Gates Rising Up the Ranks in Long-term Care

Veronica Gates, RRT, set her sights on nursing when she was a little girl, but says life got in the way, and she never pursued her dream. She ended up working in other jobs instead and eventually had a family that kept her more than busy.

Once her kids were older and she couldn’t volunteer at their schools anymore, she decided to take a part-time position at a pulmonary clinic, where she found her passion for respiratory care.

“When I was exposed to the diversity of respiratory care, I was hooked,” she said. She enrolled in the RT program at Quinsigamond Community College in Worcester, Massachusetts, graduating in 2010, then spent more than a decade working mostly in acute care at UMass Memorial Medical Center. But as COVID-19 peaked in the summer of 2020, she was ready for a change and long-term care (LTC) seemed like the right choice.

“Working with COVID patients in the ICU was intense,” she said. “I was hoping LTC would be a better pace and the break my mind needed.”

She took on some per diem work in a 40-bed trach-vent LTC unit to see what the setting would be like, then accepted a 20-hour-per-week supervisor position—all while continuing to work at the medical center. In 2021, she moved to LTC full-time at a skilled nursing facility seeking someone to establish a pulmonary program.

“It was just the change I needed,” she said.

Weighing her options

That was a great experience, and by 2024 she was seriously considering starting her own consulting business to help other facilities develop similar programs when she learned about a regional director of specialty programs position at Marquis Health Consulting Services.

“Marquis provides operational guidance and programs to enable skilled nursing facilities to overachieve on their quality and operational goals,” explained Gates. “Their specialty programs recognize and incentivize the facility to implement initiatives that further enable their success and growth.”

The job description aligned with the work she planned to do with her own company, so she decided to apply. They called her to do an initial interview the next day, but there was only one hitch. Gates lives in Massachusetts, and the job was in Virginia. “After the initial interview, I called back and told them I could not relocate at that time,” she said. “They eventually hired me for the New England territory.”

She believes her background as an RT, along with her about five years in sales for a medical/surgical company and its sister pharmaceutical company, helped her secure the position.

Three core values

As a specialty program director at Marquis, Gates is responsible for creating premier programs that improve patient outcomes in the SNFs the company serves. “We offer pulmonary, heart failure, chronic kidney disease, and ortho programs,” she explained. “I ensure the specialty physician works closely with the care team, who have been educated appropriately to provide strategic care plans ensuring timely discharges and better patient experiences.”

She says the company uses its three core values — excellence, respect, and passion — to create a culture that demands the best from the whole team. As an RT with extensive experience in the ICU and skilled nursing, she has the tools to maintain that culture.

“Whether it’s reviewing changes in condition with nurses and nursing assistants, discussing care plans with physicians, or accompanying the business development team at hospitals to discuss our Specialty Programs, my position now is as multifaceted as my work experience is,” said Gates. 

Keeping all those balls in the air isn’t always easy, but she says there is no better feeling when everything goes according to plan.

“The biggest challenge I have in this position is that there are so many moving parts that don’t always come together promptly — meaning that because of the massive interdisciplinary team involved with patient care, combined with operational needs at the facility level, it can sometimes feel as if the goal won’t happen,” she said. “That being said, it’s also my biggest reward when it does happen.”

She credits her management team with providing the support she needs to work toward positive change and outcomes, despite the challenges. “As a mentor once said, ‘Resilience doesn’t feel like resilience when you’re in it — it feels chaotic. Keep your eyes on the goal,’” she said.

Words of wisdom

Gates has these words of wisdom for any RT who might be thinking about transitioning to the world of long-term care (or any other setting outside the acute care hospital):

• Diversify and never stop learning. I am incredibly fortunate to have achieved what I have with merely an associate’s degree, but I did not let that define me. I continued learning through work opportunities; those lessons were not learned in college. I became a CPR instructor, a Better Breathers Club Facilitator for the American Lung Association, had per diem positions for respiratory equipment patient education, a part-time job for a small medical supply company breaking into respiratory care, took the supervisor role at the SNF with only a few months of experience, and said “yes” to projects offered by management at the hospital.

• Be a “go-getter.” Learn the system and all the working parts to see the greater picture. In the end, it will only benefit you, and you can choose where you want to go with this license/credential. There’s nothing wrong with working at a hospital your entire career if that’s what you want — just know there is a huge need for RTs in many different capacities with a dwindling number of graduates out there. If you’re going to continue with schooling, you can become an NP or PA with a respiratory specialty and work in ICUs at a higher level. It did not happen overnight, but I am in a position where I dreamt I would be, and it couldn’t have happened any other way.