The Nurse That Brings Saving Lives To The Next Level

I had the pleasure of meeting Tania Yarema thirteen years ago when traveling Nursing brought us to San Francisco and we settled into the ICU at UCSF Mt. Zion Hospital. I was working per-diem when Tania arrived for her travel assignment. Since then my critical care skills have narrowed to high-risk obstetrics. Tania, on the other hand is a highly respected critical care Nurse Practitioner that places central lines, intubates unstable patients and gives the term "saving lives" deeper meaning..

 How long have you been a nurse (and/or NP) and what areas of nursing did you or do you currently work in?  I relocated to the United States (Hays, Kansas) after graduating nursing school in Canada in 1996. Two years later, I moved to North Carolina for a critical care training program, before moving to San Francisco with my best friend as traveling Nurses.

I decided to go back to graduate school and completed an Acute Care Nurse Practitioner Program at UCSF in 2008 and have been practicing inpatient critical care medicine ever since. One of my newest experiences in nursing is teaching.  As an Assistant Professor at UCSF School of Nursing, I have been enjoying teaching in the same program I graduated from. 

Tania with friends from UCSF Acute Care NP program

Tania with friends from UCSF Acute Care NP program

What do you love most about nursing? There are so many aspects of nursing that I love. Having the opportunity to help someone in their most challenging moments as a patient is the most rewarding aspect of my job. People are extremely vulnerable as patients, and if I can ease and comfort them along the way, I’ve done my job.

Tell me your biggest challenges or concerns about nursing.  Healthcare is big business and we have the potential to lose sight of what is really important, such as compassion, listening, education and humanity. With all of the incredible scientific advances in medicine, sometimes we lose sight of connecting with the people who need us most.

What throws you off balance and how do you know you are out of balance? When I have been working consecutive days in the ICU with high acuity, I can definitely get lost in the sadness of it all. I feel it physically, like a generalized heaviness that I cant shake.

What brings you back into balance?  Spending time outside with my son and people closest to me realigns me. It honestly takes a couple of days to lose the feeling of imbalance, especially if I have been having a particularly difficult week. I get so swept up in the moment and with other people’s lives that I often lose balance in my own. Recognizing how lucky we are to be healthy and happy is something I try to do each day.

Tell me about your most favorite nursing job and why.  I really love being a Nurse Practitioner but I would have to say, my favorite nursing job was at UCSF Mount Zion (MZ) Comprehensive Cancer Center. I was a bedside critical care nurse there for over 10 years. We specialized in surgical oncology and I loved our patient population. The nurses, doctors, and ancillary staff at MZ were the best of the best. The compassion and dedication that we provided to this patient population is something I will never forget, and will most likely never get to experience again.

What advice would you give to new grads starting out?  Please keep in mind why you went into nursing. It is a privilege to be able to help people in their time of need. They are so vulnerable and what you do will impact them for the rest of their lives.

Tania and her colleagues at CPMC

Tania and her colleagues at CPMC

What happens when the nurse gets sick?

                      The three NP sisters:  Regina Walsh, Dr. Eileen Escarce and Veronica Byrne.

                      The three NP sisters:  Regina Walsh, Dr. Eileen Escarce and Veronica Byrne.

Once in awhile nurses switch roles and become patients.  I am no stranger to this role reversal.  I have had minor surgeries, meningitis and even broke my back, after a truck hit me while riding my bicycle.  This is small stuff compared to my friend Regina, who has been a patient since 2007.  We worked together in the ICU at UCSF in 2003.  It was at this time when she was diagnosed with Ovarian Cancer.  After treatment, Regina kept the cancer in check.  She continued to work for four years and then was thrown another curveball when she had a stroke in 2007.

 

Her life is hard, although you will not hear her complain.  The tPA (treatment for her stroke) destroyed the right parietal lobe of her brain in a bleed. She lost use of her left side and life in a nursing home dangled in her future. That is not Regina’s style.  With the support of family and friends, rehabilitation, treatment and her fighting spirit, she is able to live with family and walk with a cane. In addition to pain medication and a baclofen pump, her back spasms are treated with Botox injections to her left neck all the way to left calf.  Her Ovarian Cancer was in remission for seven years, until four years ago she was diagnosed with Stage IV Ovarian Cancer.  Unfortunately the chemo makes her stroke symptoms worse and she is challenged with significant pain. 

                Regina with her niece, Ali Escarce

                Regina with her niece, Ali Escarce

Regina was a Registered Nurse for ten years prior to working as a Nurse Practitioner for seven years.  With great reluctance, after a stubborn fight with herself, she finally listened to her fatigued body and was forced to give up nursing.  She was a crackerjack nurse and now she is an award-winning artist, published in the Lilly Cancer Canvas book.  You can follow her art on her Facebook page, My Stroke of Art.  Regina has a great perspective about life from both sides of the bedside.

Here’s what she has to say:

 Favorite nursing job

“Working as an Acute Care Nurse Practitioner with the neurology department that specialized in strokes at Loma Linda University Medical Center.  I felt like a resident, only I knew more. I liked the critical thinking, fast pace challenges and opportunities to learn. I also worked with great nurses and nurse practitioners.”

How did you know you were out of balance in nursing?

“When I started complaining and didn’t look forward to going to work, I knew it was time to find a different area of work.  It was essential for me.”

 

Biggest pet peeve

“There is an assumption by families and patients that the doctor saved their lives when in reality it was a nurse.”

 

Advice to new graduates

“Do what you love. Don't be afraid. Ask questions. Don't be a know-it-all.  School taught you a lot, but you won't really learn nursing until you've had at least a year in the same job.  Don't rush into graduate school; learn to be a nurse first, which doesn’t happen until you've worked with patients as an RN first.  Life is short. Don't waste it.”

How she gets back into balance in her life.

“When I breathe, I note the in and out effort, which helps me forget the past and live in the Now. I accept that life isn't fair.  People are limited to their own perspective and can’t always see things from mine. I don’t rely on other people to solve my problems; only I have that power and ability to do that.

 More importantly, I don't dwell on the unhappiness of a situation or conversation. I don’t waste time getting angry, I spend it resolving my portion of the problem, and let go of what is not my share of the problem.


                                     Regina's art

                                     Regina's art

                                    Regina's art

                                    Regina's art

                                 Regina's art

                                 Regina's art