When someone enters a profession as an idealist, they may find that attitude difficult to maintain. Any profession, no matter how lofty its aims, can become less appealing once the reality of long hours and repetitive procedures begin to set in. Adjusting to those facts while maintaining one's enthusiasm for the field is the task of a true professional, and it's a dance that's familiar to Marsha Hughes, manager of the Medical Staffing Network.
Hughes was born in Indiana, grew up in San Diego, and studied nursing in Santa Barbara. "I was young and starry-eyed and I wanted to cure the world," she says. "I wanted all the disease to go away and I was personally going to do it."
Her decision to pursue a career in medicine stemmed largely from a tragic experience early in her life. "I had a cousin who died from epilepsy and all I remember being told as a child was, 'There's nothing they can do.' And you get the sense, there must be something that somebody could do, so I'm going to go out and do it. That had a profound effect on me as a child."
After leaving school, she entered the workforce, working as a pediatric nurse at a hospital that was owned by Aetna before moving on to cardiology. As her experience increased, she began to notice that her attitude towards her work and her patients was changing.
"I worked cardiology for a long time and basically, you don't see a lot of cardiac patients healed - maintained, but not healed," she says. "Before I did that, I was working pediatrics and you have a great sense of closure with, 'The ear infection is gone,' 'The appendix is out,' but now here's a child with leukemia and again, you're up against that wall where you can only do so much.
"As a nurse you become desensitized to people being ill," she adds. "I noticed that in my later years of nursing that you go in and you put this gap between you and the patient. 'I'm going to care for you but I'm not going to feel for you; I can't because there's just too much of it.' It's very wearing, wears you down."
Despite the fact that she had advanced to management levels as a nurse, she also began to chafe a bit under the financial limitations of the medical care system.
"As a nurse, one of the things you see constantly is a need for treatment but not the financial means to do it by the patient," she says. "It's everywhere. It's a $3,000 lab test to a guy that's making $500 a week and trying to support his wife and a child."
With all these issues slowly building, Hughes finally found her answer after a particularly difficult Christmas Eve at the hospital. "As I rode the elevator downstairs, someone from the corporate office got in, we started talking, and he said, 'See me on Monday after the Christmas break and let's see if we can find you something that will really satisfy you.'"
That something turned out to be a management position in health insurance sales. It turned out to be an ideal solution. "I started out as a manager and moved up to director, then district manager. I went straight up the ladder. For me, it was a natural transition. It was something I saw the need for and could sell wholeheartedly. When you believe in something it will generally come across to the person that you're selling it to. If you don't believe in it, they'll never buy it."
It wasn't just a gift for sales that motivated her, however. The same desire to improve people's lives through medicine pushed Hughes forward.
"It was the perfect move for me because I came from an area where I saw that the product was needed. Selling insurance was like, 'Don't you understand? You need this! You really need to invest in this because you're going to need this - if not today, next week or next year.' It was a way to kind of take control of some of the inadequacies that I saw (in the system).
"The largest account I ever sold was to United Airlines. When you can tell them that 'My insurance is good for all of your employees and you need to have it,' and they take it, you just sit back and you go, 'I did that - because I know that we're going to handle this account right and these people are going to get what they've signed on to get.' That's a good feeling."
After the turn of the century, she considered retiring and even took two years off to travel, but she discovered that she missed the activity of the workplace. In search of a new challenge, she joined Medical Staffing Network, a service which provides nurses to local hospitals, two years ago. Her results have been spectacular.
"We've increased the revenue here in this particular branch something like 700 percent in two years. When I came to this branch, they had contracts to staff five hospitals. We now staff 35 hospitals in the Bay Area, including ValleyCare and San Ramon locally."
What makes this accomplishment even more remarkable is the fact that California is in the throes of a nursing shortage. "Nurses are getting older, they're retiring, and our schools are not turning them out as fast as we need to fill the hospitals. There's just not enough." Add in recent changes in medical staffing guidelines which require a five-to-one patient-to-nurse ratio and the demand is even greater. Hughes has taken an innovative approach to the problem, however.
"There's such a shortage of nurses in California that we actually staff from 27 different states, nurses who want to come here and work," she says. "We've had nurses from as far away as Australia who want to come and work for this company in this area. Our hospitals now are staffed probably 20 percent with travelers who come from other states and come here to work for two weeks, a month, two months."
Hughes explains that the hospitals benefit because they can meet staffing requirements without stretching their nursing staff through large amounts of overtime. The out-of-state nurses benefit from California's high wages. "A registered nurse in Georgia, say, is paid $20 an hour and they come here and they can make anywhere from $38 to $42 an hour. It's a win-win for the hospitals and the nurses."
Hughes is also pleased to be working more closely with other nurses again. "Nurses are great people to deal with. For the most part, they're fun, educated. You don't get as educated a clientele in most arenas because a college education is required for what they do, regardless of what state their from."
It's not surprising that Hughes recommends nursing as a potential profession to young people, but she doesn't stop there. "I suggest they take a look at nursing but not only nursing: Take a look at where nursing can lead you if you want to move up farther in the profession as a physician's assistant, nurse practitioner, or even physician. Nursing is a great career for anyone but why stop there? If you have the intelligence and you really want to do this, why stop there? It's an interesting field. You always carry it with you; once you've been in, you're never out of it. It's always there. You're always practicing your craft."
Just like Marsha Hughes: still finding a way to care for patients, even when she's not at their bedsides.
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