National Nurses Week is a time for nurses to celebrate the profession of nursing and the vital work they do each day. As I prepared for Nurses Week, I took time to review my 40-year career as a registered nurse. As I looked back on my career I am proud of my work, the experiences I have had and the people I have met along the way.

A look down memory lane.   

I have been a nurse since 1973. I graduated as a practical nurse from, St. Mary’s School of Nursing in Philadelphia, PA and applied for a job at the hospital connected to the school of Nursing, St. Mary’s Hospital.  As there were no career ladders or guidance counselors to help me plan out my career, I had to make my way on my own and with the guidance of close friends and family.

My first job as a new nurse was as a medical/surgical nurse on a 64-bed men’s unit. As an LPN I was given a great deal of responsibility and autonomy despite a limited education. Those early days provided a great learning experience that helped me become the nurse I am today.

During the early years, my best friends, Mary Bennet Ready and Kathleen Connell McMullen were my first mentors. We were there for each other, talked about our challenges, and did our best as nurses. We looked out for each other and supported each other as new nurses. We are all still friends today and have great conversations of our times together as new nurses.

In 1976, I decided to go back to school to become registered nurses. Again with no real direction to help plan my career, I looked for a program that would allow me to become RN’s in the shortest amount of time. I chose an associate degree program in Center City Philadelphia that would allow me to graduate in 2 years. I graduated in 1978 with an associate degree in nursing and went to work at the hospital I trained.

Upon graduation, I went to work in the Emergency Department. I worked with a great team of nurses. We learned and worked together. The hospital was in a dangerous area of the city, and we saw the worst of the worst. It was a great learning experience and taught us all about culture, humanity and working in a catastrophic environment. Sue Stanley, Bonnie Bender, and Fern Abramson were among the many colleagues I worked with in those early years. I am glad to say we are still friends today.

Taking advantage of opportunities is the key to success

After a few years, I was looking for a change. In 1980 I was offered the opportunity to transfer to the Respiratory Intensive Care Unit (RICU) at the same hospital I was working.  I was told it was unusual for an ED nurse to move to a critical care area, but I was intrigued by this area and decided to take a chance. This is where I met Kathy Zender, my first ‘real’ mentor. Kathy was an excellent nurse and oriented me to the RICU. She was amazing to work with, and I learned so much from her. Kathy is a caring nurse and had a fantastic attitude. She was a true role model. We are still friends today, and when we are together, we are immediately transported back to those days in the RICU and recall the important work we did taking care of people who were so sick. We learned much about life and the importance of communication and having faith. So many people we cared for were very ill, but with innovative care, skilled nurses and dedicated physicians, many improved and went on to live their lives. Others died, but we knew we did the best we could. We went to funerals to pay our respects to the patients and families we built relationships. Looking back, I have to say we truly practiced patient-centered care.

In 1984, I was approached by one of the doctors who knew me from the Emergency Department. He shared that his wife was working as a Risk Manager and was leaving the company to go to law school. The company was looking for someone to fill her position. He thought I would make a good risk manager and told me if I was interested he would pass my name on. I was intrigued by the opportunity despite not knowing anything about Risk Management and said I was interested. He let me know about a week later that I was to call Peter, the attorney who ran the Philadelphia Branch of Affiliated Risk Control Administrators (ARCAP) to set up the interview. On the appointed day, I went for the interview, and I was hired! Here is where I met my second mentor, Barbara Zarzuela. Barbara had worked for this company for a number years and was a trusted employee. She took me under her wing and taught me the job. She was a lovely person, who knew her job well and took the time to teach a ‘newbee’ all that she knew. We spent a lot of time together in those early days. Barbara was always open to listen and answer any question. I liked the job and excelled in it. I stayed at ARCAP till I moved to Florida in 1988.

In 1988, I was getting married, moving to Florida and wrapping up my Risk Management job. I wanted to have a job when I arrived in Florida but did not know how to go about it. A friend introduced me to a recruiter who worked for a traveling nurse company. I called the recruiter one day. She asked me a few questions about what type of nursing I liked. After our interview, she did some research and came back with a few opportunities. I picked a hospital from her list that has an Emergency Department opening. The recruiter set up an interview with the Head Nurse, Marge Gory. We talked on the phone and Marge told me about the hospital and the position that was open. She said I could sign up for a three-month contract. If I liked them and they liked me, I could renew the contract for another three months or come onto the staff. I signed up, and once I settled into married life in Fort Lauderdale FL, I started the job at Imperial Point Hospital.

Laura Keuter was the first person I met on my first day at my new job and the nurse who became my next mentor. She oriented me to the role and the department. She introduced me to the staff and helped me fit in. She was a role model for me for many years. Although she moved out of the area, we have remained friends over the years and catch-up when she comes to town every few years.

The start of a new career

About a year later, a friend of mine called and told me about an interesting role she had just started. She said she was a nurse case manager. She explained what she was doing at a new company called Intracorp. She told me she thought I would like the role, so she gave me the number to call and set up an interview.

I took her advice and set up an interview. Again, not understanding what a case manager did, I went for the interview. The person I met with was the Manager of the new unit opening in South Florida. She told me that case management was simply, good nursing. My role would be to work with patients who had catastrophic injuries or illnesses and to make sure they were getting the care they needed, at the right time, in the right setting for the most cost-effective price. They wanted RNs to do this work as we had the clinical expertise and the communication skills needed to bring the team together. I liked the concept and signed up to do 20 hours a week and continued to work 20 hours in the ER. Both organizations agreed, and this was my start as a nurse case manager.

I loved Case Management and found that it closed the circle of nursing for me. As we were a new unit, our team worked together to learn our roles and how to prove our outcomes. Ana Benach and Chantel Appoline were my colleagues on our South Florida team. There were other nurses hired throughout the state in Tampa, Orlando, and Jacksonville. We had managers across the country who assigned us cases and worked with us to managed our cases. We worked out of our homes and learned as they say ‘on the job.’ The early days of implementing the practice of case management were exciting times.

One manager, in particular, Linda Contino stands out as another mentor. She always supported my decisions and helped me make the case when I faced a challenging situation. We supported each other in an area that was making a difference in the changing how care was delivered. We helped each other and remain friends to this day.

The Importance of Belonging to YOUR Professional Organization

I left Intracorp in 1992 and moved into Independent practice. Marilyn Van Houten, a colleague from the South Florida Case Management Network, had just started her company and gave me my first case. Marilyn was an excellent mentor and friend. She introduced me to other case managers who had started their businesses, and as a result, I was able to build my practice. It was at this time; I became actively involved in the South Florida Case Management Network which was forming in Fort Lauderdale. I went to a meeting where leaders from the area were choosing officer roles. As I was new, I volunteered to be on the program committee. Here is where my interest in continuing education was sparked. Being involved on the local level was my start, but it also opened to my eyes as to the value of belonging to a professional organization. I worked my way up through the local, state and national level of the Case Management Society of America. I served as President of CMSA in 2003-4 and then went on to be awarded their Lifetime Achievement Award in 2015. I have always said I gained far more than I gave through my involvement in my professional organizations, the Case Management Society of America.

In 1994, myself and a case management colleague, Kathleen Moreo decided to form a partnership and develop a continuing education company. We saw a need in our area to offer continuing education to busy case management professionals who could not get to achieve their continuing education credits. To meet this need, we formed a company, Professional Resources In Management Education (PRIME). Today this company is a well-established organization still owned by Kathleen.

I decided to leave the PRIME in 2006. Shortly after, I was contacted by Harry Alba who offered me a position with Dorland Health. The role was to be the Editor in Chief of a new case management publication the company was launching. As I listened to Harry, I was not sure I was qualified for this position as I was not a journalist and not a ‘good writer’. I mentioned my reservation to Harry, and he said: “no Anne, we want you for your ideas and knowledge of the case management industry.”  We have people who will do the writing and editors who will make you look good! Again, I took a job that I knew nothing about but was intrigued as it would take me in a new direction.

I found myself surrounded by knowledge people who knew the publication side of the business like Robin Jay, Richard Scott, Claire Burke, Hope Kabik, Liz Graziosi, Carol Brault and Diane Schwartz. Each of these people took the time to educate and empower me. As a result, I excelled beyond my expectation in this new environment.

I learned and grew new skills in the area of writing, public speaking, education and conference planning/management. My position as Editor in Chief and Director of Education gave me the opportunity to highlight my peers in case management who were doing important work in the changing the delivery of care across the broad healthcare system. It was an exciting time, and I am so grateful that I took that chance as it has opened more doors then I ever imagined.

Life Detours

Today, as I enter the twilight years of my career, I am still learning and growing. In 2014 I took a life detour when I was diagnosed with a central nervous system brain tumor. As a result, I found myself in a new role, that of a patient. Despite almost 40 years of being a nurse, case manager, and patient advocate, I was in a position and I had no idea of what to do. I depended on my husband, family, and friends for support and direction. As a result of their support and advocacy, I alive today and can say I am a cancer survivor.

A new beginning

Due to my illness, I had to leave my job with Dorland Health. I took time to heal, and when I was able, I turned to Blogging as a way to share my experience and educate patients, caregivers and all members of the healthcare team as to the challenges I faced as a patient and to share insights on how together we can learn how to better navigate the complex world of healthcare.

People like Beth Boynton, Kathy Quan, Carol Bush, Elizabeth Scala, Michelle Podlesni, Brittney Wilson and Deanna Gillingham are colleagues whom I have met along the way who have helped me start over as a nurse advocate, blogger, and digital journalist. Together we are building a new area of practice for nurses to share their experiences and help others grow, learn and use their skills to improve themselves and the healthcare industry as a whole.

After experiencing the value of having a patient advocate during my life-changing illness, I am committed to raising the visibility of this emerging practice. One way I am doing this is by working with a team of professionals on the Patient Advocate Certification Board. The inaugural patient advocate certification examination was delivered, March of  2018. The second examination will take place September 15-29, 2018. I have learned a great deal from professional advocates who have helped me understand the role advocates play in the diverse healthcare system. These are some of the professionals I have worked and learned from over the years: Ilene Corina, Betty Long, Randi Oster, Trisha Torrey, Beth Droppert, Robin Shapiro, Connie Sunderhaus, Cathy Cress, Vicki Breitbart, Lee Mullert, Marie Connelly, Cathy Bowers and many others.

In looking back on my career, I realized a few things. First taking chances/and being open to opportunities is essential. Don’t be afraid to take a chance or take advantage of an opportunity. Second, we all need to be a mentor and help others learn and grow. I know that my success was due to the people who took the time to mentor me, so now is my time to be a mentor to those who are coming behind me. Third, be actively involved in your professional organization as it is the key to advocating for your profession and ensuring that we always remember the past as we trail blaze into the future. Fourth, “Pay it Forward,” to help others as you have been helped. Fifth, have fun! Life is short, take the time to enjoy it!

Thank you for reading this post, I hope it sparks you to look back on your career and remember the people who helped you along the way. To those that have helped me along the way, I thank you for your support and confidence in me. It has been a great ride!

Happy Nurses Week!

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