A retired nurse CEO says we need nurses in government, on the boards of for-profits, and mentoring the next generation given their powerful role in influencing people, policies, and systems.
Maria Gomez has had her finger on the pulse of our healthcare system and the people it serves throughout her storied, 30+ year career running a community health center that serves a low-income, immigrant community in greater Washington, D.C. Maria entered the United States at age 13, started Mary’s Center after becoming a nurse, and helped grow it into a powerhouse serving 60,000 people each year. Mary’s Center helped pioneer an integrated model of healthcare, education and social services to put people on a path to good health, stability and economic independence. In 2012, President Obama presented Maria with the Presidential Citizens Medal. She retired in late 2021. Here, in the second part of a two-part interview, she reflects on the challenges facing our healthcare system, how nurses can continue leading efforts to meet them, and what we can learn from the pandemic.
What are the greatest challenges facing our healthcare system?
Today, it’s all about the numbers—the number of patients you see and the number of minutes it takes. Because that’s how you get paid. To transform lives, we need to change how we address patient needs. Providers can’t do it all in 15 minutes. Some are so overwhelmed by the numerous demands on them that they’ve grown numb to what their patients are feeling. Too many smart, incredibly passionate people who devote themselves to healthcare have become disheartened, burned out, and are even leaving the workforce. This is the most discouraged I’ve seen providers in my career.
To improve things for both patients and providers, we must support interdisciplinary teams of doctors, nurses, social workers, care coordinators, etc. And we need to ensure they have sufficient time and space to discuss their patients’ needs and coordinate care. Changing incentives will transform care and help address the high costs of healthcare.
Nurses have always been on the frontlines of delivering healthcare. What is your advice and vision for the profession moving forward?
Nurses have a powerful role to play in influencing people, polices and organizations. They are leaders, and we need them to lead hospitals, health centers–even architecture firms. For example during a renovation project during my time at Mary’s Center, one of the project leads was a nurse who could see the big picture, identify safety issues and lead the project with a perspective that was empathetic to patient and providers needs.
In working closely with patients, nurses have a first-hand understanding of the need for affordable childcare and paid leave. We need nurses running for office, sitting in the House and Senate, and educating our leaders to ensure policies make sense and are relevant to our community.
We need nurses serving on the board of directors even on for-profit companies. They have an instrumental role in influencing decisions related to employee well-being, benefits, paid time off and even advocate for childcare so parents can get to work and their kids are in a safe and educational setting.
I’d also like to see more minority nurses mentor the next generation, and more nursing schools address social determinants of health so their students can continue their education without becoming hungry or homeless or leaving school to become family caregivers.
What have we learned from the pandemic?
The pandemic has shown us that our communities are very resilient, but also very vulnerable. We learned about how unevenly the wealth in our nation is distributed. Black and Hispanic individuals, children and families and those with low incomes suffered the most, both from illness and from the economic fallout. Even the middle class were just a few paychecks away from disaster. We need to reckon with the structural barriers that have created such tremendous disparities between those who have everything and those who have nothing.
A silver lining of the pandemic is how it has helped us realize that we’ve paid little attention to our families, and even to our own well-being. It’s why we need to adapt workplaces that facilitate a balance between being a productive worker, and having enough time for our own wellbeing and that of our families. Getting that balance right is very important and yes this rebalancing does take resources.
What advice do you have for those who will continue your legacy?
Never forget about the people you are serving. Systems are only as good as the people in front of them providing the guidance and support and that requires careful listening. It takes smart, passionate teams to drive change. Be pragmatic but never stop envisioning what you can achieve alongside your team. And if we are genuinely committed to tackling the racism embedded within our healthcare system, we must actively recruit racially and ethnically diverse healthcare staff at all levels. Last, but not least, we must analyze our data to drive quality, this mean equally analyzing both qualitative and quantitative data.I will continue advocating for investments in comprehensive programs and for organizations to get general support dollars, so providers are liberated to provide the care they were promised in school–the care their patients desperately need.