296 - The Role of Nurse Practitioners in Shaping the Future of Women's Healthcare with National Association of Nurse Practitioners in Women's Health's Heather Maurer

Welcome to Listening with Leaders. I'm Doug Noll, lawyer turned peacemaker. I teach executive leaders how to listen to emotions rather than words so that they can become the leaders everyone wants to follow. And I teach those same leaders how to be authentically present, available, and connected to their families despite being insanely busy. I have learned that we are 98% emotional and only 2% rational. Learning how to listen to emotions is, in my experience, the foundational skill of life. Stick around to the end of the show and I'll reveal how you can be on our next guest in 15 to 20 minutes. So let's get started. Heather Maurer, welcome to Listening with Leaders.

You are the CEO of the National Association of Nurse Practitioners in Women's Health. You're based out of Washington, D.C. And the website is npwh.org. You've had— I interviewed you on Authority Magazine. I'm so glad we could connect here on the podcast.

Welcome.

Thank you, Doug. So nice to be here. Nice to meet you.

I would like you to— you have one of the most interesting backstories I've ever heard with all the experience around the world. Why don't you just give the audience a little sense of how you grew up and how you ended up where you are today as the CEO of this amazing nonprofit.

Thank you. Oh, I grew up in rural Virginia in a place that's— was— that is called Leesburg. It is no longer rural. And raised Black Angus cattle to help pay for my college tuition, lived on a large farm that also was an estate to a foundation. That was a 501, former governor of Virginia created this foundation and it was a 1,500-acre estate and had a big, huge mansion. And I was this 5-year-old kid who'd moved down from Smithtown, Long Island, and with my parents who are from Brooklyn and the Bronx, and all of a sudden we've got all this land and it was part of my dad's job. We did not own it. So it was one of the benefits of the job and really got to live an incredible childhood and And to this day, my friends who were part of my world then, Morven Park is forever seared in our minds and was one of the most magical places to grow up. I studied journalism in undergrad and decided that I wanted to travel. And at the time, the job market wasn't so great, didn't really know how to break into places. So I became a flight attendant. Flew for United Express starting out, and then there was an opportunity to fly with a new company called US Africa that was launched just as apartheid was ending. President Mandela was coming in, and so it was a really special time to be in South Africa. And unfortunately the company went bankrupt. So then I moved to another airline and I worked for Saudia Airlines under a United United States company, but we flew with Saudia's colors on our plane, but still had the N, uh, number on the tail. And lived in the Middle East as a veiled woman. And in the '90s, mid-'90s, it's pretty conservative and strict in Saudi Arabia. It's since changed a lot, uh, however, I wasn't, uh, there to experience that. And then traveled throughout the Middle East, eventually came into nonprofit, left nonprofit, went into private sector, and then came out of private sector back into nonprofit.

Profit. Wow. And you've been in your current role since just right around the time the pandemic started.

Yeah, I started 3 weeks after the pandemic was declared. I actually started a week earlier because of the PPP loans that were going to be available for C3s. I needed to get started on the application process. So I left one job on a Friday and I started another job on the Monday. I had no decompression. I— they didn't even have a computer for me yet because they thought they were going to have another week and they were scrambling. So I used my Gmail account for a little bit until we got me set up and focused on getting that PPP loan together.

So tell us a little bit about the organization that you run.

Sure. So the National Association of Nurse Practitioners in Women's Health is the national organization, professional organization for the certified women's health nurse practitioner. We also support all APRNs who provide women's and gender-related healthcare. And our particular scope of practice is from first menarche to menopause and beyond. We are very well known— sorry, had a little dog here that needed to be picked up.

That's okay. Happens all the time.

We are very well known for our high-quality, scientific, evidence-based education on honestly anything that would impact a woman, female body in care. And we are one of the only NP groups, population foci groups that has high-risk obstetrics in the scope of practice. So we often work alongside, and I say we, I am not, just to clarify, a women's health nurse practitioner, but the WHNP walks, works independently as well as collaboratively with OB-GYNs, fetal medicine docs, all kinds of nurses and other docs in care.

I would imagine that the last 2 years since post-Dobbs has been a tumultuous time for the members of your organization in certain—

Yeah. Yeah. In certain states, half the country, it has been, and it's been very trying. And I think that most recently we're hearing the stories of women who are really facing all odds to survive a pregnancy that's not going well. And the numbers are also showing that there's an increase in abortion, not a decrease. So passing this law didn't do what was intended, which was to stop abortion. It just made it difficult, more difficult to get to, and created draconian laws that are now costing women their lives. And not just those women, but their families, the children that they're leaving behind. It is, it's really, it's unfathomable, quite honestly, in 2024, it's unfathomable.

That's the way I feel about it too. It's what, what can you possibly be thinking? But there's a large group of people obviously in the country who think that abortion is wrong and it's unfortunate. But getting away from that difficult topic, what is it that gets you excited about the leadership work that you do?

So this last week has been really interesting because I'm thinking about the new administration and what challenges that's going to bring to our work and how are we going to still— so I have this philosophy where I believe in looking for the yes. And so when the nos come, then it's time to look and be like water. So go look through the nooks and crannies and see where we can make a difference. We are looking at exploring right now an opportunity where we might be able to ensure quality safety for prenatal vitamins. That's exciting. And that's something that I think one would hope that we can all agree on. There was a study recently in Canada that showed of the 26 prenatal vitamins that they tested, all of them had toxins, all of them. And whether that be lead or ketamine or these other toxins that are not good for mom and fetus to be exposed to. So I think that's— I just— I— you have to make lemonade out of lemons and do what you can. I have a really wonderful friend who is on the other side now, and he used to say, when we go to the beach, all you need to do is pick— and we're talking about the garbage and we're talking about the plastics— and he said, be part of the solution. Pick up a handful of trash when you're at the beach. You don't need to bring a bag. You don't need to organize a beach cleanup, which you certainly can, but do what you can in the moment. And so that goes back to that philosophy of looking for the yes and being part of the solution, even if it's small incremental stages, even if it's impacting one person only. Of course, we as leaders want to impact as many people as we can in a positive way. And it's truly that one at a time.

How did you evolve into a leader? You were obviously came outta school, you were a flight attendant for a while, and then you got into marketing. I know you were a marketing director for some law firms for a while. Pretty interesting. Or you were at least in the marketing departments, and then you evolve into this leadership work. How did that all, how do you grow into that?

Really good question. And I think it's a certain level. I have always been told I was, and I'm gonna use the new term, a assertive ever since I was a little kid. I was outspoken. I was the person that spoke up. Not initially. I was bullied as a kid, and I eventually stood up to my bully. And when I stood up to my bully, I felt this great sense of empowerment as well as a level of commitment to make sure that anybody else who was being bullied would have me as a support person and me to step in and say, hey, cut it out. And so there was this level of commitment. I will say I was in 4th grade. The woman's name is Sarah Smith. Interestingly enough, I got to talk to her in my mid-20s and I went right up to her and said, you were horrible to me. And she knew, and she was making amends with all the people that she had hurt. And, and ironically was working with teens that needed extra support and help. So her childhood led her to a career. And I would say that at some level, so did mine. I was given a lot of responsibility as a child. There was always chores. There was no exception to not doing your chores. You just did them in part because often there were animals that were associated with the survival of whether you brought the chickens water and food or made sure the horse trough hadn't frozen over. There was this level of responsibility and that you were— it wasn't just for you, it was for a greater good. So I think from that young age, that was ingrained in me, plus this personality where I'm strong and I persevere.

And that's how you just evolved into a place where you could start to lead others. I know that in the— in our Authority Magazine interview, The time you spent in Jeddah, Saudi Arabia was life-changing for you.

That's what brought me to women's health. Tell us about it. I, yeah, so I learned a tremendous amount about living in a Muslim country and a very strict and conservative one. And I witnessed a beheading in Jeddah. There were 4 people the day that I went, and the first person was a woman. And their laws are Sharia law. You're guilty until proven innocent. You don't have the luxury of being innocent until proven guilty like we do in the United States. And it dramatically changed me in a way that I wanted justice and I also wanted equity and fairness. And it's what's propelled me in the work that I do today.

Mm-hmm. And so as you look at your organization, how do you see it?

What, how do you see it?

How do you see it, say, over the next 10 years growing and supporting women or nurse practitioners in women's health?

The good thing is, as of right now, 50-plus percentage of the population are women. So I don't think we're going anywhere. So there's a little bit of job security in the sense of the population that we're taking care of. I have great dreams and aspiration of doubling the size of the number of women's health nurse practitioners in the country. Currently, there are 13,100 and some change. It would be awesome to have 26,000 in the workforce.

There are 13,000 total nurse practitioners or nurse practitioners involved in women's health.

So the women's health nurse practitioner specialty, there are 13,000. There are, I believe, I think the number is 245,000 to 300,000 NPs in the country. Don't quote me on that, but I'm pretty sure it's in that range. And there's 5 population foci specialties.

Got it.

And so we are one of those specialties in women's health. We were founded by Planned Parenthood NPs who wanted to further the education for NPs that would be taking care of women and wanting to specialize in that care.

For those that don't know, what's the difference between a regular registered nurse and a nurse practitioner?

So an RN is, is not an advanced degree. So advanced practice registered nurses are— they have a master's or a doctorate degree. The RN is in essence like an undergraduate 4-year degree. And so the NP has, depending on the state, full practice authority, prescriptive authority, And in some states can practice autonomously, meaning no doctor oversight. They can open up their own practice.

And what they're doing is providing a need for healthcare, especially where there's, it's a, could be an MD desert or a—

Correct. And that as we—

The medical practice.

And as we know, that is, there are maternal healthcare deserts across the country. Oh yes. There are primary care health deserts.. And we know through over 50 studies that the nurse practitioner offers high-quality care, that it's out there. It's just a matter of investing and producing more, and especially of the specialty NP groups. It's critical to ensuring better outcomes. And our country right now needs a lot of help when it comes to healthcare and the cost of educating an advanced practice registered nurse. Versus an MD. And I'm not saying we don't need MDs because we need those too. And we need surgeons and we need specialists in the medical world. But the cost of, and the time and the length of time, we need to be investing in NPs to take a lot of the, I don't wanna say take, provide and give greater support to the medical community at large.

I know I'm reading the horror stories about Idaho and how they're just losing OB-GYNs left and right because nobody's— nobody wants to practice there because of the deal with the laws.

And we're going to see that continue on for sure. There are many folks who I would think after this election may decide to move to a different state. And there's a possibility that we have a federal ban. There's a lot of nuances there, but it could be that it goes away entirely, which that's going to cause all kinds of problems in the country.

It will. And I, as a lawyer, I'm just thinking about the battles ahead. I frankly, I cannot imagine the federal government, Congress passing a law that President Trump signs that bans abortions nationally that any— that the West Coast will follow.

Oh, I think you'll see some dissent whether it's a federal law or not. And I think I just can't see California saying, "We're going to comply with this law." I agree. I agree. And I think that's where the states will really exercise their states' rights. And I think you'll see a states' rights federal government battle going on in a big way.

It's going to be really, unfortunately, very interesting.

Yeah. And unprecedented, right? This is new territory. So we're going to really put the democracy and the Constitution to to the test.

We really are. What do you think, Heather, that's unique about you that you bring to the table that's made you effective as a leader with the organization that you're leading? Personal characteristics. You said earlier you were assertive.

I'm compassionate. I recognize that people have lives outside of this job and this organization, whether they be a full-time staff member or a board, a volunteer. There's great amount of respect for the contributions made. I keep it real. I think that I'm the CEO that stuffs bags. I'm the CEO that's gonna go to the hotel and say, hey, there's no more toilet paper in stall 1. Can you please replace it during our conference? So I have this philosophy where there is nothing out of my purview. If it, it's, we're all in this together and we're, greater when we support each other. Sure, there's— is it my job to do that with the toilet paper?

No.

But was I able to see the manager walking down and take advantage of that opportunity? Absolutely. So why pass it through the chain when that person's right there that I need to— that would need to be talked to? I also think it's important to recognize as a leader is that you can't take on all of those things. However, those details are really important and pointing those details out to folks is important as well to guide them so that they have that vision, that insight into how to make someone's experience a good one. I guess it comes back to customer service. And from the very beginning, from my first job as a docent in the Morgan Park Mansion to my job as a flight attendant, customer service was at the core of that. And I think that is essential, your external and your internal customers. Treat those, treat people like you want to be treated. And I have been treated pretty poorly in jobs. The law firm world is not easy. And as, and I know what it's like to feel disrespected. I also know what it's like to be bullied on the job and to be fearful of losing your job because your family's insurance is tied to your job and having to really swallow a lot of stuff and suck it up until I could get out.

One of the things that caught my attention in our interview in Authority Magazine was the fact that you are, you have an interest, you focus on creating a safe environment. Tell me more about that.

Yeah, I have a personal commitment to continuous growth. I'm a soul having a human experience. I truly believe that at my core, and I want to grow, whether that be mentally, spiritually, hopefully not too much physically, and become a better person and make a contribution to the world, however small or large. And I believe that you have to solicit feedback. You have to let folks know that you're open to that feedback and I always say to our small staff, if there's something that needs to be changed, if you don't tell me, I cannot make changes. And then you're just wasting your time talking about it behind the scenes and nothing gets changed. Buck up. We're all adults here. Be constructive in your feedback and let me know so that I can bring about change. And then taking that feedback and saying, hey folks, I heard this. I heard that this was bothersome. I've thought about this. This is how we can change. This is how, for example, there were folks that were upset because I said my team instead of the team, as if it was ownership, and certainly was not my intent at all. I think of my team as family, work family. There's different boundaries and different, but we care about each other and that didn't, that wasn't received well. So I changed it. I heard that and I changed. I just said, okay, now it's the team, the NPWH team, our staff, that sort of thing. So again, if somebody doesn't tell you what's bothering them, there's no way to bring about change. So creating that safe space, no retaliation. Retaliation, my goodness. I, and we know that there are folks out there that retaliate and horribly. That's, what does that solve? And, and then are you really getting, are you really accomplishing your mission and your strategic plan by creating this environment where people are fearful and it's negative and toxic? No. And think about how much more you could do with a little bit of love and kindness and compassion and understanding.

Absolutely. So you've obviously learned how to listen over your career. Tell me about your listening journey.

Yes and no. If I'm honest with you, not always. However, this year and moving forward, listening is, it's actually a focus. It's my number one personal goal is be a better listener and really hear what people are saying. I'm not leap to solution. I'm solution-oriented. It's, you have a cow that's giving birth and the calf is stuck. You don't wait, you jump into the solution. There's no further listening. You have to take action. And I have to recognize not everything is a life or death situation. And taking that time to understand what's going on, the processes, the personalities. What folks are bringing to the table, what's missing, who's not at the table. So I have made a big conscious shift this year in sitting back, taking it in, and putting some reins on my extroverted personality to be a better listener and hear what folks are saying and what we can, and also not always being the one to solve it. What is everybody else's thoughts? Let's have some consensus building around this.

And so how's that worked out for you as you've begun to practice that?

It's great because I'm letting go of what's not mine. And so the paper towel thing, that's an example of not letting go what's not mine and recognizing it before I would never recognize it. And then burnout is real, right? And I, if I didn't have a family, I would be a workaholic. No question.

Wow.

So I, I have these boundaries, which is great and healthy and doing what is my job and role as CEO and delegating and assigning when it's not.

Great. One more question and I'll let you go, Heather. What's one thing about yourself that we would never know about unless you revealed it to us?

It was a really good question. Let's see, one thing, one thing that I want to admit too, right? I think of a lot of things.

You would never know it, but I'm a jazz violinist.

Oh, really?

Among many other things.

Yeah.

That's amazing. Okay. That's a fun thing to talk about. So I am watercolorist.

Oh, there you go.

And I created a scarf for the organization using one of my watercolor patterns that we are using to raise money for research grants to give to women's health nurse practitioners.

That's wonderful. Good for you. This has been a lovely conversation, Heather. Thank you so much for taking time outta your day to chat with us. Really.

Oh, Doug, thank, thank you so much. It's so great to get to know you and I really appreciate the opportunity. You're welcome.

Doug Noll here. Thank you so much for listening to Listening with Leaders. If you are a successful executive leader who would like to be on this program, please visit podcast.dougnull.com/podcast. If you got something out of this interview, would you please share this episode on social media? Just do a quick screenshot with your phone and text it to a friend or post it on the socials. If you know someone that would be a great guest, tag them on the social media to let them know about the show and include the hashtag #ListeningWithLeaders. I love seeing your posts and guest suggestions. We are regularly putting out new episodes and content. To make sure you don't miss any episodes, go ahead and subscribe. Your thumbs up Ratings and reviews go a long way to help promote the show and mean a lot to me and my team. Want to know more? Go to my website, DougNoll.com, or follow me on LinkedIn, Facebook, and Instagram. That's @DouglasEnoll. Thanks for listening, and we'll see you on the next show.