ knowledge and skills and served as a platform for sharing cutting-edge research and advancing best practices in the field.
Furthermore, I prioritized advocacy efforts to ensure policies that promote equitable maternal and reproductive healthcare for women and gender-related populations. I collaborated with local, state, and national stakeholders to advocate for changes that positively impacted our profession and the patients we serve. Through strategic initiatives, we raised awareness about women’s health issues and influenced policies that address disparities and improve healthcare outcomes.
Lastly, I focused on strengthening the sense of community and engagement among our members. Implementing time to meet with the president of the academic WHNP program across the country, I facilitated in-person and virtual listening sessions. These initiatives fostered collaboration, shared experiences, and supportive connections among our diverse membership.
My tenure as president of the National Association of Nurse Practitioners in Women’s Health was marked by significant equity, education, advocacy, and community-building achievements. I am incredibly proud of the strides we have made in advancing women’s health and ensuring the well-being of patients nationwide.
What kind of feedback did you receive while in this position?
My feedback from members and stakeholders has been overwhelmingly positive and encouraging. Many expressed gratitude for my leadership, emphasizing the significance of representation and inclusivity in our organization. The feedback highlighted the impact of my efforts in promoting diversity, equity, and inclusivity within the association and the broader healthcare community.
This feedback has served as both validation and motivation, reinforcing the importance of our work and inspiring future initiatives aimed at promoting diversity and advancing healthcare for all women.
What are you most proud to have accomplished?
One of my proudest accomplishments was spearheading the update of our organization’s bylaws with a lens of equity at the center. It was vital to me that all members, regardless of their background or identity, felt equally represented and supported within our association.
What more work do you think needs to be done? Why?
Significant work remains. While progress has been made, issues of diversity, equity, and inclusion within the organization and the broader healthcare landscape must continue to be addressed.
Specifically, efforts must be made to increase further representation of underrepresented minority groups in leadership positions and decision-making processes. This can be achieved by implementing inclusive recruitment and retention strategies, mentoring programs, and creating opportunities for professional development to foster a diverse and inclusive membership.
Ongoing advocacy is needed to address healthcare disparities, particularly those disproportionately impacting marginalized communities. This may involve collaborating with other organizations and stakeholders to promote policies and initiatives that promote equitable access and quality care for all women.
While progress has been made during my tenure as the first Black President, there is still more work to be done to ensure true equity and inclusivity within the National Association of Nurse Practitioners in Women’s Health and the healthcare field.
What were your biggest challenges?
Throughout my tenure, I faced several challenges. However, my biggest challenge was breaking through existing barriers and overcoming deep-rooted biases within the healthcare industry.
Structural inequalities and unconscious biases presented obstacles that required persistent efforts to raise awareness, educate, and enact meaningful change.
Despite these challenges, I remained resolute in advocating for inclusivity, equity, and fairness in the field, ensuring that the voices and experiences of all nurse practitioners, especially those from underrepresented backgrounds, were heard and valued.
What were your most significant rewards?
Serving as the first Black President of the National Association of Nurse Practitioners in Women’s Health has been an incredibly rewarding experience, both personally and professionally. This milestone’s significance cannot be understated, as it represents a step forward in promoting diversity, inclusion, and equity within our field.
Being in this role has allowed me to uplift and amplify the voices and contributions of Black nurse practitioners, as well as other underrepresented minority groups. By actively advocating for their needs and concerns, we have fostered a more inclusive and supportive environment for all members.
Furthermore, the opportunity to connect with and learn from fellow nurse practitioners across the country has been invaluable. Together, we have collaborated on initiatives to improve healthcare outcomes for women, particularly those facing racial disparities and inequities.
Witnessing the positive impact of our collective efforts and the growth and success of our members has been the greatest reward of all. This experience has reinforced my commitment to breaking barriers, inspiring future leaders, and promoting inclusivity, diversity, and equity in healthcare for the betterment of all women.
Robin Geiger, DNP, MSN, APRN, NP-C, FNP-BC, NEA-BC, is an accomplished, results-driven, board-certified nurse executive with over 20 years of hands-on clinical leadership experience. Dr. Geiger’s professional focus is on health equity and clinician advocacy. Through the ACT (Advocacy, Career, Tools) program for all clinicians within the Ingenovis Health brands, Dr. Geiger aims to increase resilience for healthcare providers, improve quality care, and create solid support systems. With a long-standing history of assembling impactful and forward-thinking teams emphasizing improving healthcare quality and increasing patient safety, Dr. Geiger’s vast experience includes accreditation and developing policies to support foundational programs through assessment and data analysis.
She previously served as associate dean of academic affairs for the National University School of Health Professions and focused on strategic planning, clinical program development, and academic operations.
Dr. Geiger is an important nursing leader, and Minority Nurse is pleased to profile her as part of the Champions of Nursing Diversity Series. The series highlights healthcare leaders who are prominent figures in their organizations and are making transformational impacts in nursing.
Meet Dr. Robin Geiger, senior vice president of clinician advocacy of Ingenovis Health.
Talk about your role in nursing.
As senior vice president of clinician advocacy for Ingenovis Health, I’m pleased to lead our ACT program, which is focused on clinician well-being, resilience, and support. I hold board certification as a nurse executive advanced (NEA-BC) and chair our Chief Nurse Advisory Board, an interdisciplinary advisory group focused on creating solutions for current frontline clinician challenges.
I support the nursing community as much as possible. I serve as an editor-in-chief for a medical publishing company, focusing on nurse practitioner certification and nursing ethics. I also remain current in clinical experience as a board-certified family nurse practitioner (FNP) and cofounder of an NP-owned concierge practice in North Florida.
How long have you worked in the nursing field?
I’m surprised to say that I have been working in this field for more than 23 years!
Why did you become a nurse?
My interest in nursing peaked at an early age. I would hear stories about my grandmother, who was a nurse midwife, stories of how she helped others heal, and stories of the need that would always exist for people to receive healthcare. I would stare at her nursing picture, in which she wore a white dress and cap. She was my earliest influence in nursing; she looked like me and was someone I could relate to.
I started with the goal of becoming a certified nursing assistant (CNA). I wanted to handle the humble and respectful connection of bedside care. I immediately loved it! It was important to me to be there for some nursing home patients with little to no family and support them in accomplishing daily tasks. I knew I could grow in nursing and pushed myself to do more.
What are the most important attributes of today’s nursing leaders?
Today’s critical attributes for nurse leaders should incorporate an empathetic, resourceful, and advocacy approach. Considering the social climate when engaging new and existing nurses is essential. External factors to keep in the forefront include mental health and bandwidth, which stem from work-life balance, something I like to refer to as a “work-life blend” when assigning and delivering care and being supportive means including flexible options for staffing that align with a nurse’s history and respect for years of service, as well as physical, social, and emotional support.
What does being a nursing leader mean to you, and what are you most proud of?
Being a nurse leader means factoring in previous personal experiences of my own and those around me. An excellent example would be the formation of Ingenovis Health’s interdisciplinary Chief Nurse Advisory Board (CNAB). Solid decisions involve a multidisciplinary approach to healthcare strategy and design. Multidisciplinary teams provide a more global lens of how decisions impact all, from the social worker to the clinician and all the people who serve the patient.
I am proud to give back to the community by cofounding a concierge health clinic for the under-served population, creating MSN and DNP programs that consider the working nurse, and developing a clinician well-being program to encourage improved work-life blend and foster resilience – the ACT program.
Tell us about your career path and how you ascended to that role.
I’ve touched almost every area of nursing through lived experience, either as faculty, clinician, or leader. My life in nursing began first as an intensive care unit (ICU) nurse, followed by staffing various ICUs, ER, and OR at a level-one trauma hospital. I became a family nurse practitioner in multiple areas, including as an RN, first assisting in plastics, orthopedics, and general surgery. I have always mentored nurses along the way, and opportunities to serve as lead faculty, director, and associate dean in academia provided me ample opportunity to do so. I received my most impactful leadership training at the Veterans Health Administration. My career has included national leadership roles as VP of clinical care at a non-profit organization and later as co-owner/ CEO of a concierge clinic. My current role as senior vice president of clinician advocacy for Ingenovis Health allows me to combine my previous experience to support all clinicians – I enjoy what I do!
What is the most significant challenge facing nursing today?
Recognizing the importance of self-care is always challenging for nurses. I’m also guilty of this from time to time. Nurses are natural givers, and we often neglect the importance of reflecting on challenges, trauma, and the losses we experience. We provide our best care when we reflect on our experiences and learn from them. Covid was challenging, but we didn’t experience initial trauma and burnout with the pandemic. Nurses are strong – we have constantly been challenged. I’m glad we are now focusing on better health for the nurse, something we have needed for quite some time.
As a nursing leader, how are you working to overcome this challenge?
I’m working daily to be an example of incorporating self-care and eliminating stress. Ingenovis Health supports the ability to grow support and enhance the lives of frontline clinicians through the ACT program. I’m proud to lead this program, which is focused on providing a voice of advocacy, career pathing/ support, and tools to foster better mental and physical health. I think of the program as an ongoing conditioning and strengthening program to ensure our clinicians are prepared to lend their best selves to caring in various areas within healthcare.
What nursing leader inspires you the most and why?
Dr. Hollier is one of the many nursing leaders that inspires me. I found her certification guidelines and manuals amazingly insightful and well-written from a practical point of view. She inspires my entrepreneurial spirit to create better ways of accomplishing milestones and mentoring others to greatness.
What inspirational message would you like to share with the next generation of nurses?
We are all capable of more. You’ll receive a new challenge when you think you’re comfortable and have it figured out. Grow from each challenge by adding it to your toolbox. You’ll soon have a nice box of tools/experiences to reach for and share with other nurses.
Allowing yourself to grow through mentorship will open ideas and create lifelong connections you didn’t know you needed. Participate in shared governance and nursing associations to strengthen the profession and lend your voice and support.
Finally, consider that one day, we will all become patients. You are influencing the future care for your family and yourself. Thinking this way is powerful; this forward-thinking always leads to positive and motivating actions.
Is there anything else you’d like to share with our readers?
There’s a personal quote I often use, “Everything revolves around the need to receive and deliver education.” This doesn’t apply to academia as it might seem but to life in general. Nurses are lifelong learners. We don’t teach emotional and social learning in every education program, but to continue shaping this profession, we must learn how and when to share our stories to inspire others. Editors Note: This month, Minority Nurse proudly shines a spotlight on the significance of DEI in nursing and honors the remarkable Champions of Nursing Diversity. These individuals are not just leaders but beacons of inspiration, guiding us toward a more diverse and inclusive future in healthcare. In 2023, we introduced the Champion of Diversity series, showcasing healthcare leaders driving positive change within their organizations and the nursing profession. In this edition, we applaud the top three profiles from this series. Nursing Diversity Champions embody a steadfast dedication to diversity and inclusion within accredited nursing programs and healthcare facilities throughout the United States. We commend their tireless efforts and unwavering commitment to these vital initiatives. Moving forward, we must not just prioritize, but champion DEI in nursing. This is not merely a call to action but a shared responsibility, a commitment to shape a more equitable and compassionate healthcare system for all. Let us not become complacent, but rather, let us be the catalysts for change.
Elaina Hall, DNP(c), MSN, RN, MBA, NEA-BC, FACHE, is the chief quality officer of SnapCare, formerly SnapNurse, and an experienced healthcare executive in the areas of healthcare system operations, performance improvement, nursing practice, and leadership consulting. Hall’s passion is consistently delivering the ‘best and brightest’ for SnapCare clients. With a focus on opportunities for the clinician corps working with SnapCare, Hall has expertise in health system quality improvement and supporting clinicians in their journey to reskill and upskill for professional growth.
Hall graduated from Clemson University and extended her education in nursing, earning an MBA and MSN. She is currently pursuing her DNP. She also leads the Ventura/Santa Barbara Chapter of the Association of California Nurse Leaders. She is a Board-Certified Advanced Nurse Executive by the ANCC and an American College of Healthcare Executives Fellow.
Hall’s significant contributions to the nursing field have been recognized in the prestigious Champions of Nursing Diversity Series 2024. This series is a platform that showcases healthcare leaders who are prominent figures in their organizations and are making substantial changes in the nursing field. Hall’s inclusion in this series is a testament to her impactful work and her status as a leader in promoting diversity and inclusion in nursing.
Meet Elaina Hall, DNP(c), MSN, RN, MBA, NEA-BC, FACHE, the chief quality officer of SnapCare.
Talk about your role in nursing.
As the Chief Quality Officer at SnapCare, I play a crucial role in driving performance improvement initiatives to optimize the efficiency and effectiveness of our staffing and workforce management processes. This involves analyzing data, identifying opportunities for improvement, and collaborating with cross-functional teams to implement solutions that enhance the overall quality of our services. In addition to clinical quality, I am also tasked with ensuring that SnapCare complies with all regulatory requirements and accreditation standards
How long have you worked in the nursing field?
26 years.
Why did you become a nurse?
I became a nurse because of my passion for caring for people and my deep-seated empathy for those in need. From a young age, I found fulfillment in providing comfort and support to others during times of vulnerability. Nursing allowed me to turn this passion into a meaningful career where I could make a positive difference in people’s lives every day.
Furthermore, as an advocate for diversity in healthcare, I recognized the importance of ensuring that all individuals receive equitable and compassionate care regardless of their background. Nursing allows me to advocate for inclusivity and cultural competence in healthcare delivery, ensuring that every patient is treated with dignity and respect, regardless of race, ethnicity, gender identity, or socioeconomic status.
In essence, becoming a nurse was not just a career choice for me but a calling driven by a desire to care for others, empathize with their struggles, and champion diversity and inclusivity in healthcare. It is a privilege to serve as a nurse, and I am committed to upholding the values of compassion, empathy, and advocacy throughout my nursing career.
What are the most important attributes of today’s nursing leaders?
Visionary and innovative thinking to navigate the evolving healthcare landscape.
Strong communication and collaboration skills to foster teamwork and interdisciplinary approaches.
Emotional intelligence and empathy to support both patients and staff members.
Adaptability and resilience in the face of challenges.
Commitment to continuous learning and professional development.
Advocacy for patient-centered care and healthcare equity.
Tell us about your career path and how you ascended to that role.
Before obtaining my nursing degree, I began my journey in healthcare as a certified nursing assistant and patient care technician. These early roles provided me with invaluable experience in direct patient care and laid the groundwork for my future in nursing.
After earning my nursing degree, I embarked on a career as a bedside nurse, specializing in challenging areas such as Burn, trauma, ICU, and ED. I thrived in these high-intensity environments, gaining expertise and honing my skills while providing critical care to patients in need.
Throughout my career, I embraced opportunities for growth and development, working in various departments and even joining the float pool to broaden my experience. This flexibility and willingness to adapt allowed me to excel in different clinical settings and expand my knowledge base.
In 2006, I took a significant step forward by transitioning into my first manager role. This marked the beginning of my leadership journey, where I was entrusted with overseeing operations and guiding my team to deliver exceptional patient care. I embraced the challenge, using my clinical expertise and communication skills to drive positive outcomes and foster a collaborative work environment.
As the years passed, I continued to take on progressively complex roles within healthcare organizations, moving from community hospitals to academic health systems. Each new role presented its own challenges and opportunities for growth, and I approached them with determination and a commitment to excellence.
Today, I am proud to serve as the Chief Quality Officer of SnapCare, an AI-enabled workforce marketplace that serves the entire continuum of care. I can make a meaningful impact on healthcare delivery and champion a culture of continuous improvement.
My career path has been filled with challenges and triumphs, but through it all, I have remained dedicated to providing the best possible care to those in need. Reflecting on my journey, I am grateful for the experiences that have shaped me into the nursing leader I am today.
What is the most significant challenge facing nursing today?
One of the most significant challenges facing nursing today is the ongoing shortage of nurses, exacerbated by factors such as an aging population, increased demand for healthcare services, and burnout among healthcare professionals.
As a nursing leader, how are you working to overcome this challenge?
As a nursing leader, I am acutely aware of the significant challenges posed by the ongoing shortage of nurses, compounded by factors such as an aging population, increased demand for healthcare services, and burnout among healthcare professionals. Recognizing the critical need to address these challenges, I have been actively involved in implementing a clinician reskilling program to mitigate the effects of the nursing shortage and promote sustainability within our healthcare system.
The clinician reskilling program empowers healthcare professionals, including nurses, to expand their skill sets and take on new roles that align with emerging healthcare needs. By providing training and resources for upskilling and reskilling, we aim to optimize the utilization of existing clinical talent and alleviate some of the pressure caused by the nursing shortage.
Through this program, we offer opportunities for nurses to acquire additional certifications, pursue advanced training in specialized areas, and transition into roles that complement their existing skill sets. This helps address staffing shortages in critical areas and enhances the overall quality of patient care by ensuring that healthcare professionals are equipped with the necessary skills and expertise to meet evolving patient needs.
What nursing leader inspires you the most and why?
Beverly Malone, Ph. D., inspires me the most and stands as a beacon of inspiration in nursing leadership. As the CEO of the National League for Nursing and a former president of the American Nurses Association, Dr. Malone has dedicated her career to advocating for nurses and ensuring culturally competent care for diverse patient populations.
Her impact extends beyond the borders of the United States. As the first Black general secretary of the Royal College of Nursing in the United Kingdom, she broke barriers and paved the way for diversity and inclusion within the profession. Her global achievements include representing the U.K. delegation at the World Health Assembly, where she advocated for nursing and healthcare on an international platform.
Dr. Malone’s dedication, innovation, and unwavering commitment to advancing the nursing profession inspire nurses worldwide. Her tireless advocacy for equitable and compassionate care has left an indelible mark on the healthcare landscape, and her legacy will continue to inspire future generations of nurses to strive for excellence in their practice.
What inspirational message would you like to share with the next generation of nurses?
You are the heart and soul of healthcare, the guardians of healing, and the champions of hope. Embrace the privilege and responsibility of caring for others with humility and empathy. Your journey will be filled with moments of joy, challenges, and triumphs. Stay true to your values, never stop learning, and remember that every interaction is an opportunity to make a difference. Your passion and dedication will transform lives and leave a lasting legacy. Dream big, work hard, and always believe in the power of nursing to change the world!
Lauren Underwood, former Public Health Advisor for President Obama and current Congresswoman from Illinois’s 14th congressional district, is featured on Springer Publishing’s new health care podcast series, Conversations About Health Care Delivery in the United States. Underwood has gone from congressional candidate to congresswoman. To get you all caught up and ready for her guest appearance, this story is a repost of her interview with Minority Nurse from 2018.
Last issue’s health policy column highlighted nursing’s increased engagement in the public policy arena. To continue this conversation, this column highlights a registered nurse running for Congress to help champion access to affordable health care. Yes, Lauren Underwood, MSN/MPH, RN, of Naperville, Illinois is running for Congress to represent the 14th Congressional District of Illinois.
Underwood’s Journey to Pursuing an Elected Position
Underwood is steadfast and fiercely committed to helping shape policies and programs focused on ensuring that everyone has access to affordable health care. She is a registered nurse who received her BSN from the University of Michigan and her MSN/MPH from Johns Hopkins University. Her nursing experiences include service as a health policy advisor, research fellow, senior director, and research nurse at the National Institutes of Health Clinical Center. Her passion for public policy was heightened while serving as a health policy advisor in the Office of the Secretary at the Health and Human Services in Washington, DC initially under the leadership of Secretary Kathleen Sebelius followed by the leadership of Secretary Sylvia Burwell. In this capacity, Underwood worked on private insurance reform, summary of insurance benefits, health care quality in the Medicare program, the Agency for Health care Research and Quality, and preventive services (free screenings, immunizations, and contraceptive coverage) for four and a half years from 2010-2014.
Lauren Underwood, MSN/MPH, RN
Democratic Candidate for Congress, 14th Congressional District of Illinois
Tell us about working for the Obama administration.
Got a call the week that Mr. [Thomas Eric] Duncan was in the hospital in Dallas with Ebola asking if I would be willing to join the President’s team to help with disaster response, so I transferred over to ASPR, the Assistant Secretary for Preparedness and Response, at HHS. We worked on emerging infectious diseases (e.g., Ebola, Zika Virus, Middle East Respiratory Syndrome virus, or MERS), we also did national disasters (e.g., wildfires, hurricanes, floods) and then bioterror (small pox, anthrax) and worked with drug companies to develop vaccines, treatments, and diagnostics. I stayed in the administration until the very end, the last day. And so, when the election happened in 2016 we were working on the water crisis in Flint. I was surprised, and I thought that Hillary Clinton’s team was going to win and that we were going to hand off our work on health reform and on Flint to people who cared and wanted to continue the process. And then we got the Trump team who made it very clear they wanted to do away with health care coverage. And that’s not why I went into nursing or why I did this work. So, I knew I could stay in government and help them do that. I wanted to continue the work and so I came back home to Illinois because Illinois is a state that expanded Medicaid. I got a job working for a Medicaid managed care company in Chicago as the Senior Director for Strategy and Regulatory Affairs for a company called Next Level Health.
Are you still there?
I left my job about six weeks ago. The primary campaign was about eight months. I worked full time six and a half months; you know you have to do that. I am a young person, not someone of particular means or whatever, so it was necessary. And then it was like “Lauren, you could really win if you put your time and energy into the campaign.” And so that was an easy choice to transfer to full time.
So, you are now devoting full time to the campaign?
Yes.
This reflects your journey. Describe in a few words what really made you run for an elected position.
I am going to tell you a story. Last spring when I returned home, I went to congressman Randy Hultgren’s one and only public event. It was a moderated event hosted by the League of Women Voters. And during that evening, he made a promise and said that he was only going to support a version of Obamacare repeal that allowed people with preexisting conditions to keep their coverage. That’s important to me as a nurse. I also know how critical it is for people with chronic illness to have access to medications and procedures that they need. Obviously, I worked to implement the Affordable Care Act so I read the law and I know that it works. I know that we can fix what does not work. We do not have to throw the whole thing away. Like so many Americans, I have a preexisting condition myself. I have a heart condition, SVT (supraventricular tachycardia), and it is well controlled. As you know, it is a preexisting condition, so I would not be able to get coverage under these repeal scenarios. And so, when the congressman made that promise I believed him.
And then a week to ten days later he went and voted for the American Health Care Act, which is a version of repeal that did the opposite. It made it cost prohibitive for people like me to get coverage. And so, I was upset not at the vote itself, but because he did not have the integrity to be honest the one time he stood before our community. That’s not what a representative is supposed to do. A representative is supposed to be transparent, accessible, and honest. And we deserve better. I said, “you know what, it’s on! I’m running” and launched my campaign in August and just won the primary on March 20th. I was in a field of seven—the only woman running against six men—and I won 57% of the vote.
Were you the only African American?
Yes.
I know you are concerned about overall access to care and have a deep commitment to utilizing your expertise and experience while working in the Obama administration.
I believe that health care is the number one issue in this election across the country and in our district, and we need a solution to make health care more affordable for American families. It is not enough for families to rake together money for their premiums and have an insurance card in their pockets and cannot afford the coverage.
I believe that a lot of the conversation in the last several years has been political in nature and undoing President Obama’s legacy and not on at all focused on trying to lower costs and make health care accessible for American families. That’s my objective! I want to work on drug prices. I want to work on this opioid drug crisis so that loved ones can get the treatment that they so desperately need. And so, I believe there is a lot of value in having a nurse at the negotiation tables when we are making these decisions and passing policies that will transform our health care system. I am excited about the opportunity to be a leading voice on Capitol Hill on these important issues.
What do you think are the most pressing issues impacting nursing and health care?
Affordability. Any program that is starved of resources will fail. The ACA has been intentionally sabotaged and as a result, we see extraordinary high premiums that are unaffordable for most families. That is not how the program was designed to work and so I think there are technical fixes we can do to make the program more affordable. We can do things like negotiate drug prices, it can be done, we need to take a strong position on this opioid drug addiction crisis. We need to implement reforms like how we pay for rehab and how we award funds to municipalities in order to create a pathway for lasting change. And then there are opportunities to expand coverage so we will have fewer uninsured Americans. What we are seeing now in order to resuscitate it takes 2-3 doses of Narcan because the drugs are so strong. Municipalities who have received Narcan grants are running out of Narcan. A Narcan only solution is not a solution. Law enforcement only solution is not a solution. Addiction is an illness and we need to treat it as such. We need to send people to treatment so they can have a shot at recovery. We could have an evidence-based policy solution. We know treatment can be effective.
What do you think is the most pressing issue affecting nursing today?
I think there are a few things. The high cost of our education. We have not really seen increases in funding. What we have seen are marginal increases or flat funding. I think that this is unacceptable, in particular in the context of what we are seeing in higher education more broadly. And not just at the federal level. In higher education, many states have reduced putting money into public education, shifting the responsibility to families and individuals and with that coupled with flat funding for nursing education we are seeing a generation of nursing students with significant debt. And that is going to be a barrier, I believe, to our profession being able to grow. Right now, we have an economic situation where we are not seeing the shortage that we saw ten years ago. But it’s very easy to get back to that point if the economics of going into nursing shifts when you graduate from a BSN program with $100,000 in debt and are limited in your initial salary. Loan repayment programs are not that plentiful as they used to be. The economics of it makes it tough. Because we are talking about middle class folks who are not able to take on that debt. And when it is becoming increasingly attractive to become an APRN, that is all debt to be able to get the master’s to become a nurse practitioner or a nurse midwife. We are going to need some serious advocacy and a plan to deal with the cost of our education.
What are your thoughts about safe staffing?
It is so interesting. Safe staffing has been a legislative priority for decades. We have not been able to pass these bills. I think the approach needs to be more balanced with safe staffing committees in these hospitals. Moving away from these ratios and having hospitals have safe staffing committees that would take into consideration the circumstances that facilities and the region when staffing levels. On these committees, nurses would serve so a legislative body is not dictating it. I think that this is an appropriate approach coupled with compelling Medicare participating facilities to set staffing levels and monitor outcomes.
When elected, what would you do to go about helping to ensure equitable access to health care?
That’s like the question! For me, equitable access to health care allows everyone to get health care. Health care is a human right. Human rights have been fundamental to my nursing practice. It is written in our Code of Ethics—this idea that everyone should have health care—and I think our policies should reflect that. For me, that includes fixing the Affordable Care Act to ensure affordable coverage; and making sure we have clinics, hospitals, and facilities in communities so that the burden is not on low-income people or people with transportation challenges or resource limitations so that people are able to get the care and services they need. We have so much innovation, technology, and so many improvements now in a way we are able to provide care whether it’s telemedicine or individualized health care. It is a shame if all of that innovation and all of those improvements are seen in resource communities. We need to be focused in these conversations about reform and transforming our system to ensure that it is serving everyone—rural, urban, low income, and elderly.
What advice would you give to aspiring policy advocates who may be considering a run for public office?
Your country needs you! There are too few nurses in policy positions. Seek a County Board position. The County Board supervises the local Department of Health. Run for state legislator, they address scope of practice issues. Run for Congress! There are many opportunities to serve and lead. Step forward!
Tune into Springer Publishing’s new monthly health care podcast series, Conversations About Health Care Delivery in the United States, featuring discussions with prominent experts, innovators, and leaders in the health sector available on Spotify, Apple Podcasts, and Amazon Music.
This National Nurses Week, learn more about Mary Eliza Mahoney, America’s first professionally-trained Black nurse whose birthday lies on May 7, the second day of National Nurses Week.
Mahoney’s journey to becoming a nurse in the 1800s was full of setbacks she couldn’t control, yet she persevered to create a decades-long career as a nurse known for compassion and bringing comfort to others.
However, her story doesn’t end there—she later became a well-known leader in the nursing field, co-founding the National Association of Colored Graduate Nurses (NACGN) in 1908 and supporting the women’s suffrage movement before it became popular. She was inducted into the National Women’s Hall of Fame in 1993 for her contributions to breaking racial barriers in nursing.
Today, Mahoney inspires Black nurses and other nurses of color who relate to her struggles in a world where breaking the mold is never easy.
From Nurse Aide to Nursing Graduate
Born in Dorchester, Massachusetts, on May 7, 1845, Mary Eliza Mahoney knew at a young age that she wanted to be a nurse. She started her career at the New England Hospital for Women and Children at the age of 20. The hospital was progressive in its time, including an all-women staff of physicians, and provided healthcare to only women and their children. Mahoney first worked as a nurse aide among licensed nurses, but her wages were too low, so she worked in various roles, including washerwoman, janitor, and cook.
After 15 years of domestic service duties, Mahoney was offered a spot at the hospital’s prestigious graduate school in 1878, assisted by a doctor who believed in her potential.
The graduate school’s program was intensive, consisting of 16-hour days learning how to prep and complete ward duty, overseeing up to six patients. The program was so intensive that out of the 42 accepted students, only four remained, including Mahoney. However, Mahoney’s hard work ethic and experience in nursing paid off. After 16 months in the program, she graduated with her nursing diploma, making her the first professionally trained Black nurse at the time.
Mahoney’s Legacy to Nurses
For the next four decades, Mahoney worked as a private nurse to wealthy white families in the Boston area due to discrimination against Black women in hospitals and other professional settings. Mothers and families who worked with her admired her professionalism and work ethic, and she received requests across the Northeast to work with other wealthy families. Over time, Mahoney grew fond of her work, referring to her clients as family.
Mahoney knew that her work would set an example for minority nurses who could work in fields outside of domestic service. As a result, she raised the bar for more Black women to find careers in nursing and similar professions.
In her later years, Mahoney was a vocal advocate for all nurses, including nurses of color. From 1911 to 1912, she was the director of the Howard Colored Orphan Asylum for Black children in Long Island, New York. As a leader in the NACGN, she was already known as a pioneer in nursing. She gave the welcoming address at the NACGN Convention in 1908 and was made an honorary lifetime member and elected chaplain in 1909.
In 1923, Mahoney was diagnosed with breast cancer and died on January 4, 1926, at the age of 80. To remember her legacy, the NACGN created the Mary Mahoney Award in 1936 for any nurse who made a lasting contribution to social justice within their field. This award is still being given today by the American Nurses Association (ANA) after the NACGN merged with the organization.
Mahoney’s legacy shows the values many minority nurses bring to the field. Her efforts to build organizations that highlight the accomplishments of minority women teach what every nurse of color can offer to patients today.
Learn more about Mary Eliza Mahoney
If you want to learn more about this nursing pioneer, here are some resources for a deeper look at her past and significance to nursing:
BlackPast is an online encyclopedia providing information on Black history internationally, especially in North America. Read Mary Eliza Mahoney’s biography and learn more about the history of Black nurses in the U.S.
The American Association of Nurse Practitioners (AANP) wrote an article on the impact of Mahoney’s work on diversity, equity, and inclusion in nursing.
As part of the ANA’s Journey of Racial Reconciliation series, the organization will host a webinar on Mahoney’s birthday with diverse nursing leaders on how nurses can draw inspiration from her impact on the field.
Kendra Coles, DNP, RNC-OB, C-EFM, NEA-BC, is a seasoned nursing leader with over 20 years of experience in the field. For 17 years, she has been dedicated to women’s services and has a wealth of knowledge in managing inpatient and outpatient obstetric care. She also has a knack for communication and team empowerment. Coles is known for optimizing performance and outcomes for obstetric and neonatal populations, achieved through fostering collaboration and building multidisciplinary teams.
Since 2019, Coles has been Director of Women’s & Children’s Services at the University of Maryland Baltimore Washington Medical Center (UM BWMC). In this role, she oversees a team of 125 FTEs across various units, including Labor & Delivery, Postpartum, Pediatrics, and Special Care Nursery. Coles is responsible for strategic planning, equity, diversity, and inclusion initiatives and developing nurse leaders. She is committed to achieving organizational goals while maintaining fiscal responsibility and ensuring the highest quality and safety standards for patients and staff.
She’s highly skilled in change management and program development, which has been critical in introducing obstetric and newborn care services. Her expertise and leadership have made her a trusted figure in the field.
Coles’ contributions to the nursing field have earned her a spot in the Champions of Nursing Diversity Series 2024. This series highlights healthcare leaders who are prominent figures in their organizations and making significant changes in the nursing field.
Meet Kendra Coles, DNP, RNC-OB, C-EFM, NEA-BC, Director of Women’s and Children’s Services at the UM BWMC.
Talk about your role in nursing.
As the Director of Nursing for Women’s and children’s services, my responsibilities include the operations of obstetrics, newborns, and pediatric care. In this role, I have the honor of impacting the care that women receive during pregnancy and delivery, a newborn’s early days of life, and sick children who require hospitalization. The role requires leading health initiatives such as hypertension and hemorrhage management, safe sleep, and pediatric respiratory illness management.
As a health equity leader and advocate, I have led initiatives to reduce maternal morbidity and mortality and served on the Anne Arundel County Maternal Infant Health Task Force. I co-chair the Equity, Diversity & Inclusion Council at UM BWMC and train other nursing teams in leadership, communication, and staff empowerment to optimize performance and patient outcomes.
How long have you worked in the nursing field?
I have over 26 years of nursing experience and have been a nursing leader for 20 years. My clinical experiences include caring for patients in Labor and Delivery, Mother, Baby, and Nursery. I also have expertise in the operations of inpatient and outpatient care.
Why did you become a nurse?
I became a nurse because I genuinely wanted to care for others. I was raised in a family of five kids and watched my mom always care for someone in the home or family. Nursing is a noble and humbling profession that allows interpersonal reward.
What are the most important attributes of today’s nursing leaders?
Resilience, compassion, innovation, and grace. Today’s nurse leaders must be resilient as they face daily changes in healthcare. Compassion is needed to care for the patients, but it is also required for the care of the staff caring for others. Nursing leaders must develop and embrace new technologies and advances in clinical practices in a rapidly evolving healthcare system. As the nursing leader supports innovation, it’s through grace that you allow forgiveness and create an environment where learning occurs for team members. Grace can also be given to patients who desire to improve their health status and may not always have the resources to make the healthiest choices. We offer our patients new opportunities to be informed and empowered in their care through grace.
What does being a nursing leader mean to you, and what are you most proud of?
As a nursing leader, my task is helping others to help others. Nursing leaders can ensure our patients have the best outcomes by leading a team of professionals to their highest potential and encouraging their growth as caregivers. Nursing leaders drive changes that change lives. I’m most proud of starting an obstetric program at UM BWMC in 2009 and participating in its ongoing growth to improve maternal and newborn care in Anne Arundel County.
Tell us about your career path and how you ascended to that role.
My nursing career started in 1997 at the University of Maryland Medical Center, the University of Maryland Medical Systems’ academic hospital in downtown Baltimore, serving in Labor & Delivery. I simultaneously worked at another hospital in the region in the Mother Baby Unit. I found myself excited about the nursing profession and joined a nursing agency where I took on a variety of nursing contracts caring for obstetric and newborn patients. My interest in leadership began as a charge nurse at UMMC and grew into a senior clinical nurse role. I was offered an opportunity for frontline leaders to obtain a Master of Science in Healthcare Leadership & Management. I completed my Master of Science in Nursing in 2009 as UM BWMC started recruiting for their new OB program leadership and staff. As a brand-new manager, I recruited a phenomenal team to open the Pascal Women’s Center. In 2018, following the retirement of the director at the time and a national recruitment effort, I was chosen to advance into the Director of Nursing role.
What is the most significant challenge facing nursing today?
The most significant challenge facing nursing is staffing shortages. Like many industries, especially health care, COVID-19 changed the workforce. Nurses experienced compassion fatigue, burnout, and difficulty finding work-life balance. They began to leave the bedside, searching for a less stressful environment or more profitable opportunities. Subsequently, the nursing shortage grew, and we continue to rebuild the nursing workforce.
As a nursing leader, how are you working to overcome this challenge?
Developing and introducing new nurses into the profession is an ongoing challenge. As a nurse leader, I have embraced programs such as the Academy of Clinical Essentials, an initiative developed and spearheaded by the UMMS Chief Executive Officer, which allows nursing students to partner alongside one of our experienced nurses and have early exposure to the art of nursing. We have modified our nursing preceptor program to enable our most experienced nurse to focus on a core group of new hires. We have customized our nurse residency program for the OB, Neonatal, and Pediatric specialties. We have integrated simulations as a core training component in team building and communication skills in high-risk situations. To help our teams address fatigue and burnout, we offer flexible staffing, relaxation rooms, and RISE support resources.
What nursing leader inspires you the most and why?
Rose L. Horton, MSM, RNC-OB, NEA-BC, FAAN, the Founder and CEO of #Notonmywatch Consulting Partners, inspires me. She is a Women & Infant health care executive leader at Emory Decatur Hospital, who believes nurses can change maternal morbidity and mortality. Horton called nurses to action by encouraging them to use their voices to support and advocate for others. She has been a strong influence for improving care during her tenure as the Association of Women’s Health, Obstetric, and Neonatal Nurses (AWHONN) president and while serving on the Synova leadership Board of Directors. I’m really inspired by her dedication to raising awareness about issues compounding black maternal health and how she successfully advocates for change.
What inspirational message would you like to share with the next generation of nurses?
No matter how hard your shift may seem, never forget why you became a nurse. Take every opportunity to serve and care for someone else because you never know the difference you make.
