A personal organizer who wants to help people in a more palpable way enters a much-changed profession: nursing
By Christina Ianzito
Sunday, February 19, 2006
Hilary Winkler darts into the supply room at Washington Hospital Center on a quiet Sunday morning and grabs an extra gown for one of her patients. With a stethoscope draped around her neck, her hair caught up in barrettes and a "NURSING STUDENT" nametag pinned to her short-sleeved blue shirt, Winkler is two hours into a 12-hour shift that will take her one more exhausting step toward her new -- and, she's pretty sure, final -- career.
"I have this pattern of quitting jobs when I get bored with them," Winkler admits, "which I hope is going to stop."
Winkler, 33, who graduated in 1994 from the University of Virginia with an art history degree ("no particular idea why," she says), is beginning the last day of her final "clinical," a hands-on hospital shift, before graduating from the School of Nursing & Health Studies at Georgetown University. After 16 months of plodding through the Second Degree BSN Program -- established for students who already have a college degree -- she'll graduate in a few weeks with a bachelor's of science in nursing. Once she passes her licensing exam, she'll dive into a profession that has little in common with her former occupation, personal organizing.
Over the course of her morning in the cardiac unit, Winkler assesses the blood pressure, heart rate, respiratory rate and temperature of two patients, gives insulin and anticoagulants to two others, cleans up some soiled bedding and reheats a breakfast that's gotten cold.
"What makes you most nervous is missing something," she says, noting that she had "no health background and never have been particularly sick or had any kind of exposure to hospitals" before all this. She'd never even had an anatomy class prior to entering the nursing program, although, she says, "I had an archaeology class where we learned a little about bones."
There are 23 students, including four men, in Winkler's Second Degree class. Georgetown created the program in the mid-1990s with an enrollment of 10. The program now graduates nearly 60 students a year, with an average age of 28. "The word got out about the opportunities," says Tricia Lawlor Jorden, the school's director of admissions and outreach. "It isn't the old profession you thought it was."
Colleen Norton, who teaches "Complex Nursing Problems" at Georgetown, says nursing today is wildly different than it was when she graduated in the 1960s. "When I was a young nurse, you were still very much subservient to the physician. The responsibility and autonomy of the nurse has just blossomed." School was different, too, she adds, "It cannot even be compared. [Today's nursing education] is so much more sophisticated, scholarly and demanding."
Like a lot of other Second Degree students, Winkler had to plow through prerequisites such as organic chemistry, microbiology, anatomy, physiology and statistics before her regular course work could begin. There's "tons of reading," she says, and sometimes she wishes the program required less analysis of journal articles and more hands-on training. But besides her seven shifts at Washington Hospital Center, she's also had seven clinicals, including training in maternal-and-child health at Holy Cross Hospital in Silver Spring, mental health at the Psychiatric Institute of Washington and pediatrics at Children's National Medical Center. She's never been in an ER or on a trauma unit, so "I haven't seen anything that grosses me out yet," she says. "Misaligned body parts might be difficult. . ." But she wants to work with "sick people, people who really need me."
Her very first patient was a woman who had suffered a brain hemorrhage. "I asked her, 'Is there anything I can get for you?' She looked up at me and said, 'I want a beer.'"
Another participant in the Second Degree program, Andrea Dubenezic, a 28-year-old who majored in Spanish and art history at Sweet Briar College, describes the shock of "going to the hospital for the first time, seeing people who are sick and just, like, the equipment and the lights beeping. . . It's really intense." She says she's not sure she wants to do hospital nursing -- maybe something in public health. But she has watched Winkler interact with patients, and says, "If I had to hand-pick anyone in my class to be my nurse, it would be her." Winkler, she says, is "so empathetic" and "really committed."
Thoughtful and articulate, with large gray-blue eyes, Winkler has a résumé with length if not breadth, and had a relatively unsettled childhood. Her parents divorced when she was young, and she grew up with her journalist mother, Claudia Anderson, who's now managing editor at the Weekly Standard, and younger brother, Tom, now 31 and a member of the Navy's elite flight demonstration squadron, the Blue Angels. In those early years, they lived in her grandmother's house on Capitol Hill, along with brief stints in Buffalo and Cincinnati, where her mother worked as an editorial writer. Summers were spent in England with her British father, who died five years ago.
After four years of a solidly liberal arts college education in Charlottesville, Winkler floated through various jobs in London, Washington, Des Moines, White Plains, N.Y., and San Francisco, which included selling cutlery in a knife store, helping to edit gardening books, and working as a technical writer and then as a renovations coordinator for Starwood Hotels' Design Group. "I was kind of casting around," she says. "I think I have a tendency not to want to settle somehow. I don't know if things just aren't quite good enough or if they're just not how I envision them."
In San Francisco, she started her own professional organizing business; then, in 2002, she moved back in with her mom, who lives on Capitol Hill. In Washington, Winkler picked up some new organizationally challenged clients, a few of whom she's held on to, helping them keep their finances and papers in order. (She's very, very neat, she acknowledges, though "not in a creepy way.") But she wanted to help people in more palpable, life-and-death situations. Nursing, she says, "just came to me one day -- I didn't even know much about it, but it fit."
She says that reactions to her decision were frustrating. "People would say, 'You're really smart, why don't you go to medical school?' People think nursing is for people who couldn't go to medical school, but they're very different professions. It's two members of a team but that have different roles in the team."
Winkler isn't likely to have trouble finding a job once she graduates. "There's a huge nursing shortage," says Jorden, the Georgetown admissions director. In the hallway of Washington Hospital Center, a poster near Winkler's station depicts three serious but kind-looking nurses, and the words, "Be a Nurse . . . Join the Ones Who Dare to Care" in the style of military recruitment posters.
The money isn't huge. New graduates earn about $25 an hour at Washington area hospitals, one nursing recruiter says, an amount that can rise, depending on the shift and specialty. A federal survey found that the average annual salary for full-time RNs in 2004 was $57,784. But there's security in knowing that many experts say more new jobs are expected in nursing over the next 10 years than in any other profession. Some believe the staff shortfall will be 800,000 by 2020.
There seem to be far more recruiters than students at the job fair hosted by Georgetown's nursing school in December. About 50 representatives from hospitals around the country are on hand to lure new grads to their nursing staffs. Many have placed bowls of candy next to their brochures, a sort of reward for listening to their spiel. Lissa Nelson from NewYork-Presbyterian touts the Manhattan hospital's subsidized housing and flexible schedules. She's joined by reps from Virginia Hospital Center in Arlington, which offers a scholarship of as much as $10,000 to students who commit to working there for one year after graduating; Stanford Hospital & Clinics in California, which has a popular six- to 12-week training program for new RNs; and St. Joseph's Hospital and Medical Center in Phoenix, whose brochures note that the city's average temperature is a balmy 72 degrees.
Winkler stops by after class and does some browsing. She'll most likely apply to Washington Hospital Center and a few others, she says, possibly in intensive care, critical care or the emergency room. But she doesn't feel pressed to choose. She knows she's needed.
Christina Ianzito is a frequent contributor to the Magazine.
View all comments that have been posted about this article.