The Power of "No"

Meet Brandy Wilkins

Facing rejection can sometimes feel like a career-ending moment, but it was the exact opposite for Brandy Wilkins. What seemed like a career setback turned into a pivotal moment, redirecting her toward a significant role in the healthcare Safety and Quality workstream.

While Brandy's personal story captivated me, I was also excited to interview someone deeply immersed in this workstream. Safety and Quality is often-overlooked within healthcare but it holds immense potential for passionate professionals to make a significant difference in the workplace.

Brandy is two and a half months into a new Hospital Quality Director role in the USA at the time of our interview. Appreciating the limited visibility many of us have of Safety and Quality health career paths, I asked her to help me understand what that involves. She explained, "It's all about overseeing outcomes, compliance, and patient experience. I may not directly control the results, but I manage the processes and support our clinical staff in ensuring patient safety. It's a bit like being a consultant—the go-to person."

She elaborated further, "I don't have direct reports, but several individuals are indirectly responsible to me. For example, I oversee infection prevention, safety and regulatory efforts. While they report to other supervisors, we work closely together daily. My scope covers one campus within our larger 12-hospital system."

When I dig deeper to find out what else Brandy does, she quickly admits, "Too much! Just kidding!" It turns out that Brandy also channels her experiences and insights through her podcast, Kairos Conversations, where she hosts essential dialogues to foster positive changes within communities.

She also has a coaching and consulting business that supports clients' Safety and Quality career efforts. 

While I agree with Brandy that she does a lot, as I learned more about who she is and how she ticks, I could see how this is doable for her. 

I've worked in hospitals most of my career, so I can see how her Quality Director role fits within the system. But in my experience, nurses have operated in those senior quality roles. Brandy is a licensed Physical Therapist(PT) with 20 years of experience.

Her first roles out of university were mainly in hospitals and casual work in various clinical settings. She then became a travelling PT, embracing life on the road, which included 13-week stints at multiple locations. She ultimately finished up that four-year season of her career in Atlanta, Georgia. During her final travelling year, she scored a permanent full-time role in a hospital rehab centre. After a year there, she took the most obvious next step in advancing her career and applied for a supervisor position.

But she didn't get it.

If we are honest with ourselves, many of us may have responded to rejection similarly to Brandy. Some might even conclude that we aren't good enough, prompting us not to try again.

But Brandy describes this knockback experience as a catalyst for shifting direction in her career. "It was probably one of the best 'No's' I could have gotten because it caused me to self-reflect on what I wanted." What followed was what she called some 'deep reflection' that ultimately led her to conclude that she didn't want that path anyway. 

Her example reminds me of my conversations with earnest and determined clinicians keen to advance their careers. Clinical management is a common and important way we can do that, and it's often one of the most visible ways for us as bedside clinicians. But it's not for all of us. 

Instead, Brandy searched for a position in healthcare that aligned with her interests.

A few months after being rejected from the supervisor role, the same person advertised a newly created position called Program Coordinator in the health system’s Rehab Services. They knew Brandy was looking for ‘more’ and mentioned the role to her.

We can often underestimate the power of rejection, but what it can do is alert recruiters of your intention for roles in that space. "I did communicate to my supervisor that I was keen on something more, but I realise not everyone feels safe doing that, which is unfortunate, right? Sometimes, the leader wants you to stay in the role when you make the money as the clinician. But in these non-clinical roles, you're not revenue producing, so that's a challenge".

Brandy quickly adds that she was volunteering for projects while fulfilling her clinical duties, highlighting this as an essential strategy for moving beyond exclusive patient care. 

Hearing this highlights the privatised business nature of the US healthcare system. It's interesting to see how the difference influences one's approach to career development. In Australia, moving beyond clinical practice in a public health service but staying within the same healthcare system doesn't change the bottom line. In public or national health systems, clinicians are cost-saving agents rather than revenue-producing, as in the USA. Pressure nonetheless.

I'm always learning more about how healthcare systems act as an external contextual influence on our careers. But I'm also constantly trying to understand internal drivers, such as why people pursue more responsibility on top of their job description. I know my reasons, but I was determined to find Brandy's. I mean, there isn't anything wrong with doing your role well to the fullest extent of its description. Excellence in patient care is to be celebrated. Why go beyond those expectations?

I sensed a kindred spirit, attracted to progress and momentum.

So Brandy went for the Program Coordinator role and got it!

Little did she know how well-suited she was to the Safety and Quality workstream. The role was new, and leadership wasn't entirely sure what the scope of the position entailed. Regardless, Brandy's proactive approach led to substantial professional and personal growth.

"I had the opportunity to shape it based on my strengths. Over time, I realised I've always liked maths, but I started getting into data and dashboards and figuring out how to use this information to help leaders make decisions."

With her efforts and initiative, the role morphed over time, resulting in widespread standardisation of processes that improved quality and outcomes for the multi-site health system. 

From her clinical beginnings, it sounded like there was a steep learning curve, so I was curious whether she did formal learning. "I just used Google and would ask it, for example, how to do something in Excel or write a particular type of report." 

As I'm listening, I'm quickly getting the impression that Brandy is not someone who waits for others to give her what she deserves or needs. She goes and gets it.

Even with a new role and new professional focus, it wasn't enough. Brandy took on a casual consultant role with a company that surveyed hospitals for Safety and Quality. She did this concurrently with her full-time Program Coordinator role. 

These intense periods of growth and commitment can pay off for our careers, and they are often more common and feasible earlier in our careers. In my twenties, I willingly opted into significant extra commitment, not thinking twice about it. It was fun and stimulating, and I was attracted to the learning opportunities. Hearing Brandy, I sat reflecting on how hard it was for me to change the pace when life's demands changed later on.

This period of seven years was described by Brandy as pivotal to both deep and specialised learning, positioning her as a competitive option for more executive roles in Safety and Quality. Her tenacious and proactive approach to moving her career forward is particularly highlighted in the next chapter of her professional journey–coaching. Friends, family and colleagues would ask her how she got into Quality and moved beyond the bedside. "It kind of happened organically, just helping those who happened to ask". Little did she know she'd turn this into a business later on.

It's not just rejection that Brandy knew how to make the most of. She also seemed to learn how to make a principled decision on a successful job offer. She went for a role within the organisation, in different departments, but with more senior quality responsibilities. But they refused even to pay her on par with her current role. Different units. They had different budgets, and they wouldn't budge.

So Brandy declined, refusing to take a step back and not even be supported in a lateral move within the organisation. She explains that a critical factor in this was consideration of the long commute she was already making to and from work. In her eyes, it simply needed to pay off for the time investment, and a pay cut for a more aligned role would have unwanted consequences for her family. 

Not too long after, Brandy discovered a promising opportunity at a newly constructed Rehab Hospital near her home. As she passed the building site each day, her anticipation grew alongside the emerging structure. Eager to position herself for a more senior Safety and Quality role, Brandy turned to LinkedIn, where she diligently reached out to anyone with "recruiter" in their title associated with the hospital's parent company. 

Her persistence paid off when she finally connected with the recruiter for the new facility. Brandy nurtured this connection over the next several months, patiently waiting for the position to open officially. "Then, once the CEO was named for that hospital. I found out who he was and looked him up because who you report to matters. And I reached out to him on LinkedIn, too. And I said, 'Hey, I'm interested in this role'".

This strategic networking over those six months ensured her resume stood out from the pile, securing her an interview. When the interview day arrived, Brandy faced the challenge of proving her capability for a role that required supervisory experience - a responsibility she hadn't yet shouldered. Her determination and the wealth of her previous experiences spoke volumes, convincing the CEO to take a chance on her.

There was a downside though. 

The new Director of Quality role involved a pay cut relative to her other role in a different company. She aptly explains why a pay cut, in this instance, was a sound decision for her. "I knew that if I went, I would get the experience of opening a hospital that I would not have otherwise gotten. So, I did it to gain experience leading people, opening a hospital, and building something from scratch. I can't say there's a hard and fast rule to it. You got to kind of play it based on each person's situation. But it's all about the goal at the time". Brandy told herself she would try this role for a year. 

She stayed for two and a half. 

But why leave? She'd made a financial sacrifice to take this opportunity. Indeed, this role was to make her mark and advance further within the new hospital, where new places often have more opportunities. I ask these questions, hoping Brandy can share why another change. She explained that one reason was that the pay wasn't increasing, but the second was that she didn't like the risk part of the role.

I felt a deep respect for Brandy as I witnessed someone who knew how to make hard decisions, remembering all the uncertainty they often bring. It takes effort and courage to admit your constraints while highlighting a level of self-awareness that guides her decision-making. She loved her colleagues, she loved her boss, and she would decide to work there all over again, but she admits, "I don't know if there could have been an amount that they could have paid me that would have matched the weight of dealing with the adverse outcomes process". 

Together, we share our thoughts on how we can often find ourselves in a position where it's hard to stay and hard to change. But it's important to ask what it will cost you not to change. I resonated with Brandy's reflection and framing of seasons in our careers, as it reminded me of the shift in my thinking I needed to make when leaving clinical practice.

We agree that this is a challenge many clinicians face, realising they no longer wish to continue in their chosen path and wondering what comes next.

With an encouraging and coach-like expression, Brandy believes that we should embrace our lives as works in progress, understanding that we're navigating our path in real time. If we take a 'wrong' turn, it could be redirected, or perhaps that turn was necessary, though we couldn't foresee its importance earlier. "Life doesn't follow a set timeline—achieving certain milestones by specific ages, like career steps at 25, 30, or 35, marrying, or having children for those who desire them". 

We all know reality is more unpredictable and complex.

Embracing her values and desire for more control over how she uses her time and what she gets in exchange - it was here that she decided to transition her ad hoc coaching into a registered business. 

"I never imagined I'd become a business owner. Two years ago, if someone had suggested I'd become an entrepreneur, I would have dismissed the idea entirely. Yet, here I am. My journey into entrepreneurship has been a gradual evolution. Initially, these were not avenues I had considered. However, as I established myself, referrals started coming in naturally. People began saying, 'If you're interested in that, you should talk to Brandy.' My growth into this role has unfolded organically."

Believing that change was exactly what she needed, Brandy began exploring what else was out there over six months. She was clear to herself and recruiters what she wanted and needed from the role, including remuneration that adequately matched the value she brought. But after talking with her husband, they agreed that the search could extend into a different state.

That's what brought her to her current position. This new role brought with it significant upheaval. "Our whole life is different today than it was even four months ago. I had to sell a house and change my son's school. But I have no regrets. This role is opening my eyes to see what else is possible."

I could see the contentment in Brandy's eyes as she shared how her views on work have changed:

I am reminded of the small moments I've had with myself just a few years ago, like Brandy, redefining my definition of success. Reassigning value away from work doesn't hinder your performance. If anything, it probably sustains it. 

Brandy is quite clear on her priorities at this point in her life: "I no longer say, 'Let me make $200K a year, 'because I know that comes at a cost to my personal boundaries in my weekends and vacations. I'm not willing to pay that price today.'”

Diving deep into Brandy Wilkins' career journey from bedside to leader in Safety and Quality and Coach, I've seen her story as an encouragement to embrace change, redefine success, and have the courage to explore uncharted paths. Brandy's experience, warmth, and positivity make her well-suited to her coaching role for those seeking guidance on a path beyond the bedside. 

As we wrap up, we recognise that our journeys are ongoing, and while we may not have 'arrived,' we can all lend a helping hand to those who see our current position as their own aspirational goal.

Brandy's Wisdom

• Embrace Proactive Participation: Start engaging in projects and building your skills outside your current role; this visibility and varied experience can create new opportunities.

• Value Genuine Networking: Networking is crucial and should be genuine. It should focus on building authentic connections rather than seeking immediate benefits; it's about quality interactions, not quantity.

• Invest in learning and applying new skills, especially in unfamiliar areas, through affordable resources like LinkedIn Learning rather than costly formal education; practical application of knowledge is vital.

LinkedIn, Defining Point Coaching and Consulting, Kairos Conversations Podcast

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