changes

okay, so it is cliche, but we can all agree that the one constant in life is change, yes?

the changes that have been happening to me because of the changes that were manifested (through lots of prayer and conversation with god) and then acted upon, in regards to my career, are changing me in ways that were not fully thought out. i mean, how can you really think through something entirely that hasn’t happened to you yet? some of the changes are very welcome- i feel myself resonating, vibrating, with a much slower, and relaxed energy. the difference between two minutes being too long to wait for something a patient needs and two hours being a fast turnaround for a request. the difference between having to clock in and clock out and being salaried. the difference between chest compressions and a caring conversation.

sure, there are lots of reasons that my new gig is challenging: politics, learning the tactics needed to move a large bureaucracy toward the changes it says it wants, but that all actions suggest otherwise, the inefficiencies of a clinic workflow that have gone unchecked for years. not to mention adding a new specialty area to my repertoire.

and it would be a lie if i said i didn’t miss the OR.

but this new work that i am being called to do, the new spotlight on the areas of my self, of my soul, of the way i walk through the world, it is intense. i feel directed to lean in and do some hard work on how i interact with my environment. to look at the root cause of my impatience, to explore the deepest, darkest parts of my personality and draw those places into the light.

to surrender to the imperfection, acknowledge it, and love it anyway.

and, i think my very favorite consequence of my new job is that i am really sleeping again, dreaming again. when oscar died my sleep left. don’t get me wrong, i still slept “well” because i’ve always been a strong sleeper, but i didn’t dream and explore as much in my sleep as i did before he died. that has been my very favorite change. and one i think comes from my heart being satisfied that i am on the right path.

like my nurse navigator mentor told me yesterday, “you have the heart of a navigator”. that resonates so deeply with me; i feel that. ultimately, it will be my heart that keeps me pushing forward on this new path. and, truly, i would not have the relationship i have now with my heart if i hadn’t spent the last year of my OR career working in open hearts. beyond grateful for my experience in the CVOR.

so, i choose to keep rolling with the changes. learning from life. open to the challenge. baby steps.

last day

I’ve had one other last day in the OR, in 2018, when I left the OR briefly right before Nick died. I made the leap from OR to primary care. As in ambulatory, doctor’s office visit, primary care. I remember really liking it and feeling like it had the potential to be an incredibly powerful platform to reach patients with mental health issues, but then Nick died. He died only several weeks into my transition from OR to primary care. His death by suicide, on the third anniversary of Oscar’s death, which was also by suicide, was more than I could bear and be learning a new specialty area. So back to the OR I went. I was so blessed to have an OR family that welcomed me back with open arms. I hadn’t even been gone for 3 months when I came catapulting back, on the wave of yet another personal trauma and tragedy.

The OR has been home for so long. Over a decade of my life. It felt good to get lost in the rhythm of surgery again. It helped me learn how to walk with the grief of yet another tremendous loss. Still, there was this whisper, this yearning of wanting to do something more, something different, something that would scratch the itch that reared it’s ugly head the moment that I understood Oscar was dead. I explored so many different options. Countless resume submissions to all manner of different fields in nursing: school nursing, occupational/ employee health nursing, case management, I even applied for a floor nursing position at one point when I was exploring the idea of being a nurse educator! I applied at colleges to teach, to be on public health think tanks. Zero of these ever came back with positive outcomes- I never got interviews. These serial application cycles would happen about every 6 months to a year from the time that Oscar died. It was sort of exhausting, but I felt led to do it. To get out into the job market about every 6 months or so and see what other avenues of nursing I might call home, a position that would utilize this new set of skills that I had learned related to overwhelming grief and our experience getting lost in the system. Often, when I look back at our experience the few months before Oscar died, hindsight being what it is, I see how incredibly perfectly all the holes in our slices of Swiss cheese lined up. And Oscar fell right through. Unfortunately our outcome was the worst, death.

A sort of breaking point for me was when I didn’t get promoted past boardrunner/ charge nurse in the OR that had welcomed me back with open arms after Nick died. I wanted to lead that department with such a deep desire, but my director didn’t think I was ready. So, when I didn’t get hired as the OR manager in that department, I decided it was time to do something that I had always wanted to do in surgery: open hearts. I researched programs in our local region. St. Luke’s Mid-America Heart Institute was the only choice hands down. I applied. Was offered a job. And I turned it down the first time because I was SCARED! 3 months went by, I was incredibly stressed and stretched to my limit working 12 hour shifts 3 days a week as boardrunner/ charge nurse for an OR that ran 12 starts daily with, more times than not, 50+ cases. We would be balls to the walls busy from 7am to 7pm (and after) more often than not. When I finished my BSN program at the end of 2019 I applied to the CVOR (cardiovascular operating room) at Luke’s again. Immediately got an interview. Second time around I accepted. Time to face the fear and trust the process; embrace the lifestyle of CVOR nurse.

My time in the CVOR over the past year has been an incredible learning journey. I have learned this amazing specialty. I have learned a lot more about my own limits. I have learned what I really want to focus on in patient care. That has been the most exciting. I have been pushed to learn more about myself as a nurse and what really makes me tick. What makes me excited about what I do and more convinced than ever that I have been called to this profession. I feel, more than ever, that I was made by Him to be a nurse. And just how important my voice as a strong nurse is to the patient care TEAM. The team isn’t just docs. It isn’t just nurses, or techs. It is all of us, each one with a different way of seeing the patient’s experience. I did my best in the CVOR. I learned how to really pray, each call shift stretching me to my personal limits in handling stress in a healthy manner. I participated in some of the most incredible, and life-saving, patient care of my career. I learned to understand how to monitor critical patients and what it really means to have someone’s life in my hands. I will never, ever regret my time in CV surgery. In fact, I believe without any doubt that my time in the CVOR is what opened doors to me to my forever career path: patient navigation.

There were so many conversations I had with the staff in the CVOR that helped me to find my place. From my manager, to my charge nurse, to my fellow staff nurses and techs, to the nurse liaison for our department, to the docs, to the physician assistants, to the anesthesia providers, to the perfusionists. Every single person was open and receptive to me exploring life outside of our department. That meant so much to me. It says a lot about the overall culture at St. Luke’s and why I am so incredibly blessed and proud to be a St. Luke’s nurse. I started keeping an eye on the job site at Luke’s in the fall of 2020. I applied for case management positions and a nurse resource position. No bites. I decided to fully commit to the OR and give my all in my current specialty so I applied to test for my CNOR (certified nurse operating room) certification and began studying OR standards and guidelines. I became involved in a system-wide committee to standardize our malignant hyperthermia preparation and response. All the while keeping an eye on jobs at Luke’s. That was the one thing I was sure of: I wanted to stay with Luke’s.

I first noticed the Thoracic Center Patient Navigator position a month before I applied for it. I stalled that long because I had seriously just made the commitment to stay in the OR and I was insecure because I had already been passed over for case management positions. This position kept coming up for me, though, because it was posted under education and the job description sounded exactly like what I wanted to do. It would incorporate my communication and leadership skills and also grow my coaching and education skills along with challenge me to develop a new role for the center. And, I was fairly certain it would build on my relationships that I had already established with some of our cardio-thoracic surgeons. The thing that finally pushed me to apply was a conversation I had with my child, Viv. They got real with me and that made me realize that it was really time to get serious about changing my work lifestyle. I needed to dial down the stress and uncertainty and dial up the consistency. So I finally applied. Had an incredible journey to my job offer and just finished my second week in the clinic as the Thoracic Center’s new Patient Care Navigator.

This change in my career path has been a long time coming. I feel more certain with each day that I have made the right choice and that I do, indeed, have something really special to offer patients. With my combined professional and personal history, my ability to grow through post traumatic stress, along with my ability to communicate clearly, succinctly and efficiently, interwoven and enhanced by the amazing Thoracic staff and our doc champions that keep the clinic humming, I have faith and hope that we will be able to build an amazing, world-class Thoracic Navigation program at St. Luke’s.

Oh, and did I mention I start my MSN in Care Coordination at Nebraska Methodist College in August?!

This is going to be fun! 😉