A candy-striper volunteer program sparked a passion for nursing in the soul of a 16-year-old girl. Today, 35 years later, Mary Navin, MS, RN, CAN MC, is the Ambulatory Practice Director for The Children's Hospital in Denver, Colo. and in charge of six hospital-based outpatient clinics. "Nursing and healthcare is the best choice I ever made in my life. It's made me a better person. I love it more today than the day I graduated. It's a vocation. A calling," she says.
Ms. Navin received her initial training and RN diploma from St. Vincent's Hospital School of Nursing in New York City and then went on to earn her master's degree in nursing at the University of Colorado Health Sciences Center.
Continuing education (CE) has always been integral to Ms. Navin's professional life – both as a pediatric nurse and a healthcare administrator. She became the first director at Children's to be Board Certified in Nursing Administration and also recently renewed her clinical certification in Emergency Nurse Pediatric Certification. She is additionally a member of organizations including the Society of Pediatric Nurses, the Denver Health School-Based Clinic Advisory Council, the Family Star Montessori Preschool Health Council, the Colorado Asthma Coalition, the Medical Home Advisory Board and the Colorado Organization of Nurse Leaders (a regional chapter of the American Organization of Nurse Executives).
Ms. Navin describes nursing as a wide-open field that goes far beyond patient care. "You can get a job in nursing informatics, which includes clinical information, education and administration decision support or become the CEO of a hospital. You can teach, do research, work as a consultant to senators, practice international nursing. With the Net, you can go online and collaborate with anyone anywhere in the world."
Tell us about your career. Where did it start? Did you always plan to become a nurse?
I wanted to be a journalist. But I volunteered in a hospital as a candy-striper when I was 16 and discovered that nursing appealed to me. I began looking into colleges for nursing. It seemed right.
What do you enjoy most about your career?
I really like working with different kinds of people – the families and other professionals. I like putting together services to help the families.
How did your career unfold?
I always wanted lots of different experiences. I started in adult medical-surgical nursing. Over time, my work became family-centered. It evolved. I moved from adult care to pediatrics as I became aware of the family's influence on a child's health and welfare.
How did you come to work in pediatrics?
I needed a full time job and there was an opening in the newborn intensive care unit. It was stressful, but I found I really enjoyed working with the kids and families. I've spent the last 27 years in pediatrics; I've never seen a reason to leave.
You started out as a nurse and now you're an administrator. How did that happen?
The profession started clinical and administrative career ladders for nurses about 22 years ago. At the time, my job was 80% clinical and 20% administration. I was developing in-services for the clinical staff; I found I had an intuitive knack for staffing and patient flow. Also, in the 1980s, there was a movement to provide and improve quality healthcare.
What kind of training did you receive to become an administrator?
I was working for Kaiser-Permanente in California. I worked with good people. I went from manager to director. My scope of responsibilities kept increasing. Kaiser was among the first organizations to bring in industrial engineers. They worked with us to analyze and improve our processes and efficiencies. How many phone calls do we get or need every day? How long does it take a patient to get from the front desk to an examining room? How many doctors and assistants do we need? What are all the steps in our process? It was great training.
Describe a typical day of work for you.
5:30 a.m.: I may start getting pages about people who won't be able to get to work that day. I often start with staffing concerns.
6:45 a.m.: I'm usually in the office. I check my voice mail and triage my e-mail.
7:30 a.m.: The first meeting of the day. Sometimes I have meetings back-to-back all day. I rarely take a formal lunch.
5:30 p.m. or later: The workday may be over.
Weekends: I usually come in to work at least part of one day.
In between meetings, I work on plans, check on department audits and doctors' schedules, work on budgets, make plans to expand services to uninsured kids, check on kids admitted into the clinics, go talk to a doctor who's being a royal pain, participate in committees, work on quality of improvement projects. It's like running your own business. There are no set hours.
What are some of your responsibilities as director? Can you tell us a little about the clinics?
I'm responsible for the clinical and administrative functions and quality for all six clinics – from the range of services, staffing and budgets to process improvement and program growth. Three of the clinics – Child Health, Adolescent Medicine and Special Care – provide primary care for children, adolescents, and special needs children and their families. The Child Protection Team helps children and adolescents who may have been physically or sexually abused or neglected. The Young Mothers' Clinic helps teen moms stay in school and take care of their babies. And the eye clinic offers ophthalmology services that range from routine eye exams to the diagnosis and treatment of complex childhood eye disorders and trauma.
You work for a very successful enterprise. What unique challenges and rewards come from working with a prestigious organization?
It's challenging to strike a balance. You need to resist becoming elitist. You need to keep asking questions. You have a huge responsibility to the community. How do you keep contributing? The benefits include that it looks good on your resume. Your organization is a magnet for good people. People listen to you. You're usually in a stimulating environment. For example, we're in a direct partnership with an academic institution, which creates an exciting learning environment.
Do you have any favorite anecdotes about your career the field of nursing?
I have lots of good stories. I think it's interesting that I don't remember the bad ones. I had an epiphany in the 1980s. We had a kids' clinic patient whose immune system was severely compromised. He had lots of health issues. We were trying to find some respite for the mom; Dad was a farmer. There was a drought and they lost the family farm. In spite of everything, they were the most positive people. At Christmas, they came to the clinic with a case of jelly the mom had put up. They gave them to us to thank us for what we had done for them. But we were grateful to them because they had taught us to be positive every day.
On a basic level, what qualities should someone have to be a success in nursing?
Well, of course, first you have to care about people. You need to be non-judgmental. It's important to be honest and open and flexible. You have to be willing to "sit in someone else's chair," to understand what someone else is going through. You need to be selfless, a life-long learner, and willing to struggle.
What are some common myths about nursing?
That you get to flirt with doctors and wear sexy uniforms.
What are the tools of the trade that you use the most as a healthcare administrator?
Computers are integral to my work. They are a communication medium, a source of information and data, reports, PowerPoint. You name it. I never thought I would be this dependent on computers.
What tip do you have for someone starting out?
Be sincere and be ready to commit.
How is the job market now? How do you think it will be in five years?
The job market is great. And it's going to stay great. Technology is going to drive changes. Technology is going to help people live longer and save lives. We'll see advances in pharmacology and in vitro and from stem cell research. And nursing will evolve with it.
What kinds of jobs are available for graduating students?
It's a wide-open field. You can get a job in nursing informatics, which includes clinical information, education and administration decision support, or become the CEO of a hospital. You can teach, do research, work as a consultant to senators, practice international nursing. With the Net, you can go online and collaborate with anyone anywhere in the world.
What factors should prospective nursing students consider when choosing a school?
When you select a school, you have to consider your grades and your finances. Do you have to stay in state or not? Where you go to graduate school is important. Do the research. Select a school based on the course work and the number of clinical hours.
How can nurses train to be administrators?
It's something you do in graduate school. Some nurses are getting MBAs in addition to master's degrees in nursing. Some are getting advanced degrees in public administration or healthcare management. Certification is hot right now. I was the first director at Children's to be Board Certified in Nursing Administration. I also renewed my clinical certification in Emergency Nurse Pediatric Certification. Executive coaching is important to learn good leadership skills.
What would you change about nursing education in America?
There aren't any more undergraduate diploma schools for nursing. There needs to be more clinical training and experience. New nursing graduates are not ready to practice.
What topics are emerging as hot issues in the healthcare field?
Bioethics: organ transplants and rationing, is universal health coverage a Constitutional right, prolonging life/delaying death.
What skills do nursing students need?
Good computer skills and the ability to stay open, learn how to be flexible, and to go along with trends. In short, recognize that change is a constant.
What students might not be suited to become nurses?
If you need structure, don't go into healthcare.
Do you feel it's important to be passionate about nursing to be successful?
Yes. I know that nursing and healthcare is the best choice I ever made in my life. It's made me a better person. I love it more today than the day I graduated. It's a vocation. A calling.