The Rookie

November 5, 2006 -- Today The Boston Globe ran a very good piece about George Geary, who spent 18 years as the "successful CEO" of Milton Hospital before resigning--and then attending nursing school. Rich Fahey's article "Man of patients" explores Geary's unusual journey, which at the time of the article finds the former CEO working as a staff nurse on the night shift in the critical care unit of Caritas Carney Hospital. The piece naturally conveys a fair amount of wonder that anyone would pursue this career path. But for the most part it resists easy assumptions about the relative merits of the two jobs. It makes clear that even a hospital CEO who is not a nurse must return to school to become a nurse. And it gives readers some sense of how much the jobs of CEO and direct care nurse have in common, particularly the need for good critical thinking and interpersonal skills. We thank Fahey and the Globe for this article.

The piece alternates descriptions of Geary's current CCU position with details from his personal history. Geary, now 59, reportedly first received a bachelor's degree in biology from Boston College. He did "some teaching," then studied respiratory therapy at Northeastern, and got a job at Milton Hospital. Later, he got an MBA from Northeastern, became Milton's assistant director of human resources, then director, then vice president for clinical services, and in 1985, president and CEO of the hospital. The piece stresses that under Geary's leadership, Milton "flourished, finishing in the black 14 years in a row," and tying for first in the state in a 1998 consumer satisfaction survey. After overseeing the negotiation of Milton's affiliation with Boston's Beth Israel Deaconess, Geary left his post in 2003--after 18 years as CEO when the average tenure in that position was six years.

The article reports that Geary entered the Labouré College of Nursing, graduated as the valedictorian at the end of 2005, and passed the state nursing boards in early 2006. Those who have known Geary for a long time were not surprised at his move. His "wife of 29 years," Maryellen Geary, notes that Geary had talked when they were first dating about "going into nursing at Yale's masters degree program." Former Milton vice president for nursing Nancy Gaden says that Geary occasionally "dropped hints about returning to patient care" during his time as CEO, and adds that "[h]e's always valued nurses."

The piece also gives a good picture of Geary's current work in the "busy CCU" at Carney in Dorchester. It describes Geary's discussions at the start of his shift with nurse Marie Fallon about an elderly patient with several chronic conditions. Geary takes detailed notes--Fallon says he's "very conscientious"--and he explains to the reporter:

With this type of patient, her treatment is only one of the issues. You have to get in touch with social services. Will she be able to get care at home? These are all things we start working on when the patient is admitted.

Geary is also quoted as noting that the CCU "involves critical thinking on my part, the ability to quickly and correctly make decisions and think on my feet." The piece says that the "biggest surprise" for Geary has been "the amount of time he needs to spend with patients and families in explaining procedures." No doubt most people would be surprised at how much patient education nurses do, especially since the mass media rarely shows them doing any. (Geary seems to see this as somehow outside the main work of nursing--he's quoted as saying "you're part social worker, part healthcare provider"--but it has long been central to nursing's mission.)

Positive comments from other nurses at Carney highlight other aspects of Geary's work. These nurses say Geary has (in the piece's words) "fit right in." Joyce Phalen, whom Geary shadowed in his six months at the hospital, says she did not know he used to be a CEO until he had been there for a month. She notes: "He's a very humble guy. But you can see the interpersonal skills he learned as a CEO every day in the way he deals with patients."

The piece does a number of helpful things. It emphasizes how hard Geary had to work to become a nurse, even though he was already a hospital CEO with a bachelor's degree in biology. He still had to go back to nursing school, pass licensing exams, shadow a veteran nurse for six months, and so on. The piece also gives a good sense of a few key elements of nursing, including its patient education role and its holistic focus, evident in Geary's comments about the elderly patient's need for social services and home care. And the article includes links between Geary's CEO work and his new work, even though this runs counter to the understandable "isn't this some contrast?" theme of the overall story. Phalen's quote emphasizes that Geary's CEO interpersonal skills are very useful in his patient relations as a nurse. And Geary, to his credit, stresses the importance of "critical thinking" and the ability to make good, timely decisions, qualities that most readers will themselves likely relate to his work as a CEO.

Some might object to the "gee-whiz" quality of the piece, or the fact that it was written at all, under the view that to be so amazed that a CEO would become a nurse suggests that nursing is lowly work unworthy of such an exalted achiever. But Geary's story is news because there cannot be many CEOs who would choose to accept the huge change in working conditions and genuine public respect that would come with such a move. And the piece as a whole shows that Geary's skills are not wasted, that nursing is a challenging job requiring advanced training. It reports no contemptuous remarks about Geary's shift, though it's hard to believe there were none. The piece might have made clear that some hospital CEOs actually begin their health care careers as nurses, lest readers think that the two employment categories are mutually exclusive. Of course, such CEOs remain nurses in a real sense, just as physician CEOs remain physicians.

One curious note: the piece asks near the start, "how many people give up, at age 56, a six-figure salary and the prestige that comes with being the CEO of a hospital to go to nursing school?" That's a fair question, except that the Globe recently made something of an issue of the fact that some veteran nurses in Massachusetts themselves make six-figure salaries. But whatever.

We commend Mr. Fahey and the Globe for this article. Thank them here and please send us a copy of your letter at letters@truthaboutnursing.org.

See the article "Man of patients: After 18 years as a successful CEO at Milton Hospital, George Geary chooses a second career in nursing to give care directly"
by Rich Fahey in the November 5, 2006 edition of the Boston Globe.