Nursing Outside the Walls

A journey in nursing outside of the hospital, learning from history, finding congruence with your values, and finding a path leading from burnout during a pandemic.

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The year 2020 where the Nurse was redefined

Not just as an angel giving peace of mind

Roads less traveled, unfamiliar roles and seats

Proving amplifying nurses often achieves great feats

A profession no longer stagnant or bound by walls

Innovation, change making, challenging the status quo; our new ward halls

So, we’ll keep mastering the technology and critical thinking for care

And although it may be new, nurses are no longer defined by where

Briana White

People say hindsight is 2020, but this year for me has transformed into insight. In a time when chaos erupted, it enabled me to not fall into the chaos but to become ignited in a different way and consider what values I held the closet, where my passions were and what I wanted my legacy to be as a nursing professional. Values come from different angles, but one of the sharpest most important for me is from family. I’ve personally always sought the road less traveled, and this may have come from my grandmother who was a nurse in the 1950s. She told me stories about working as an industrial nurse where she was responsible for the workers’ health as they worked in a mill. 

My late grandmother, Norma Terrill in the 1950s as an industrial nurse

My career as a nurse began as a nurse’s aide, and the LPN working with the disability community from camp nursing to an adult group home. I then journeyed into pediatrics as a new RN and absolutely fell in love – not only with the population, I mean where else is play part of the care plan? I also enjoyed working with the families together in caring for the children and adolescents. Every day was different, we weren’t an ortho floor, an oncology floor, a surgery floor or psychiatric floor, but all wrapped in one and the diversity of those experiences was a large growing point for me. I soon began a new path as the nurse educator and enjoyed teaching other new nurses, yet eventually I had this pull towards the community and was a nurse supervisor for an ambulatory pediatric clinic. I don’t think that the world at large understands that often when you are calling the Doctors office, the nurse is the one actually triaging your ailments or requests with hundreds of others, handling what they can, and then communicating with the Physician/ APRN/ PA to coordinate and make things happen. It’s a craft needing critical thinking, excellent communication skills, and teamwork – it is not easy by any definition. 

Along the way I have worked with team members who inspire me to be my best self. Find those people for your circle and watch you grow as you support them too. Along the way, two of my close colleagues, we called ourselves the Dream Team, were applying to LPN, and MBA program which motivated me to apply for DNP school and the Johnson and Johnson Nurse Innovation Fellowship – to my awe, I received acceptance letters within the same week! While jumping into these two paths for expanded education and thinking, I knew that my career was still pulling me away from those traditional walls of care and out into the great open community. 

That is where I have journeyed, following that magnetic pull towards the community, and am now the Home Health Care Manager for the Visiting Nurse and Hospice for Vermont and New Hampshire, and absolutely love my role, the team, and the communities we work with. Embracing this role has allowed me to use my passion and skills for innovation, leadership, collaboration in the best possible ways. One week I am helping to coordinate a team meeting to discuss goals of care, the next I am working on a quality improvement project on improving education for patients with long term urinary catheters, and the next I am creating new care models to reduce hospitalizations – all the while elevating the voices and the input of our frontline clinicians and partnering with the community. 

A path on old train tracks near my family home in Hancock, NH

I have held space for my friends and colleagues in the nursing profession during the pandemic. I see the burnout, I see the moral distress, I see your fatigue on more than a physical level. What I would say is to reach out for help, even though that is hard for caregivers to do – I know. Not only has our profession been thrust into the public eye as the exemplars in fighting the virus, but we have also been intertwined in political opposition to following public health recommendations for prevention – and holding those two realities while still providing excellent care takes immense energy. 

In anytime I would be recommending that nurses need to go within to find their passion, their strengths, the type of work with is congruent with who they are and how they want to spend their energy. For me, I loved being a clinical bedside nurse, but it took so much out of me because it didn’t play on my strengths yet now bringing together teams, systems, patients and families – that is my jam, my essence and it breathes life into my day and reminded me that nursing is not bound by the four walls of the hospital setting. Even if nursing school pushed the traditional setting, you may not be so traditional, and the sooner we accept that and celebrate differences as a nursing community the more transformation in care we will have (and incorporate these ‘other’ settings and philosophies into the curriculum). 

Burnout during a pandemic is one thing but adding on doing something for many hours of your life not in congruence with who you are all builds to that burnout. If you are considering leaving the profession, pause to consider a different path before you leave the trail – there are guides like me to help you along the way. Step inside you to find out who you are and what swims in the same channel with what your strengths are, and then step outside of those traditional settings to explore others. Home health nursing is an underappreciated, often ambiguous space, but truly highlights the work that many nurses go to school wanting to do – being autonomous, thinking creatively, having 1:1 uninterrupted time with patients and families to transform their understanding and empowerment of health in the place that matters most to them – home. 

Nurses are in so many settings, from the hospital, to clinics, to homes, to policymaking, to schools, to workplaces, to informatics, to education and so much more. There is a vigorous argument for the strengths of a nurses to enter non-traditional settings in the near future – business, product development, corporate board rooms and more. It simply started with one step for me, following that pull, and exploring the unknown. My past two jobs have been new positions crafted for my strengths, and I foresee this as my pattern into the future, and one that you can seek too. The road less traveled may just be waiting for a trailblazer like you to show others the way, enjoy the journey! 

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