Ask Donna J. Thompson, MS, RN, about the view from the chief executive officer suite at Access Community Health Network, the nation’s largest network of community health centers providing care to medically underserved communities, and she will tell you that she feels she is still a “novice CEO.” However, when you listen to the story of her journey from an entry-level nursing job to the top executive position at one of Chicago’s most progressive health care organizations, the leader she has always been is clearly evident.

“I grew up in a small factory town in Central Illinois,” Thompson says. “My dad was a high school dropout and my mom was a certified nurse assistant (CNA) for 10 years. My grandmother used to read paperback romances [in which the heroines were] nurses. When I asked her why, she said, ‘I always wanted to be a nurse but I never could. It was not in the cards.’”

Indeed, professional careers were not in the cards for most of the African Americans who made up 10% of the town’s population. They worked in factory or service-oriented jobs. Very early in her life, Thompson’s family emphasized education as “the way out.”

“You didn’t see anyone in professional jobs and there were no black nurses in the hospital where my mother worked,” she remembers. “That resonated with me. My parents were Depression babies and took a very practical approach. They instilled a strong work ethic in my sister and me. When I turned 16 and received my driver’s license, my dad met me at the door with the keys, told me to go get a job and not come back until I did.”

Thompson did well in high school and at age 18, she too started working as a CNA. She eventually graduated from a diploma nursing program and started her nursing career as a staff nurse in pediatrics. Three years later, she transitioned to a job as a neonatal ICU staff transport nurse.

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It was during this early stage of her career that she first began to develop her leadership skills. “I had never set foot in a hospital until I started my nursing program, and the seriousness of dealing with people in that environment came to bear with me,” she says. “The experience taught me great organizational skills, as I was dealing with rapid-fire demands from patients, doctors and nursing staff. I had to learn rapid reprioritization. I began developing excellent communication skills.

“Being a CNA on a very busy pediatric unit had required me to interpret the needs of infants, children and their families. At the same time, I was learning assessment skills, which included reading body language. I also relied on intuitive skills. If I had a hunch about a patient’s status, I learned to act upon that intuition. I also learned the importance of teamwork. If you can’t get everything done by yourself, tap into the resources of the team.”

Advancing through Education

Whether interfacing with the medication nurse, the charge nurse, an assigned corridor of patients or the rest of the hospital team, Thompson continued to hone her communication and administrative skills while fortifying her education in the profession.

“I was 20 when I graduated from my diploma program in the mid 1970s,” she says. “At that time, there was really a push for nurses to have higher education. I recognized that the more I developed my skills, the more it would have a positive impact on my patients. So at 24, I realized I had to go back for more education.”

At about the same time, Thompson moved to Springfield, the Illinois state capital, where she worked in a university hospital for two years. By the time she was 26, she had moved north to Chicago and was working at Michael Reese Hospital, a major teaching and research hospital on the city’s South Side.

“I was in a whirlwind,” she recalls. “It was a bustling academic center and I obtained a job that offered full tuition payment for studies in nursing, up to your PhD. I worked 12-hour shifts, three or four days a week, taking classes here and there while I was working. It took about 10 years total to get my BSN.”

It would have been easy to become frustrated and give up on finishing her bachelor’s degree, but Thompson remained focused on her long-term goals. She also made it a point to look for role models whose leadership skills she could emulate. “There was a very, very strong nursing leader [at Michael Reese] named Heidi Beck,” she says. “She was the chief nurse and an immigrant nurse. She promoted nurses getting more education and she focused on research in nursing. There were other clinical specialists and nurse managers and I would always ask them, ‘How did you ?’ I decided that if they could do it, I could, too.

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“I tell nurses today that when you go into orientation, look for the highest ranking nurses in the organization and look to them for inspiration. Ask them how they keep going and ask them for words of wisdom and advice. Too often, people look at these leaders from afar instead of asking them how they made it.”

Through this experience, Thompson learned the value of mentoring. She encourages all nurses to search for mentors–and not just within the nursing profession.

“I interfaced with other nurse leaders and I learned that many of them turned to mentors outside of nursing,” she explains. “I remember one person who was excellent with negotiation, a very crucial skill for a leader. She could take tense, controversial meetings and turn things into a win-win situation. She was not a nurse, but she had a skill set I wanted to have. I studied her and watched her when I had an opportunity to sit in on her meetings. Sometimes nurses feel they have to turn only to other nurses for mentor relationships.”

Moving into Management

At 32, Thompson received her MS from DePaul University in Chicago, and all the while she was gaining valuable leadership experience. She also learned a lasting lesson in dealing with the disappointment of rejection.

“I had been a nurse for nine or 10 years when I tried for my first management position, but I was turned down,” she says. “I was told I didn’t have enough education. I went back to school and got my master’s degree and another management opportunity came up. I spoke to the same person who had interviewed me for the previous position. I had a master’s degree in nursing administration, and this time I was told that they were looking for someone with a master’s degree in maternal-child nursing. I did not get that job either, despite my years of maternal-child experience in pediatrics, neonatal and pediatric ICU.”

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But because she believed in herself, Thompson refused to take the rejection personally. Instead of seeing it as a defeat, she turned it into a learning experience. Today, she is eager to share those lessons with other minority nurses who may find themselves in a similar situation.

“When you go to school, don’t think that everything will change overnight for you once you have that piece of paper (degree) in your hands,” she says. “Also understand when it’s time to move on to a different institution or role. Sometimes in your career, the person making the decision can only see you in a certain role, for whatever reason. I refused to let my dream disappear just because of what one naysayer thought about my abilities.”

Undeterred, Thompson did move on, becoming director of pediatric nursing at Christ Hospital and Medical Center in suburban Oak Lawn, Illinois. She then joined Access Community Health Network and served as chief operating officer for nine years. During that time, she led the organization’s successful JCAHO accreditation efforts, implemented a Continuous Quality Improvement system and organized the Stand Against Cancer, a political advocacy campaign that resulted in increased Illinois state funding for breast and cervical cancer programs. She received a Robert Wood Johnson Executive Nurse Fellowship in 2003 and was appointed CEO of Access in November 2004.

Work/Life Balance

Thompson’s ascent to the CEO suite has not gone without personal sacrifices. One of her first administrative roles occurred at a time when she was more than eight months along in her first pregnancy. However, she readily asserts that her husband and two children have been both a solid foundation and a propelling force in her career.

“I could never have done what I did without my husband’s support,” she says. “[Being a parent with a career] is never going to be easy. There is a lot that I’ve missed [as my kids were growing up] and I can never get those things back. I’m not a stay-at-home mom and I do have regrets. But I feel I am a better parent because of my career, and I have also been able to satisfy my own intense yearning to make a difference.

“I always say to nurses who are contemplating taking on a management or leadership role, ‘What’s going to be the balance for you?’ You might be working 60 hours a week. Are your head and heart going to be at home while your body is at work? When you’re a leader you can’t afford to have an off day, a bad hair day or be less than yourself. You’re always on stage. If you can’t be on, get off. You can’t walk in and think everything is going to be predictable.”

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Thompson takes that understanding with her as she does her walkarounds at Access. Just as she did in her days as a CNA and staff nurse, she continues to place great value on teamwork and communication.

“I do a lot of coaching and talking to people,” she emphasizes. “I listen to what they say and watch how they say it. I pick up on the verbal and the nonverbal. I ask questions to achieve clarity. I usually say, ‘Let me see if I understand what you’ve said.’ When people ask me how I learned those communication and administrative skills, I tell them I learned it at the bedside. The accountability and responsibility came at the same time.”

Learning how to make the transition from team member to team leader was another valuable educational experience for Thompson. “I remember being in one of my first management positions,” she relates. “I wanted to make changes right away on the clinical unit that I thought would have a positive impact for patient care as well as improve our clinical systems. We had worked together as a team for many years and were a close-knit group of mostly minority nurses. Well, once I became their new manager, I quickly introduced and implemented my new ideas in rapid-fire succession.”

The nurses weren’t happy about so many sudden changes, and they let Thompson know it. “They raked me over the coals and I rightly took it on the chin,” she says.

Based on what she learned from that confrontation, she advises future nurse managers of color to “listen twice as much as you speak. I had forgotten to listen as well as plan with my team. I thought that because I had worked with this group as their peer for many years, I could automatically make the changes that I wanted with their full support. I did not take the time to bring the team together and create a vision with corresponding goals. I wanted to go at my pace instead of the team’s pace.

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“It’s difficult for anyone to embrace change if there is not a shared vision and a commitment to implement change,” she continues. “I also recognized that individuals in any group face the challenges of change differently. It was now my role to help each of my staff to transition through change as well as keep the team together and guide them in the right direction.”

Thompson also learned this lesson: “Don’t think that because you are a part of the community, you know what the community wants or needs. Don’t infer that because we look like each other, we’re thinking alike. You have to bridge yourself.”

Sharing Stories

These days, Thompson is doing more talking along with her listening–up on stage, behind a podium. While her speaking engagements allow her to inform her audience, she is also using the opportunity to critique her own performance.

“I’m doing a lot more public speaking,” she says. “I plant some friendly faces in the audience, not so there are people there that I already know, but so that they will give me honest feedback. I’m still a novice CEO and I’m learning about different areas that are broadening and stretching me. You go through the same insecurities no matter what role you’re in, but you can always reach out to mentors who will say, ‘You’re not alone, because I have felt the way you feel.’”

Thompson hopes more nurses of color will also remember to reach out to each other and take advantage of the cultural and professional wealth of knowledge they all bring to the patient care experience.

“As an African American and someone who has heard story-telling in my own family, I would encourage minority nurses not to forget their own stories,” she says. “That sharing will allow you to see a different side of people, perhaps a side that’s more vulnerable. It’s an opportunity to share wisdom and the richness of who we are. I encourage nurses to write their experiences down and keep a journal. There’s so much that we miss by not sharing our stories.”

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