After Earning Your Nursing Degree: Best Practices for Landing a Great Job
When the COVID-19 pandemic began surging through the United States, Erin Keefe was working at a hospital in downtown Los Angeles—a demanding role in a challenging healthcare crisis. And this nurse leader wouldn’t have had it any other way.
“I’ve spent maybe most of my career working in urban hospitals that provide care to the underserved population,” says Keefe, who at the time was senior director of patient care services at Dignity Health’s California Hospital Medical Center (CHMC) in Los Angeles. “For me it’s a choice. I feel like my role is to be an advocate for those populations, with the thought being that if it was me, and I didn’t have anyone, and I didn’t have the resources, I would want to know that it was safe for me to go to that facility for care. My purpose is fulfilled when I can make a difference.”
Keefe says that’s why, when she decided to earn two advanced degrees online, she chose Walden University, whose mission aligns with her desire to effect positive social change. In 2010 Keefe earned a Master of Science in Nursing (MSN) with a specialization in Nursing Education and in 2014 she received her Doctor of Education (EdD) in Higher Education and Adult Learning—graduating with a 4.0 GPA.
Today, Keefe’s nursing career has taken her east from Los Angeles to San Bernardino, where she is chief nursing executive officer at St. Bernardine Medical Center. We caught up with this busy healthcare professional recently to learn more about her nursing career, education, and experiences during the COVID-19 disease outbreak.
Walden: Can you tell us more about why you’re passionate about working in urban settings like Los Angeles?
Keefe: In Los Angeles, the hospital is right next to the Staples Center. You’ve got million-dollar condos here, Skid Row there. … And to me, it is just this great big mix of cultures. I loved going into the facility in Los Angeles. Everyone works in these types of hospitals on purpose. People don’t work in an inner-city hospital accidentally, and if you start working there, you figure out really quick if you don’t fit, if this is not the clientele you want to care for. People who are underserved and vulnerable are not always the easiest to care for, but if you make a difference to one of them, then you can consider yourself successful. I loved my time working there.
Walden: You mentioned Skid Row, the Los Angeles neighborhood established in the late 1880s which today has a large population of people experiencing homelessness.1 What special circumstances did you encounter in your work there?
Keefe: There was a focus on care and making sure that the people who had nothing were safe to go back out to where they considered home. And you learn so much. And it’s about humility as well. You talk to some people that have lived on the streets for decades; they don’t consider themselves homeless. They say, ‘Oh, my tent is over here, and I have a family.’ It may not be by blood. But they have a community. Some do it by choice, but some of it is mental illness and other things. Effecting positive social change is the whole focus of the Los Angeles facility and the people that are working there are there because they want to make a change. They want to make things easier for people who don’t have what the rest of us have, including access to healthcare. It shouldn’t matter what your socioeconomic status is, when you walk through the door—or roll through the door—you are a human being, and we are here to provide that care and that includes emotional care.
Walden: In Los Angeles, your scope of responsibility included quality care and patient safety. What challenges did you face with the initial impact of the COVID-19 outbreak?
Keefe: The challenges with the coronavirus pandemic in the beginning were supplies. We didn’t have enough personal protective equipment (PPE) and so we had to very rapidly change how we approached infection control. Normally, you put your gear on for each case and take it off when you walk out the door and throw it away. But because of the limitations, we had to go to extended use. My focus was, how can we keep our patients and our staff safe from contamination and infection, as well as how do we maintain what we have, and how do we keep up with the constant change? What I would say at noon might not necessarily be true at 3 o’clock in the afternoon because the CDC was changing things. The California Department of Public Health was changing things. So, it was extremely volatile.
Walden: What results did you see after implementing procedures for the extended use of PPE at the Los Angeles-based hospital?
Keefe: We didn’t have massive employee infection and that sort of thing. We weren’t infecting the patients in the facility. And when you look at the statistics for CHMC, the mortality rate for their COVID patients was actually lower than the national average, so I thought we did a really good job at keeping them safe.
Walden: And then there was the third surge. What were you facing then?
Keefe: Yes, the third wave happened over the holidays and our issue was staff, because by that point people were just pandemic-fatigued. They were getting sick, and so we had at one point about 400 employees out on FMLA. At the same time, we had a surge of patients and we had more patients than we had physical beds. So, we had to—again, thinking on our feet—very rapidly educate nurses on how to change their whole nursing focus. We had to go from primary care to team nursing, so that we could work more efficiently with less. … We needed to double our ICU capacity and we were able to do that through innovation with the staff. We looked at rooms that were big enough and we put two beds and two ventilators and all the equipment in. We turned conference rooms and classrooms into patient care rooms. We had tents that we turned into mobile units. And in our whole conference center, we built a 24-bed hospital unit.
Walden: Looking at these and other responsibilities you’ve assumed in your nursing career so far, what areas of interest would you say you’re most passionate about?
Keefe: My main focus is on quality care and patient safety and looking at it as a leader, as a consumer, and as a family member of others who need health services. If I can effect positive social change in my role for the team here, it has a broader reach into the communities. And so ultimately, I’m here, too, to improve the health of the community.
Walden: You’ve earned a master’s degree in nursing and a doctorate in education—it sounds like you’re a lifelong learner. Can you walk us down your educational path so far?
Keefe: I earned my MSN with a focus in education. At the time, I wasn’t 100% sure if I wanted [to pursue] leadership or education. My thought process was that education is very similar to leadership; you’re trying to convince people to follow you. I was still clinical at the time and so I was able, for my MSN project, to build a program. And after I left the facility where I was working at the time, they put it together and they actualized it, which I thought was really cool. And so, when I finished, I was just thinking to myself, ‘Well why not?’ I was looking at different degree programs and the EdD spoke to me.
Walden: And why did you choose Walden to earn your MSN and EdD degrees online?
Keefe: I had started my master’s degree in Arizona, in a brick-and-mortar setting. But I ended up moving and wanted to transfer. When I was doing my research and looking at the mission of Walden University, it connected me with that desire to make positive social change. When I finished my master’s, and I was deciding to earn a doctoral degree, I thought, I enjoyed the process of Walden, and just how the structure is. There’s a lot of interaction and to me it was very thought-provoking. … Walden is extremely supportive. My doctorate committee was fantastic, and although it was stressful, it was well worth it. Walden’s programs are collaborative, and you have the ability to interact with people from different cultures and different places, and with different worldviews. It really is a place where people who believe in advocacy come together and succeed.
Walden: What insight would you offer other working professionals who are considering earning an EdD or other doctoral degree online?
Keefe: If you’re coming into a doctoral program, I realize that it can be done in three years, but typically there are confounding variables that you have to look at. Pace yourself. Follow the program knowing that it may take a little bit longer, but at the end of the day, the work that you create means something, and it makes a difference. Remember that you have to have to have boundaries for yourself, set guidelines, and you have to be able to focus. And sometimes it’s not the right time [to start a degree program]. You have to look at your whole world, your whole life. Do you have the time to dedicate? It’s not all-consuming; you can still have “me time,” which you need to do for your own mental standing. But earning a doctorate is achievable and at Walden, you are set up to succeed.
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Pursuing a degree can change your life. If you want to expand your potential career opportunities, one of the best choices you can make is to earn your bachelor’s, master’s, or doctoral degree. At Walden, an accredited online university, you can earn your online degree while you continue to work full time. That means you can better maintain a work-life balance while you enhance your credentials and further your skills.
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