December 7, 2022

Staff photo / R. Michael Semple
Krista McFadden stands on Trumbull Regional Medical Center’s pedestrian bridge overlooking East Market Street in Warren. McFadden is president and CEO of the hospital.

They’re hard-wired to excel, willing to bet on themselves to reach their goals and ready to confront, scale or break any barrier that might stand in their way.

The women who run the Mahoning Valley’s four major hospitals also lead by example in an open, honest and transparent way, and share other important qualities — among them, a truly deep commitment to care for the ill and infirm.

The individual paths of Genie Aubel, Kathleen Harley, Char Wray and Krista McFadden to become health care executives are distinct but share some similarities; perhaps the most glaring result of their hard work is rising to the top of a field traditionally dominated by men.


Aubel, president of Mercy Health-Youngstown’s St. Elizabeth Boardman Hospital since 2006, doesn’t have a clinical background like her colleagues Harley, president of Mercy Health’s St. Elizabeth Youngstown Hospital; Wray, president of Mercy Health’s St. Joseph Warren Hospital; and McFadden, president / CEO of Steward Health Care’s Trumbull Regional Medical Center.

Instead, Aubel of Canfield, started in administration. Opening that door, however, proved to be a challenging task.

Aubel knew not having the medical background meant she needed experience in a hospital, so she went to one in her hometown of Jamestown, N.Y., “to do anything,” she said, but couldn’t get past the secretary in human resources despite repeated attempts.

Not discouraged, she researched and found the hospital’s board chairman was the head of the chamber of commerce in Jamestown, so she camped outside his office and waited. When he arrived, she said, she introduced herself and explained why she was there.

The next day, human resources called to offer her a summer internship that paid $4.50 per hour, she said.

After nursing school, Wray accepted a job in the surgical intensive care unit at Cleveland Medical Center downtown caring for the sickest patients with complex health problems.

Living in Elyria then, she was offered a job at a hospital there. She accepted the position as charge nurse, being a new mom and it being closer to home, and when the nurse manager there left, it was suggested to her she apply. She did despite having no real desire to do so.

“I ended up taking the job and I loved it, and I realize now it was because I was able to advocate and I was able to solve problems, and I look at my career … I have always been attracted to something new, big and complicated, and it’s health care,” Wray said.

For Harley, she entered the medical field as a means to build a nest egg to attend college, so someone would take her seriously when she applied for student loans. Her job as a nurse’s aide was the beginning of a trajectory to the corner office.

McFadden started as a night-shift bedside nurse in the intensive care unit at a Cleveland hospital. A want for a more traditional schedule was the starting point for her.

“My husband and I were reading the newspaper … there was a position that was posted for a skilled nursing facility and all they wanted, it was a for a manager, and all they wanted was ICU experience,” said McFadden. “I thought this was crazy. It was twice the money, and all they wanted was ICU experience. So my husband and I faxed my resume in … and they called me back, and I went through a series of interviews and I got the job. That started my career in leadership.”


“Oh, I’m wired that way,” Aubel said of her personal drive to excel. “Part of it is how I was raised; it was my parents. Those are the biggest influences in our life to begin with.”

Her father quit school at 12 to support his mother and younger sister after his father died. Aubel’s dad eventually started a construction company and grew it to one of the two biggest in her hometown, she said. Her English mother also helped instill strong morals, work ethic and the concept of doing right by people.

She was the first in her family to attend college.

“I thought if he could do all of that with that little, with all I have been given, I need to really give it my all, and that is how I looked at everything,” Aubel said. “I worry about failing. The first thing I would worry about is failing anything. You just have to achieve it to say you did the best you could at whatever it was.”

When Harley was a girl, her father lost his job and her mother stopped working to care for Harley after spine surgery; she was in a full body cast for nine months. When it came time for college, her parents didn’t have the money to send her, so she went to work. Both parents were motivated people, she said.

“You give it all you have to give. You need to get out there and you have to earn it,” said Harley, who became president in 2019.

Wray, whose mother died when Wray was 12, is driven, too, but admits as a 19- or 20-year-old, she was a little bored in nursing school and didn’t give it the attention it deserved.

The dean of the school knew Wray wasn’t working as hard as she needed and pulled her aside and said becoming a cardiac or critical care nurse — the path Wray was on — “is not for everybody. It’s a really hard area of nursing to get into. Are you sure you can do it?”

Wray said she believes the dean knew she needed a fire lit under her and pulled the lever.

“That was the best thing that ever happened to me,” Wray said. “Looking back, all I had to have was somebody dare tell me I couldn’t or shouldn’t, and it was game on. So from that point, I was a grades maniac, just total immersion in everything.”

McFadden had a paper route as a girl. Delivering the news shaped her work ethic, along with her father, who worked in a rubber plant in Akron, and her mother, who was an administrative assistant.

“I’m an ’80s baby, I’m a latchkey kid. Both my parents worked … but even back then at 13 years old, I had a paper route. I think that kind of sets the tone for work ethic because 365 days a year, those papers had to go out. Rain, snow, blizzard, it didn’t matter, dogs chasing you down the block.”

She also worked at McDonald’s, becoming a crew trainer.

“So even back then, there was that drive to do a little better, to do a little more,” McFadden said. “I think it’s just somewhat natural, something that I have been able to latch onto and embrace.”

Harley was working in the ICU at the former Trumbull Memorial Hospital and wanted to transfer to the operating room, but ran into a roadblock — the ICU nursing director didn’t want her to leave. So Harley met with the chief nursing officer, who explained the director had a management plan for Harley.

“I said I really don’t want to get into management — I want to get into the operating room,” said Harley, who after meeting with the top nurse made the move.

Working in the operating room meant long hours that eventually wore on Harley, who when a new surgery center opened on Elm Road wanted to transition there. She had just met her husband and the new role meant a more traditional Monday to Friday work week.

The nursing leader in the operating room, however, didn’t want Harley to go. She bid on the nurse manager job at the center anyway.

“So I interviewed for the nursing leadership job so that the director could see me in a different light because she pigeonholed me,” Harley said. “I knew I wasn’t management material. I didn’t even have any experience, but I thought this lady has to see me in a different light. So after I did, they asked me to take the leadership position role in the main over at Trumbull.

“I think sometimes God’s plan, fate’s plan, there is a plan. It might not be your plan, but there is a plan out there for you, and I really believe that. I love what I do. I love mentoring, teaching and watching other people grow, like the front line leaders, watching them grow and develop and watching them build a team and watching them get the outcomes they want.”


It’s about being present.

For example, when Mother Nature dumped a ton of snow on the Valley this winter, Harley came into work the night before and slept overnight at the hospital.

“The purpose of it was, I didn’t know how many people weren’t showing up, and when we got those 16 inches, I thought, well, if the president can’t show up when there is 16 inches, how can I expect other people to show up, to get in their car and get here?”

Aubel said it’s partly due to the generation in which they were raised and partly upbringing.

“If you expect it, you get in there and do it,” she said.

McFadden, named president / CEO in 2020, also likes to be visible, available and to have a good ear — qualities she said are found among the best leaders.

“It’s not about the office and the big chair and the desk and all of those things,” she said. “It’s really about your ability to connect with people and motivate people to be better and do more and sometimes do more with less. The pandemic showed us it’s not always going to be that you’re going to have all the resources that you’re going to need, so then what?”

Said Wray, who in April was announced the new president at St. Joe’s, “for me, it’s about being where the people are. You have to be here, you have to be present, you have to watch, you have to support, especially being new. They have to know who you are, they have to trust you, because you’re going to advocate for what they need, you’re going to have to make some hard decisions sometimes, but you’re also going to have to make a good business argument for an investment or a change because you know it’s the right thing to do.”

Also part of Wray’s perspective: “It’s OK to stumble and make a mistake. You just get yourself up and dust yourself off and you go.”

That’s a message she imparts to younger folks, using herself as the example. When the nursing school director pulled Wray aside to question her commitment, she was on the verge of not making a grade in the course, which she didn’t. Not making the grade, she said, resulted in her having to start from scratch in another nursing program.

“It’s OK, it’s OK, you learn from it and you move on and you don’t let somebody tell you that you can’t do something you want to do,” she said. “It doesn’t matter what that is, if you’ve got the mind to do it, then get in and do it.”

Wray replaced Kathy Cook, who retired in April after 38 years with Mercy Health, including eight as president of St. Joe’s.

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