By Matt Skoufalos
A competitive horseback rider in her youth, equestrianism taught Lisa Farace the values of responsibility and caring from an early age. She wasn’t much out of her teens before she put those into practice when she decided to study nursing. Farace attended Thomas Jefferson University in Philadelphia and, while there, was recommended to apply for a nurse externship in pediatrics at Children’s Hospital of Philadelphia (CHOP). It wasn’t the first specialty Farace had expected to pursue, but once she entered into it, the field just took.
“I loved it,” she said. “After that, they kept me; I pretty much grew up at CHOP.”
“I went into it for the cliché of taking care of people, but it’s true,” Farace said. “Some people are nurturers. I like making people feel better. When I am with a child, I will do everything to make that kid relax, or just smile, or engage. That’s how I started.”
Farace has worked at CHOP for more than 20 years. She started as a staff nurse in a medical-surgical adolescent unit, where she cared for children requiring a variety of specialized care, including neurology, gastroenterology, pulmonology and more. Farace later shifted to outpatient program coordination for patients with blood disorders, worked as a clinical nurse, performed case management, discharge planning, gastrointestinal nursing and home care.
At one point, she even left Philadelphia for a two-and-a-half-year travel nursing position at Northwest Medical Center, a community hospital in Tucson, Arizona. Farace was hired for an assignment in adult outpatient gastroenterology. She thought she was making a permanent relocation.
“I was lock, stock and barrel out to live there until the day I died,” Farace said. “Then, the economy started to take a huge dip. A lot of our patients were elective; a lot of procedures were getting cancelled. That meant my hours got cut back.”
At the same time, Farace’s stepfather was having medical issues, and her best friend was diagnosed with cancer. Flying back and forth to Philadelphia had become prohibitive. When her former position reopened at CHOP, she started to think it was time to return home.
“I thought maybe this wasn’t supposed to be a lifelong dream,” she said. “Maybe those three things were the universe telling me it was only supposed to be for a short while.”
However short-lived, her relocation also offered Farace a great deal of perspective on her career and the beauty of the variety it afforded her. Seeing things with fresh eyes also inspired her most recent assignment: a transfer into the operating room.
“After being there for 13 years, I could sit in the same position because I know it and I’m really good at it, or I could shake things up,” she said. “When I was in nursing school, I did a perioperative nursing course. I thought, ‘That’s something I’ve not done yet,’ and it’s such a different level of nursing, and that’s why I ended up in the operating room.”
Farace completed a nine-month orientation in April 2018. Now she’s on her own, to scrub or circulate, depending on the needs of the unit on a given day. The position places different demands on her than those of her previous assignments, including rotating shifts on evenings, weekends and holidays. It’s a notable change.
“Now I’m almost 50 years old, and I’m going to be taking calls again, doing night shift, doing 12-hours, which I haven’t done in 20 years,” Farace said. “In my head, I know I can do this; my body’s saying, ‘I hate you.’ ”
After years in the field, Farace has an informed perspective from which she believes younger nurses can benefit. The variety of specializations in which she’s participated afforded her a variety of pay grades, but after a certain number of years in the field, she’s talked about hitting a financial plateau.
“The nice thing about nursing is there’s so many things you can do, you’re not pigeonholed,” Farace said. “You can go into pharmaceuticals, you can do research, you can do home care. It’s a great job, it’s very rewarding, but nurses don’t make a lot of money for what they do. You hit a certain plateau in the amount of time and years you work in a place, and you sort of get capped.”
The career also invites a certain degree of burnout, an occupational hazard that Farace said can be countered with a bit of mindfulness. She recalls having found herself working to the point of exhaustion as a younger nurse because she thought that’s what the job demanded. Learning “to pull back and do something for yourself” is a skill that Farace said she developed over time. Beyond physical and emotional self-preservation, self-care also enables her to contribute to the greater success of her unit.
“I know I’m not going to be good for anyone else unless I can do something for myself,” Farace said. “I think we try to save the world, and I think that it’s really a hard lesson to learn. I would lift patients heavier than I was; I’d get involved in working a lot of hours to help and put the time in.”
The sooner young nurses can learn what their limits are and what their rights are in the field, the further they can advance in their careers, Farace said. In addition to the burnout, there’s the old saying that nurses “eat their young.” Finding ways to learn the emotional ins-and-outs of the profession can help alleviate both risks.
“[Health care] has become a little bit more sensitive to people’s learning and people’s needs, and there’s more education than being sent into the deep end of the water,” Farace said. “But once you’re trained, you will get thrown in.”
“Young people coming in need to know self-worth,” she said. “Know what your limitations are, what you can afford, what you need to do, and really investigate what it’s going to mean for you. People now practice with a questioning attitude, which is very good. Before, you didn’t question, you just did it.”