Walking in Her Purpose: Nurse Leader Kimberly M. Williams on Health Equity

For more than three decades, Kimberly M. Williams, DNP, MSN, RN, NE-BC, has dedicated her career to serving patients at every level. She started in health care as a front desk clerk and worked her way up to her current role as director of Nursing Operations of the Bass Center for Childhood Cancer and Blood Diseases at Stanford Medicine Children’s Health.

In this Q&A, Williams discusses how her career journey has informed her work as a leader and a woman of color, as well as the health equity efforts she is leading at Stanford Medicine Children’s Health.

How did you get started in the health care field?

My first job in health care was as front desk clerk at an endocrinology clinic doctor’s office in Texas. During this time, I was able to find my niche of helping others and commitment to service excellence for patients and families. This was also during a time when few women were providers or medical directors. A wonderful female provider I worked with strongly encouraged me to pursue a nursing career. This was not a part of my plans, as I enjoyed the role I was in, but this doctor refused to give up and suggested I enroll in a course—the rest is history. Because she saw something in me that I didn’t realize and allowed me to stand on her shoulders, I got started on what is now my unique journey to walking into my purpose.

As I climbed the ladder, I began to recognize there were few people who looked like me across the board. And the few that did almost always were in housekeeping or working in the cafeteria. It was during that time that I made the decision to always put my best foot forward and model what I didn’t see: someone who looks like me. It became my motivation and determination to do my part so that no other Black nurse would have to repeat the vicious cycle of having to be better, work harder, and sacrifice more than my white counterparts just to be treated equally.

This especially hit home for me recently when I heard a speaker say, “I can’t be what I don’t see.” I rarely had the opportunity to have a Black mentor, role model, coach, or someone who looks like me and understands the challenges we as Black leaders encounter every step of the way. Now, I tell my story in hopes of shifting the culture of inclusion and equity in all areas of health care, from the front line to the boardroom. Today, I am a well-educated Black woman walking in her purpose—bruised, but not silenced. I’ve committed to my roots, culture, and myself to be an advocate and example of what is possible.

As a nurse leader, what are you doing in your role to champion diversity, equity, and inclusion (DE&I) at Stanford Medicine Children’s Health?

As a Black nurse leader, my commitment to patients, families, and our workforce is to ensure that diversity, equity, inclusion, belonging, and justice are a fundamental part of being my life’s work. One of the areas of high impact is the work of the Stanford Medicine Commission on Justice and Equity, which was formed in 2020 to dismantle racism and discrimination and advance equity and inclusion research. The commission released a comprehensive report with recommendations, which created a road map for building a just and equitable Stanford Medicine. Four critical domains identified to ensure success included leadership commitment and accountability, a more diverse community, a culture of belonging, and health equity responsibility. The recommendations generated concrete recommendations in each area, and I am proud to contribute to developing and implementing the commission’s work in the health equity domain.

At Stanford Medicine Children’s Health, Diversity, Equity, Inclusion, and Health Equity have become core goals of our organization to ensure the full integration of justice and equity across all our mission-driven work. I have the distinct honor and privilege to serve alongside leaders and staff across the organization on the Stanford Children’s DE&I Council. The council is made up of three committees focusing on key areas that intersect: Patients and Families, Workforce, and Community.

As co-chair of the Patients and Families committee, I’ve directly supported employees who have led more than 200 grassroots projects addressing DE&I and health equity. Projects have included providing equitable care for our patients and families, regardless of their primary language; addressing social determinants of health, such as food insecurities; removing technical barriers to access for care; and ensuring that all members of the workforce develop a deep understanding of the cultural, historical, and lived experiences of their colleagues, patients, and families.

In terms of supporting Black nurses, especially Black nurses in leadership, I am working on ensuring that our organization represents people from all ethnicities, cultures, and backgrounds and acknowledging gaps in diversity, equity, and inclusion. That involves having frequent candid, open discussions with Black nurses, including having them at the table when making decisions on how to hire and retain nurses, and truly taking the time to listen to Black nurses who have experienced institutional racism. Taking the opportunity to listen, follow up, learn, and correct these issues is critically important.

How have you seen the conversation around health equity evolve over the years?

Health equity is a very complex term and one that is difficult to discuss in a few minutes. The Centers for Disease Control and Prevention (CDC) defines health equity as the state in which everyone has a fair and just opportunity to attain their highest level of health.

I have the unique experience of looking at this from two lenses: one as a Black woman, and the other as a Black nurse leader. Over the years, my experience, role, and journey have been a constant evolution of fighting for equal treatment across the board. Several years ago, my understanding of health equity included managing things on the surface, such as providing interpreters, learning how to honor religious beliefs, engaging in learning about different cultures, and improving practices around addressing the immediate needs of patients and families.

What we’ve learned in recent years is that health equity is not just checking the box. It is a process. We have to now look at health equity as a community process and what that looks like in terms of social factors that contribute to the health and well-being of communities of people. For example, we think about how violence, poverty, and unstable living conditions impact health equity. Stanford Medicine Children’s Health has made this a priority and has stood up an impactful, engaged, and committed DE&I Council that is working tirelessly to change the culture. One step at a time, we must ensure that we are speaking the same language, but also understanding, we all have to contribute to this process in order for all of us to significantly benefit.

What are some of the next steps?

There are a few next steps that are happening and ongoing across Stanford Medicine Children’s Health. I am enrolled in the HEAL (Health Equity Advanced through Learning) Anti-Racism Seminar, which includes workshops on medical racism, structural racism, microaggressions, and effective allyship. The classes offer tools to help create more inclusive work environments and how to advance equity in our work and personal lives. I will then step into the role of facilitator to help integrate concepts into our practice across the organization and serve as an operational sponsor.

Last year, Stanford Medicine hired its first chief diversity and inclusion officer, Joyce Sackey, MD, FACP. Her expertise and guidance are furthering empowering us to foster and integrate DE&I across all levels of the enterprise.

As the co-chair of the Patients and Families committee on Stanford Children’s DE&I Council, we are in the process of establishing a Respect and Dignity committee in partnership with the Office of Patient Experience to evaluate, respond to, and learn from patient grievances and complaints regarding discrimination and racism. In collaboration and coordination with the Center for Pediatric and Maternal Value, we’re addressing health equity and health disparities within safety and quality issues. Our committee is also implementing formal Health Equity Rounds, where a presenter will use real case discussions to focus on approaching patient care through an equitable and inclusive lens to address health disparities. Involving those closest to the patient can help integrate a just and fair playing field.