We have been fascinated by the professional careers of those colleagues who have had the opportunity to spend time on Capitol Hill. Sandra Haldane served in our office as an Indian Health Service (IHS) Congressional Fellow, eventually being appointed Chief Nurse of the IHS. She has returned to her original roots as a clinician, serving her Alaskan Native people as an elementary school nurse (Title 1, PK-5th grade, including a special education preschool and school for the deaf), which she loves! We expect that a number of our public service colleagues are traveling in different stages along similar personal and professional journeys, perhaps completely unaware. The unique opportunities provided by public service careers allow for the "value added" benefit of becoming one of the "learned professions."
"At what point(s) in your professional life do you identify as the moment(s) that changed the trajectory of where you thought your career was heading? I imagine that many of us can name several points and people that have influenced our direction. I look back on my now 37 year career as a registered nurse and still can't believe the path I've trod, the luck I've had, and especially the moments that took me in a different direction!
"It was spring of 1991. I was only 10 years into my career as a registered nurse, new to the Commissioned Corps of the USPHS, and working as a staff nurse on the adult medical/surgical floor at the Alaska Native Medical Center (ANMC), then the largest IHS hospital in the country (still the largest but Tribally operated). Out of the blue, I was called to the Nurse Administrator's office and was informed that the IHS nursing leadership had received a call from the office of the late Senator Ted Stevens (R-AK) and they were looking for an Alaskan Native nurse to participate in a forum that the National Institute of Nursing Research (NINR hadn't been designated as an Institute yet) regarding the recruitment and preparation of ethnic minority nurses into nursing research and how to engage more ethnically diverse communities in nursing research. Back then (and I mean way back then) I knew virtually nothing about nursing research, it didn't receive much attention in my bachelor's program. I'll never forget walking into that conference room on the NIH campus and seeing place card after place card all around the room titled Dr. (insert name here). Talk about feeling out of place and way out of my league!
"But shortly after walking in and finding my place I was approached by CAPT Audrey Koertvelyessy, Chief Nurse of the IHS. I was flabbergasted, my stomach now doing more flip-flops! Here I am a bachelor's prepared nurse in a room full of Ph.D. nurses and in the company of the highest ranked nurse in the Indian health system, the system from which I had received care almost my entire life and the system in which I was now working. This became a defining moment in my career. Within the subsequent three years I was doing things I had never dreamed of, things that had never even entered my mind, all because I had crossed paths with the right person, at the right time – Audrey ( CAPT Koertvelyessy). That evening and the next during the research forum, she introduced me to other IHS headquarters' staff and gave me a brief tour of headquarters. I was duly impressed, getting to meet such senior staff. But I returned to Anchorage and my job at ANMC, not really giving much thought to my recent experience or what it meant for me professionally.
"It wasn't long however that I received a second call to the ANMC Nurse Administrator's office and this time with an even more incredible request. A request from the IHS Chief Nurse for an Alaskan Native Nurse to report to the office of the late Senator Daniel K. Inouye (D-Hi) for a six week legislative nurse Fellowship. I was stunned that I was the one being asked to fulfil this request. I'd never been involved in the legislative, policy-setting side of healthcare or nursing. Suffice it to say, the six weeks I spent as the IHS Legislative Nurse Fellow was perhaps the most eye-opening, thought-provoking, and career-impacting points of my career! Another defining moment in my career! During the ensuing six weeks I sat front and center in the office of Senator Inouye, right next to an Air Force nurse officer who was stationed in the office for an entire year! The Department of Defense (DOD) nursing leadership had the where-with-all to know the importance of preparing future nurse leaders and that preparation included a firm understanding and first-hand knowledge of how national healthcare policy is made, how it impacts their constituents, and how federal budgeting and program development occurs at the highest level and then trickles down. As such, the DOD stationed an Air Force, Army, or Navy nurse in the Senator's office every year. Many of these nurses went on to become the Chief Nurse of their respective Uniformed Service or held other very high-ranking assignments in the DOD. Our desks also sat directly across from the office of the Chief of Staff who was the lead on all things health care legislation/policy related. Under his wings we learned that the health care of our people, in my case Alaskan Natives and American Indians, and the constituents of the DOD-our Veterans and Uniformed Service personnel, not to mention our professions, lay in the hands of people who had little to no experience in the health care field. As such, policy makers relied heavily on relationships they had built with professionals out in the field, in their home states, in universities, in professional organizations, in practice settings to help them identify and understand the impact of proposed policy and to develop policy for the greater good.
"It was a daily occurrence in the office of the Senator that we would be invited on a walk. It was these walks that led us to the offices of other legislators and staffers, or to meetings over coffee to discuss the pros and cons of proposed policy or just to keep up the relationship with staffers and leaders on both sides of the isle, working together to formulate plans that would be acceptable to all parties. The other thing we learned was the concept of "the concept" – that is, how to conceptualize. In the legislative arena, things are never black and white, nor are they absolute. We learned the indispensable requirement for establishing and maintaining relationships with the experts in our field. We learned the necessity of calling upon their expertise so as to define all aspects of any given topic. And, we learned the critical element of thinking outside of the box (before thinking outside of the box was even a term). It wasn't good enough to just dream, it was to dream big, dream strategically, and find partners on The Hill to work with on seeing these dreams of legislation come to fruition. What was so profound, however, was the Inouye staff's innate commitment to mentoring and encouraging us fledgling policy-makers. We felt way out of our comfort zone but on a daily basis we were helped to realize what possibilities there were for our futures, what influence we could have on the health of our families and communities, and what impact we could make in our professions and the country. It was never just about the Inouye staff or us; it was about all of us.
"I left Washington, DC and the IHS Legislative Nurse Fellowship on Capitol Hill a changed person, changed nurse, changed citizen. My future as a nurse, my professional life would never be the same. I had caught a mild case of what we humorously call Potomac Fever; a desire to be involved and influential; to remain informed and active in the policy arena; be it local, state, or national. My experience laid the groundwork for the rest of my career. While I loved direct patient care, I recognized the broader impact I could have as a nurse leader. And, with the support, recognition, and influence, not to mention the mentoring I received from Audrey, Senator Inouye, and others who have crossed by path since, I took what I learned and have used it at every step in my subsequent career moves and community involvement.
"It's been 27 years since I left the challenges of working on The Hill but that time is forever engrained upon me and has influenced almost all aspects of my career choices. It taught me to dream and dream big about what I wanted to accomplish; to think outside the box and to look at the greater good, the public's health. I learned to seek out the experts and those who will be impacted, to be aware and involved and not let my profession be driven by others. It taught me the importance of relationships and how to turn a concept into a reality. What I learned on The Hill stayed with me as I traversed all the subsequent positions in my now 37 year career. And while the skills and knowledge gleaned those many years ago were essential for my roles as a Nurse Executive and Chief Nurse of the IHS, they are just as essential in my current role as a school nurse. Not a day goes by that I do not think of what our children need to stay healthy and well, and mine and others' role in achieving that.
"While local, state, or national policy-making might seem nebulous, and dipping into the policy-making arena may be well outside one's comfort zone, I can't stress enough how rewarding and life changing it can be. Whether one chooses to influence locally or on a broader scale at the state or national level, one will never be disappointed; you will know that you have worked to change, for the better, your community and your profession."
Hopefully, Sandra's enthusiasm will encourage several of our early or mid-career colleagues to participate in the APA Congressional Fellowship program. If interested, contact Gabe Twose (gtwose@APA.org). It truly is a life-changing experience. Aloha,
Pat DeLeon, former APA President – Division 18 – November, 2018
Sent from my iPhone
