Nineteen nurses share what they would tell their younger selves, knowing what they know now.
We invite all nurses and nursing leaders currently working in healthcare settings to participate in series of Q&As about their experiences.
Next week's question: How do you prepare mentally and emotionally to have a difficult conversation with a patient?
Please send responses to Anuja Vaidya avaidya@beckershealthcare.com by Monday, March 2, 5 p.m. CST.
Note: The following responses were edited for length and clarity.
Question: What is one piece of advice you would give to your younger self?
Kristin Christophersen, DNP, RN. Chief Nursing Officer at Fountain Valley (Calif.) Regional Hospital & Medical Center: Be kinder than you think you need to be. As I have matured in my role as an executive, I've realized that my 'maximizer' strength isn't always what gets work done. A keen understanding of those around me, subtle clues and inquisition has assisted me in working with others' strengths to gain positive movement and outcomes.
Denise Ray, RN. Chief Nursing Executive at Piedmont Healthcare and CEO of Piedmont Mountainside Hospital (Atlanta and Jasper, Ga.): The advice I would give to my younger self would be to always live your life with courageous authenticity. Do not allow fear to prevent you from expressing your ideas, taking a position on difficult issues or being true to yourself and your beliefs.
I keep a poem taped to my desk and look at it when faced with difficult decisions. The poem is called 'The Guy in the Glass' by Dale Wimbrow. It begins by saying to go to the mirror and look at yourself and concludes by describing that your final reward will be heartache and tears if you have cheated the person in the glass. In other words, have the courage to be true to yourself.
Trish Celano, RN. Senior Vice President, Associate Chief Clinical Officer and Chief Nursing Executive at AdventHealth (Altamonte Springs, Fla.): If I could go back and talk to young Trish, I'd start with, 'don't wear the blue eyeshadow!' — it was the '80s — but more importantly, I'd tell her not to worry. It'll all work out.
I feel strongly that every experience I've had got me to where I am today, and I wouldn't change the choices I've made. But I do wish I would have been more relaxed and open in my first few years of nursing. I was so concerned with doing the right thing that I don't think I let myself connect with patients as much as I did later in my career. That's when I got the most out of my job, and ultimately when patients and families got the most out of me.
Nearly everyone struggles with confidence early in their career, but if you can have faith in your skills and trust that your hard work will get you where you need to be, you'll enjoy the journey so much more.
Michelle James. Executive Director of Providence Nursing Institute (Renton, Wash.): I would tell my younger self you can do anything, and always remember that nursing is privileged work and always be open to new challenges.
Ruth Flint. Vice President of Patient Care Services and Chief Nursing Officer at St Joseph Medical Center (Tacoma, Wash.): As I reflected on this, I was surprised at what came to mind. First, I would have not stayed on the sidelines as long as I did. So often, I would watch others and think 'wow that looks fun' or 'I would love to be brave enough to take that step.' If I had a do- over, I would say yes more and enjoy more of my life instead of just putting my head down and putting one foot in front of the other as the world expected me to do. I believe, if I had done that, I would be a better person, nurse, mother, wife and leader.
Kelli Hohenstein, RN. Chief Nurse Officer at Dallas Regional Medical Center (Mesquite, Texas): Don't be afraid to step outside the box to take on new challenges. Especially as a student nurse, see and experience all that you can in efforts to broaden your knowledge base and to be the best that you can be.
David Cox, RN. Population Care Manager of the Managed Care Department at UF Health Jacksonville (Fla.): As I finish up a long career in a profession I dearly love, there is one thing I wish someone I trusted had told me: Always remember why you became a nurse, and be sure that every career decision and move you make reflects and supports that.
In nursing, there are three basic career paths you can take: clinical, administrative and entrepreneurial. And sometimes you can pursue work that provides some combination of two of the three. I spent the middle part of my career working in areas that, while valuable and worthwhile, got me away from my first love — making a difference for patients on a daily basis.
In my work now, much of the focus is on helping our organization move toward value-based care and addressing social determinants of health. But part of my work is in direct patient contact. Doing the latter keeps me grounded enough to be better at doing the former.
Becca Smith, RN. Learning Specialist in the Neuroscience Trauma Unit at Primary Children's Hospital (Salt Lake City): Not every day is rainbows and happiness. Some days will make you so happy you want to burst! Some days will be awful. You will fall. Get up and dust yourself off. You will fall again. And that is OK. Keep getting back up. Keep trying. You are not alone in this experience. It's what makes us all human. It's what gives us the passion to do it differently, to do it better. It's worth it!
Lorraine McDonald, RN. Psychiatric Staff Nurse in the Center for Behavioral Health at Shasta Regional Medical Center (Redding, Calif.): Don't assume anything. Ask questions and be open to receive all answers. Try to learn from the unexpected.
Melodie Toll, RN. Executive Director of Medical/Surgical Operations at Intermountain Healthcare (Salt Lake City): Nursing is hard, but it is also one of the most rewarding jobs. You will laugh, cry, starve, not go to the bathroom in over 12 hours and get frustrated, but you will impact people's lives in ways you would never imagine you could, and that makes the hard work worth it. Give yourself time to reflect on the good things in nursing, smile at those around you, hold your dying patient's hand, celebrate that you help people every day, and most importantly, [that] you make a difference.
Tammy Richards, RN. Assistant Vice President of Professional Practice and Learning at Intermountain Healthcare (Salt Lake City): Don't wait for the storm to pass, learn to dance in the rain.
Kathleen Sanford, RN. Chief Nursing Officer of CommonSpirit Health (Chicago): Looking back over a lengthy career, the one piece of advice I would give my younger self is this: Get as much management and leadership education and knowledge as possible, as early as possible.
In healthcare, we have not always recognized that management is a specialty, with specific expertise, competences and evidence-based leadership practices. The need for all levels of formal leaders to understand organizational finance, the changing regulatory world, human resource management, advanced communication skills, team-building, diversity issues and change management hasn't been widely recognized or articulated. I often think I owe a letter of apology to the staff on the first nursing unit I led, because I know now that the knowledge I lacked at that time made their jobs more difficult than they needed to be.
I would tell myself I should learn the subjects above, recognizable as 'management 101' topics, in a classroom. I would advise that I also seek the understanding of the intricacies that make that education more valuable to staff, patients, families and organizations. That knowledge was less available in the academic setting, but I could have gained it more quickly by seeking counsel from trusted mentors, experienced leaders and colleagues.
Rather than learning to lead by trial and error, I would have learned about how to navigate the inevitable silos and politics, and how to make a business case to support doing what is right for people. With help from experienced, trusted colleagues, I could have learned, much more quickly, that management is not a popularity contest, and that it sometimes can be lonely. Those same colleagues could have pointed out my blind spots and helped me know what other education I needed.
I know my early teams would be grateful to my future self!
Christine Tillisch, RN. Clinical Educator in the Education Department at Saint Mary's Regional Medical Center (Reno, Nev.): Apply to an undergraduate nursing program out of high school.
Katherine L. Bechtold, RN. Senior Vice President and Chief Nursing Officer at Covenant Health (Tewksbury, Mass.): Find a mentor. Find a nurse you aspire to be like. Ask them to be your 'person.' You will need a sounding board when things get rough or on those inevitable bad days. You will need someone to talk to as you navigate your career. This person will be your lifeline. The mentor will be honored you asked them, and you'll be forever grateful to have their wisdom. I didn't do this until later in my career, and I wish I would've done it sooner. It would've saved me a lot of sleepless nights.
Grace M. Carcich, RN. Corporate Director of Education at Prime Healthcare (Ontario, Calif.): I would tell my younger self that no matter what the circumstance, if you aren't sure of something don't be afraid to ask. Clarifying will only prevent errors from happening. If you make an error, you never want to have to respond 'I don't know why I did that.' The saying 'there are no stupid questions' is very true in healthcare.
Erin Madewell, RN-BC. Nursing Supervisor in the Emergency Department at Saint Mary's Regional Medical Center (Reno, Nev.): Set high, clear goals, but remain open to taking a different path. Life is better with adventure.
Louann Bean, RN. Hospital Supervisor at CHI Franciscan Health's Harrison Medical Center (Bremerton, Wash.): The call for a hospital supervisor to talk with a patient will almost inevitably involve a difficult conversation. Often, I am called when a patient is dissatisfied, upset or angry. Climbing the stairs to the nursing unit is my mental prep time. I use those moments to gather my thoughts and give myself a little pep talk. I remind myself not to take things personally if negative emotions are expressed. I coach myself to seek to understand what the patient really needs and to validate the concern, even if I can't solve it immediately. While no one enjoys difficult conversations, the outcome is often rewarding when an empathetic response makes a big difference for a patient.
Lee Woodman, RN. Staff Nurse, Behavioral Health at Shasta Regional Medical Center (Redding, Calif.): Don't compare yourself to other nurses. Everyone has their own unique strengths and weaknesses as well as background experiences. Be kind to yourself and take care of yourself. You can't pour from an empty cup.
Melani Mangum-Williams. Program Manager of Emergency Department and Critical Care at Providence Nursing Institute-Clinical Academy (Renton, Wash.): Stop talking and listen more. My younger self was so worried about being 'heard' that I often interrupted or blurted out my ideas and opinions. The net result is that my responses were often unrefined and my behavior caused others not to share their ideas since I spoke so emphatically. It has been a humbling journey throughout my professional career to talk less and listen more. I know that when I practice this, better ideas are generated and a more balanced set of information is available for decision-making.