By Matt Skoufalos
When Hannah Miller began studying for a career in health care at the University of California-Santa Cruz, she didn’t anticipate that career would be nursing. Miller, who’s about two years into her professional life as a staff and charge nurse at Good Samaritan Hospital in San Jose, California, initially pursued a degree in molecular, cellular and developmental biology.
“I was teetering back and forth as to which path in the health care field was best for me,” she said. “The focus on health education and preventive care that nurses have drew me toward that field.”
Miller pushed through an accelerated degree program, and not long after, found herself in the orthopedic setting. She hadn’t planned on that specialty, but quickly fell in love with orthopedic care, in large part due to the opportunity to educate her patients prior to and after their surgeries. Good Samaritan performs a number of joint replacements, and she appreciates its “really smooth flow” from start to finish. Most patients are discharged within a day or two after their procedures.
“Ortho was the job that I was offered, but I ended up loving it more than I expected to,” Miller said. “I love surgery a lot because it’s a very streamlined process. There’s a lot of education that goes along with that. The nurse is there to explain what happened in surgery; how we’re going to get them home and back to their regular lives.”
“I like the consistency of the patient population and how positive and encouraging my work environment is,” she said.
“Within four hours, patients have to ambulate for the first time. Having them take their first steps is always a really exciting moment for me,” she added.
Although she wasn’t sure for how long she’d keep that assignment, Miller’s fledgling career was turned completely upside-down in March 2020, when the orthopedic unit closed in the midst of the novel coronavirus (COVID-19) pandemic. Elective surgeries were postponed, and staff who weren’t required to report to work were offered 30-percent pay cuts rather than layoffs or using paid time off. Miller made herself available to work in the COVID unit when the need arose.
“It’s been kind of crazy,” she said. “My unit shut down completely in early to mid-March. They opened up one of the floors as a COVID unit, so I was just floating to that and a couple of other units as needed. It was totally out of the context of my normal job.”
Miller said she faced a steep learning curve – different skills are required in a respiratory unit than in an orthopedic setting – and she was grateful for the support of her coworkers.
“It always makes it so much better when you have people supporting you and helping,” Miller said. “I didn’t have any issues being on the COVID floor; I was happy to be available to help these patients. Yes, we are putting ourselves at risk, but we treat patients with infectious diseases all the time. It’s a part of the job that I’m happy to take care of these patients.”
For health care workers, as much as anyone else picking their way through the pandemic, the biggest difficulty Miller said she felt was “the information wars.” With constantly shifting policies amid a rapidly evolving (and occasionally conflicting) governmental response, “it was really stressful for me to not know what’s coming,” she said.
“We had to play it by ear,” Miller said.
The San Francisco Bay Area was locked down earlier than most parts of the country, and by doing so, managed to suppress its COVID-19 cases. The only patients still in Miller’s unit at Good Samaritan are the ones who are the sickest; some have been in a hospital for a month or longer. Although she hasn’t had any patients intubated or die on her watch, those who are under her care “are really sick,” Miller said.
“The hardest part is how alone and really isolated they are,” she said. “Patients are in physical isolation, and we don’t allow visitors. There is a very limited number of health care staff allowed to enter the room, so many times nurses are the only ones there.”
Those conditions put a priority on her bedside manner. Miller’s roles largely include handholding, counseling family members, and trying to mitigate the stress of missing loved ones. She emphasized the support of her colleagues in helping “hold us all together.”
When she’s not working, Miller spends time with family and enjoys reading, writing, dining out and being outdoors. Her brother recently moved in because the pandemic struck while he was attending college, and the two are bonding “more than ever before,” she said.
As her career continues to flourish, Miller says she could see expansive opportunities in the nursing field in any variety of care settings. Eventually, she may move on from a bedside care environment, and can see herself pursuing leadership or educational roles.
“What I’m trying to do is figure out what I’m really good at, what do I enjoy doing, and trying to find my niché,” Miller said. “Teaching is something I want to be a big part of my career at some point.
I’m also the go-to person when there’s technological issues on the unit, so I could see health care tech being a part of my future as well.”
Part of that future could well include the operating or recovery room, Miller said, although she foresees developing different skills in an environment where patients are “almost always asleep.”
“One of the most rewarding things about nursing is getting to be a patient advocate,” she said; “noticing something at the bedside that’s not right, that saves someone’s life, or that prevents a bad outcome. Just knowing that you did something, that you were there to intervene, is important.”