Stepping Up: Deciding if a Nurse Leadership Position Is Right for You

Podcast Transcript

Carol Pehotsky:

Many of us go into nursing with a sole focus on a career in patient care. We might be intimidated by the thoughts of being a leader in the field, we may flat out reject it, or we may not see that in ourselves. But for some of us, we benefit from a gentle tap on the shoulder that says, "I've seen something in you, you might not have seen in yourself." We're joined today by Dr. Kelly Hancock, chief caregiver officer at Cleveland Clinic, to discuss her nursing leadership journey and what we can all learn from it.

Hi, and welcome to Nurse Essentials, a Cleveland Clinic Podcast where we discuss all things nursing, from patient care to advancing your career, to navigating tough on-the-job issues. We're so glad you're here. I'm your host, Carol Pehotsky, Associate Chief Nursing Officer of Surgical Services Nursing.

Well, hello, again. Welcome back. We are recording today's episode during Nurses Week 2023. And with Nurses Week comes, of course, lots of fantastic celebrations and great things out there in social media, sometimes (laughs) freebies, sometimes acknowledgement of thank you and gratitude. But one tweet in particular caught my attention. To summarize, it said, "Amidst the excitement and activity of Nurses Week, please take a moment to reflect on your profession." I'm thrilled to be joined today by the author of that tweet, a woman who really needs no introduction. She is Cleveland Clinic's chief caregiver officer and nurse leader extraordinaire, Dr. Kelly Hancock. Kelly, thank you so much for joining me today.

Kelly Hancock:

Oh, thank you, Carol. It's a pleasure to be here. And happy Nurses Week to you.

Carol Pehotsky:

Thank you very much. I'm just in awe of having you here. You know, uh, a lot of our listeners are from the Cleveland Clinic. I've had such a privilege to be able to be mentored by you and led by you over the years. And I'm hoping to have a little conversation with you today so everybody can see just how easy it is you are to talk to and how much you have to share with all of us.

Kelly Hancock:

Oh, thank you. I look forward to the conversation.

Carol Pehotsky:

Okay. So, we know that our listeners are probably everywhere from... hopefully, maybe it's people who are considering nursing school all the way through people who have been nurses for years and maybe even at the end of their career. We haven't spent a lot of time talking about leadership yet in this journey, but we know that some people are terrified of leadership roles and some people are maybe curious about that. You've obviously spent some wonderful years in leadership and touched so many lives through that role. And I'm wondering if you could share a little bit with us about your journey from bedside nurse to your leadership journey today.

Kelly Hancock:

Oh, it'd be my pleasure. I mean, there's so many wonderful experiences that I've had over the years. So, as I reflect back on that journey, you know, I think about, you know, 30 years ago when I began here. So, it's actually this month.

Carol Pehotsky:

It's your anniversary.

Kelly Hancock:

Yes.

Carol Pehotsky:

Yes, folks, it is.

Kelly Hancock:

30 years. It's hard to believe 30 years have gone that fast. But I began at the Cleveland Clinic as a nurse associate. And as you know, we brought that program back a number of years ago. But at the time, it was a program, as it is today, designed for somebody entering their final year of their program, and in, at that time it was a four-year program. So, I attended Ursuline College Breen School of Nursing. We had a presenter in one of our courses saying, "This is a wonderful opportunity to get this internship at the Cleveland Clinic." And I thought, "I think I'm interested in that."

Carol Pehotsky:

Was that brand new at the time when you started?

Kelly Hancock:

It was brand new at the time, and it was highly competitive. And the way they described it is that you get to be alongside of a nurse, you know, for 10 to 12 weeks over a summer, do everything that a nurse does within reason.

Carol Pehotsky:

Of course.

Kelly Hancock:

But also, what a wonderful opportunity to prepare you for your final year of your nursing program. And so, I pursued that opportunity and was fortunate enough to be a nurse associate on one of the cardiothoracic step-down units now in the G Building which was formerly called the Heart Center pre-HVTI days. And so, I really enjoyed that experience. And I did agree that it, it prepared me very well for my final year. I stayed on PRN during my schooling, my final year as a nurse associate. And then when I graduated, I stayed there as a registered nurse, and so I had a wonderful opportunity. At that time, this was pre-12-hour days.

Carol Pehotsky:

Oh, really?

Kelly Hancock:

Yeah. I know. So, I worked 5:00, 8:00s, 3:00 to 11:00 shift as a registered nurse every other weekend.

Carol Pehotsky:

Evening shift. Woof.

Kelly Hancock:

Yes.

Carol Pehotsky:

The evening shift. That's hard.

Kelly Hancock:

In fact, I enjoy the evening shift.

Carol Pehotsky:

It's very active. It goes by fast.

Kelly Hancock:

It is very active, but I did enjoy it. I enjoyed the camaraderie, to be honest with you, of the team.

Carol Pehotsky:

For sure.

Kelly Hancock:

And at that time, they had charge nurses as opposed to assistant nurse managers as we do today on various shifts. And so, early on in my career, I was asked to assume the charge nurse role on the 3:00 to 11:00 shift.

Carol Pehotsky:

Woof.

Kelly Hancock:

And that was really the entry into my journey of leadership. And so, I thought, "Okay, I'm relatively new as a nurse. I'm asked to be the charge nurse "What does this all entail?"

Carol Pehotsky:

And a shift where a lot of decisions have to be made pretty quickly.

Kelly Hancock:

Exactly. Exactly.

Carol Pehotsky:

Yeah.

Kelly Hancock:

And if you think about it, you know, back then caring for these patients on that unit, post open-heart, we also had the first left ventricular assist devices on that unit.

Carol Pehotsky:

Sure.

Kelly Hancock:

So those patients are waiting for transplant and post heart transplants. So, this is before transplant units, and it was all on one.

Carol Pehotsky:

Still mixed. My goodness. Yeah.

Kelly Hancock:

So, there was a lot to manage to ensure that you had the appropriate resources to take care of the patients, a- as you can imagine how busy it was. And so, I embraced the opportunity and really leaned on my teammates who've had that experience to kind of show me the way. And I enjoyed it. So, I enjoyed caring for the patients, while being in charge, managing the unit, was something, this isn't so bad. So, you fast-forward a couple of years, to be honest, into my career my clinical career, and our organization, and again, it was just Cleveland Clinic 9500 was going through an organizational change. And they introduced some new nursing leadership titles into the organization.

Carol Pehotsky:

Oh, okay.

Kelly Hancock:

So, they transform the traditional assistant nurse manager role to a clinical coordinator role.

Carol Pehotsky:

Oh, okay.

Kelly Hancock:

And so that was a person who was like an assistant nurse manager, but you had more functions in terms of scheduling, payroll and some of those different items.

Carol Pehotsky:

Succession planning.

Kelly Hancock:

Yes.

Carol Pehotsky:

All that good stuff. Yeah.

Kelly Hancock:

Yes. Yes. And so actually, one of my mentors was a clinical nurse specialist who was dedicated to her unit. Her name was Josie Domingo and many people who work here may remember her, you know, she was just an awesome clinical nurse specialist. She encouraged me to pursue this.

Carol Pehotsky:

Oh, how about that?

Kelly Hancock:

And I said "Josie, I don't know if this is what I want to do." She says, "You know, Kelly, I've witnessed you at the bedside being this informal leader, being an advocate for patients. I know you're relatively new in your clinical career. I see you assume the charger's responsibilities; I think you would be great because it's the blend of both worlds. It's also clinical still as well as leadership."

And so, with her encouragement, and advisement, I pursued it and, and fortunate for me, I was awarded one of those positions on that unit.

Carol Pehotsky:

Fantastic. Yeah.

Kelly Hancock:

And so that really began really the journey of a true leadership track for me that I really did not intend when I graduated at all. I really didn't imagine myself going down that path. So, one thing led to another, and as the organization grew in terms of open-heart surgery, cardiothoracic units, there were additional units that opened up that needed nurse managers.

Carol Pehotsky:

Okay.

Kelly Hancock:

So that would be the next logical step for me in my eyes. And again, I had some encouragement from colleagues and mentors to pursue an open position for nurse manager, and I did. And again, I was fortunate enough to earn that position. It was over one unit, two units, and did that for a number of years. And then the director of nursing for the heart center became open. And that was all of the ICU stepped down areas, et cetera, Cath Lab, and I pursued that and was awarded that. And then Dr. Cosgrove was appointed president and CEO. And in that time, as you may remember, we converted to the clinical institute model.

Carol Pehotsky:

Yes.

Kelly Hancock:

So, the institute's reforms. And so, it was HVI, the Heart and Vascular Institute was formed at that time. And again, another opportunity as a director of that role became open. And so, I navigated into that role as well. I held that role for a number of years and had the fortunate opportunity to witness the new building of the, maybe a part of it, the Miller Pavilion, which it is hard to believe how old it is now, since we opened it.

Carol Pehotsky:

Yeah. How many times do you have an opportunity to help watch something be built and have a fingerprint design?

Kelly Hancock:

Absolutely.

Carol Pehotsky:

Wow.

Kelly Hancock:

And what I loved about that opportunity, as a leader is really ensuring that those who are going to be working in that facility, they had a voice, they had a voice in designing you know, what does the lab room look like?

What is the patient room, where's my charting space? And that was really, you're right, an amazing opportunity to be a part of that. And then, at that time, we had some changes in our, uh, chief nursing officer at the main campus. And that opportunity presented itself and I did pursue it and was awarded that position. The organization also pivoted to form the nursing institute.

Carol Pehotsky:

Yes.

Kelly Hancock:

Right. And so, a credit to Dr. Cosgrove as when he was thinking about the clinical institutes as he shared that. He thought that from a nursing perspective, nursing should be governed by nurses across the institute as well and really under one entity, for a few purposes, one of which is to really ensure that we have nursing practice that standardize across the organization, that from a nursing perspective as individuals and contributors, that you really can enjoy a fulfilling career at any one of our locations, and the ease to do that because of the standardization is really one of the factors that drove him there. So, he put into place an executive chief nursing officer. And we had a wonderful leader who was in our organization who really established the framework for that institute. And as she moved on that opportunity presented itself as well. And so, it was interesting, Carol, I remember having conversations about this because I thought "Okay, we're going higher and higher. You know, is this something really, I want to continue to do?" And a couple of reasons why I thought it was the right thing.

I certainly enjoyed working with so many different people within nursing and outside of nursing. I know, I wasn't going to be alone, on that journey, that you have wonderful teammates, mentors that can help you along the way. So, I decided to pursue that and had a dual role of the chief nurse registered on campus. Yeah. The CFO for the institute nearly nine years. So, I know that's a long-winded answer to your question.

Carol Pehotsky:

Yeah. But, but what a fantastic journey.

Kelly Hancock:

But that's the journey.

Carol Pehotsky:

Yes, sometimes when, you know, we all get to those days where it's like, "Oh, my gosh, you have so much to do. It's like Kelly Hancock could be the executive chief nursing officer."

Kelly Hancock:

Oh.

Carol Pehotsky:

And you know, right, it's, I can pull myself together, you know, we think about what, uh, what an inspiration and as I listen to your story, two things really resonated with me, you know, I think back to, to Josie and those, those wise words of hers that, you know, sometimes we get that tap on the shoulder from people in formal leadership roles.

Kelly Hancock:

That's right.

Carol Pehotsky:

But this was somebody who really saw you, saw things in you that maybe you didn't see in yourself. And so how are we all listening today thinking about what the amazing impact we can have on each other within nursing just by taking a few moments to say, "You know, I see something in you." And even it wasn't in her. It wasn't the nurse manager saying, "Hey, come and be part of my succession plan." She, she was brave enough to take the time to say, "I see something in you that I think you should consider."

Kelly Hancock:

I think that's very important. And, and I think that's a lesson I took away from myself as well as to provide that encouragement that people don't see that they have that special skill set, that competency that they can do to give them that confidence and encouragement.

Carol Pehotsky:

Yeah.

Kelly Hancock:

Conversely, I also think it's important to ensure that if you do see your colleagues or people who perhaps don't seem fulfilled in the role that they currently hold, you get them to the right role where they will be fulfilled.

Carol Pehotsky:

Yes.

Kelly Hancock:

I think that's also our responsibility, not only as leaders, but as fellow caregivers for one another.

Carol Pehotsky:

We need every single nurse.

Kelly Hancock:

That's right. That's right.

Carol Pehotsky:

So, yeah, if you're feeling restless, there's always something else to do.

Kelly Hancock:

Yes.

Carol Pehotsky:

The other thing that I don't think I knew about you is that you had no intention of ever going into leadership, because that's as you know, it has been very much my journey as well.

Kelly Hancock:

Yes.

Carol Pehotsky:

And so, what I'd say to you, listeners, if some of your, I have said that I've literally said to somebody, some, one time, "I will never go into leadership." Way back in my career, somebody said, "You should be a service manager." And I said, "Well, I don't want to be, want to be a nurse manager." And they said, "Well, you don't have to be a nurse manager."

Kelly Hancock:

That's right.

Carol Pehotsky:

It's like, "What do you think the assistant is supposed (laughs) to do next?" And here we are, right?

Kelly Hancock:

Here we are.

Carol Pehotsky:

So, you've also really been a great example of saying yes, right? You know, what is the opportunity, what does that look like talking with your loved ones, talking with your family, exploring if it's the right thing for you, and then going for it?

Kelly Hancock:

I think that's important, because as you assume more responsibility in the organization nobody takes it light. And you have to ensure that you're going to be re- dedicated, committed, and it's a balancing act. So, if you think about, you know, my case, in particular, I had a young family at the time in different roles, and it was important for me to always be there for my children, not to miss the, you know, spring concerts, winter concerts, the honors and all that good stuff assemblies. And I was able to, to balance both and, you know, thankfully, a very supportive husband as I know, your husband is as well.

And, you know, we make it work. Was it easy? No, not always. But we were able to make it work. And I, and I think that's the important piece is having that balance. You know, it's interesting, because as I think about that journey along the way, you talked about how some of these experiences form and shape who you are as a leader. And there's also the formal educational piece of it.

Carol Pehotsky:

Of course. Yeah.

Kelly Hancock:

And as I think about when I went back to pursue my master's, and then my doctorate, that too, was another undertaking. So, having the different leadership roles as you know you've been through the same path and understanding, "Okay, can I do this? Can I balance all this?" And then when you come to the right reason why you want to pursue that further education, it is all about making yourself a better leader, so you can serve our nursing colleagues, the organization and our patients differently and better. And so, when I pursued my master's at Ursuline, and then, you know, about seven years later decided to do my doctorate, I wanted to do both for those reasons that I've just mentioned. And I also wanted to do them on my own and be the role model.

Carol Pehotsky:

Yes.

Kelly Hancock:

Because as we know what the evidence will suggest the more that you have education in the area of your specialty and/or a certification in your specialty the better that you can serve patients, caregivers, and the outcomes speak for themselves. And so, I wanted to be that role model for others.

Carol Pehotsky:

You absolutely have been. When I was curious in my doctorate, I went to an information session, walked into a room, and there you were, and every other chief nursing officer in the Cleveland Clinic, it's like, "Oh, okay, message received."

"This is something that the organization and our chief nurse values." So, you've been a great role model in that as well. So gosh, you've given me so much to think about, Kelly. So maybe we have listeners out there that are thinking, "Hmm." I'm sure you've inspired several of them too, to do a little reflection and consideration. So as part of that, what would you recommend somebody who's a bedside nurse do to sort of self-assess, "Do I have what it takes? Am I ready for this in my career and in my time of life?"

Kelly Hancock:

Yeah, that's a great question. I think when you're reflecting, "Whether leadership is for me or not," you have to really reflect on what impact do you want to have in that role? So, if you reflect on it, you know, "What am I really good at? Am I a strong communicator?"

Carol Pehotsky:

Sure.

Kelly Hancock:

And what I mean by that is not only being an effective communicator in terms of messaging but also listening.

Carol Pehotsky:

Absolutely.

Kelly Hancock:

You know, I think one of the strongest competencies that a leader has, the ability to really listen and be presence.

Carol Pehotsky:

Yes.

Kelly Hancock:

So, if you feel that you have that attribute, that skill set, and you really want to make an impact, uh, the quality of care, the engagement, the culture, I would say, if that aligns with you, and what you want to do in terms of commitment, and balancing where you're at personally and professionally, I think that's something that you should pursue.

Carol Pehotsky:

Yeah.

Kelly Hancock:

What I often share with people who are contemplating a journey in leadership, is shadow with some different leaders.

Carol Pehotsky:

That's a great idea.

Kelly Hancock:

You know, not only within nursing, but outside of nursing as well.

Carol Pehotsky:

And not just your own manager, but yeah.

Kelly Hancock:

You know, so you have our physician colleagues you know who went to medical school, right? And they didn't necessarily think they were going to assume leadership roles for some of our administrative colleagues. So, I mean, there's a variety of talented leaders in our organization in particular, that you should just go have a conversation with, and ask them what they find their joy in leadership.

Carol Pehotsky:

Absolutely.

Kelly Hancock:

What are some of the things that they've done to prepare them for this leadership journey? And that always seems to be a positive recommendation that people appreciate and find value in.

Carol Pehotsky:

Absolutely. And whether you're within our organization or another one, people are always so gracious with their time when somebody says, "Gosh, could I spend a few hours with you?" I've never had somebody say, no. They're just so honored to be contacted and asked. You know, one of the things that, you, you know, you took a risk on me, and I'm very grateful for that. And as I was able to grow and, and learn from you, you know, one thing that we, you and I have talked about a lot is, "But I haven't, haven't been this type of nurse or that type of nurse. So how can I lead them?" And you've always had such wise words, uh, behind that. Do you mind sharing some of those with our listeners?

Kelly Hancock:

Oh, absolutely. And so, I'm a firm believer, we have so many clinical experts in our organization, you know, across different specialties. So, when I think about leadership selection, in different clinical areas. So, we'll take nursing, for example, I'm not necessarily sold on the fact that you have to be the clinical expert of that specialty.

Carol Pehotsky:

Sure.

Kelly Hancock:

What I'm looking for, and I think with the organization and those that we serve, is ensuring that we have the right leader at the right time serving our caregivers.

Carol Pehotsky:

Sure.

Kelly Hancock:

So, it's looking for those skill sets and competencies. We think about our leadership behaviors, making sure that it's aligned, you know, that individual is aligned with our leadership, you know, behaviors in the organization, the values of our organization. And I think if all of those line up, then I feel very confident about selecting the most appropriate leader, you know, a leader who has the mindset that they could have the courage to be vulnerable.

Carol Pehotsky:

Sure.

Kelly Hancock:

And, and that's cute.

Carol Pehotsky:

That's hard to learn. But it's absolutely true.

Kelly Hancock:

That is hard to learn.

Carol Pehotsky:

Yes.

Kelly Hancock:

And I've, I've learned that from my own experiences, but I see that and other people when they say, "You know what, Kelly, I'm just going to let you know I don't know if I could do this. I haven't done this. But here, boy, do I have the passion for it."

Carol Pehotsky:

Sure.

Kelly Hancock:

"And this is what I believe in." That's a lot of courage to make yourself vulnerable. And I think that's something that is key to success in terms of leadership.

Carol Pehotsky:

Absolutely. And I would challenge our listeners to think about that, maybe you've been somebody on the side of the conversation that said, "I'm curious about leadership. But, you know, I haven't, you know, I'm not an ICU nurse, how could I lead an ICU team, et cetera?" But gone are the days where we've been every type of nurse to be a leader and gone are the days that we could possibly know everything. And so on that side of the piece, if you are a nurse who is not interested in leadership, and maybe feeling frustrated, "You know, my manager isn't right there at the bedside with me," is that, what role would you want your leader to play in advocating for you and, and being present for you, but maybe not taking a staff assignment?

Kelly Hancock:

Exactly, you, you know, it reminds me of questions that I've received from many people over the years. "Kelly, don't you miss taking care of patients?"

"Didn't you go into nursing to care for patients?" And I said, "Well, certainly I miss the daily interactions with patients and their families, but I am caring for patients."

Carol Pehotsky:

Absolutely.

Kelly Hancock:

"I'm caring for patients in a different way, by my leadership, by the ways that I'm advocating for patients and for our colleagues." And to your example, about the nurse manager know, they don't necessarily have to be right with you taking an assignment to make them an effective nurse manager. But do they need to be effective communicator advocates?

Carol Pehotsky:

Yes.

Kelly Hancock:

Of course, they do.

Carol Pehotsky:

Yes.

Kelly Hancock:

And that's where they deliver the quality care that we want them to.

Carol Pehotsky:

And certainly, in the last three years, we have seen nurse managers, nursing directors, CNOs across the country, rolling up their sleeves and helping.

Kelly Hancock:

Absolutely.

Carol Pehotsky:

And I think that the bounce then becomes that if you're a new leader, for example, it's almost more comfortable to be at the bedside, it's what you know and it's having that courage to say, "I can't take an assignment every day, because I'm not leading my team if I'm always right there."

Kelly Hancock:

When you think about engagement in an organization, and the impact that that frontline leader has on engagement, it is so critical.

Carol Pehotsky:

Absolutely.

Kelly Hancock:

You know, when you look at all the evidence, and all the research spanning all the industries, that is really key. So, if to your example, if we have leaders jumping in an assignment every day, they're not going to be able to impact strategically. Exactly.

Carol Pehotsky:

Yeah. Yeah.

Kelly Hancock:

And so, we have to have them be supported and have the courage to step away and say, "I'm here supporting you. But I also have to be strategic to think about where I'm taking this unit, where I'm leading you as a team."

Carol Pehotsky:

Mm-hmm. Yeah. If I'm in clinical service, depending on whether that's OR, or med-surg it's anywhere from one to six or seven patients at a time, if I'm in a leadership role, I'm taking care of thousands of patients.

Kelly Hancock:

Thousands.

Carol Pehotsky:

Yes, absolutely. That's fantastic. Well, I'm sad to say we're, we're wrapping up on time. I can talk I know, I can talk, talk for hours with you about this. So, I want to transition to, to maybe a slightly more personal questions to help our audience get to know them more.

Kelly Hancock:

Yes.

Carol Pehotsky:

So, what brings you joy?

Kelly Hancock:

What brings me joy? My gosh, there's many things that bring me joy. I think first and foremost, my family, of course, my husband, I have two children. Both are going into the medical. My son's going to be a resident here July 1.

Carol Pehotsky:

So exciting.

Kelly Hancock:

My daughter is a nurse here.

Carol Pehotsky:

Yeah.

Kelly Hancock:

And so of course, they bring me joy every day. And then of course, I have a new granddaughter, as you know.

Carol Pehotsky:

Yes.

Kelly Hancock:

And so, Harper's, full of joy. I think on a professional side, the joy that I find in my work is really the team that I surround myself with. And working alongside people like yourself and, and many of our colleagues has truly been inspirational for me, particularly over these past few years. It's really been dynamic. And one mentor once told me, "As a leader, the greatest asset you can have been the team you surround yourself with."

And I've always taken that with me, and that's what really finds me the joy in my work. Knowing that we work in an organization that supports our caregivers in the way we do, that supports the highest quality of care for our patients. That's what brings me joy to be a part of that.

Carol Pehotsky:

Well, Kelly, it's such an honor to be part of somebody you consider your team. And it's been so wonderful having you here today.

Kelly Hancock:

Well, thank you so much, Carol. This has been great.

Carol Pehotsky:

As always, thanks so much for joining us for today's discussion. Don't miss out. Subscribe to hear new episodes wherever you get your podcasts. And remember, we want to hear from you. Do you have ideas for future podcasts or want to share your stories? Email us at nurseessentials@ccf.org. To learn more about nursing at Cleveland Clinic, please check us out at clevelandclinic.org/nursing. Until next time, take care of yourselves and take care of each other.

The information in this podcast is for educational and entertainment purposes only and does not constitute medical or legal advice. Consult your local state boards of nursing for any specific practice questions.