By Shannon Nachtigal
Style by Kelly Householder-Giuliano
Photography by Jaren Beavers
The Journey of a Passionate Nurse
I believe one of the highest forms of professionalism is reflection. Reflection is used to look back on any given situation or choice and ask yourself what you would have done differently. As I reflect on my life and what brought me to nursing, of course there are specific things along the way that I would have done differently, but I wouldn’t change the journey, and my destination would be the same. I love being a nurse.
I was raised by a nurse. I remember how dedicated my mother was to her profession. Her profession was always a vital part of her life. She rose to positions of leadership in whatever work setting she was in. She modeled that a woman could have a career and a family. As one of four children, I never felt that my mother put work first, though she worked many hours. I never felt neglected because she was not at every practice, game, or class party. I always felt a sense of pride that my mother was a nurse and worked in the career she loved to support her family. My mother, Dorothy Carr, is now retired but still holds a nursing license. She worked at Baxter Regional Medical Center for many years. With her as my role model, I knew that I wanted both a career and a family.
I did not plan to be a nurse until I learned very soon after graduating from high school that I was pregnant. I didn’t tell anyone except the father, Jon Jenkins, and quickly enrolled in nursing school at the University of Arkansas at Little Rock. I was determined to be the responsible woman my mother raised me to be. I needed a career, fast. My sister, Julie, lived in Little Rock and was a nurse in labor and delivery (she is now a physician). I asked her if I could live with her and go to school. She said yes, and was a tremendous help in my success at school.
Jon had another year of high school to finish, so I moved to Little Rock by myself. It was difficult living apart and seeing each other on weekends when we could.
I was six months into my pregnancy and three months into nursing school when I told my parents I was pregnant. It was one of the hardest days of my life. I knew how disappointed they would be, and I had waited so I could show them I was taking responsibility. My dad asked what I expected from them. I said I wanted them to treat me just as they would if I weren’t pregnant. I expected nothing more and would be accountable for my decisions. My dad looked at me said, “Ok, it’s a deal.” My mother was tearful but stayed calm; I think my dad’s reaction was a big factor in her ability to turn her tears into a smile. I felt like a thousand pounds had been lifted off my shoulders. Now I could really focus on my education.
Most nursing students take their general pre-requisite courses like chemistry, algebra, anatomy and physiology, English and history, before enrolling in nursing school. I completed all of my pre-requisites while going to nursing school. Full-time students take 12 credit hours per semester. I took up to 23 hours to fit it all in. They no longer allow you to do that. I went to summer school and even took a required speech class over Christmas break. Thirty years ago, online classes were not an option. I worked very hard to complete school so I would have a career in time to support my family.
I was horribly sick with nausea and vomiting from the minute I found out I was pregnant until my sixth month. I went to the emergency room a few times for IV hydration. I would leave class to go vomit and then run back so I didn’t miss anything. I delivered my daughter, Melanie, on the Friday night starting spring break and was back in school one week later. I was so thankful that I didn’t miss any school. Mel went to her first babysitter when she was a week old. As I look back, I have no idea how I did it except for the support of my family and my faith. My faith pushed me forward and has always been an unending source of strength for me throughout my life.
Jon and I married that summer, and he moved to Little Rock to be with me. He worked a night position at a meat-packing plant to support our family. I graduated nursing school on my birthday and Mother’s Day in May of 1989, and started at Arkansas Children’s Hospital. I loved working there but was not a fan of Little Rock, so our small family moved to Flippin in 1990, and I started on the night shift at BRMC.
Within three months, I was moved to days to start training as a relief charge nurse. I worked with some of the smartest nurses. I remember watching, listening, and learning everything I could from them. I wanted to be as smart as they were. I wanted to know why they were doing what they were doing. I took every class I could and learned from nurses, doctors, physical therapists, respiratory therapists, social workers, case managers, and many other healthcare teammates.
I soon became a fulltime charge nurse, one of my favorite positions. You certainly learn a lot about people when you become their leader. They can be a tough audience and they depend on you in many different ways: decision maker, referee, coach, mentor. I was in charge of nurses who had been practicing longer than I had so it was very important to remain humble and at the same time grow in my competence to earn their respect.
A few years later, I became the house nursing supervisor, and then went back to 2 West to be the nurse leader. I went on to become the assistant vice president of medical surgical services. As the organization grew, the director of nursing at the time, Margaret Fielding, was looking for assistance to manage clinical operations. She needed more time to strategize and plan for the future of nursing at BRMC. I stayed in that role for five years. I will always cherish the many leadership qualities I learned from Margaret. She was a pro at providing support without removing accountability.
Along this journey I had many personal joys and losses. Our second daughter, Bailey, was born in 1991, and was another joy in my life. Jon and I divorced after eight years of marriage. Over the years, he has always been a great father to our girls, and as we have gotten older, we are both able to look back at the blessings of our relationship, Mel and Bai.
I remarried four years later and lost Richard to cancer only 21 months after we were married. He battled cancer for most of our marriage. This was my first real experience with such deep grief. I didn’t know what to do with the anger. I went back to work fairly quickly and was angry that everyone was moving on, business as usual. I knew logically that the anger didn’t make sense, but I wanted life and everyone in it to stop. A social worker recommended grief support and it was life saving for me. It was a profound experience to sit in a room and listen to people who were experiencing the same feelings I was, and I no longer felt crazy. I think about Richard often and smile knowing that we had a great marriage. We did everything together, and I am so thankful that I was able to care for him and love him during his battle. Today, I know he would be very proud of his three children and grandchildren.
Life went on, and I married Kent Nachtigal. We both wanted to start fresh. We moved to California to start a solo surgical practice, another new adventure in my career. I learned how to code, bill, and all that comes with helping manage a surgical practice. We had a very successful business and met some very special people—Paul, Carolee, Mary Alice, and Eric Ratzlaff. Not only did they help run the practice, they became our family away from home.
After two years of very busy work, I knew that California was no place for a girl who grew up in Peel, Arkansas. I wanted to go home. Kent was not quite ready as he was enjoying a busy vascular and trauma surgery practice. Thank goodness he loved me more than California and agreed to move to Mountain Home. He went into practice here, and I started as the customer service coordinator at BRMC in 2005. I helped the organization focus on service by providing data and assistance to the leaders and staff. A couple of years later I took over the float pool. The float pool covers different units when staff calls in sick, when there is a higher than usual patient volume, and when there is a vacancy.
In 2010-2011, my daughter, Melanie, became very ill and was hospitalized for a long time. She was diagnosed with a congenital disease that we didn’t realize she had until she became pregnant. This disease left her terribly weak throughout her pregnancy, unable to lift her arms above her shoulders or swallow food without difficulty. After Grady was born, she became even weaker and was eventually paralyzed. It was devastating to watch her struggle to breathe until she was eventually put on a breathing machine. She was unable to eat and was given a feeding tube. She couldn’t hold or care for her baby. My niece, Amanda Still, would go to the nursery to feed Grady and love on him since he was not allowed to come to the neuro-intensive care unit to see his mom. At the time, I had no idea what we were going to do, but I knew I would do whatever it took to care for both of them, even if I had to leave my career.
When Grady could no longer stay at Barnes-Jewish Hospital where Melanie was hospitalized, my younger brother, Shon, and his wife, Angela, took him home. They cared for him and took him to his first doctor’s appointments so that I could stay by Melanie’s bedside. Eventually Mel got to come home, where my mother stayed and helped care for her. My mom had day shift and I had night shift. We made a good team! We happened upon an experimental medication that became our miracle drug, and within days, Mel was able to start moving and breathing on her own. She was eventually able to care for herself and Grady with the help of our other miracle, the Gower family.
I went back to work, but decided to step down from leadership and become a clinical educator so I could better manage my personal life and care for my family. I went back to school to work on my master’s degree, which I completed in April 2016. I had no plans for future leadership positions, but I wanted to gain more knowledge about the nursing profession.
In August of 2014, while on vacation with my friends and my niece, Amanda, I got a call asking if I would consider taking the interim chief nursing officer position at BRMC. I was completely surprised. My friends yelled in the background, “Don’t do it, we’ll never see you again.” So many things inside me were telling me “No,” but my heart was telling me “Yes.” My passion for my profession was calling me. I had a real desire to make a difference.
Almost three years later, I hope I have done just that, made a difference. I am fortunate to lead the best nursing staff. I work with the best nurse leaders. I collaborate with the greatest ancillary leaders and staff. The physicians are the best you will find anywhere. I work with a very supportive senior leadership team and board of directors.
My friends were right, I have seen a lot less of them over the past three years, but they are still right beside me supporting me every step of the way. I cherish them and my family, and honestly don’t know what I would do without them during life’s ups and downs. My first grandson, Grady, was born in 2011. My second grandson, Kenton, came exactly one year later in 2012, and Olivia was born in 2016. Grandchildren are certainly a gift, and I am so thankful for mine.
Three months into my new position as CNO, I declared Wednesday night “Grady Night.” He knows that is the night he spends with me, Gee-Gee. I try to make sure that I leave work by 5 p.m. on Wednesdays. If something unavoidable comes up, we switch nights or make it two nights the next week. He doesn’t forget either. He loves staying with his PaPa and Gee-Gee, and I love to have him.
I have always said that my career has been good to me. It has offered me great opportunities and the means to support my family. Like my mom, I wasn’t at every practice and was never able to be a home room mother; however, my girls are strong, independent women and I am so proud of them. I feel that my contribution as the CNO is my thank you to the organization and the profession of nursing. As a leader, I always try to see the good in everyone and appreciate what they bring to the organization. I am certainly not perfect. I have made mistakes, but as long as people know that my intentions are always good, I can lead with confidence. Healthcare has become a financially tough environment—doing more with less is a phrase that has become way too familiar. As the CNO, I am responsible for making sure the nursing staff has the resources they need to take great care of patients and, at the same time, be financially responsible.
Back row from left: Anthony Reed, Dale White, Susan Musgrove and Rachel Farris.
Not pictured: Janie Pugsley, Steve Sinor, Renee King, Becky McCoy, and Tammy Penka.
I come to work every day with a goal of taking care of the nursing staff so they can take care of the patients. My desire is that the staff love nursing as much as I do and it shows in the care they provide to our patients. If I can create an environment that allows them to love their profession, they will do the rest.
Everyone encounters barriers in life. Mine were being an unwed pregnant teen, a teen mom, a teen wife, divorce, illness, and death. These barriers brought emotions of fear and pain, but they also brought determination, determination and desire to rise above my mistakes and become successful. When you find yourself in what seems like impossible situations in life, you will be amazed at the strength you can find within yourself, a strength that propels you forward, an unstoppable drive that comes from wanting to prove to yourself and to others that you can rise above any challenge. As a nurse, I am now able to empathize with and offer to others the support and compassion I so desperately needed throughout my life. I can extend a helping hand to those who wish to become nurses, and reach out to nurses who struggle with barriers in their own lives. I believe that is what led me to the CNO position—a passion for nursing, a passion for people, a passion for wanting others to succeed. M! June/July 2017