Erica's 30 Year Path in Nursing Of Meaningful Work

How long have you been a nurse and what areas of nursing did you work in?  I’ve been a nurse for close to 30 years. I started out as a new grad on a Cardiovascular and Plastics surgical floor at UCSF and then worked in Kidney Transplant and Post-Partum. With that foundation, I transferred to Home Health (HH) and Hospice - which allowed me autonomy and the ability to teach patients in a setting where they could absorb the practical health info they really needed to enhance their lives. I was also able to be with patients and (when the patients were so blessed) the families of patients at the end of life. I became familiar with disenfranchised communities as I saw a lot of patients in the Tenderloin and Bayview Hunters Point. After many years of HH I went back to school and earned my Masters degree and a Psychiatric CNS license and began working in Mental Health. I started out in East Palo Alto working with seriously mentally ill and dually diagnosed patients and then worked for many years at the SF VA. I taught Community Health and Psych nursing for two SF universities and then went back to Home Health. It was 15 years later and HH was NOT what it had been in the past (patients are sicker, and carrying a computer around and charting in patients homes is distracting). I now work at the UCSF Pain Management Clinic where I do a lot of triage, run interference for the doctors, do some case management, work on projects, and take the time to listen to patients when they are overwhelmed with their pain and associated issues/concerns. My psych skills are very valuable to this clinic.

What do you love most about nursing?  I have never doubted that my career path has been “right livelihood.” I have so many other interests and I could have made so many other choices in regard to job and career.

Tell me what you consider the biggest challenges or concerns about nursing today.  While I need to be paid for what I do, I think that financials rule too much of how good health care gets delivered. In both hospital and clinic settings it doesn’t feel that staffing is ever adequate. Productivity ruled Home Health and even though we were paid for 40 hours, it was a 60-hour work week. We need a better health care delivery system with a lot more well-trained practitioners.

You have worked in both benefited and per diem roles. Can you share with us how you came to making that choice?  I was able to work per diem for most of my career because I had insurance benefits from my husband. I’m now single and need to provide my own benefits. I had never saved for “retirement” (I laugh, I don’t think I can ever retire) so working full time is a necessity…when I was looking for work when planning my divorce, no one would hire me at 80% (4 days/week). Working 5 straight days is very tough, especially as one gets older. I have to do all my activities in the evening (getting anything done in SF on the weekends is difficult) is exhausting.

What throws you off balance and how do you know you are out of balance?  Not eating well, not sleeping, not swimming, not meditating. Difficult situations with either patients or colleagues tend to make my monkey mind vibrate.

What brings you back into balance?  Eating well, sleeping, swimming, meditating! Having necessary conversations immediately and not putting them off because they’re going to be unpleasant. I love to cook, take jewelry making classes, and play endlessly with beads.

As a Nursing Instructor, what was challenging and how do you keep your students engaged? What was most important for you to have them understand?  My students were undergrads, generally young, and because Psych and Community Health involve communication skills rather than hands on skills, many of the students didn’t value these classes. Because their clinicals often were not in psych specific locations, I had a blast coming up with projects. We were often in homeless shelters and I loved teaching them how to facilitate health education groups, taking them out in the community to rehab centers, setting it up so they could work at Glide Memorial, or health fairs at Senior Centers. What was most important to me was for the students to attempt to find some compassion within themselves for whomever they were working with and not judge, not carry their learned prejudices into their nursing. But along with compassion, it was important to me for them to learn healthy boundaries in order to care for themselves.

Tell me about your most favorite nursing job and why.  I think I complain less about the job I currently hold than I ever have in the past! I get to take time speaking with and being kind to patients. In my clinic very few Doctors or support staff have the time to engage with potentially difficult people, and pain patients have a myriad of factors in their lives, which often make them difficult to work with.

What has changed most over time for you in Nursing?  I don’t expect to be the person who will change my patient’s universe. I hope that somewhere along the way they will remember some good advice I gave and be able to utilize it to good means.

What advice would you give to new grads starting out?  Get a foundation of solid skills and look around while you’re doing that at all the other roles nurses play. Do NOT think you can ever go straight into administration with any idea how to support the nursing community without having first worked the front lines.