Summary
- Katie Boston-Leary, who will deliver a keynote address at the IHI Forum, shares lessons about advancing equity, addressing burnout, and engaging nurses in decisions about new technology.
Katie Boston-Leary, PhD, MBA, MHA, RN, NEA-BC, FADLN, FAONL, FAAN, is the Senior Vice President of Equity and Engagement at the American Nurses Association. She leads the National Commission to Address Racism in Nursing Forum and organized ANA’s inaugural Equity Summit.
Boston-Leary is a 2024 ICN Global Nurse Leaders Institute Scholar and was identified by Health Leaders Media as “One of Five Chief Nursing Officers Changing Healthcare.” She authored two chapters in The Sage Encyclopedia of Multicultural Counseling, Social Justice, and Advocacy, the first encyclopedia focused on racism and Diversity, Equity, Inclusion and Belonging, and was featured in the award-winning documentary film, Everybody’s Work. She recently co-authored Harmony by Design: Navigating Work and Life in Healthcare, and held a TEDx Talk on leading with our natural human gifts.
She has conducted research on care delivery models, time allocation, nurses’ well-being, racism, and civilized oppression. She is a board-certified Nurse Executive with publications and speaking engagements across national outlets, including CNBC, New York Times, Forbes, Bloomberg News, and NBC’s Today Show.
Boston-Leary will present a keynote address at the 2026 IHI Forum (December 6–9, 2026 in Phoenix, AZ).
You’ve noted that nursing as a profession came out of advocacy. Can you say a little about that history?
Early on, people cared for other people and used trial and error. Even after nursing was professionalized, there were certain assumptions around who should be in the profession and the place that nurses should have in the social hierarchy within healthcare.
Nurses also saw the shortcomings of policies in their practice. If you want to learn about opportunities for policy work in your community, sit in an emergency department all day. Everything shows up there, and everyone.
Nurses saw a need to advocate for the profession, and also for what they were seeing in their patients. Today, there’s a reawakening of that advocacy.
Among many other efforts, you organized ANA’s inaugural Equity Summit in Washington, DC. What are you hearing from the field about progress and challenges in advancing equity and anti-racism in healthcare?
The headwinds are stronger than ever. I heard from a nurse who put one of our tools to promote allyship on her unit. A manager said she needed to take it down because it was making her fellow nurses uncomfortable. That’s the time that we’re in.
As disheartening as it is, it presents an opportunity for us to build something more long-lasting and revisit the principles of this work. It’s always been based on humanity, what Martin Luther King refers to as “the interrelated structure of reality,” where your future impacts mine and my future impacts yours.
I do my best not to be judgmental of those who used to do the work and are doing less now. Everyone manages their own personal, professional, and institutional risks.
History shows that during times when threats were a lot more unforgiving and riskier in terms of life and death, people kept pushing. It’s ‘hold the line’ time. The key takeaway is not to stop the work.
In your TedX talk, you quote Senator Raphael Warnock, who said: “You cannot lead the people unless you love the people. And you cannot love the people unless you know the people. And the only way to know the people is to spend time among the people.” What does it look like to love people in the workplace?
Love is about leaning into our five senses, and also the sixth sense of intuition, to understand people more. We have to see people, to hear them, to leverage every sense. A lot of the polarity that we’re seeing is because we’re not taking the time to get to know each other. We’ve become lazy because we’re so busy. We get to surround ourselves with people that believe what we do.
I'm trying not to talk as if nurses are a monolith with the same political views. We need all of us. Other nurses can reach patients that would not listen to me. We have some non-negotiables; we don’t harm anyone because of beliefs.
A lot of people fear AI; to me, the imminent threat is our humanity being minimized. AI is being built to become more human-like, while we humans are being less humane.
I listened to a bot call a patient to coordinate care. The patient had just buried her son. The bot was programmed to make the next appointment. I didn’t think the bot would be able to keep up. After the patient kept bringing up her son, the bot asked questions about him. The patient knew it was a bot, but she was connecting. She even told the bot, “I love you.”
If it were you or I on that call, we would try to bring that patient more emotional support. But we might rush through it because we have a list of 20 patients to call.
If the bot can have that call, are you spending time with somebody else — a colleague or another patient? How does this play out?
There are so many trade-offs right now. We need to connect with the people we care for. We don’t want to be relying on bots to give us the information. We have to establish that relationship. For example, if that bot took care of that call for me, and then I’m oblivious with the patient, that’s not good. It is the mundane tasks that we need bots to manage for us.
No matter what our interactions are, or with whom, we have to try to lean in a little bit more. There’s all this sensitivity around relationships now, and we have fears, but I think we can go back to some basic things.
You’ve talked about how “Technology has not been particularly kind to nurses.” When leaders make decisions about technology, how can they understand what the impact will be for the people providing direct care?
Engage people, not towards the tail end, but early in the process. Be intentional in employing nurses to design these products. Make sure that the goals are being met, and if not, then continue to refine.
Often, companies get the expertise for free. Nurses are so willing to give their opinion to get something fixed. The financial piece is important because of recognizing the value of nursing. That could mean compensation, not necessarily that the dollars come back to individual nurses, but documentation of what it costs and what was reimbursed.
Burnout is a tremendous issue among nurses right now. What is one thing you wish all leaders were doing to support and retain nurses?
I wish everyone could have structures where nurses’ voices are heard all the way up to the board level, and it’s not reliant on one person to share as the CNO [Chief Nursing Officer]. There has to be a way to connect with nurses as a standard. In addition to that, I’d like to see more nurses on boards in healthcare institutions.
How do you sustain your own well-being and joy in work?
Whenever things get really bad, I reflect on my life. I scale what I’m dealing with now against the worst thing that I’ve encountered.
I read the writings of historical and current leaders: Raphael Warnock, Martin Luther King, Nelson Mandela and how he overcame hardship in his 27 years of imprisonment. I stumbled across an interview that Nixon gave after Watergate that asked what lessons he learned. He said if you don’t pay attention to the little things, little things become big things. While he wasn’t a great leader to learn from, I want to pay attention to everybody. I'm particularly curious about leaders that go through strife. John F. Kennedy said that the issues that we face are man-made, and our destiny is to fix these things.
Lastly, the social piece is huge for me. I need something to pull me away from consuming the news and responding to emails. I surround myself with people that minister to me and pull me into spaces where I can be wonderfully distracted.
Over your career to date, you’ve been drawn to work with numbers, to work at the bedside, to big-picture work, and more. What advice would you give to early-career professionals who are feeling pulled in multiple directions?
Surround yourself with people that will help you to grow, and to sustain yourself during hard times.
It’s trickier now, because there used to be people who we’d rely on to give sage advice because they’d weathered the storms and were in the place of rest. Now, everyone’s in a storm. It’s not just young people trying to figure out life; everybody’s trying to figure it out.
Put people in the right boxes. For example, there are certain people that we love, but are not appropriate to be our mentors. We have to build our network of mentors, leaders, role models, coaches, and loving critics — people in our lives that keep us honest, that are not just going to tell us what we want to hear. Make sure you’re talking to the right people for the right reasons.
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