Losing and Finding Identity in High-Stakes Surgery

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When I was notified about being hand-picked as a scrub nurse on our high-risk cardiothoracic surgery team, I was very excited, but also nervous. As most would, I sought counsel from many - some that worked in the O.R., and others that had very demanding careers outside of healthcare. My one question to them was, "Would accepting this job end up defining my life?"

High-risk cardiothoracic surgery is as intimidating as it sounds and for those that knows what those rooms are like can attest that it requires all team members to give everything 'day-in and day-out' to get patients through the most trying times in their lives. When approached about the potential opportunity, the lead attending was very clear about his expectations for being on the team:

Timeliness is everything - ensuring on-time starts for cases is not about efficiency; it's about keeping the team in rhythm. The structure is essential and anything less is unacceptable;
Preparation is key to results - everybody in the sterile field is expected to show up every day with a thorough understanding of the patient's presentation, potential pitfalls and complications, and a firm understanding of the patient's anatomy and etiology. This means studying the night before cases, reading through many chapters in texts and recent studies, etc.;
Your position is not guaranteed - offers to be in the field on the high-risk CT team is a privilege and it is revocable at any time. There are not always second chances because mistakes in these cases cost time, and time can mean the difference between life and death, paralysis and full function, and whether a patient is burdened for life with irreversible neuro damage.
Accountability is everything - everybody on the team was chosen and therefore, everybody is expected to know what to do without being asked - this goes from anticipating the next move by having the instrument ready and in a position where the field remains clear to knowing everything that needs to happen during the prep.

I was beyond intimidated but after talking to so many, I realized that this was a chance of a lifetime where I could work with the best and be exposed to rare cases not just in our institution, but in the world - cases that are written up in studies and textbooks.

The first year was beyond rough - I felt that so many things that made up my identity left me - I lost touch with my friends; I stopped dating; hobbies I enjoyed went on the back-burner; and, I felt that my identity became exactly what I dreamed of: "I hand-picked to be a part of the high-risk cardiothoracic surgery team."

By month 14, I was ready to quit. I began suffering burnout; my nights were spent studying for the next day's cases; and, I became one-dimensional. I told the attending who selected me of my thoughts and he advised me to take a couple weeks off.'

So, I decided to go somewhere in nature and spent 10 days in Yosemite. I was able to hike everyday, not think about work, read the books that had alluded me, make phone calls to old friends, and ask myself, "is this all really worth it?" When I left Yosemite, I decided that I still loved what I did, but I needed to make changes:

I was able to work out a schedule that provided me more downtime between long days in the O.R.;
i committed to a new exercise routine that included a personal trainer and yoga sessions;
I committed days to see friends - for the first time ever, I planned out days that would be only for me and my personal relationships; and,
I committed to monthly meetings with the attending to talk about how things were going and whether additional tweaks were needed.

i really committed to all of these things for a full year. During that time, I learned very important lessons about career and its role in my life:

Our identities can't be one-dimensional because when something isn't going well in that one thing (such as a career), then what do you have to turn to;
You can give your all in service of another without losing service to yourself;
You have to pick the things that make you happy and show the discipline needed to make them 'fit' in your life;
The word 'balance' is dangerous - it implies that to be good at one thing, you have to sacrifice your commitment to something else; and,
Diversity in your life is accretive to your mental well-being, and your mental well-being is accretive to your career performance.

And so here I am, a proud scrub nurse on the high-risk cardiothoracic surgery team. But, you know what else I am? I am a fiance; I am a yogi; I am a baker; I am a friend; and, I am a daughter and sister. The list goes on and I am as proud of what I do as of who I am. High-stakes healthcare requires commitment.

But that commitment presents a choice: We can be defined by that one thing. Or, we can choose to be many things. It requires discipline and self-reflection, but in the end, it creates an enriching life that allows us to find multiple forms of love.

I love all that I am today and it has never taken away from the tremendous love I have for being a nurse in cardiothoracic surgery.

Don't feel cornered into the idea that love is a finite, zero sum game, and that becoming many things takes away from your passion for serving others.

Losing and Finding Identity in High-Stakes Surgery

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