“I have always had big dreams, but I never thought, in my entire nursing life, I would be in a place like this, and at the professional level I have been privileged to serve,” says Ena Williams, PhD, RN.
The place is Yale New Haven Hospital (YNHH) in Connecticut, the largest single hospital in the state and country and, one of the top medical facilities in the region, and where Williams oversees all nursing practices. As Chief Nursing Officer and Senior Vice President, she has direct and indirect oversight of nursing practice, nursing resources, nursing research, patient experience and nursing quality. She also leads the system-wide nursing leadership development programs.
Curious, driven and – as the eldest daughter of eleven children – a natural leader, it isn’t surprising that Williams is now responsible for more than 5,000 nurses and clinical staff, or that she was able to lead them through a global pandemic while achieving a third magnet designation.
But leadership wasn’t preordained for Williams. Nor was a career at YNHH.
“I grew up on a little Caribbean Island,” says Williams, who is originally from Jamaica. “When I arrived at Yale New Haven Hospital, I was suddenly surrounded by physicians developing procedures I had read about in books. I was in awe.”
Since arriving on the hospital campus as a perioperative nurse three decades ago, Williams has held various leadership roles. In 2018, she was appointed to her current position and is the system’s first Black CNO. In addition to her responsibilities at YNHH, she also sits on the Connecticut Hospital Association, the Joint Commission’s Board of Directors, and the American Nurses Foundation’s Board of Trustees.
It was a spirit of inquiry and a willingness to jump into new roles that spurred her path to becoming CNO – but that path first began in nursing school.
The Power of Representation
As a student in Jamaica, Williams found inspiration in the dean of her nursing school. “It was the first time I met a woman with a doctorate. She was the most amazing nurse I had ever met and a wonderful example of an educated, brilliantly bright Jamaican woman. I wanted to be like her.”
As a young nursing student in Jamaica, she set her sights on becoming a nursing school dean, which demanded an academic stint as a midwife. While waiting for a midwifery spot to open, Williams tried ICU nursing and quickly fell in love with the ICU setting, eventually making her way to the operating room.
For the next eight years, Williams worked first as a charge nurse at University Hospital of the West Indies, then as an OR nurse and OR supervisor at Hargreaves Memorial Hospital, both in Jamaica.
Along the way, she continued rising in leadership roles. When her husband Leonard, a minister, received a divinity scholarship, they moved to America, where he eventually became a chaplain at Yale New Haven Hospital.
Barriers to Practice
Despite her experience, transitioning to nursing in America wasn’t without its challenges. She and her family lived in Connecticut, but she wasn’t able to obtain reciprocity for her nursing license in the state. So, Williams started working in New York, where she was hired as a staff nurse at Bronx Lebanon Hospital. But even after obtaining her Connecticut nursing license, barriers remained.
“At first, I never thought I would get a job in Connecticut. I applied to a couple of other hospitals that were smaller, more community based, and there just always seemed to be a barrier,” she said. “One woman suggested I work in a nursing home. I had 12 years of OR experience. I was working in one of the most sophisticated Level 1 Trauma Centers in New York City, and I was applying to a hospital that was not even a Level 1.” At the time, she says, the suggestion didn’t make any sense. Now, though, she says the impact of bias is clear, and unfortunately persists even 30 years later.
“There are still a lot of challenges for nurses of color,” she says. “There are still a lot of misperceptions about our abilities.”
Advice for the Next Generation
Williams’ advice for nurses of color is clear: “You have a right to be a nurse,” she says. “When a minority nurse walks into a space, they should feel as if they have as much right to be there as anybody else. Unfortunately, our systems sometimes make it very difficult. But you can’t give up. Work hard and look for people who can support you.”
Williams champions mentoring young nurses and encourages them to find role models. “When I came to Yale New Haven Hospital, there was no beyond the nurse manager level who looked like me,” she says. “People want to see individuals like themselves who have achieved and overcome the same struggles they face. My story is the story of those who have gone on before me and I honor them and stand on their shoulders,” she says.
Mentorship has been an important way for Ena to support the next generation of nurses facing persistent biases in the healthcare setting. But mentorship is just one piece of the puzzle – the entire nursing community must step up to be inclusive of peers of color, she says. “Eliminate the biases and the stereotypes because those can create so much stress that failure becomes a self-fulfilling prophecy,” she said. “We need allies to partner in removing the barriers that nurses of color face every day.”
She also offers some sage advice for nurses and nursing students interested in leadership. First, you have to stay wide open to opportunity.
“I never could have created this spot for myself, because I would not have seen it or thought it possible,” she says. “So, stay open, because the opportunities come to you in the most unusual ways.”
Next, keep academic advancement and clinical experience in alignment.
“You don’t want one to be so far ahead of the other, because then you get a little imbalanced, right? As you develop professionally,” she says, “make sure you're developing your academic side, and understand the skills you’ll need for whatever the next opportunity is.”
Last, learn from others. “None of us know it all. Even at this stage in my career, I have mentors and confidantes,” Williams says. “Don’t be afraid to ask for help – people are willing to say yes more often than we ask them.”
It's helping other nurses create connections and open doors that gives Williams the most satisfaction now, but she remains proud of the nursing profession and its impact on patients.
“You get to be in the hearts and minds and lives of people in special ways because you are with them when they need you the most,” she says. “What better gift is there than this privilege to touch another person’s life like that?”
