Today in the chart

From Injections to Objections: The Inspiration You Need to Move Beyond the Bedside

In this essay, Tatyana Norman-Webler reflects on her journey from ICU nurse to law student.

I graduated from nursing school in May 2020. In December 2020, I began researching law schools in my home state of Ohio. By January 2021, I was studying for the LSAT. In May 2022, I started law school as a part-time evening student. I cared for my last patient in the Medical ICU in August 2023, when I left the bedside to commit to law school full-time. The first question most people ask me about this pivot is: why? The rigors of my second year of law school and the frequent Whys have given me ample time to reflect on how I got here. While my why evolves, I am grateful for this opportunity to share my journey in hopes of inspiring you to take your compassion and talents beyond the bedside.

Bedside Stories

When I explain that I graduated in May 2020, most people usually let out a quiet, sympathetic, “Oh, I see… that must have been hard.” But I didn’t leave the bedside because it was hard. Of course, the job was challenging. I miss the bedside and caring for patients and their families. I especially loved being part of the critical care team because it was inspiring to work so diligently to bring people back from the brink of death. Working in the ICU filled my cup more than it drained me. It gave me a new appreciation for life—the vitality of the human spirit and the resilience of the human body. But, like thousands of other nurses who served during the COVID-19 pandemic, I was physically and emotionally depleted from back-to-back 12-16 hour shifts, the impact of vicarious trauma from grieving families, the moral distress of working under impossible circumstances with minimal resources, the devastation of losing patients day after day, and the numbing routine of post-mortem care.

To blame my career pivot on the pandemic would be too reductive, but as a bright-eyed and bushy-tailed new grad nurse, it’s fair to say the pandemic greatly influenced my view of our healthcare system and ultimately pushed me to where I am today. However, the single most impactful experience I had in the ICU which sparked a desire to move beyond the bedside occurred well before the pandemic hit. 

Once, I cared for an elderly woman as a student nurse preceptee in the Medical ICU. As I was preparing to do my first head-to-toe assessment, she slowly lifted her arm and pointed her mittened hand at the whiteboard, trying to mouth something around her ET tube that I couldn’t understand. The date? The time? Do you need a mouth swab? She shook her head no. Do you want to turn on your side?  She rolled her eyes and shook her head again. I grabbed a clipboard and paper, removed her mitten, and placed a pen between her swollen, shiny fingers. I watched patiently as she mustered all the energy she could to write out, “I want to die.” I looked up at her to see her eyes welling with tears, back to the clipboard, then back at her. She nodded, seemingly in response to what I’m sure was a bewildered expression on my face. She continued to write: “Please, I am so tired.” 

I went straight to my preceptor, who said, “Okay, what do you want to do?” She shared a few words of wisdom with me, but otherwise empowered me to handle the situation as I saw fit. I called the patient’s spouse, took a call from her kids (who came in shortly after to yell at me for entertaining such a conversation—they later apologized), the charge nurse, and the resident. I did everything I could to ensure that our conversation and her Full Code status would be discussed with the care team the following morning during rounds. The reality was that my patient had spent most of that year in and out of the hospital, pinging back and forth between LTAC and the ICU. Her medical history included an exhaustive list of disease acronyms, infections, and medications. She would never be strong enough to come off the ventilator, so the care team anticipated that she would be “trached and pegged” later that week and, thus, likely to spend the rest of her days in an LTAC. She was acutely aware of this, and that was not the life she wanted.

When I came back a few days later, I saw that she had been “trached and pegged” and was being transported to an inpatient LTAC. I was overwhelmed with disappointment, anger, and sadness for the shell of the woman that laid in that hospital bed. I failed her. Her family failed her. Our healthcare system failed her. As I saw it, we had just taken her prisoner. This didn’t feel like the “patient-centered care” model that I learned in nursing school. 

Then, along came COVID. As our healthcare system crumbled under the pressure of the pandemic, I felt powerless to help my patients. Every time I lost a patient, I felt like I had failed them and their families. One day, I was laughing with my patients, taping pictures of their families all over the room, helping them get comfortable as they self-proned, cheering them on as they sat up on the side of the bed with PT, and the next, I was compressing their chest, watching the life fade from their eyes, wheeling their body down to the morgue, and consoling their loved ones. This is it? I remember thinking to myself. This is healthcare? 

Spending eight years at the bedside (5 as a PCT and 3 as an RN) and experiencing a once-in-a-lifetime pandemic instilled in me a drive to do more. When I enrolled in law school, I didn’t know exactly what “more” meant, but I knew I wanted to be more, to do more, to help more people, and to—brace for the cliché—be the change I wanted to see in healthcare. I’m still learning, growing, and figuring out what “more” looks like and how I can create positive change in this field.

As nurses, we get the opportunity to wear many hats: advocate, counselor, educator, problem-solver, caretaker, confidant, and fellow human. I discovered pretty quickly that I was inclined towards advocate. Right now, I am focused on gaining the knowledge, skills, and career capital to become the best advocate I can be. I have since discovered an interest in health information privacy, so we’ll see where that takes me during my law school journey.

Beyond the Bedside

Over 100,000 nurses left the bedside during the pandemic, and NCSBN estimates that nearly one-fifth of nurses intend to leave the workforce by 2027. While everyone sounds the alarm for the impending mass exodus of nurses from the workforce (understandably, since we are the backbone of the healthcare system),

"I am here to tell you there is nothing wrong with leaving the bedside."

But, if you leave, I urge you to take your frustrations, your problem-solving mindset, your growth mindset, your resilience, all your transferable skills, and all your bedside stories with you and transform them into positive change for nurses, patients, and our healthcare system. 

The ability to do meaningful work, have positive interactions and maintain good health are some of the most critical factors that influence nurses to stay in their current positions. If you lack the opportunity to do meaningful work or have positive interactions at the bedside, you can create that environment for yourself and others. That may look like getting involved in hospital committees, shared governance, administration, your local ANA, non-profits, nursing coalitions, networking within the nursing community on LinkedIn, or going back to school for an advanced degree in public health, public policy, law, or healthcare administration. 

Think of all the workarounds we developed. Think back to a time when you thought—this is silly, why is this like this, this could be so much easier, or this would be so much more efficient if—the list goes on, right? You can use those observations to create an innovative product, service, workflow, or care model to improve healthcare delivery.

Every professional nurse I’ve met along the way who has moved beyond the bedside shares a sense of hope, drive, and humanity. But they also share some frustrating, disturbing, and morally distressing bedside stories that have launched them beyond the bedside. Nurses can bring that hope and humanity to the community, the boardroom, the business of healthcare, the courtroom, and even to Capitol Hill. 

*Cue John Lennon’s Imagine* You have the knowledge, the skills, and the passion for people. You have your own bedside stories and your own unique perspective on our healthcare system. I hope you share that with the world by moving beyond the bedside.

I’m happy to chat with you if you're contemplating law school! Connect with me on LinkedIn.


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