From the time she was a child, Bettie Coles, RN, dreamed of becoming a nurse. Her older brother suffered from severe asthma attacks and Coles accompanied her family on frequent treks to the emergency room.


“I remember my brother coming into the ER barely able to breathe,” she recalls. “Upon discharge, he was a healthy child again. Even at the age of 10, I knew I wanted to be a nurse and practice that same kind of medical ‘magic.’”

True to her word, Coles went to nursing school and began working for Kaiser Permanente, the Oakland, Calif.-based not-for-profit integrated health care system—first as a staff nurse, then an ER nurse. Thirty-two years later, she is still there, but she has traded her scrubs for a business suit and works in an office, not a hospital unit. As senior vice president and area manager for Kaiser Permanente’s East Bay Area, she oversees operations at medical centers in Richmond, Calif., and Oakland.

Coles is one of a growing cadre of minority nurses who have made the transition from bedside nursing to careers in the administrative side of health care. Nurses who work for health maintenance organizations, insurance companies, medical equipment manufacturers, pharmaceutical and biotech firms, health care advertising agencies, consulting firms, medical associations and other corporate entities say their clinical skills and knowledge enable them to help larger patient populations. In addition, they command competitive salaries and benefits without the physical and emotional demands often required in traditional hospital nursing jobs.

A staunch advocate for patients and the nursing profession, Coles realized early in her career that she could make a greater impact on patient care by a moving into a leadership position. “All nurses come to the point when they must choose whether to continue on a clinical track or pursue an administrative path,” she says. “For me, it made sense to work in an area where I could make decisions that benefit both patients and staff.”

Coles had already established a track record for implementing innovative programs within Kaiser Permanente. She was the founding president of Kaiser’s African American Professionals Group and she co-chairs the organization’s Northern California Diversity Council.

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Today she continues to empower nursing staff and praises Kaiser Permanente for creating an environment where nurses can achieve upward mobility. Her days are spent working on a variety of strategic issues affecting both patient care and hospital services. She enjoys being in a position where she can help her staff implement exciting new ideas.

“There are many leadership opportunities for nurses within Kaiser,” says Coles. “Our president of Southern California operations is a nurse and many of our executive vice presidents are nurses.”

For Coles, being a woman in the corporate world has proven far more challenging than being a person of color. “There have been many times where I’ve been the only woman in the meeting,” she notes. “My mother often told me that as an African-American woman, I would always need to perform the best job possible to be a success.”

Coles encourages other minority nurses to explore career opportunities in the corporate sector. “If nurses feel their voices aren’t being heard, they should pursue a career in administration,” she maintains.

On the Cutting Edge of Biotech

As a clinical nurse, Connie Krause, BSN, RN, helped many patients on an individual basis. Today she works as a clinical safety specialist in the drug safety department at Genentech, a biotechnology research company based in South San Francisco, and her efforts benefit millions.

As one of the world’s leading biotech firms, Genentech has 12 protein-based products on the market for serious or life-threatening medical conditions and another 30 products in the pipeline.

Krause, who is of Filipino descent, works as part of a team that reviews serious adverse event (SAE) reports from clinical trials. She is responsible for defining and initiating follow-up through the appropriate channels, participating in the triage of these reports for regulatory reporting purposes, and facilitating communication with the Medical Affairs Clinical Team.

While her current work may seem a far cry from her previous jobs in home health care and at a blood bank, Krause continues to impact patient care. “At first I really missed the patient/family interaction of working as a clinical nurse,” she says. “But I quickly realized how exciting it is to be on the cutting edge of science. When a drug finally goes to market to fill an unmet medical need, you feel proud knowing you helped [ensure the drug is safe] and that it’s going to benefit many patients.”

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Krause sees a huge need for nurses in biotech, pharmaceuticals and other medical industries. “The basic skills of ADPIE—assess, diagnose, plan, implement and educate—help nurses make an invaluable contribution in every job capacity regardless of the industry,” she emphasizes. “Nurses can give so much added value in any job entailing medical or clinical experience.” A solid hospital nursing background combined with experience in specialty areas such as oncology or ICU will open many doors for nurses, she adds.

Although she now spends her days working at a desk, Krause says the benefits far outweigh the disadvantages of having a somewhat sedentary job. “It took a little while to get used to sitting at a desk after being on my feet all day in a hospital,” she remembers. “But the flip side is that I have a nine-to-five job that I love, and I can see my friends and family during the week, on weekends and holidays. If you need to call in sick, no one has to pull a double shift on account of your absence!

“Everyone is very informal here at Genentech,” she continues. “We call each other by first names, not titles, and we work as a team. It’s refreshing and reassuring that everyone is treated as a professional equal.”

Making a Difference in Managed Care

A chance encounter with a patient led Cassandra Hutchinson, RN, BS, CPUR, CCM, to a new career in case management with Blue Shield of California.

Hutchinson, who is African American, spent 16 years working in a neonatal intensive care unit. While she enjoyed the job, she grew tired of the long hours that kept her from her family. One day, a casual conversation with a patient turned into a networking opportunity. The patient, a Blue Shield nurse, encouraged her to consider career opportunities at the company.

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Initially hired as a utilization review nurse at Blue Shield, for the last eight years Hutchinson has served as senior manager in the medical management operations department in the firm’s El Dorado Hills, Calif., offices.

“My work primarily involves being a patient care advocate for our members who have suffered from catastrophic illness or have been hurt in accidents,” she explains. “I follow their care in the hospital; I communicate with their physician, discharge planner and occupational therapist; and I continue to follow their progress through rehab and back into the community.”

She currently oversees approximately 30 to 40 active cases and ensures continuity of care for patients. In her division, there are 100 nurses who work on case management reviews.

“Working at Blue Shield has been an incredible learning experience,” says Hutchinson. “In hospital nursing jobs, nurses are pretty specialized. But here they need to be familiar with a variety of conditions and diseases.”

To obtain a job in case management, nurses should have at least three years of clinical expertise, and preferably some experience in discharge planning, Hutchinson advises. “Although you don’t work face-to-face with patients, you do impact patient care,” she says. “You also learn the business side of health care.”

According to Hutchinson, the corporate world offers many viable employment alternatives for nurses who are burnt out by the demands of traditional hospital nursing but still want to remain in the field. “Working for a corporation is definitely less stressful than working at the patient’s bedside,” she points out. “We work regular hours, can telecommute, and never have to work weekends or holidays.”

Like Hutchinson, Barbara Bishop-Reid had an extensive clinical nursing career before joining the staff of health insurance giant Aetna. Bishop-Reid, who was born in Guyana, South America, joined the company seven years ago as a case manager after previously working in oncology, orthopedics and pulmonary diseases units, and as an operating room nurse. She is now a supervisor in Aetna’s patient management department, where she oversees 22 nursing and non-nursing staff members.

“The potential for advancement in the corporate world is limitless,” she says. “There is also greater flexibility for nurses with young children or other family obligations.”

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In her current job, Bishop-Reid is responsible for a clinical staff that conducts hospital utilization management and case management reviews. “Nurses in the managed care arena can intervene when medical outcome data indicate a member has problems that need the attention of a case manager,” she explains. “As nurses, we can direct members to the appropriate services available in their benefit plan, or if the plan doesn’t cover specific services, we can refer them to our community liaison who works closely with organizations such as the American Cancer Society and the American Heart Association.”


Bishop-Reid notes that many managed care organizations are actively recruiting nurses who bring a sound clinical perspective to their jobs. In return for this expertise, these employers provide competitive salaries, including a year-end bonus if the company performs well financially, and attractive benefits, like tuition reimbursement.

“I work in an office and I love my job,” she sums up. “I feel that I’m still helping patients and that I’m respected by my colleagues.”

From Product User to Product Trainer

At the age of five, Marcia Richards, BSN, RN, decided she wanted to grow up to be a nurse—which she did. Today, at Medtronic, Inc., a company that manufactures diagnostic equipment and medical devices used to treat chronic conditions such as heart disease and cancer, she continues to work on the front lines of health care, training caregivers on how to use state-of-the art medical technology.

After starting out her nursing career as a surgical CCU nurse at Newark Beth Israel Medical Center in Newark, N.J., Richards, who is African American, eventually felt the urge to seek new career challenges within the health care field. She began researching the medical equipment companies she had become familiar with in her job.

“I made a list of all the products and devices I used at the hospital and requested annual reports from those companies,” she recalls. “Then I found a headhunter who could assist me in finding a corporate position.”

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Although she misses direct patient contact, Richards enjoys her job as principal instructional consultant in Medtronic’s education services division in New Jersey, where she conducts training seminars on the company’s cardiac rhythm management products for nurses and physicians.

“Every six seconds somewhere in the world, a patient receives a Medtronic device,” she says. “I truly believe our company mission of creating a world where every patient suffering from cardiac disease who could benefit from our therapies will receive them.”

Having the Best of Both Worlds

In Chattanooga, Tenn., Latisha Toney, BSN, RN, has found her niche working as a senior clinical consultant for UnumProvident Corporation, a disability insurance company. Toney, who is African American, reviews medical records for a variety of disability claims for patients with both medical and psychiatric restrictions. “My job involves helping the claim specialists to determine what is going on medically,” she says.

Although she didn’t initially plan on entering the corporate world, Toney loves her new career. After working as a clinical nurse, she did a brief stint in utilization review at a large hospital, where she heard about the UnumProvident job from a co-worker.

“As the mother of a son with special needs, I appreciate the flexibility [this position] offers,” says Toney. “After my son was born, I no longer had the desire to work 12-hour shifts. Now I can often work from home.”

Although she sometimes misses the patient contact, Toney doesn’t miss the emotional drain of working in a hospital. And if she finds herself becoming too nostalgic for the world of bedside nursing, she simply applies to work per diem at a local hospital.

“It’s a great way to keep up my skills and have contact with patients,” she comments. “The difference is I don’t do it every day and I no longer take the stresses of my job home with me.”

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