When her husband Kyle told Kelsey Smith they were relocating she took a deep breath and did her best to smile. Kyle was climbing the ladder at the financial institution for which he worked, and his reassignment was the third move the family had made in twelve years. However this time they were moving to the largest city either of them had ever even considered living in. Kyle was elated to be transferred to the organization’s national headquarters and with fifteen years’ experience as a labor and delivery nurse, Kelsey had no problem securing a position with the massive Lakeview Hospital System, at their suburban Wildwood Hospital.
Yet every move the family has done has involved relocation, hard work and anxiety about the future. This meant uprooting Lynette, 14, and Jay, 11, from schools and friends at a time when their social identities were forming. It meant emptying a house they loved, traveling nearly a thousand miles and decamping in a temporary apartment. The apartment was comfortable but bland furnishings made Kelsey yearn to retrieve their belongings out of storage as soon as possible—that is, once they’d gone through the headache of finding a new house.
And for Kelsey it meant working in a hospital roughly three times the size of any workplace she’d ever known.
Still, Wildwood represented a significant advancement in Kelsey’s career and when she reported for work on a sunny Monday her first impression of the place was how beautiful it was—a vast, rambling single-level structure, set in a lush garden-campus. In the hospital’s gleaming lobby, she was directed to the OB-GYN department. Kelsey made her way down the light-filled corridors, along with what seemed to her like crowds of people in colorful scrubs, all heading purposefully toward their tasks. It felt like a little city.
In the department, she was met by Yunjin Kim, RN, Nursing Director for obstetrics.
“Kelsey, welcome,” said Yunjin. “We’re so happy to have you! We’re getting back to full staffing and it’s great to have someone with your experience. Let’s start right away with the paperwork so you can hit the ground running.”
And thus began Kelsey’s onboarding—which was a bit of a whirlwind. She was versed in the process and brought all her educational, licensure and credentialing requirements with her. But Wildwood also required a vaccination record, a physical exam, drug screening and a criminal background check and she had to make arrangements for all of these, adding another item to her already long to-do-list.
Yunjin assigned senior nurse Lainie Mazottato to show Kelsey around the OB-GYN department. A no-nonsense New Yorker, Lainie kept a fast pace with her speedy stride and rapid-fire explanations. Lainie pointed out or briefly introduced her to what seemed like two dozen other people—nurse and nurse practitioner colleagues, physicians and PA’s. Among the physicians Lainie pointed out from a distance as they did their fast-paced tour was Amelia Morton—“a super diagnostician for complications and very serious and all business at work,”” was Lainie’s comment. The pair found anesthesiologist Luke Ward taking a brief break after a delivery and he gave Kelsey a matter-of-fact nod without a smile as the two of them shook hands. “Dr. Ward sometimes micro-manages the nurses, you may want to watch out for that,” whispered Lainie as they moved on.
“Lainie,” she said, with a nervous little laugh, “I assume there are some people here who are good to work with—right? They aren’t all challenging, right?” ”
“Of course there are solid people that work here,” said Lainie. “We’re just very busy, which creates a fast-paced environment and sometimes results in stressful scenarios. Everyone works hard and there’s low tolerance for inadequacies. You need to know your stuff and also make it happen.”
Lainie wasn’t exaggerating as Kelsey experienced her first week. It was challenging as she didn’t know Wildwood yet. One of her patients needed an IV and blood work, but she had no idea whom to contact to transfer the blood to the lab. When she asked a nurse who was passing by in the corridor, the tone of the reply she received struck her as critical—“You call Jason.” And who and where was Jason? It took her half an hour to find him.
A physician she hadn’t met told her that her documentation on a difficult delivery she’d attended had “gaps,” and then was called away before she could learn where and what the “gaps” were. For another patient, she gathered what she assumed were all the medications, paperwork and supplies for an epidural, only to have Dr. Ward, the unsmiling anesthesiologist, frown and let her know “You might want to check with Lainie about how we do this at Wildwood.”
One night at dinner with Kyle, Kelsey cried a little.
“I’m good at this, you know?” she said, her eyes shining. “And three times today I felt like a fourth-year nursing student.”
“Honey, you’re new,” said Kyle softly. “You can’t know everything right away. A new place is a learning curve.”
“I know, I know,” she said. “But this place has the steepest curve I’ve ever been on. There are so many travelers there, and when I ask a question or do something they say, ‘that’s not our process at Wildwood,’ I know they think I’m a traveling nurse and because I’m a traveler I’m paid better than they are, so why am I…”
Kyle took both of her hands in his.
“You’re going to be fine, sweetie. I know you. You know you. Now, what we should focus on is figuring out who’s going to the open house on Ginter Street and who’s going to talk to Jay’s principal about him settling in at school.. I’m at that offsite all week, so…”
Kelsey closed her eyes.
Know my stuff and do it. Know my stuff and do it. Learning curve. Ginter Street. Jay’s principal. Know my stuff and do it. Know my stuff and do it.