Resilience in the Face of Adversity: Natalia Cineas ’01 Talks Nursing in a Pandemic

2019 nataliacineasComplex leadership situations are nothing new to 40 Under Forty honoree Natalia Cineas ’01.
A senior vice president and system chief nurse executive for New York City Health + Hospitals, Natalia Cineas normally oversees more than 10,000 nurses and social workers. However, things have been far from normal. In a year that has seen unprecedented challenges in the healthcare sector, Cineas and her team have gone far beyond, at one point leading an additional 5,000 additional nurses and nursing specialists to address the temporary surge in patients brought on by COVID-19.
Cineas acknowledges the pandemic and its pressure on the hospital staffing came with a level of fear and uncertainty for all, but Cineas’ resilience and success in facing tremendous obstacles did not go unnoticed. In fact, Crain’s New York recently highlighted Cineas for her leadership in crisis management. Now, with the future still unclear, she’s preparing for a new normal.
Tell us about your journey from Stony Brook to your role as senior vice president and system chief nurse executive for New York City Health + Hospitals.
Education has always been very, very important to me. Education represents the best and brightest promise of America, and as a child of immigrants who came to this country to build a better life for themselves and their families, I feel deeply privileged to have grown up here and to have access to the finest educational opportunities, including my undergraduate years at Stony Brook University, where I received my Bachelor of Arts degree in psychology. 
I furthered my education at New York University, earning my Bachelor of Science degree in nursing and entered the workforce as a clinical nurse in the Neurological Intensive Care units at New York-Presbyterian Hospital, Columbia University Medical Center. While working in progressively more responsible positions at New York-Presbyterian/Columbia, I returned to NYU for a master’s degree in management, which prepared me to take on new challenges as a patient care director.
Continuing my professional development, I took on a new role as director of nursing for Mount Sinai St. Luke’s/Roosevelt Hospital, and then moved into the role of senior director of patient care services. While there, I earned my Doctor of Nursing Practice degree at George Washington University School of Nursing and became deputy chief nursing officer for the entire Mount Sinai St. Luke’s system, a post I held until stepping up to the exciting and energizing role of chief nursing executive, senior vice president for New York City Health + Hospitals in March 2019.
Most recently, I have expanded my role to include serving as co-chair of our system’s Equity and Access Council, which is charged with identifying and defining system-wide strategic diversity and inclusion priorities, fostering an environment that delivers high-quality health services with compassion, dignity and respect to all.
I also continue to demonstrate my passion and commitment to education by serving as an instructor for the Columbia University School of Nursing, where I hope to inspire the next generation of nurse leaders.
Was there someone at Stony Brook who inspired you on this journey?
It wasn’t so much a case of “someone” as “something” inspiring me at the beginning when I was a student at Stony Brook. Working in an administrative capacity at Stony Brook’s Student Health Center started it all off for me. I found that I really enjoyed the work, and it got me thinking about a job in the healthcare profession. Working at the Student Health Center allowed me to become involved in a clinical atmosphere. The work I did there was truly instrumental in me wanting to pursue a career in healthcare administration.
Can you tell us a little more about the work that you do in this role?
As the chief nursing executive and senior vice president, I am responsible for the planning, oversight and evaluation of all aspects of clinical operations, services and nurse education. This involves a full range of administrative and operational obligations to ensure the delivery of quality, safe, standardized, and cost-effective nursing care to patients and the community. Additionally,  I am responsible for care management, social work and respiratory therapy throughout NYC Health + Hospitals’ more than 70 locations across the City’s five boroughs.
What does it mean to you to be a leader? What leadership style have you found the most effective?
I would describe my leadership style as “transformative.” Our mission as a public healthcare system is to deliver essential services to all New Yorkers – particularly the most vulnerable members of our society – regardless of ethnicity, culture, creed, gender, age, sexual orientation, income, immigration or insurance status. All across the country, healthcare organizations ─ especially safety net systems like ours ─ must respond to significant changes in governmental support, rules and regulations, and consumer expectations. When we talk about “transformation,” we mean the urgent need to reinvent public healthcare delivery in response to those structural changes. Specifically, this means transforming “nursing” to “nursing excellence,” emphasizing an overall culture of safety, and improving patient and staff satisfaction.
You have shown dedication and passion for your career in the industry. What is it that inspires you in your work?
I strive for authenticity in everything I do, so seeing positive outcomes, improving metrics and substantive progress is what really keeps me inspired and engaged. I consider myself a very positive person, and I have surrounded myself with an amazing team of positive people who are making a big difference in the professional practice and culture within our organization.
Most recently, during the COVID-19 crisis, my team and I directed the recruitment and deployment of more than 5,000 additional nurses and nursing specialists; implemented a new Virtual Deployment Team; created a “fast-track” credentialing program; and developed a virtual orientation and educational program for all new staff. We converted existing nursing orientation procedures and materials to online training, developed specialized COVID-19 educational materials, and reduced the typical onboarding process for new nursing staff from the traditional four-week time frame down to just two days.
I am also inspired by our nurses and nurse leaders’ dedication and commitment to grow and develop professionally. I strive to create an environment that brings out the best in people. These are the types of significant and ongoing improvements that continually inspire me and keep me going even when times get rough.
You’ve received recognition for your response during the COVID-19 crisis. What has this time been like for you?
This has been an extremely challenging time for everyone in the healthcare industry, and society in general. Everyone has been touched by this crisis, and many people have struggled with fear, anxiety, uncertainty and loss. We worked to the point of exhaustion and beyond. We faced acute levels of stress and anxiety, for our patients, for ourselves, for our families, for our colleagues and for our staff. 
It is a time when I have had to be resilient, both personally and professionally. It made me extremely proud of our efforts and our overall commitment to nursing excellence. As the chief nursing executive, I have seen first-hand the incredible dedication and commitment that our nurse leaders and nursing staff have brought to this fight. When and where they were needed the most, our nurses have been there, displaying unprecedented courage, assurance, and endurance during this crisis – they are true heroes.
Looking forward, how do you foresee your work evolving in a post-COVID world?
The global pandemic certainly added a layer of complexity to everything we do as healthcare professionals. As we transition into the next phase of our organizational transformation, it is also important that we pay attention to what author Rita McGrath calls ‘inflection points.’ These are the moments when assumptions about your business fundamentally change or become irrelevant, and these are not easy to spot. We are all getting prepared for the ‘new normal,’ even as we continue to care for recently-stricken COVID-19 patients. We also are continuing to care for COVID-19 patients who may be experiencing long-term health issues due to the coronavirus.
What piece of advice would you give to students looking to follow in your footsteps?
Keep learning! Learn as much as you can whenever you can. Take advantage of any and all opportunities to advance your education. For example, on a personal note, this year, I was proud and honored to be named one of an inaugural class of 11 post-doctoral fellows in the Frances Payne Bolton School of Nursing at Case Western Reserve University.
Even at this stage in my career, there is still plenty to learn – this far-reaching program involves executives from all over the world, including fellows from the United Arab Emirates, Ireland, Canada and here in the U.S. Being involved with such a strong and diverse group of people supports meaningful dialog about the current state of nursing on a global scale and gives us a glimpse of what the future may hold. The instructors and colleagues in this fellowship program are providing me with invaluable insights and observations that are helping me today. And the knowledge that will continue to help me craft my future…just as the instructors, friends and colleagues that you encounter in your journey will be able to help you as you move forward.
— Kristen Brennan

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