Who Gets to Become a Nurse? Dr. Roberta Waite Gets Real About the Pipeline, Power & Leadership

We are short 263,000 nurses — and turning away 80,000 people who want to join the profession. So what's really going on?

In this episode, Dr. Reneé Roberts-Turner sits down with Dr. Roberta Waite, Dean of Georgetown University Berkley School of Nursing, for a candid conversation about what it actually takes to get into nursing, who gets to lead, and where the system breaks.

They get into the road to the deanship — and why it was never a straight line. The faculty shortage, the financial barriers, and the policy decisions quietly limiting who can access nursing education. What social structure has to do with who moves up in leadership. Why the status quo is the biggest threat to the profession. And why nurses have more power than they think.

Plus — Dr. Waite stays for Off the Charts. Her go-to treat, her theme song for nursing, and the one thing every nurse needs to know.
This is the conversation nursing needs.

🎙 Let's Get Real is a candid conversation series about leadership, impact, and showing up authentically — hosted by Dr. Reneé Roberts-Turner, healthcare executive, speaker, and author of The Diamond Model.

🔔 Subscribe so you don't miss what's coming next in Season 2.

Transcript

SPEAKER_01 0:00

We need excellent nurses within acute care, without a doubt. But we need nurses that are working in so many other contexts and spaces, because as I mentioned, nursing is about improving health of individuals, communities, and families. It's not just about the delivery of health care. So when you recognize that we have nurses that go back to become attorneys, we have entrepreneurship where they're building their own businesses and branding, leading within the AI and health tech space. We have nurses that are in politics, right? Creating policy as legislators. We have to, we leverage our insight, our skills, our education, our practice in so many different ways.

SPEAKER_00 0:43

Welcome to Let's Get Real, a candid conversation about leadership impact and what it means to show up authentically. Today we have our very first guest in this series, Dr. Roberta Waite, who is the Dean of Georgetown Nursing, one of my mentors, somebody I stalk on LinkedIn and social as well. And so I am super excited to have her join us on Let's Get Real today. So, Dr. Roberta Waite, let's get real. What's one thing about your world that people in your position don't say out loud?

SPEAKER_01 1:21

Hmm, that's a big question. You know, I really don't know. I think it depends on the individual, and I can only really speak for myself. Um, maybe some of the things they may not say out loud or some of the challenging things um they may hold um internally and may struggle with. For me, particularly at this stage of my life, I've evolved so much. I do what's gonna support me, what's gonna promote my well-being, and what truly is aligned with my values and the work, my purpose. So it probably is really individual, but for me, again, at this stage and journey of sort of my career and my personal life, I show up and this is who I am.

SPEAKER_00 2:05

Um, I'm just gonna say this. I can't wait till I get there because I think when you think about what people don't say out loud, a lot of times they're so concerned about what that's gonna mean, what other people are gonna think. And so I spend a lot of time in my head about what I should and shouldn't say. So um I hear you with experience, you're saying you start to be think about like what how does this align with what I need, what my values, and then the wellness piece is really important as well.

SPEAKER_01 2:30

I do. I think that's important. And I think, you know, I've evolved over time. So I would say earlier in my leadership career, one of the things that can be and is a real struggle is representation, right? That is really important because sometimes you could have self-doubt, you might hold things in internally. Um, and I could say I absolutely had some of that earlier in my career. And then over time, I'm not gonna hold baggage that's not mine, right? And so you start to evolve in sort of how you manage, how you want to move, how you want to lead to accomplish your goals in ways that's aligned with your values, in ways that bring you joy, in ways that you want to have impact, right? And so you let go of that other stuff to really, I would say, move towards your North Star and what you need to do. And you find sort of the team members that support you, the mentors that support you. And honestly, I have mentors who don't even know. They mentor me, and I have mentors that I really identify as historical mentors and individuals that I have been in contact with who have moved me and really supported me in different ways. So I think it really changes over time and how you might approach some of those things from a leadership perspective, because leadership is an ongoing process. It truly is an ongoing process, and I think you really have to move with clarity and move with purpose.

SPEAKER_00 3:58

Great, thank you. Thank you for that. Dropping those wisdom pieces. Okay, so the road to deanship isn't straight. What part of the journey, what is the part of the journey that people don't see on the resume?

SPEAKER_01 4:12

Hmm, I think it actually aligns with somewhat uh some of the things that I just mentioned. But I want to start off by saying the road to deanship isn't straight, but the road to, I think so many leadership roles are not straight, right? There's so many different sort of maneuvers and things and circles. There are things that I probably would have done differently, but then when I reflect on it, I'm like, I really wouldn't have changed because those things have created my knowledge and experience for where I am now to do what I want to do. So I don't know about sort of the the change piece, um, but you know, you learn with each experience that you have. I learn a lot from mistakes, I learn a lot from people who I've been around, from patients to community to students, from colleagues, right? It is um a learning process. And I think life teaches you so much.

SPEAKER_00 5:05

Yeah, I agree. I agree. I and I love what you said about that it's never straight, because everyone's, I always say this, everyone's journey is their journey, right? And my next step is not the same as someone else's. Absolutely. And I think sometimes we get in our head, this is the only way we can get to to X, or this is the only way we can get to Y. And there's so many different ways to get there. And I um so I really appreciate that. Um, because I think people as they're stepping into nursing or stepping into like starting their masters, they think this is the only way to get to this end goal. And there's again, there's so many different my master's is in nursing education, it's not in administration. But I use that every day in terms of how I think about executing things. So um, to your point, you can you pull the stuff that you learn and it helps you move forward.

SPEAKER_01 5:56

And I think that's so important. The reason why I say that is because I didn't set out to become a dean. Right. So when you say sort of the path to deanship, you could say the path to leadership. And I think part of that um is really being able to step into those doors of opportunity, and it means showing up. Right. So for me, I really did love um administration. And so that's been a long time from clinically, and then as I moved into um education. And the role that I'm in right now, as I mentioned, I didn't seek it because the previous two roles that I had before becoming dean in a leadership capacity were created for me. We co-created those roles. So when I was at that stage in my career where I was looking for something else, I didn't have necessarily a deanship in mind. I was looking to have a greater impact on the nursing profession, something that energized me. And I really clearly said I didn't want to move until I moved someplace else that was more aligned with my values. So it happened to be this deanship, and that's one of the things that I say is important is you want to have mentors and you want to have friends that you engage with because it was a friend that brought this to my attention, right? Because when you're in leadership roles, you get a lot of sort of males, you get a lot of consultants reaching out to you. And I had a good colleague who knew me, and she said, Roberta, did you see this call for this deanship? And I was like, I I did see it, but I didn't get a chance to read it. She was like, You need to apply. I read it. It sounds just like you. Wow. Right? So that is really sort of that crack of that door opening for me to look at this, take it seriously, and then to move in that direction. So it's, you know, it you have to be open to opportunity, but you also want to share with individuals, you know, when you might be open to a move, right?

SPEAKER_00 7:53

Yeah.

SPEAKER_01 7:54

I think that's so important because your network is powerful. It is.

SPEAKER_00 7:57

Your story is powerful though. I think you because there's so many little nuggets with that, and within that, even or like to your point, you weren't even looking for it, you know. So just being open and available and you know, being willing to say yes, I think is a big piece too. I think a lot of times in our mind, this is what we want to be. But sometimes, and I it's funny because every position I've had either has been created for me or I wasn't looking forward, and it has crafted my career. Um, and it when I'm like, I want that, is I feel like sometimes God or the universe is saying, maybe not now, or maybe is that really for you? So being open, I really love that. Being open to opportunity and possibility. Yeah.

SPEAKER_01 8:38

I think being open to opportunity and I think exposing yourself and showing up. So sometimes when things might come your way and you're like, oh, I I don't have time or I don't want to do it, sometimes you want to step in there because honestly, those opportunities really can afford things that are much bigger in so many different ways. So I think that is so important is showing up and then being open to opportunity. Even though you might be a little bit fearful, a little bit reluctant, but really explore it. Okay. I love it.

SPEAKER_00 9:14

Okay. This is a question because I think as you go to these levels, you know, what does it take to lead as a dean?

SPEAKER_01 9:23

Well, I would say knowing yourself is really important because as a dean, you're really, I think knowing yourself, having clarity, having purpose, and leading with your values. I think those things are so, so important. And knowing yourself because you need to know how you're engaging, those things of um that might trigger you, how you might respond. Because as a dean, you're modeling. As a leader, you're modeling, right? And nobody is perfect. We're all learning, we all have our biases, we all have areas that we want to continue to grow and develop. So that's why I think that is so important. And I joke all the time and I say, you know, my psych skills have really helped me in a leadership position because you really are understanding systems, right? It's managing and developing people. And so that my those skills, that background that I had from a clinical perspective, they're so transferable when you're working within other structures and working with other groups to help you understand sort of the social, the emotional competence, developing individuals, understanding challenges and how people will respond to different things and how to best support them to help them in their growth, to help them in their development.

SPEAKER_00 10:40

Love that. I will say psych 101 was the class that I feel like that therapeutic communication case in all the time in terms of when you're dealing with people and family and friends.

SPEAKER_01 10:49

Yes.

SPEAKER_00 10:50

That doesn't come in. As the dean of Georgetown University Berkeley School of Nursing, Berkeley School of Nursing, um, take us back to the beginning.

SPEAKER_01 11:00

I can't pinpoint a beginning because I would say within my ecosystem, within my life and growing up, caring, community, and service have always been so pivotal. My father was a community dentist. I say community dentist because he was a dentist that served in the West Philadelphia area. My mother also was a registered nurse, and I always say she was a VA nurse because she loved her veterans, but that was always so central within our household. And we have a lot of individuals within my family, within the healthcare sort of field. So I was I gravitated there. I grew up working in my father's dental office. So I knew health was a place that was really central and I wanted to have an impact. Now I didn't know specifically nursing earlier in my career because I thought about nutrition. I thought about pharmacy. For the longest time, I thought about becoming a veterinarian because I always love pets. What's your favorite pet? Oh, I love dogs. I'm a dog lover. Oh, I'm I'm a fur baby mom at three. Really? F three. But you know, I really then gravitated towards nursing, not just because of my mother, but we have so many people in my family. And I said, there's almost no area you can't work as a nurse, right? Because I knew earlier on you were not limited to working necessarily only within a healthcare or health um hospital context, but it was really about impacting health, supporting community. And I said, in nursing, you can do that. And you didn't have the limitation. So that really is what moved me within that in that area. And I've never regretted it. Nursing is the best profession ever. Best profession, I so agree. And we have to treat it as such. I agree. And we have to inform others about our profession. To me, that's our job, that's our duty. And too much is left open for people to figure out on themselves or for them to think about what nursing is about by looking at a TV show. That does not tell you about nursing.

SPEAKER_00 13:06

Yeah. I agree. And I think there's a lot more we have to do, to your point, to help people understand what we do. I think outside of nursing and even within. So when you think about these organizations, it's amazing how many people don't understand our practice. Um, I just was having a conversation with someone yesterday, and I said it's up to us for people to share with people what it is we do and how it's done so that they can help support, yeah, um, or so that they can remove barriers, whatever that is. But people need to understand that it's it's more than to your point what you see on TV. The critical thinking that's involved, the amount of preparation that's involved, the this then this than this, how we I just think how we think is just so unique. And I'm I'm not not biased at all, but I am. I think nurses are probably the most intelligent people out there because of our training um education-wise and what we have to do in our spaces. And then that translates translates to so many things. So yeah.

SPEAKER_01 14:05

I I absolutely think sort of opportunities for nursing, what we and even how I would say we engage and prepare our students, we have to approach that in a different way. Because we need excellent nurses within acute care, without a doubt. But we need nurses that are working in so many other contexts and spaces, because as I mentioned, nursing is about improving the health of individuals, communities, and families. It's not just about the delivery of health care. So when you recognize that, we have nurses that go back to become attorneys. We have entrepreneurship where they're building their own businesses and branding, leading within the AI and health tech space. We have nurses that are in politics, right? Creating policy as legislators. We have to we leverage our insight, our skills, our education, our practice in so many different ways. Right. Right. And we could have touch points in so many different areas. And we have to expose our students and prepare our students to think differently outside of just preparing them to go work within a hospital.

SPEAKER_00 15:13

That's a really good point. Right.

SPEAKER_01 15:15

That is one important place, but that is not the only place where nurses should have an impact. Absolutely. And we need to start that thinking and those expectations and that understanding and the innovation and the entrepreneurialship, and really also looking at nursing from a broader lens, not just a deficit, because so often I also find that we're teaching from a deficit medical model perspective, right? And we really we talk about it, but we really need to look at nursing across the realm from prevention, promoting health to also treatment and um caring for individuals who may have acute and chronic health conditions. And there's so much emphasis, and it's that way, because of how our systems are structured from a monetary and financial return on investment from that perspective. But we really need to be working and becoming and utilizing our nursing knowledge and skills to actually promote health and not just to focus on a sick care system, because that's where the emphasis of our focus is.

SPEAKER_00 16:22

Okay, I'm I'm going off script a little bit. So the do you feel it's that way because of reimbursement? Do you feel it's that way because of, you know, compensation? Um, because I think that a lot of times the focus is where money is, right? So is it is that that has a big piece to and so then how do we transition to where we need to be in terms of um placing the nurses where they need to be, getting the education they need to in order to support those spaces. How do we transition to that?

SPEAKER_01 16:50

I do agree. I do think the emphasis on is where the finances sit. So because we're in a capitalistic society, and I would say a capitalistic society without guardrails, right? Um, I think that is the impetus of a huge component. So it's not just in how we prepare our students, but it's actually how we engage as nurse citizens. And so if we're about promoting social justice, if we're about promoting, you know, humanity, promoting health, our work also leans into not just our professional, but how we also align the work that we're doing from a political and a policy standpoint to really support that. So it's a broader issue beyond just the nursing profession, but we need to leverage our power and skills in that space because we know that we need to invest more in those resources that promote health in that way. Okay. That's really important. Okay.

SPEAKER_00 17:50

We are short about 263,000 nurses and turning away about 80,000 people who want to join the profession. Um, can you share with us what you think and walk us through why that's happening and um what do you think we can do to help support getting more nurses in the field?

SPEAKER_01 18:09

It's not the lack of talent or the lack of interest. I don't think I think so many people want to become nurses. I think it really is multifaceted from the opportunities of being able to get the number of students within nursing programs because of the, I would say the faculty shortage as well, to supporting individuals financially to pursue nursing. Um, nursing programs, nursing education is quite costly. And so you're limiting sort of a pathway for many individuals. And even what's happening right now, what we're being confronted with right now, with the grant plus loans and the challenges of limiting the $100,000 lifetime um use for education for our nurses, it's going to have huge implications. So for those individuals who have the resources and financial ability to pay, it's not going to impact them. It will impact individuals who have a limited capacity from a financial standpoint and those who have so much to contribute. So you have individuals who are really privileged who can, um, but nursing needs a wide swath of individuals. We have a lot of talent. We have individuals who can contribute in immense ways, but they may not have the financial resources to be able to do that. I mean, so that really is a more succinct, but it really is multifaceted in so many ways. Um, even from a clinical placement standpoint, we have so many students who want to come in, but then we're also limited in how we're preparing them or how we can access from a clinical education experiential um stance. So it is um it's very intricate, it's multifaceted. It's not that it can't be modified or we can't change things, but it will take a different coordinated level, if you will.

SPEAKER_00 19:57

Understood, understood. I think there's so many things within our profession then that we have to revamp in terms of where we are right now. Um, and to your point around opportunities and space and finance, I have three people that older women that are very interested in nursing. I've talked to the last three days, and the finance piece comes up every time in terms of trying to find a way to to um make it happen for them for their future.

SPEAKER_01 20:20

So I mean, really think about it. If you're working, let's just say, for example, within a um health system, I know there are a lot of maybe LPNs or nursing assistants who really want to continue on to become registered nurses or advanced practice nurses or other nurse anesthesia, but they're not able to because of financial reasons, right? Because many health systems, they're not financing or they're not contributing enough. And people have to work while they're in school, right? So it really is challenging because people have to support their families. So unless there are ways from a financial standpoint to really support that, it's going to be really challenging. We don't have the federal government that's um supporting nursing in the same ways as it does graduate medical education, right? And so we don't have the same type of financial supports right now, not saying that it couldn't be, but we don't have those same type of financial supports right now from the clinical um support, but also that financial support as well, which is really, really important.

SPEAKER_00 21:23

Yeah. I agree. So this is a trick question. Who gets to become a nurse? Who gets to lead? Where does the system break?

SPEAKER_01 21:36

Well, I think part of our conversation earlier really frames that. And so who gets to become a nurse are those who have access, you know, that can come in. So it is going to limit individuals who I think are more challenged financially. But I also want to hearken back to even earlier. We we really need to prepare our students to get into nursing programs, so rigorous elementary. High school education, so how our tax dollars flow and that are invested within our schools and early education preparation really forms that foundation of the students who are able to access because you have to get in with certain GPAs, um, with certain strong foundational knowledge within the science, um, the sciences. And so those who are taking AP courses and having strong and rigorous um science backgrounds from their earlier schooling, they're gonna be really um, it's gonna heighten their opportunities. Let's just say that to get in. Those um financially who are able to get the support to get in, it's gonna heighten that capability of getting in as well. So, you know, our whole social structural dynamic strongly influences who gets to get in. And then from a leadership perspective, just like everything else, those opportunities, who's within your network? Sometimes it's really limited based on the school that you go to, right? They're unspoken things or preferences, I guess you could say, that individuals might have to get into certain leadership roles or within certain spaces or certain organizations, right? So there is the social structural dynamics really influence who gets to get in and then maybe how they're propelled or how they're able to move and moving through the nursing, I want to say nursing ladder, but different positions that individuals might be interested in seeking. So it's not saying it can happen, it could make it more challenging, but it influences, you know, how people are able to move.

SPEAKER_00 23:37

I don't think I thought about it like that. That that's a really good point in terms of, I mean, I know it, but I don't think I really thought about the like even so a couple of things social structure, how it impacts individuals' advancement, who opportunities, et cetera. And then also how it how it impacts us and our profession, how we work, all of that. Um thank you.

SPEAKER_01 24:03

Really think about it also regarding representation that I said earlier and sort of the the social dynamics or the social networks, right? It's sort of exclusive. So as you continue to move up, and even outside of nursing, really who's in the boardrooms, who's leading, who's making the decisions? You typically don't have the diversity of individuals who are there. So it's who you know, sort of that's it within your network. And earlier in my career, we used to call it the good old girls' network, right? Because still nursing is predominantly you have women who are within the profession. So sometimes you could see that those individuals as gatekeepers and making decisions or who is moved in or who is allowed in. It may not be spoken about explicitly in that way, but the decision making and what you see, it often plays out in that way.

SPEAKER_00 24:57

Understood. Yes. So for the leader watching this right now, what do you want them to do differently tomorrow?

SPEAKER_01 25:04

So for a person who is already a leader, I would say, are you executing and living according to your values and your goals? Um, so often we can get socialized and conditioned to engaging and reacting, sort of like within our normalized systems and structures. And to me, the status quo is a problem because that means we're not moving to accelerate and to improve our society, our world, and the humanity of everyone. So we don't want to become comfortable in the status quo. We should always be striving to be better, to do better, and to enhance all to be the best that they can be.

SPEAKER_00 25:55

That's me dropping the mic. All right. Okay, so now we're gonna go into all the charts. A few questions are gonna pop out. And so the first one is best advice you ever ignored?

SPEAKER_01 26:10

I don't know that I I can't think of a specific thing that I've ignored. Um, I would say that anything, any advice that I've taken or any advice that I've received, I tried to be open to it. Um, but I can't think of any the best advice that I've ignored per se. I can't think of anything. Okay. All right. Coffee or tea?

SPEAKER_00 26:33

Coffee. Yes. One thing nurses need to know that they have power.

SPEAKER_01 26:43

Don't let anyone discount the power that you have. Okay.

SPEAKER_00 26:47

The leader who changed everything. Chris. If nursing had a theme song, what would it be? There's no stopping us now. All right, the last one. What is your go-to treat?

SPEAKER_01 27:10

Oh my goodness. I am gonna say chocolate. I love chocolate. But you know, that's a hard question because um I have a sweet tooth, so I like a lot of sweet things, but I'm gonna say chocolate. Dark or um milk. I love milk. Dark's better for you, but I love milk.

SPEAKER_00 27:25

Yeah, and I'm I'm starting to like white chocolate too. White chocolate too. Dr. Roberta Waite, thank you so much for joining on Eslim. Let's get real, candid conversations. I so appreciate you. Appreciate your leadership. I am blessed to have you in my spaces. Thank you.

SPEAKER_01 27:41

Thank you so much for inviting me. And I'm telling you, I am energized by everything that you're doing. Oh, thank you. Thank you.