Sarah Gray, pediatric nurse and Trusted's Founding Clinician, was interviewed by Anna Rodriguez of the Burnout Book (and winner of our first ever giveaway!) about the nursing profession, leaving the bedside for a non-traditional role at an early startup, and her passion and why for what we’re doing here at Trusted to change the way us nurses work, connect, and live.
Let's dive in!
Sarah Gray: Pediatric Nurse and Founding Clinician
What has your career looked up to this point? Where do you see it going in the future?
I’m a pediatric nurse and the Founding Nurse at Trusted Health. I’m a born and raised Jersey girl, number five of six kids. I’ve always been a nurturer, a giver, and a do-er at heart and have known for as long I could remember that I wanted to work in healthcare. I initially had my heart set on orthopedic surgery but as I got older it became clearer that I wanted to be hands-on with patients, to be the boots on the ground, and that I valued the time and personal connection that is inherent to the role of a nurse.
I decided in high school that I was going to be a nurse and majored in nursing for my undergrad.
I hated it at the time – being an undergrad nursing student at a school where a majority of my friends had other majors and entirely different responsibilities and schedules. I’d head home from social events early to be up for clinical at 0500 while they were returning to our apartment just hours before I woke. They complained about exams and papers while I struggled with having to talk an elderly soon-to-be widow through making sense of cancer and death or coming to terms with the social situations that had landed some children in the hospital.
In hindsight, it was one of the best decisions I ever made.
It would take some guts to do it all over again, but I highly encourage anyone with even an inkling to go for it.
I’ve ditched my Jersey roots and have been living in San Francisco for nearly five years now. My husband got a job out in the Bay Area early on in our senior year. I was not keen on the idea of long-distance and hadn’t yet decided where I would get licensed. After looking into San Francisco, it seemed like a no-brainer that I would hitch my wagon to his. San Francisco is one of the best places in the world to be a nurse.
Prior to moving out here, anyone I was in contact with told me “Don’t come out here without experience. You won’t find a job, it’s so competitive.” Well, too bad, because I was coming and that was that. We drove cross-country mid-June and I was licensed by the first week of July. I was willing to roll up my sleeves and start getting any and every bit of experience that I could get my hands on.
I started doing flu shot clinics and that evolved into school nursing. I applied to New Grad programs and residency programs for months. They weren’t kidding when they said it was competitive. But I’m a big believer in persistence and while I was frustrated and had my doubts, I never let myself get short-sighted.
I landed one of the 60 positions in UCSF’s New Grad program of over 10,000 applicants - because of sheer persistence. I wasn’t willing to take no for an answer. I had my heart set on Pediatric Heme/Onc because that’s what I did my capstone in and loved it, but ultimately ended up on a Pediatric Medical Surgical Unit. Hey, beggars can’t be choosers. And it turns out that life has a way of making things happen the way they should.
I knew I wouldn’t be a bedside nurse forever and always assumed that I would end up back in Philly for my Master’s in nursing. Year after year, I failed to feel the draw or need and found other ways to fulfill my hunger for knowledge and experience. In three years, I became the youngest charge nurse, youngest Clinical Nurse III, completed a leadership project on the implementation of Standardized Bedside Handoff across two units, and conducted an Evidence Based Practice Fellowship on The Use of a Rounding Checklist for Interdisciplinary Bedside Rounds.
I always wanted to be more involved, understand more, and learn more. About a year ago, I started getting serious about where I wanted to take my career and what I could do to set the foundation for making it happen. I had always done something "on the side" (i.e. ran operations for a granola startup, was a personal assistant, dabbled in home health, market research, and am a lifelong au pair!) in addition to my full time (3-4 days a week) nursing position and have been intensely curious about business, innovation, technology, and entrepreneurship.
I began applying for business school in the fall when a mentor encouraged me to see what was out there for me to get my feet wet. I stumbled upon Trusted Health and still pinch myself every day that I get to do what I’m doing and that we as a company are doing what we are.
For me, my future toggles between being very clear and very murky. Since I’ve pivoted away from clinical care rather recently and sooner than I anticipated, it’s hard to know. I find it difficult to believe that I won’t be clinical in some shape or form in the near or long term because I seriously love patient care. But if things continue to unfold as they have for Trusted in the last few months, there are so many other hats to wear too.
But I will always, always, be and identify as a pediatric nurse. I love kids- I love my patients and their families, I love urgency and chaos, and I love being in the thick of it with my co-workers.
Have you ever felt burned out? How did it develop and how did you handle (or not handle) it? How do you avoid getting burned out again?
Duh! Who hasn’t? I can’t say my decision to leave bedside nursing was a result of feeling burnt out, but it was definitely a part of it. I think it was more of a combination of feeling burnt out, frustrated, and a bit jaded combined with no longer feeling challenged and inspired coming to work each day.
It developed as frustration with processes, rigid policies, lack of management, poor staffing, and honestly, becoming a charge nurse. As a charge nurse, you get a much deeper understanding into the politics of healthcare and hospitals and it’s really disheartening. I would constantly be on the brink between being truly inspired to change it and weighed down by barrier after barrier.
Initially, I handled it by finding meaning and balance in other aspects of my life. I also tried to schedule my days to ensure that I was really giving myself time away and to re-charge. I discussed my frustrations and feelings with co-workers, managers, friends, and my husband. Practicing gratitude and slowing down always helps too. The days when I have the time to truly connect with patients and their families or help my co-workers are truly fulfilling.
There’s nothing like laughing with co-workers, getting the seal of approval from a pediatric patient, or feeling the appreciation of patients and parents.
Honestly, I’m not sure I think that we can avoid burnout - not just as nurses, but as human beings. It seems it’s a different kind of burn-out with nursing, but the same concept applies to every aspect of our lives. Generally - be aware that it’ll happen, that it’s somewhat ‘normal’, that it will pass (and there are things to speed up that period), and that there are things you can do in the meantime until it does. I think too just being realistic that life and everything that comes with it is a rollercoaster and there will certainly be highs and lows, some longer than others.
How have you spent your days off to recover and recharge?
This is kind of a loaded question for me! Especially since I’ve found that my answer to this is very different than others. I’m a big proponent of ‘a soul in motion stays in motion.’ And though I definitely believe in slowing down, especially to bounce back, my days off are freakishly productive. I slow down, but I literally don’t stop. My go-to is fitness. I don’t think there’s a better feeling you can deliberately and easily achieve than the post sweaty-workout endorphins, skin flush, and energy-boosting exhaustion.
There’s something I refer to as my "Sunday morning feeling" (which as a nurse isn’t limited to Sundays, by the way): an early wake-up after 7-8 hours of sleep followed by an intense workout, sauna session (usually with some form of a face mask), cold shower, and then sitting down for a cappuccino or matcha latte with my husband or a best friend. I’ve found that the best way to gear up for a couple shifts in a row is to ensure every other aspect of my life robust, productive, and ‘taken care of’ so to speak.
"Zero-days" on my days off actually just make me more anxious and stressed. I thrive on productivity.
So, my days off almost always consist of some variation of laundry, grocery shopping, errands, cooking & meal-prep, long workouts, emails, writing, and cleaning. I can go to work and come home feeling at ease knowing that there aren’t piles of clothes waiting for me at home or a long list of to-do’s that I’ve had to put on hold while I’m at work.
The other non-negotiable is people and laughter. I’m constantly on the phone with family, and trying to herd friends for dinner and game nights. Though I do cherish periods of solitude and quiet on my days off, since the hospital can be overly stimulating and chaotic.
How long did it take you to feel "comfortable" in each new role you've taken on? What advice do you have for nurses who are experiencing the stress of starting something new?
Well, this is timely, haha! Since the role I’m currently in is still relatively new, this is so relevant. I haven’t felt this uncomfortable since I became a Charge Nurse. And before that since I was a New Grad. It’s SO interesting. I’m extremely introspective, cerebral, and self-aware and I’ve definitely experienced such a rollercoaster of emotions that were hiding away since I had become comfortable in those prior roles.
And to be frank, this is what I wanted to feel, this is what I was felt I was lacking in my role as a clinical nurse. The way one of my co-founders put it – it’s like jumping off a cliff with a parachute one size too small. It’s scary as hell, but it’s what I asked for! It’s what I was actively seeking. So I’m embracing it and trusting the process and having confidence in myself that I’m eventually going to learn to utilize the parachute to land safely. And I have a feeling that once I land safely, I’m going to want to do it all over again, with an even smaller parachute.
My advice is to embrace it. Growth happens the second you step out of your comfort zone. And sometimes we’re not brave enough to step – we get pushed. And if you’re lucky enough to get pushed, embrace that. Don’t squeeze your eyes shut as you’re free falling – go eyes-wide-open, ‘holy shit I’m doing this, okay let’s do this.’ Trust that it’s a really good thing and won’t last forever. As an athlete my whole life, I try to remember what I was told years ago during rigorous training: get comfortable with being uncomfortable. It’s too easy to be comfortable. So, seek discomfort.
In terms of how long it’s taken – I think the period of discomfort has gotten shorter and easier with each new role. You learn how to cope with the discomfort and associated feelings and emotions. You become familiar with them and it’s becomes a “oh there you are again” situation. But with each new role there’s an entirely new opportunity for discomfort. It can take months to years.
Side note: As a new grad nurse, a mentor told me “Oh, it’ll take about a year before you feel comfortable.” This mortified me. But she was so right. I try to be that same mentor for New Grads or new nurses – stick with it, stay confident, be comfortable with being uncomfortable, and have faith that you’ll get there.
What is the hardest part about your role at Trusted? What about the most rewarding?
It’s mostly hard and entirely rewarding, much like bedside nursing but in different ways. I’ve been compiling a list of ideas for a blog post I want to write about the major differences between bedside nursing and office/startup life – some are quite hilarious.
I’d say the hardest parts are related to staying focused, a lack of rigidity, staying confident in what I’m doing, and finding balance in an entirely new lifestyle. I wear so many hats in my new role and my attention shifts at a moment’s notice. In the hospital, we have a pretty strict schedule that we adhere to. In this role, there aren’t such exact timelines or priorities. There is also nearly immediate feedback as a bedside nurse that doesn’t really exist in this role.
I have to trust that what I’m doing is what I should be and is effective even if I won’t know for days or weeks or months.
Also – my day doesn’t finish at 1930 anymore. There is no “taking off my scrubs” and I can now bring work home or wherever I go. As a do-er, that’s hard to balance, but I’m learning.
One of the most rewarding parts is the opportunity to connect with nurses. It’s not uncommon for me to be hanging up the phone multiple times a day feeling intense energy, connection, energy, and passion. Nurses are so cool! We’re the same, but so different. It’s really inspiring to hear about what others are doing, building, imagining, and talking about.
It’s also incredibly rewarding knowing that what we’re doing is going to fundamentally change nursing forever, on a scale bigger than I would be able to touch as a bedside nurse.
What advice do you have for nurses who are thinking about stepping away from the bedside and trying something nontraditional?
Go for it. Seriously. Clinical nursing will always be there. And as nurses we have such a unique combination of concrete skills and soft skills. We are so, so valuable. The experiences we have, situations we’ve been in, perspective we’ve gained, flexibility and unpredictability we’ve come to expect all makes us so dynamic. We have so much to offer the world and other industries and sectors, as nurses, but also as human beings who have clinical skills and experience.
We are so much more than nurses.
If you have a passion or interest, dedicate the time to developing it. Harness the confidence, flexibility, passion, and perseverance that you’ve gained as a nurse to run full speed towards it. We’ve got a long career ahead but only small and fleeting windows of opportunity to take chances and feed what really gives us energy.
Fill in the blanks:
If you could change one thing about nursing to address burnout, it would be:
Working conditions and environments. Literally just drafted a blog post with the opening lines “I don’t want my job to be easier, I want it to be easier to do my job.” We’ve come to accept certain things as is because that’s the way they’ve always been. But I refuse to accept that as an answer and I’m really excited to see what happens when nurses are in the driver’s seat and there is transparency into what nursing is and what it can be.
I keep my spark for nursing alive by:
knowing that I have not only the skills, experience, and ability but also a genuine and organic desire to make others’ lives healthier, happier, and longer.
What's your workflow like?:
There are quite a few parallels to clinical nursing - no two days are the same and each day is constant problem solving and interacting with people - whether they’re nurses, Nurse Advocates, or an interdisciplinary team of engineers, designers, operations, etc.
How has your nursing training helped you in the start-up world?
Clinical experience prepares us for pretty much anything in ways we don’t think too much about. It gives us such a unique set of both soft and hard skills - from problem solving, customer service, and coordination to critical thinking, needing to be ready for whatever walks in the door (literally and figuratively), and seeing the bigger picture when being in the weeds.
What have been some of the most surprising things you’ve learned or observed in your new role?
Engineers and designers are magicians. I’m pretty much in aw everyday and am convinced there isn’t anything an engineer can’t solve or do. It’s really so cool to work with an ‘interdisciplinary’ team that is so dedicated to improving the lives of nurses. They’re all so curious about our profession, what we actually do, and have been super passionate about learning our world.
Healing patients is a pretty incredible feeling and justification for a job well done. What kind of rewards do you get from your new job that are comparable? Any stories you can share?
It might sound silly but I feel the same type of reward now, but from being able to help nurses (rather than patients). Nurses are now my primary focus and my role here is essentially to ensure everything we’re doing, saying, thinking about, building, and allocating resources to is with a nurses’-first perspective and is knocking down walls and creating bridges for us nurses.
The biggest compliment and best feeling is when we get feedback from our nurses about what we’ve been able to do for them, when they express their gratitude, and when they share their photos and stories of them in places or accomplishing things via Trusted.
How did you know this was the startup for you, growth wise?
I’ve got a pretty strong intuition and I knew off the bat that what we’re doing at Trusted is game-changing. That, combined with the people I get to do it with left 0 doubt in my mind. I’ve been fortunate enough to be in a position where I can truly scratch my own itch and chip away at my own expectations for what nursing can and should be. I’m constantly challenged, learning, and growing, and there’s not much more I can ask for :)
If you're curious to learn more about what we're doing at Trusted, come check us out!
