“I’m the oldest of four children; [I] grew up in a small town in Massachusetts, halfway between Boston and Providence. My dad was an electrician and my mom sold real estate, and both my parents started working at a really young age. My dad actually started working when he was eight years old and would ride his bike to the local dairy store and put newspapers together at five o’clock in the morning before school. Then out of high school, he got drafted into the Vietnam War, served there, and then when he got back, went to work for my grandfather in the family business. He was one of seven brothers, actually, who all worked for my grandfather. 

From a young age, both of my parents—because they didn’t have the opportunity to go to school, and it was always a bit of a struggle financially and making ends meet—were really focused on both myself and my siblings getting an education. And so [there was] really a tremendous focus on making sure that we got educations and actually worked in roles that helped us serve others. And in particular for myself and my sister, who’s fifteen years younger than me, both of us went into what I would call “service work”—me in nursing, and she teaches special needs children. And if you look at the four of us, three out of the four of us have master’s degrees, and I just completed my doctoral work … and we really have just always focused on giving back—but also working hard and not forgetting where you come from. 

I remember years growing up and after church on Sundays we’d go out with my father and do house calls, often by people who we saw at church who said, ‘Oh, you know, this light is out,’ or ‘We don’t have any hot water,’ or ‘This isn’t working.’ And I’ll never forget, so often we’d go into these homes and people would go to pay us after and he’d say, ‘No, don’t worry about it. Just say a prayer for me.’ And I think that kind of service is really what was so impactful for me growing up, and for me, the message was always: use your education to do better, and use your education to help others, and just never forget where you came from.”  

“In Massachusetts you have to be a certain age to start working and you have to get what are called ‘working papers.’ On my thirteenth birthday, I remember going to the superintendent’s office to get my working paper signed so I could start working. And I started working at a local pharmacy—actually one that my father had worked at when he was in high school and that a number of my cousins had worked at when they were in high school. And when I started working there, I really got to enjoy working behind the pharmacy counter and watching the pharmacist interact with people—watching how they really counseled and coached and talked, and the relationships they built with people, so that, more and more, health care became something that I was really focused on [and felt] could be a good pathway for me.  

When I was a sophomore in high school, I was really weighing in kind of, do I go the pharmacy route? Do I go physical therapy, occupational therapy? Looking at all kinds of different roads. And one day we had a career fair. One of the rooms for the career fair was a nursing room, and I went, and I attended it. What was great was there were about six different parents who spoke that day. And I’ll never forget it—I was a sophomore in high school, and six of the parents that spoke that day, I want to say three of them were dads and three were moms. And when I looked across, one of the moms was a nurse manager, another person was a critical care nurse, one worked in the ED, one was a flight nurse and a military nurse, one worked in the OR. It struck me how many different opportunities there were … and what I really loved about it is that you could move around a lot and really put your all into something, and then when you’re ready for a change, there’d be other opportunities out there. 

During that time, actually, we were in a pretty significant recession where I had grown up. A number of the factories and other employers were really downsizing, and so unemployment was really high, and a number of my friends’ parents were out of work. I remember a big part of that conversation was that no matter where you live, there’s always the need for nurses. It didn’t matter if you lived in the most rural or the most urban areas in the world; there was that need for nursing. So, it provided that backing to do whatever you wanted, and it was a great foundation to launch whatever you wanted to do long-term in your career.” 

“If I look at my leadership journey, [I] worked at the bedside for about eight years. And then I remember a friend of mine had just taken a leadership position, probably six months prior, and a new position had become available in the same organization that he really wanted. He talked to his boss and his boss said, ‘If you can find someone that’s equal to you or better than you to replace you, then I’ll give you that other position.’ And so, he tapped me on the shoulder one day and he was like, ‘Hey, I have an opportunity for you, any interest?’ 

I was soon to be married. We had just bought a house and the house was a ‘handyman special,’ so I had to gut it and get it renovated, so I actually was really banking on my nursing hours of having weekdays off to be able to get my father and some of my uncles there to help me. But after a long conversation with my wife Becky, she was like, ‘Just try it and go for it,’ and gave me that push I needed and quickly realized two things. One is I realized that I could have a broader impact across multiple patients and multiple people in my leadership role than when I was at the bedside focused on my one critical care patient. And although that impact was incredibly meaningful to that patient and their family, the broader impact that could have was looking at a hundred patients, or 200 patients, or 1,000 patients, or 2,000 patients, and making sure that they ended up in the right place at the right time, getting the right level of care just gave it a little bit of a broader reach.  

I early on got assigned a number of projects to work on. It really just shaped my overall view of what kind of impact you could have in a leadership role. And really from there it just took off, I spent a couple years in that role and then spent about five years in a nurse manager role, and then another five years in senior nursing executive role before I became the chief nursing officer here at UMass Memorial.”  

“I remember a research fellow saying to me, ‘When you’re at the bedside, you get almost an instant gratification. Whereas when you’re in leadership roles, it’s a little bit of a longer, slower path. But when you look back, the accomplishments are the same—you made an impact on patients.’ And basically, he was sharing that with me to tell me to slow down and be patient and realize that it’s not going to all get done in one shift. 

I remember, as a staff nurse in particular in the critical care environment, when you went in in the morning, your goal really at the end of your day was to make sure your patient or patients were doing better than they were when you got there in the morning… And honestly, you got your gratification knowing that you gave it your all.  

In leadership, it’s a little bit different. What really brings me tremendous joy [is] watching a staff nurse who maybe was struggling at one point in time, and you give a little bit of coaching and mentoring to, and [then] has tremendous success. Or knowing that a program you put in place is actually helping a unit or a floor run more consistently and run with less variability, so that the staff have a greater level of engagement and are more satisfied, and in turn are taking better care of patients. Or seeing a program that you choose to fund have success and patients saying, ‘Thank you.’ 

It’s really funny, we recently had started a Hospital at Home program, and we’ve really have had so much success with it. But a lot of the staff that we hired into it were staff with twenty, twenty-five, thirty years of hospital-based experience. Within a couple months of being in the program, all of them came up to us and said, ‘This is the best thing I ever did. It’s renewed my sense of purpose. It’s renewed me as a staff member.’ And just knowing that you’re making that kind of an impact—and out of the 600 patients that we’ve treated this year in the program, knowing that those 600 patients have gotten better care because of it—that’s where I think, as a leader, you get that gratification. And that’s what fills my cup.  

And then the last thing I think that kind of tops it off for me is really seeing leaders have success. Seeing managers, who maybe have worked for me for years, take that next step and have success at the next step. Seeing leaders who maybe came in and didn’t have all of the tools they needed and tools they wanted from the start, but being able to work with them and coach them and help them have success—to me, there’s no greater feeling.”  

 
“We’ve had stories where patients who were seen thirty, forty, fifty times a month in our emergency departments, we get them admitted into Hospital at Home, and when we get home, we see that they have no food, or they have a hoarding issue. So, some of the nurses have gone in and actually helped clean individuals’ apartments out (with their consent) to help give them a space so that they can ambulate to the bathroom. Doing laundry, going out food shopping, making sure that they have food. 

And all of that has, I think, opened the staff’s eyes to social determinants of health and what patients are dealing with on a day-to-day basis. And then how those social determinants of health impact their ability to stay well and impact their ability to stay out of the hospital, stay out of the emergency departments. That’s where I think Hospital at Home has such a profound impact, because in the hospital, patients lose control and dignity, and we provide this very controlled, structured environment for them. They go back to the environment that they live in, which is kind of anything but that. So, everything else gets in the way. What Hospital at Home does is it allows us to deliver care and come up with a safe care plan with those in that environment that they live in each and every day… And the beauty is, technology is such nowadays that we really have the ability to monitor the patients safely in their home and provide greater care to them.” 

“One of the things that’s come up recently, people have talked a little bit about workload, but it’s also the 24/7 nature of the hospital business. One of my big focuses has always been, ‘What do we have for support during the off-hours, and on weekends, on holidays? And how strong is that structure and that foundation?’ That’s important for [two reasons]. One, for your frontline leaders, that is the time that they need to be off. That is the time that they need to either be with their families or doing something else that helps them find additional purpose, or it just gives them that headspace so that they can come in and be their best selves. And then also, that’s the time that the staff needs you most. And so having individuals who are really strong leaders in those roles, who can help troubleshoot, and build relationships, and who the staff trust, is really important. And so much of my focus is on that: how do you build and create systems that really work during those off times so that the frontline management team can have a break, clear their head, and do whatever it is that helps them come in and be their best selves the next day? 

And that’s so important. And I think a lot of organizations sometimes miss the mark, we don’t invest enough in those off-hours and kind of weekend times and holidays… and understand the importance of it.  

I learned a really important lesson a couple years ago around that, where we had had a patient issue in one of our emergency departments. It was on Christmas Eve, and I remember working with the nurse manager around it and it was kind of off-hours. Instead of working through the nursing supervisor who was the in-house coverage at the time, I worked through this nurse’s nurse manager. And I wasn’t super happy with the way that things had played out, and I ended up making the mistake of texting her on Christmas Day a couple more thoughts I’d had. We later discussed it, and I actually later apologized to her. As I sat back and reflected on it, there was no need for me to bother on Christmas day, you know, she has young kids, and she was trying to just enjoy her Christmas morning. I lost sight of the fact of getting a text, not just from her boss, but from her boss’s boss, on Christmas Day was really poor form on my part. I took that lesson and really took it to heart. I really think that as we continue to try to grow and develop leaders, we have to be so mindful of that—because we’re so connected all the time, it’s very easy for them to get pulled into a hundred different directions.”  

“We were in their first wave of Covid. This was before vaccines and really when the world was locked down. We had a nurse whose grandmother was in one of our ICUs who was dying, and the family just really wanted to go in and say their goodbyes. And more importantly, they really wanted the grandmother to see her pet. And the staff, through their own accord, came up with a plan to get her down to one of our ground level floors in a safe way and face her out the window so that people could say goodbye. We chronicled this through a number of media outlets at the time because it was just such a great display of humanity by the staff, and they came up with it on their own. When you give people space to innovate and give people space to be creative, they can really solve some significant problems. And at that time, that was an absolutely significant problem. We were under mandates not to allow family and staff in, the grandmother had Covid—and we really didn’t know a lot about the disease at the time—but the staff really went out of their way and above and beyond to help support that family.” 

“Through our DAISY Award program, the family that wrote in talked about how when their loved one was nearing death, he had had friends visiting late one Saturday night and all he really wanted was a steak. And this nurse knew that the only pub in town that was still serving food […] actually had halfway decent steaks. And she ordered takeout for him, and had it delivered, and he was able to have a steak dinner with his friends, and [he] passed away a couple days later. The nurse, unbeknownst to the family, attended the funeral, and in the eulogy, the family mentioned this as really a moment of dignity for their loved one who had been struggling for so long, and that for the next couple of days, up until his passing, that’s all he talked about—that steak dinner and how great it was. And I’ve joked with her because she’s like, ‘It’s a rubbery $10 steak,’ but it really made such a profound difference. And what I often say to staff is, ‘Don’t underestimate the impact you have. That family will remember you for the rest of their lives. They’ll remember your name, they’ll remember where you were from, and most importantly, they’ll remember how you made them feel.’ And enough so that when they talk about glimmers and moments of an individual’s life, that’s so important.” 

“The opportunities are endless, from a nursing perspective, and the way that we can help impact kind of delivery of healthcare—and I would say, actually, wellness services to the communities we serve. … What Covid taught us is: Get back to what you’re passionate about and get back to what you really care about.  

I think honestly, in some ways, that’s impacted the labor market, because we have the vacancy rates that we have and the challenges that we struggle with. But I do think people have gotten back to like, ‘Let me get back to what I find meaningful and what brings me meaning and fulfills me.’ And that’s what’s great about [the] nursing sector. There is a ton of opportunity.”   

“Always bringing it back to the patient and the community that you serve is incredibly important. So, when you’re in conversations and you’re making decisions, especially as a leader, about, ‘Do we do this, or do we do that? Can we support this? Can we not?’ Bringing it back to, ‘What is the impact on patients going to be?’ is really an important true north metric. It’s really an important true north compass of, ‘This is how we do business,’ and that really focused kind of core value. It’s so important.” 

“I think when you talk about leaders… what one person needs is different than what someone else needs. My nurse executive team and I had this conversation today—we’ve had a couple of our younger, less experienced nurse managers turn over or talk about doing something different recently, and we had the conversation today of, ‘What do we need to be doing differently to meet the expectations and to give the support needed so that we can continue to grow leaders?’ Healthcare, especially academic medicine, is so hierarchical and it’s very traditional. And if we don’t break some of those molds and really support the growth and development of newer leaders, we’re never going to bring about the change that we need to have, the success we have and to engage our frontline staff.” 

“I work really hard to understand the value of work-life balance and people having time off. Whether it’s to take care of an aging parent, or sick child, or anything else that kind of comes in between, just recognizing that that’s important in people’s lives. And then honestly, giving people the space to make mistakes. I learn best from those mistakes that I make, and I know a number of people do, and so giving people the space to figure it out on their own but knowing that they can always come to me if they have a question, I think, has helped us have success.” 

“You’re with patients at such a vulnerable moment in their life. And treating them with respect and dignity, and then building that trusting relationship—there’s nothing more important.”  

“What I often say to staff is, ‘Don’t underestimate the impact you have. That family will remember you for the rest of their lives. They’ll remember your name, they’ll remember where you were from, and most importantly, they’ll remember how you made them feel.’”