Man of patients

If people turned out to be skeptical and a bit quizzical at first, well, why wouldn't they be?

After all, how many people give up, at age 56, a six-figure salary and the prestige that comes with being the CEO of a hospital to go to nursing school? And then, upon graduation, at age 59, find themselves as a rookie nurse taking orders and instruction from other nurses, after almost two decades of overseeing an entire nursing department?

Well, maybe Milton resident George Geary wasn't a typical hospital CEO. And he certainly isn't a typical new nurse right out of school. He began his 33-year career at Milton Hospital as a respiratory therapist, then spent the last 18 of those years as the hospital's CEO and president.

Now he's working the graveyard shift -- 7 p.m. to 7 a.m. -- in the critical care unit of Dorchester's Caritas Carney Hospital, at a time when many others in his position might be resting on their laurels.

Geary was wary at first about how his new colleagues might view his career change. Would they think it was a publicity stunt? What was he trying to prove?

"It was exactly the opposite," said Geary. "People couldn't have been more supportive, including the people at Labouré College of Nursing, who encouraged me from the very beginning."

Registered nurse Joyce Phalen, whom Geary shadowed in his first six months of work at Carney, says she didn't know Geary was a former hospital CEO until he was a month into the job. "He's a very humble guy," she said. "But you can see the interpersonal skills he learned as a CEO every day in the way he deals with patients."

It is, by all indications, a slow night in the critical care unit, or CCU.

From the centrally located nurses' station, you can see into all the rooms. There are a few empty beds, but it is the bank of heart monitors that tells the story: This is an area where life and death often hang in the balance, and where decisions must be made quickly. On this night the monitors are quiet, the situation stable.

Registered nurse Marie Fallon talks with Geary during the 7 p.m. shift change and goes over the treatment details for an elderly woman with cardiac problems and other chronic diseases. Geary takes detailed notes.

The patient lives alone, exacerbating the problem of treating her.

"With this type of patient, her treatment is only one of the issues," says Geary. "You have to get in touch with social services. Will she be able to get care at home? These are all things we start working on when the patient is admitted."

Fallon calls Geary "very conscientious."

Those who know Geary best say they were not surprised by his decision to become a nurse.

Nancy Gaden, who worked at Milton Hospital from 1987 to 2000 and was vice president for nursing from 1993 to 2000, said Geary had dropped hints from time to time about returning to patient care.

"Even when he was full-out as the CEO, he talked about getting closer to the patients," said Gaden, the interim vice president for patient services at Caritas St. Elizabeth Hospital in Boston. "I could really imagine him as a caregiver, either a physician's assistant or a nurse. He's always valued nurses."

Geary left the Milton Hospital post in January 2003, entered Labouré a year later, emerged as the valedictorian last December, and passed the state nursing boards in February. A week later, he found himself, at age 59, a rookie in the busy CCU at Carney.

A Brooklyn native, Geary attended Boston College as an undergraduate, earning a degree in biology. After some teaching, he studied respiratory therapy at Northeastern, which led to a job at Milton Hospital.

The hospital's CEO at the time, Linwood Galeucia, encouraged him to think about becoming an administrator and offered him a job in human resources.

After he earned his MBA at Northeastern, he became assistant director of human resources, then director, before moving up to become vice president for clinical services. Galeucia's search for a successor ended with Geary, who became president in 1985.

During his tenure as CEO, Milton Hospital flourished, finishing in the black 14 years in a row, at a time when many community hospitals were being consolidated or closed. A 1998 consumer satisfaction poll, conducted by the Massachusetts Health Quality Partnership, found Milton tied for the best rating among all hospitals in the state.

"It validated what we were doing and how we did it," Geary said.

Geary said the medical office condominiums built by the hospital allowed it to add specialists, such as internists, orthopedists, and cardiologists.

When the call became stronger for Milton to associate itself with a Boston hospital, Geary said he was adamant that the hospital not lose control of its own destiny, as many community hospitals had. He pushed for an affiliation with a Boston teaching hospital and not an outright merger.

He decided to leave after the affiliation with Beth Israel Deaconess Medical Center in Boston was concluded.

"The average years of service for a hospital CEO was six, and I had served 18," he said. "I also felt we needed a new set of eyes for the beginning of the new affiliation."

Maryellen Geary, his wife of 29 years, said Geary had been talking about getting back into "hands on" healthcare for the last couple of years he was at Milton Hospital.

"I wasn't that surprised," she said. "While we were first dating, he talked about going into nursing at Yale's master's degree program."

She said her husband found what he was missing at Labouré, then Carney.

"The people at the hospital were like a second family to us, and he missed those relationships after he retired. He lit up again when he got into nursing."

Nurses and administrators at Carney say he has fit right in.

Peggy Conlon, one of the nurse leaders in the CCU who oversaw his clinical trials last fall, said he was eager to learn. "He has that sense of excitement that all new nurses have," she said.

"He's been very motivated as both a student and a nurse," said Mary Coneeney, the unit's clinical manager.

Conlon said that Geary, in his first few weeks on the job, found himself dealing with some very sick patients. "We threw him right into the fire," she said.

Geary said his experience in the hospital setting allowed him to begin his nursing clinical trials earlier in his schooling process.

"I wanted to find out as early as possible if I was suited to it," he said.

He worked at Children's Hospital in Boston and the VA Medical Center in West Roxbury before finding his home at Carney. As both a former CEO and an athlete who enjoyed testing himself -- he completed the Boston Marathon and played competitive basketball for many years -- he found he liked the fast pace of the CCU.

"It involves critical thinking on my part, the ability to quickly and correctly make decisions and think on my feet," he said. He says he entered the profession at such a late age he probably won't be looking to retire anytime soon.

The biggest surprise thus far in his new profession has been the amount of time he needs to spend with patients and families in explaining procedures.

"There's no doubt you're part social worker, part healthcare provider," he said.

In the CCU, Geary thumbs through the paperwork for a newly admitted 47-year-old patient who came in with "sub-sternal" pain, which could indicate cardiac problems. An initial test has turned up nothing; the next step will be an echo-cardiogram.

"He's in stable condition now," says Geary.

In several orderly stacks, he arranges the medical notes and charts for the patients he has under his charge for the night, and settles in for the 12-hour shift.

"It's good to be back," he says.