My advice is to “seize the day” and seek out all opportunities that may pique your interest and satisfy your internal drive to improve the nursing profession.
Have you ever considered living abroad and using your nursing skills in an exotic country? Michelle Machon has lived that dream and has much to share about the Year of the Nurse.
"Having worked in one of the richest countries in the world, we were part of many presentations by WHO's MENA (Middle East and Africa) nurse leaders. While we were geographically close, we were worlds apart in the disparity of funding for nurses, nurse training and basic nursing care."
What is it that you do in your current role as a nurse?
I am a Nursing Director reporting directly to the Chief Nurse Executive in a 360-bed hospital in Northern California which is one of the 32 hospitals within the Kaiser Permanente (KP) system. My role is to lead the clinical education, practice and informatics initiatives at the facility level and to collaborate with my peers in Northern California to elevate the professional practice of nursing in our NCAL facilities. I also work with the KP National Nursing and IT teams as a clinical business partner tasked with improving and innovating clinical communications amongst the multi-disciplinary team across the continuum.
Tell us about your journey.
Nursing was always, always, always what I wanted to do. As a 10-year-old the night before my appendectomy, I made one of the nurses tour me through the Operating Room because I was so fascinated about where I was going to be the next day! The first medical person in my family, I went to nursing school at barely 18 and was an Associate Degree nurse when I was still 20. Soon after qualifying, the travel bug took hold and Nursing is certainly a career in which one can travel. I have now practiced in Ireland, Australia (twice), Saudi Arabia, Kuwait, Hawaii, United Arab Emirates and California (again, twice). After a new-grad year in med surg in Australia, myself and a friend went to Saudi Arabia and, with a shortage of western-trained nurses, we were both asked to take Unit Manager positions. Three years of ‘indoctrination by fire’ gave us a skill-set that most new nurses do not have the opportunity to get so early in their careers. I also had the opportunity to meet my husband (Australian) and so began a 25-year odyssey of moving countries for either his job or mine. Back in Australia I had the opportunity to train in neuro-surgical ICU in a Unit that still feels like perhaps the most supportive experience of my career. I had a young baby in a new country and the words “nurses eat their young” had never crossed their minds. They were loyal, caring, and sympathetic to me and I try to remember their kindness and explain that to new nurses as often as possible. Not feeling the desire to settle down yet with a new baby, we moved to Kuwait for my husband’s job and again, opportunity knocked to allow me to become the clinical educator in a small private hospital in Kuwait City. They were the first hospital to apply for Joint Commission Accreditation (JCI) in Kuwait and when our green cards came though, the JCI surveyor offered me an Education Manager role in Hawaii. We felt this was an amazing opportunity to expand my career and live an amazing tropical life. However, Hawaii was not what we expected and 6 months later for many reasons, we came to California. The shortage of nurses in California was at its height in 2000 and I was offered jobs in all 4 major health systems on arrival. However, an education role beckoned at Kaiser Permanente (KP) and I spent 9 amazingly productive years there. Never did I expect to be an Informatics Nurse, but I had the opportunity to combine Education and Informatics when KP implemented their Electronic Medical Record (EMR) between 2005-2008. Being involved in the design, validation, build and implementation of any process in a large health system is an opportunity that comes very rarely in a career, yet for me, it has happened twice. During my time in Sacramento, I completed my Bachelor’s and Master’s degree in Nursing through the University of Southern Queensland in Australia.
My husband’s career then took him to the United Arab Emirates (UAE) in 2009 and at the same time, the Cleveland Clinic was starting the process of opening a hospital in Abu Dhabi. I was hired as the first nurse on the project and was the only nurse for a year. The CNE was hired in 2011 and we divided all meetings between us for another year before the rest of the team was hired. This opportunity saw us traveling the world hiring nurses and being the on-site nursing experts working with facilities, builders, regulators, HR, finance and all other members of the healthcare team that was opening the first quaternary medical center in the UAE. We opened in 2015 and in 2017 when offered the opportunity to come back to KP, I left a facility that was up and running and is now the first Magnet hospital in the UAE. I completed a Fellowship in Healthcare Innovation Leadership with Arizona State University/AONL in 2018 and I started my Doctorate in Nursing Practice in January 2019.
In the 2020 WHO Year of the Nurse and the Midwife, I cannot believe I will be qualified for 30 years as I still have the same excitement walking into the hospital every day. I am lucky to never come back from vacation and dread coming back to work. I work with a fabulous healthcare team who support and inspire me every day. I feel blessed to work with ALL facets of the multidisciplinary team, to work at the facility and health-system level and to have had the chance to work on national level boards and committees. I believe “opportunity” is a word I have used multiple times and it is the leaps of faith and opportunities that I have had which continues to inspire me in my career.
Some individual mentors spring to mind but the overarching ‘theme’ found within my mentors are nurses to were kind and supportive, smart and progressive, inspirational and a driving force to make me step out of my comfort zone and take career risks that would enhance me personally and professionally. Many would not even know they were Mentors for me but when I look back at the “Board of Directors” of my life, they are at the forefront of my mind.
I see the biggest challenge in nursing to be the desire to elevate the professional practice of nursing, to inspire frontline nurses to lead from the bedside and to see nursing as more than a daily grind but to practice to the height of their license and own their nursing unit’s quality, safety and care experience goals every single shift.
It’s 10 years in the future, where do you see this role taking you or where do you envision the expansion of your area of specialty?
Having worked in positions that were redesigning care or framing the shape of a new organization, my desire is to continue to shape and lead nursing care at the C-suite level within a team that will inspire and innovate the whole healthcare team to raise the bar for patient care. While not quite “in its infancy” still, I feel the nursing informatics is still at the ‘toddler” stage and the link between the highest level of care and the technology that supports that care is still being explored and developed. I hope to be part of the solutions for linking technologists and bedside nurses in the most positive and innovative manner.
What advice would you give to prospective nurses about the field of nursing, considering your unique career path?
My advice is to “seize the day” and seek out all opportunities that may pique your interest and satisfy your internal drive to improve the nursing profession. Take responsibility for your own professional growth and do not expect it should be handed to you on a plate or that everything you do in your professional life should be paid work. Listen to your internal desire to improve yourself and your profession and grab opportunities that are presented to you… or more importantly, seek out opportunities proactively that inspire you to love your job every day.
I feel the nursing informatics is still at the ‘toddler” stage and the link between the highest level of care and the technology that supports that care is still being explored and developed.
How would you describe the significance of “The Year of the Nurse” for our profession?
I read Elizabeth Iro’s (WHO Chief Nursing Officer) article today about her vision for 2020 and I look forward to the WHOs “State of the World of Nursing” report being published in April. Having worked in one of the richest countries in the world, we were part of many presentations by WHO’s MENA (Middle East and Africa) nurse leaders. While we were geographically close, we were worlds apart in the disparity of funding for nurses, nurse training and basic nursing care. I always felt there was so much more than the “first world” nursing structure could offer to developing countries. For example, in the age of technological advances, why can’t we in the developed world offer to stream our nursing classes to developing nations and take advantage of the MOOC (massive open online courses) culture that other industries have embraced. I feel I have a unique view of the world of nursing in many countries and my biggest hope is that WHOs “2020 Year of the Nurse and the Midwife” highlights nursing around the world and that we help breach the disparity in nursing care that is so obvious when you get to travel and work worldwide.