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Episode 19: Practical career advice for the modern nurse

August 19, 2020

Episode 19: Practical career advice for the modern nurse

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August 19, 2020

Episode 19: Practical career advice for the modern nurse

August 19, 2020

Dan:
Beth, welcome to the show.

Beth:
Thank you for having me. It's so great to be here and hello to all of your listeners. So, Dan, you want me to chat a little bit about what I'm doing currently, and I would say the majority of my time now I'm spending career coaching with nurses at all different phases of their career. I'm also writing the Career Coaching column for AONL in the Nurse Leader magazine. And I'm just having a lot of fun working with nurses who are trying to repackage themselves, and understand what their brand is, and then what are those different career options because we often aren't as aware of them because all we're ever taught about is those very traditional careers. And there's a lot of really interesting things nurses can do, and I'm really excited to be able to help nurses sort of spread their wings, if you will.

Dan:
That's great. I mean, you've talked about that in the past on this show too that... I've taken the really non-traditional path. I never did the charge nurse manager, director, chief nurse route. I did everything around operations, really from education, to innovation, to research, kind of touched every other part of the health system. But that was always looked down upon, and even some of my mentors have said, "Well, Dan, you got to dive into operations if you want to do anything in the future." And I always challenged that saying, "I think there's other skillsets that nurses have outside of operations that adds even more value." I wondered what your thoughts are on those kind of non-traditional paths.

Beth:
I personally think they're the most fun and the most exciting, and often they're some of the best ways for the public to see nurses... and consumers, to see nurses in a different light. So, much like you, I've had a very non-traditional career. I've spent some time in a temporary nurse staff agency way back in the day. I've also done hospital operations or more on the strategy side for nursing leadership and magnet and staff development and those kinds of things. But my one job that people always sit up and look at me and say, "Huh," is when I worked in a global advertising agency. I did that for probably three and a half or four years.

Beth:
It wasn't my first time working in an advertising agency. It was my second stint and I absolutely loved it. All of our clients were healthcare providers and I was able to work with the creative team, the copywriters, the digital team, the research team, and help translate some of the things that happen in healthcare that might be foreign to a copywriter, and how do we position this health system as this type of an employer in this whole idea of employer branding and internal communications. That was probably the most fun, awesome job I've ever had in my career. People will look at me and kind of scratch their head and say, "huh! How did you work in an ad agency?"

Beth:
I'll never forget I was going on a business pitch and it was for one of the big pharmaceutical companies, and I was talking to the team and getting the pitch ready and one of the young guys in one of our branch offices said to me, "Well, do you know anything about pharmaceuticals?" And I looked at him and said, "Yeah, I am a nurse and I actually administer pharmaceuticals." It was eyeopening to him that, how would a nurse know anything about pharmaceuticals? Well, guess what, that's what we do. So that was just really great and it's a very non-traditional path that you could take.

Dan:
I feel like I wear hats like that all the time here too. We do a lot of work related to language and framing things and marketing and all that kind of stuff. And we have a lot of tech people in our company and to orient them to nursing has been really fun to do.

Beth:
Yeah. I mean, I've worked in a dot-com startup, is what we called it back in the day, I've worked in higher ed, I've been on faculty, I've been in charge of graduate programs in nursing leadership, and I've also taught at the graduate level, and of course done some research at different point in my career. And then I've worked in a hospital. So I have all these little pieces, if you will, if you thought of a pie, and I've had all these experiences. I remember when I was the president of the university here in Chicago, at first I thought, "Oh my gosh! How am I going to be a president of a university? I've never been a department chair. I've never been a provost. I've never been a Dean."

Beth:
But that was one of those first jobs where all those experiences I had and all those competencies I built had sort of all come together at the same time. Then you become a leader rather than a manager and you're just bringing those competencies together and bringing the right ones to the table at the right time. I was very, very grateful for having had this sort of non-traditional career because I think it made me a better university leader than if I would have come up through the traditional university hierarchy. All these skills that you build do come together at a point in your career and then it just... your heart just sings because you're just doing what you always knew you should be doing.

Dan:
So how do you coach your nursing colleagues? You've talked about coaching them in their careers and making them better and doing these non-traditional paths. So what does that look like? How do you assess where their skill sets are and where they might be a good match to roles that are outside the normal things nurses get exposed to?

Beth:
Yeah, there's a couple of things I typically do. If anyone calls and says, "Oh, I really would like to explore career coaching. What does that look like?" And I believe there's a difference between career coaching and leadership coaching. For leadership coaching, it's helping me be successful in my current role whereas career coaching is maybe I need to look for something different in my career. So with career coaching, I always spend 30 minutes with someone on the phone just asking them to talk about their career. I have a little assessment that I have been checking off as I'm listening to them.

Beth:
But sometimes, someone doesn't know what type of grad school to pursue, or sometimes someone doesn't know what kind of work they really like, or sometimes someone will call and say, "I really want to do something non-traditional. How do I do that?" It depends on the goal that the person has. Then I have different tools that I have, and I have one that I absolutely love. Then there are others on the market, but I like Edgar Schein's Career Anchors inventory. And I ask the person, the nurse, to do the Career Anchor inventory.

Beth:
That helps them understand what is that one anchor that holds them down or holds them to the ground that is the kind of work that their heart will sing and it's just like the core of who they are and it anchors all the work that they want to do in their career. More often than not, I'll have a client do that survey and then we will talk about it and they will find that it's completely different than what the job is that they're currently doing. Not always, but often, because we don't spend a lot of time as nurses looking at our career or planning a career or trying to understand what is the best fit for me.

Beth:
So I try to go through just a self assessment with a nurse who calls me and tease out what their real needs are, but then I also have some tools that I'll just say, "Hey, why don't you fill out this survey and let's talk about the results?" And there's a different websites too that have some really good inventories around values and likes and it just helps the nurses spend some time thinking and slowing down a little bit so that they can spend some time on themselves. Then of course I always use AONL's different competency inventories to have a nurse at least do a self assessment so that they have an understanding of where their competencies are.

Dan:
What do you find as the outcome for this? I mean, I think a lot of times nurses end up going the route people think they should go, which is I think more of that kind of traditional operations route or quality or something more in the realm. But as you coach people through finding where their passion are, where their skill sets are, do you find that they stay in roles longer or they're happier, they have a better quality of life? What are some of those things that you hear back from clients as they do this work?

Beth:
I mean, there's a couple of people that I'm thinking about. In a couple of instances, it has been a client has said, "Okay, I'm... " And I should also say too, Dan, that I don't only just coach nurses. So I've have career coached some physicians and also some dentists. So it depends on what they want. Sometimes they want to open their own business and open their own consulting and then they'll call and say, "Oh my gosh! This is amazing. I'm doing the kind of work that I only want to do, the only kind of work that makes my heart sing. I'm able to make a living doing this and it's afforded me a chance to work my contacts in my Rolodex."

Beth:
So some people find that it fits very well with their lifestyle. They wanted to have a little more flexibility and a little more freedom to work with the kinds of people they want to work with, doing the kinds of work they prefer to do. Then there are other clients where they're in their current position and they feel like they need an outside set of eyes and ears, if you will, to look at a resume, and they are pursuing a position in their own organization that is up the ladder, so to speak. So they want some advice around, what does this resume look like? And do you even think I'm qualified for this type of role?

Beth:
I just recently started working with a nurse who was very interested in a position. She sent me the position description, she sent me her resume. Well, actually she sent me her CV. And so right there, I said, "Okay, you need a resume and a CV. I looked at her resume and then I looked at this position and I said, "I don't see a fit here for you." So trying to maybe manage expectations. So now she has found a position that she's interested in pursuing that's much more in alignment with her competencies, she's done an assessment, she understands where her heart will sing, and so now she's pursuing that opportunity.

Beth:
Then I have had other clients where they wanted to pursue like a position in a tech company, for example, and then, how do they do that? And one client, it was, "Let's work on this resume. Let's reposition you as an expert in this area. Let's have you meet some of these companies." Eventually, she found a position in one of those tech companies where she was able to... sort of like what you're doing, Dan. She was able to advise, if you will, the non-healthcare experts in the organization, ground them in what the business was about from a healthcare perspective and then just helped the business grow.

Beth:
So the success of people that I've worked with depends on where they're going and what they want. I'll talk to some people and they'll say, "Oh my gosh! I am just so glad to be doing what's making my heart sing." Then I do have clients that just haven't done anything to their resume and think they're going to pursue a job and then have actually pursued positions, and then... My husband is a former chief HR officer and he'll help them, like we'll do mock interviews. I have one client that actually moved for a position from Missouri to New Mexico, and she loves it because it's the exact kind of work she wanted to do.

Beth:
And she's finding herself listened to as the expert. Sometimes it helps to be the new person coming into an organization and she's just enjoying it and having the pleasure and the satisfaction you get from using the skills that you've built over a number of years.

Dan:
Yeah. I think that's the key, right? Is matching the skills to the job and feeling satisfied that what you've spent all your time developing as a professional link with the work that you can wake up and be excited about every day. That's really great.

Dan:
Have you seen any changes as COVID has been around? Any trends in people wanting to shift positions or take complete right turns or maybe even just taking advantage of the crisis and stepping up into roles that either are open or being created as a result of the pandemic?

Beth:
How I want to answer that question is, I've had a couple of folks call me and say, "Is this a good time to look for something new?" The general answer is, yes, but also knowing that depending on the type of role you're looking at, how quickly the hiring process will go probably depends on the type of role you're looking at, right? So I've had a couple people that have said, "I want to look," and so they started looking and one of two things has happened. They've either said, "Okay, I need to fix this resume and I need to apply for that position."

Beth:
Or, as you said, some people find themselves in their current organization asked to do other things and then they just... this idea of changing jobs, I think it's put on the back burner because now they're doing some new things in their current organization that they hadn't anticipated doing and maybe they want to see where that might lead. I'm not on the front lines enough to know, other than I talked to my CNO colleagues, what's going on in their organizations around staffing, but people are either doubling down with what they're doing and taking on more responsibilities at their current position or they're thinking, "Okay, I'm going to look for something because there's some new opportunities because of COVID." So it's a little bit of both.

Dan:
That makes sense. Yeah. I mean, we've been talking about... with some of our other guests, around, there's a lot of chaos and energy and you can either kind of sit back and wait for it to pass or you can jump in and see where it takes you. And so it sounds like people are doing both and there's probably no right answer, but don't recoil, keep your eyes open for those opportunities.

Dan:
I wanted to pivot us a little bit too, because I know you're really involved with board work and that's something I'm really interested in. I actually I've been on a couple boards at the nursing organization level and continuing to try and find more places to have that influence. So I'm personally interested in it. But I would love to hear your thoughts on how we've progressed on the goal to get more nurses on boards and what you're currently doing to continue that movement and get us moving on that line.

Beth:
I have sort of mixed feelings on this one. I'm a governance coach for the Private Directors Association, which is a professional association of board members for private companies. And I have been trying for the better part of two years now to find a position for myself on a private company board and/or a position on a small five to 20 million ish public company board. And I will tell you, it has been extremely more difficult and extremely more challenging than I had ever anticipated. The irony there is that there's a lot of talk across the country in some States like California who have now regulated how many women have to be on a public or private companies board.

Beth:
And so I expected this flood gates to open and would find it much easier to be interviewed and selected for one of those public company or a private company board and it's been a slog. I'm actually coaching four women right now and all of us are sort of in the same boat. We have pretty darn good experience, have lots of not-for-profit governance experience, aren't necessarily interested in doing more not-for-profit, although that's a great place to start, and are really having a difficult time. What I'm finding is it's a really difficult nut to crack on public and private company boards.

Beth:
I think there's a lot of movement of people within that community and they tend to refer one another and people move between boards and there's a pretty low, I think, it's 2% of board turnover on private company boards. So it makes it a really difficult proposition when there's such low turnover. Then there's research... I talked about this before, about, when a man leaves the board, they will often be replaced by a man and when a woman leaves the board, she could be replaced by either a man or a woman. So there's this... it's called the gender matching heuristic.

Beth:
There are some inherent, I'll say biases or structures within replacing board members that have made it incredibly difficult for women to get on boards on private and public companies and I know I'm experiencing that, gosh, I feel like every day. So that's kind of on that side of the ledger.

Dan:
Outside looking into a private company board, it does very much seem like a good old boys club. They just hire each other, they trade people between companies. You have to have some sort of membership, and sometimes that's the... it seems like that's the white male membership or something, old white male membership or whatever. And I think that puts nursing at a disadvantage specifically because 90% of the profession is female. I think also that cohort of people don't understand what nurses do at any real significant level.

Dan:
So, I mean, it's kind of this double whammy of, "Why would I have this person on the board? I'll get a physician." or if they want a healthcare kind of expert or business expert, they go for the CEO, CFO types or the physician types and skip over any other clinical expertise. Is that something that you're seeing?

Beth:
Oh gosh, yes. Absolutely. I think that's part of the reason I've been mentoring at MATTER, which is the healthcare technology incubator and accelerator in Chicago. So it's startup technology companies. And nine times out of 10, when I'm talking with a CEO or a founder who has started a company that in my world I would define as a nursing care company, nine times out of 10, that advisory board or the board of that organization has physicians on it. And that's just because of the visibility of physicians, the credibility of physicians.

Beth:
And the physicians may absolutely know nothing about care coordination or discharge planning or patient education, which are some companies that I've seen, but yet the board is full of physicians. So it does make it really difficult because we are invisible. And honestly, part of my method to my madness of becoming a mentor at MATTER was to try to open up some board opportunities for myself, that as these companies grow, if you play your cards, right, hopefully at some point, you'll be on a board of a company.

Beth:
You may start out on their advisory board, but you could become a board member for a company that grows into a decent size private company, and who knows, someday goes public. I mean, you just don't know. But I'm not really quite sure how to crack the nut because you're right, it is very much the old guard and the white men's club. But they will go to physicians before they go to a nurse even if the company is more... take a private or a public company that's skilled nursing or retirement community, CCRC kind of thing.

Beth:
There will be physicians on that board, and perfectly fine to have a geriatrician let's say. But a lot of what happens in those communities is nursing care and there won't be a nurse on those companies. So it is a dilemma.

Dan:
Yeah. Well, and 60% of those workforces are made up of nursing or nursing assistants and fall under our scope of practice. And so you'd think you'd want someone with that expertise to be guiding the direction of the company. But I'd also love to get into the nonprofit side. So what are some of those differences and what are you seeing on that side?

Beth:
So if it were me, I bucket non-for-profit into three buckets. And this is just my nomenclature, my structure. I'm going to be on a board of a non-for-profit that is an organization that's a community-based organization that's doing, let's say homelessness. I'm making that up. Then there's a group of professional organizations that are... all of us are professional nursing organizations, are non-for-profits. So that's another type of non-for-profit. Then you have this other bucket, which is practically our entire healthcare system on the provider side, right? The majority of hospitals and healthcare systems in this country are non-for-profit.

Beth:
So those are three very different kinds of nonprofit boards. I've been on hospital board. I'm on a quality committee of a hospital right now. Big enterprises, right? Lot of revenue, lot of employees, but the fact that it's not for-profit hasn't helped me in the for-profit board setting because when they're looking for board directors they want someone that has public or private company board experience. They'll very rarely look at someone that only has non-for-profit, which is a bit frustrating to me because some of those non-for-profits in the healthcare space are pretty darn big companies. Same with higher education, right?

Beth:
I helped the chairman of MATTER board run the board at Resurrection University. So I have higher education board experience, that doesn't necessarily translate to a private company board in the minds of people that recruit for those companies, because it's not for profit. Well, just because it's not for profit doesn't mean the company's not making money, right? So you kind of have that mindset where people think, "Oh, well, you only have not-for-profit experience," but actually there are some pretty darn big non-for-profit companies that frankly would run... I mean, they do run like a private company board and they are more business-minded.

Beth:
And then your professional associations are running and doing what's right, but it's a non-for-profit and they're trying to make money and trying to run a business. And then you have your community organizations where it seems like the rigor of the governance can get a little bit weaker depending on the type of nonprofit. And I think, at least for me, I try to look for experiences in non-for-profits where there's some rigor around the running of the business and business savvy that's required because some non-for-profits seem like they're always looking for money and always, always, always looking for money and donations when... you wonder if they're running the business that well.

Beth:
So it's difficult. And so I'm not looking at any more non-for-profit positions because I have a lot of that experience, but it doesn't always translate to the other side, which is frustrating.

Dan:
Well, yeah, and it sounds like some of the red flags are if your only job on that board is to continually fundraise, that might be an issue. But yeah, no, those are great distinctions. And yeah, it's very interesting how people see experience. I think we see that even at the leadership level within hospitals. If you don't have that formal operations experience, you're considered not a leader in some respects and I think we need to broaden that significantly because it's an old way of looking at things.

Dan:
And there's research that shows innovation and change and the growth of companies is improved by creating more diversity of conversation and thought within the leadership team. And so I think we need to flip the script and get that as a core competency for boards rather than focusing on the numbers of the people who managed the numbers in the past.

Beth:
Okay, so what was the highest, if you will, level that I ever achieved in a hospital operations? So I was a charge nurse, I was a nurse manager, and I was a director of nursing. Okay. But my director role was a little bit what I would call non-traditional. That experience and those operation roles, while I wasn't a CNO, I don't know that you need to go much higher than a nurse manager or a director to understand operations, right? And this is my bias. Because I'm able to advise technology companies, I'm advising one right now, and the solution is very much for the staff RNs at the bedside.

Beth:
I still know what's going on at the bedside even though it's been a lot of years and I know what's going through the mind of the manager on those unit even though it's been a lot of years. So those operational experiences, I don't know if they have to be in the last two years, or you can have had operations younger point in your career and it still translates. Not a lot changes in healthcare and we still run units lot like we did when I was a new grad 25 years ago, right?

Dan:
Yep. Midnight staffing and poor shift report and we're still focused on infections and falls and-

Beth:
That's right.

Dan:
You're right. Some of the technology's changed, but everything else is pretty much... We still patients every two hours like [inaudible 00:00:26:46]. So that's really interesting. Yeah. So I think we need to kind of reframe that experience level and I think rounding it out. And this is what we're actually seeing in medical schools now too, is they don't want the pure science play anymore, at least some of the newer medical schools don't want that as their student. They want the well-rounded humanities major, music major who just has a different connection with people in the world as their targeted students and I think corporate America healthcare has not caught up to that yet.

Dan:
They're still kind of going by the playbook that's been around since Rockefeller and all that kind of stuff. So I do think we need to change it. So we're getting to the end of our time together here, but I would love... So one of the traditions we have here on the show is we... it's the handoff, which is that shift the shift report, that pertinent information we share with our oncoming colleagues as they start their day. What is one of those things that you'd like to hand off related to your work in careers and board work that our emerging nurse leaders and nurses can take away and do something with tomorrow.

Beth:
First one is the easy one. On the board side, absolutely you have to be registered in the Nurses on Boards Coalition website that you're interested in being on a board. And if you're ever asked, say yes, because you can do it even though you think you can't do it. You can do it, because nursing has provided us with a wealth of knowledge, background, critical thinking, systems thinking that is very applicable to a board position. So if you're approached, say yes even if you're not sure, just because you will do great at it.

Beth:
On the career side, I would say, "Spend some time thinking about what you want to be when you grow up." And I don't say that facetiously, I'm serious, because I think too many nurses just do the traditional up the ladder and there is a world of new things out there and different things. And you might need help opening some of those doors, but the doors are there. And even before you go to grad school, talk to someone to help you decide where you want to go with your career and maybe be a little more purposeful. Those are my two pearls.

Dan:
I love it. And so, Beth, how can interested leaders get a hold of you if they are interested in using your services to do exactly what you said?

Beth:
Well, two ways. I'm on LinkedIn. So my profile, I think it's Dr. Beth A. Brooks on LinkedIn. And I also have a website, thebrooksgroupllc.net, which is where I have information about career coaching and professional brand, what's your leadership brand, those kinds of things. So best way is to reach me on the web.

Dan:
Thank you so much, Beth, for being on the show today. I'm excited to see where we can go and get more healthcare professionals on boards and help them find their passionate career, because I was mentored early with that in mind and it made a world of difference and I hope we can share that with others. So thank you so much.

Beth:
Awesome. Thanks. It was really fun, Dan. I appreciate you asking me to be on your podcast.

Dan:
Thank you so much for tuning into The Handoff. If you like what you heard today, please consider writing us a review on iTunes or wherever you listen to podcasts. This is Dr. Nurse Dan, see you next time.

Description

What are the best tools and resources for nurses who are thinking about their next career move? How should a nurse go about exploring non-traditional career paths? Is now even a good time to think about making a move? In this episode of The Handoff, Dan covers these questions and more with veteran healthcare executive and career coach Beth A. Brooks. 

Beth’s career spans more than three decades across three distinct sectors of the healthcare industry: for-profit companies, academic administration and nursing operations within health care systems (though she says her favorite job ever was at an advertising agency!). She’s an expert in the quality of nursing worklife and developed Brooks' Quality of Nursing Worklife Survey. Today she helps nurses and nurse leaders make smart decisions about their careers. 

She’s particularly passionate about helping nurses get on to company boards. She shares advice for nurses who want to go down this path, while being candid about the fact that it’s still a struggle, even with recent legislation in California mandating that every public company needs to have at least one woman on its board. 

Links to recommended reading:

https://www.careeranchorsonline.com/SCA/

https://www.aonl.org/resources/online-assessments

https://matter.health/ 

https://www.nursesonboardscoalition.org/

https://www.trustedhealth.com/blog/5-simple-ways-to-advance-your-nursing-career 

Transcript

Dan:
Beth, welcome to the show.

Beth:
Thank you for having me. It's so great to be here and hello to all of your listeners. So, Dan, you want me to chat a little bit about what I'm doing currently, and I would say the majority of my time now I'm spending career coaching with nurses at all different phases of their career. I'm also writing the Career Coaching column for AONL in the Nurse Leader magazine. And I'm just having a lot of fun working with nurses who are trying to repackage themselves, and understand what their brand is, and then what are those different career options because we often aren't as aware of them because all we're ever taught about is those very traditional careers. And there's a lot of really interesting things nurses can do, and I'm really excited to be able to help nurses sort of spread their wings, if you will.

Dan:
That's great. I mean, you've talked about that in the past on this show too that... I've taken the really non-traditional path. I never did the charge nurse manager, director, chief nurse route. I did everything around operations, really from education, to innovation, to research, kind of touched every other part of the health system. But that was always looked down upon, and even some of my mentors have said, "Well, Dan, you got to dive into operations if you want to do anything in the future." And I always challenged that saying, "I think there's other skillsets that nurses have outside of operations that adds even more value." I wondered what your thoughts are on those kind of non-traditional paths.

Beth:
I personally think they're the most fun and the most exciting, and often they're some of the best ways for the public to see nurses... and consumers, to see nurses in a different light. So, much like you, I've had a very non-traditional career. I've spent some time in a temporary nurse staff agency way back in the day. I've also done hospital operations or more on the strategy side for nursing leadership and magnet and staff development and those kinds of things. But my one job that people always sit up and look at me and say, "Huh," is when I worked in a global advertising agency. I did that for probably three and a half or four years.

Beth:
It wasn't my first time working in an advertising agency. It was my second stint and I absolutely loved it. All of our clients were healthcare providers and I was able to work with the creative team, the copywriters, the digital team, the research team, and help translate some of the things that happen in healthcare that might be foreign to a copywriter, and how do we position this health system as this type of an employer in this whole idea of employer branding and internal communications. That was probably the most fun, awesome job I've ever had in my career. People will look at me and kind of scratch their head and say, "huh! How did you work in an ad agency?"

Beth:
I'll never forget I was going on a business pitch and it was for one of the big pharmaceutical companies, and I was talking to the team and getting the pitch ready and one of the young guys in one of our branch offices said to me, "Well, do you know anything about pharmaceuticals?" And I looked at him and said, "Yeah, I am a nurse and I actually administer pharmaceuticals." It was eyeopening to him that, how would a nurse know anything about pharmaceuticals? Well, guess what, that's what we do. So that was just really great and it's a very non-traditional path that you could take.

Dan:
I feel like I wear hats like that all the time here too. We do a lot of work related to language and framing things and marketing and all that kind of stuff. And we have a lot of tech people in our company and to orient them to nursing has been really fun to do.

Beth:
Yeah. I mean, I've worked in a dot-com startup, is what we called it back in the day, I've worked in higher ed, I've been on faculty, I've been in charge of graduate programs in nursing leadership, and I've also taught at the graduate level, and of course done some research at different point in my career. And then I've worked in a hospital. So I have all these little pieces, if you will, if you thought of a pie, and I've had all these experiences. I remember when I was the president of the university here in Chicago, at first I thought, "Oh my gosh! How am I going to be a president of a university? I've never been a department chair. I've never been a provost. I've never been a Dean."

Beth:
But that was one of those first jobs where all those experiences I had and all those competencies I built had sort of all come together at the same time. Then you become a leader rather than a manager and you're just bringing those competencies together and bringing the right ones to the table at the right time. I was very, very grateful for having had this sort of non-traditional career because I think it made me a better university leader than if I would have come up through the traditional university hierarchy. All these skills that you build do come together at a point in your career and then it just... your heart just sings because you're just doing what you always knew you should be doing.

Dan:
So how do you coach your nursing colleagues? You've talked about coaching them in their careers and making them better and doing these non-traditional paths. So what does that look like? How do you assess where their skill sets are and where they might be a good match to roles that are outside the normal things nurses get exposed to?

Beth:
Yeah, there's a couple of things I typically do. If anyone calls and says, "Oh, I really would like to explore career coaching. What does that look like?" And I believe there's a difference between career coaching and leadership coaching. For leadership coaching, it's helping me be successful in my current role whereas career coaching is maybe I need to look for something different in my career. So with career coaching, I always spend 30 minutes with someone on the phone just asking them to talk about their career. I have a little assessment that I have been checking off as I'm listening to them.

Beth:
But sometimes, someone doesn't know what type of grad school to pursue, or sometimes someone doesn't know what kind of work they really like, or sometimes someone will call and say, "I really want to do something non-traditional. How do I do that?" It depends on the goal that the person has. Then I have different tools that I have, and I have one that I absolutely love. Then there are others on the market, but I like Edgar Schein's Career Anchors inventory. And I ask the person, the nurse, to do the Career Anchor inventory.

Beth:
That helps them understand what is that one anchor that holds them down or holds them to the ground that is the kind of work that their heart will sing and it's just like the core of who they are and it anchors all the work that they want to do in their career. More often than not, I'll have a client do that survey and then we will talk about it and they will find that it's completely different than what the job is that they're currently doing. Not always, but often, because we don't spend a lot of time as nurses looking at our career or planning a career or trying to understand what is the best fit for me.

Beth:
So I try to go through just a self assessment with a nurse who calls me and tease out what their real needs are, but then I also have some tools that I'll just say, "Hey, why don't you fill out this survey and let's talk about the results?" And there's a different websites too that have some really good inventories around values and likes and it just helps the nurses spend some time thinking and slowing down a little bit so that they can spend some time on themselves. Then of course I always use AONL's different competency inventories to have a nurse at least do a self assessment so that they have an understanding of where their competencies are.

Dan:
What do you find as the outcome for this? I mean, I think a lot of times nurses end up going the route people think they should go, which is I think more of that kind of traditional operations route or quality or something more in the realm. But as you coach people through finding where their passion are, where their skill sets are, do you find that they stay in roles longer or they're happier, they have a better quality of life? What are some of those things that you hear back from clients as they do this work?

Beth:
I mean, there's a couple of people that I'm thinking about. In a couple of instances, it has been a client has said, "Okay, I'm... " And I should also say too, Dan, that I don't only just coach nurses. So I've have career coached some physicians and also some dentists. So it depends on what they want. Sometimes they want to open their own business and open their own consulting and then they'll call and say, "Oh my gosh! This is amazing. I'm doing the kind of work that I only want to do, the only kind of work that makes my heart sing. I'm able to make a living doing this and it's afforded me a chance to work my contacts in my Rolodex."

Beth:
So some people find that it fits very well with their lifestyle. They wanted to have a little more flexibility and a little more freedom to work with the kinds of people they want to work with, doing the kinds of work they prefer to do. Then there are other clients where they're in their current position and they feel like they need an outside set of eyes and ears, if you will, to look at a resume, and they are pursuing a position in their own organization that is up the ladder, so to speak. So they want some advice around, what does this resume look like? And do you even think I'm qualified for this type of role?

Beth:
I just recently started working with a nurse who was very interested in a position. She sent me the position description, she sent me her resume. Well, actually she sent me her CV. And so right there, I said, "Okay, you need a resume and a CV. I looked at her resume and then I looked at this position and I said, "I don't see a fit here for you." So trying to maybe manage expectations. So now she has found a position that she's interested in pursuing that's much more in alignment with her competencies, she's done an assessment, she understands where her heart will sing, and so now she's pursuing that opportunity.

Beth:
Then I have had other clients where they wanted to pursue like a position in a tech company, for example, and then, how do they do that? And one client, it was, "Let's work on this resume. Let's reposition you as an expert in this area. Let's have you meet some of these companies." Eventually, she found a position in one of those tech companies where she was able to... sort of like what you're doing, Dan. She was able to advise, if you will, the non-healthcare experts in the organization, ground them in what the business was about from a healthcare perspective and then just helped the business grow.

Beth:
So the success of people that I've worked with depends on where they're going and what they want. I'll talk to some people and they'll say, "Oh my gosh! I am just so glad to be doing what's making my heart sing." Then I do have clients that just haven't done anything to their resume and think they're going to pursue a job and then have actually pursued positions, and then... My husband is a former chief HR officer and he'll help them, like we'll do mock interviews. I have one client that actually moved for a position from Missouri to New Mexico, and she loves it because it's the exact kind of work she wanted to do.

Beth:
And she's finding herself listened to as the expert. Sometimes it helps to be the new person coming into an organization and she's just enjoying it and having the pleasure and the satisfaction you get from using the skills that you've built over a number of years.

Dan:
Yeah. I think that's the key, right? Is matching the skills to the job and feeling satisfied that what you've spent all your time developing as a professional link with the work that you can wake up and be excited about every day. That's really great.

Dan:
Have you seen any changes as COVID has been around? Any trends in people wanting to shift positions or take complete right turns or maybe even just taking advantage of the crisis and stepping up into roles that either are open or being created as a result of the pandemic?

Beth:
How I want to answer that question is, I've had a couple of folks call me and say, "Is this a good time to look for something new?" The general answer is, yes, but also knowing that depending on the type of role you're looking at, how quickly the hiring process will go probably depends on the type of role you're looking at, right? So I've had a couple people that have said, "I want to look," and so they started looking and one of two things has happened. They've either said, "Okay, I need to fix this resume and I need to apply for that position."

Beth:
Or, as you said, some people find themselves in their current organization asked to do other things and then they just... this idea of changing jobs, I think it's put on the back burner because now they're doing some new things in their current organization that they hadn't anticipated doing and maybe they want to see where that might lead. I'm not on the front lines enough to know, other than I talked to my CNO colleagues, what's going on in their organizations around staffing, but people are either doubling down with what they're doing and taking on more responsibilities at their current position or they're thinking, "Okay, I'm going to look for something because there's some new opportunities because of COVID." So it's a little bit of both.

Dan:
That makes sense. Yeah. I mean, we've been talking about... with some of our other guests, around, there's a lot of chaos and energy and you can either kind of sit back and wait for it to pass or you can jump in and see where it takes you. And so it sounds like people are doing both and there's probably no right answer, but don't recoil, keep your eyes open for those opportunities.

Dan:
I wanted to pivot us a little bit too, because I know you're really involved with board work and that's something I'm really interested in. I actually I've been on a couple boards at the nursing organization level and continuing to try and find more places to have that influence. So I'm personally interested in it. But I would love to hear your thoughts on how we've progressed on the goal to get more nurses on boards and what you're currently doing to continue that movement and get us moving on that line.

Beth:
I have sort of mixed feelings on this one. I'm a governance coach for the Private Directors Association, which is a professional association of board members for private companies. And I have been trying for the better part of two years now to find a position for myself on a private company board and/or a position on a small five to 20 million ish public company board. And I will tell you, it has been extremely more difficult and extremely more challenging than I had ever anticipated. The irony there is that there's a lot of talk across the country in some States like California who have now regulated how many women have to be on a public or private companies board.

Beth:
And so I expected this flood gates to open and would find it much easier to be interviewed and selected for one of those public company or a private company board and it's been a slog. I'm actually coaching four women right now and all of us are sort of in the same boat. We have pretty darn good experience, have lots of not-for-profit governance experience, aren't necessarily interested in doing more not-for-profit, although that's a great place to start, and are really having a difficult time. What I'm finding is it's a really difficult nut to crack on public and private company boards.

Beth:
I think there's a lot of movement of people within that community and they tend to refer one another and people move between boards and there's a pretty low, I think, it's 2% of board turnover on private company boards. So it makes it a really difficult proposition when there's such low turnover. Then there's research... I talked about this before, about, when a man leaves the board, they will often be replaced by a man and when a woman leaves the board, she could be replaced by either a man or a woman. So there's this... it's called the gender matching heuristic.

Beth:
There are some inherent, I'll say biases or structures within replacing board members that have made it incredibly difficult for women to get on boards on private and public companies and I know I'm experiencing that, gosh, I feel like every day. So that's kind of on that side of the ledger.

Dan:
Outside looking into a private company board, it does very much seem like a good old boys club. They just hire each other, they trade people between companies. You have to have some sort of membership, and sometimes that's the... it seems like that's the white male membership or something, old white male membership or whatever. And I think that puts nursing at a disadvantage specifically because 90% of the profession is female. I think also that cohort of people don't understand what nurses do at any real significant level.

Dan:
So, I mean, it's kind of this double whammy of, "Why would I have this person on the board? I'll get a physician." or if they want a healthcare kind of expert or business expert, they go for the CEO, CFO types or the physician types and skip over any other clinical expertise. Is that something that you're seeing?

Beth:
Oh gosh, yes. Absolutely. I think that's part of the reason I've been mentoring at MATTER, which is the healthcare technology incubator and accelerator in Chicago. So it's startup technology companies. And nine times out of 10, when I'm talking with a CEO or a founder who has started a company that in my world I would define as a nursing care company, nine times out of 10, that advisory board or the board of that organization has physicians on it. And that's just because of the visibility of physicians, the credibility of physicians.

Beth:
And the physicians may absolutely know nothing about care coordination or discharge planning or patient education, which are some companies that I've seen, but yet the board is full of physicians. So it does make it really difficult because we are invisible. And honestly, part of my method to my madness of becoming a mentor at MATTER was to try to open up some board opportunities for myself, that as these companies grow, if you play your cards, right, hopefully at some point, you'll be on a board of a company.

Beth:
You may start out on their advisory board, but you could become a board member for a company that grows into a decent size private company, and who knows, someday goes public. I mean, you just don't know. But I'm not really quite sure how to crack the nut because you're right, it is very much the old guard and the white men's club. But they will go to physicians before they go to a nurse even if the company is more... take a private or a public company that's skilled nursing or retirement community, CCRC kind of thing.

Beth:
There will be physicians on that board, and perfectly fine to have a geriatrician let's say. But a lot of what happens in those communities is nursing care and there won't be a nurse on those companies. So it is a dilemma.

Dan:
Yeah. Well, and 60% of those workforces are made up of nursing or nursing assistants and fall under our scope of practice. And so you'd think you'd want someone with that expertise to be guiding the direction of the company. But I'd also love to get into the nonprofit side. So what are some of those differences and what are you seeing on that side?

Beth:
So if it were me, I bucket non-for-profit into three buckets. And this is just my nomenclature, my structure. I'm going to be on a board of a non-for-profit that is an organization that's a community-based organization that's doing, let's say homelessness. I'm making that up. Then there's a group of professional organizations that are... all of us are professional nursing organizations, are non-for-profits. So that's another type of non-for-profit. Then you have this other bucket, which is practically our entire healthcare system on the provider side, right? The majority of hospitals and healthcare systems in this country are non-for-profit.

Beth:
So those are three very different kinds of nonprofit boards. I've been on hospital board. I'm on a quality committee of a hospital right now. Big enterprises, right? Lot of revenue, lot of employees, but the fact that it's not for-profit hasn't helped me in the for-profit board setting because when they're looking for board directors they want someone that has public or private company board experience. They'll very rarely look at someone that only has non-for-profit, which is a bit frustrating to me because some of those non-for-profits in the healthcare space are pretty darn big companies. Same with higher education, right?

Beth:
I helped the chairman of MATTER board run the board at Resurrection University. So I have higher education board experience, that doesn't necessarily translate to a private company board in the minds of people that recruit for those companies, because it's not for profit. Well, just because it's not for profit doesn't mean the company's not making money, right? So you kind of have that mindset where people think, "Oh, well, you only have not-for-profit experience," but actually there are some pretty darn big non-for-profit companies that frankly would run... I mean, they do run like a private company board and they are more business-minded.

Beth:
And then your professional associations are running and doing what's right, but it's a non-for-profit and they're trying to make money and trying to run a business. And then you have your community organizations where it seems like the rigor of the governance can get a little bit weaker depending on the type of nonprofit. And I think, at least for me, I try to look for experiences in non-for-profits where there's some rigor around the running of the business and business savvy that's required because some non-for-profits seem like they're always looking for money and always, always, always looking for money and donations when... you wonder if they're running the business that well.

Beth:
So it's difficult. And so I'm not looking at any more non-for-profit positions because I have a lot of that experience, but it doesn't always translate to the other side, which is frustrating.

Dan:
Well, yeah, and it sounds like some of the red flags are if your only job on that board is to continually fundraise, that might be an issue. But yeah, no, those are great distinctions. And yeah, it's very interesting how people see experience. I think we see that even at the leadership level within hospitals. If you don't have that formal operations experience, you're considered not a leader in some respects and I think we need to broaden that significantly because it's an old way of looking at things.

Dan:
And there's research that shows innovation and change and the growth of companies is improved by creating more diversity of conversation and thought within the leadership team. And so I think we need to flip the script and get that as a core competency for boards rather than focusing on the numbers of the people who managed the numbers in the past.

Beth:
Okay, so what was the highest, if you will, level that I ever achieved in a hospital operations? So I was a charge nurse, I was a nurse manager, and I was a director of nursing. Okay. But my director role was a little bit what I would call non-traditional. That experience and those operation roles, while I wasn't a CNO, I don't know that you need to go much higher than a nurse manager or a director to understand operations, right? And this is my bias. Because I'm able to advise technology companies, I'm advising one right now, and the solution is very much for the staff RNs at the bedside.

Beth:
I still know what's going on at the bedside even though it's been a lot of years and I know what's going through the mind of the manager on those unit even though it's been a lot of years. So those operational experiences, I don't know if they have to be in the last two years, or you can have had operations younger point in your career and it still translates. Not a lot changes in healthcare and we still run units lot like we did when I was a new grad 25 years ago, right?

Dan:
Yep. Midnight staffing and poor shift report and we're still focused on infections and falls and-

Beth:
That's right.

Dan:
You're right. Some of the technology's changed, but everything else is pretty much... We still patients every two hours like [inaudible 00:00:26:46]. So that's really interesting. Yeah. So I think we need to kind of reframe that experience level and I think rounding it out. And this is what we're actually seeing in medical schools now too, is they don't want the pure science play anymore, at least some of the newer medical schools don't want that as their student. They want the well-rounded humanities major, music major who just has a different connection with people in the world as their targeted students and I think corporate America healthcare has not caught up to that yet.

Dan:
They're still kind of going by the playbook that's been around since Rockefeller and all that kind of stuff. So I do think we need to change it. So we're getting to the end of our time together here, but I would love... So one of the traditions we have here on the show is we... it's the handoff, which is that shift the shift report, that pertinent information we share with our oncoming colleagues as they start their day. What is one of those things that you'd like to hand off related to your work in careers and board work that our emerging nurse leaders and nurses can take away and do something with tomorrow.

Beth:
First one is the easy one. On the board side, absolutely you have to be registered in the Nurses on Boards Coalition website that you're interested in being on a board. And if you're ever asked, say yes, because you can do it even though you think you can't do it. You can do it, because nursing has provided us with a wealth of knowledge, background, critical thinking, systems thinking that is very applicable to a board position. So if you're approached, say yes even if you're not sure, just because you will do great at it.

Beth:
On the career side, I would say, "Spend some time thinking about what you want to be when you grow up." And I don't say that facetiously, I'm serious, because I think too many nurses just do the traditional up the ladder and there is a world of new things out there and different things. And you might need help opening some of those doors, but the doors are there. And even before you go to grad school, talk to someone to help you decide where you want to go with your career and maybe be a little more purposeful. Those are my two pearls.

Dan:
I love it. And so, Beth, how can interested leaders get a hold of you if they are interested in using your services to do exactly what you said?

Beth:
Well, two ways. I'm on LinkedIn. So my profile, I think it's Dr. Beth A. Brooks on LinkedIn. And I also have a website, thebrooksgroupllc.net, which is where I have information about career coaching and professional brand, what's your leadership brand, those kinds of things. So best way is to reach me on the web.

Dan:
Thank you so much, Beth, for being on the show today. I'm excited to see where we can go and get more healthcare professionals on boards and help them find their passionate career, because I was mentored early with that in mind and it made a world of difference and I hope we can share that with others. So thank you so much.

Beth:
Awesome. Thanks. It was really fun, Dan. I appreciate you asking me to be on your podcast.

Dan:
Thank you so much for tuning into The Handoff. If you like what you heard today, please consider writing us a review on iTunes or wherever you listen to podcasts. This is Dr. Nurse Dan, see you next time.

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