Karen Nicholls shares what she's learned after 20 years in healthcare

Karen Nicholls talks about the joy she has found in her work, and it’s hard not to have some of that joy rub off when speaking to her.  

Karen began working in the health system 20 years ago as a volunteer coordinator in the palliative care unit at the Victoria General site, moved on to work in patient relations and then as an administrative coordinator—responsible for the flow of patients from the QEII emergency department to inpatient units, operating rooms, ICUs and throughout the hospital. Most recently, she has been director of the Frailty and Elder Care Network, working with Dr. Ken Rockwood, a world leader in the field. 

She will retire this month. But before she goes, we sat down with her to reflect on what she’s learned. (Responses have been lightly edited and condensed.) 

On palliative care: 

Death is our everyday and it was a really great privilege to work with patients and their families. Many patients don’t have a family so I tended to be the person then who would sit with them while they were dying and have the last conversations. It really broadened my perspective of death and made me feel very comfortable with death and the human experience of dying. I love the palliative care team--they were wonderful people and you could see their passion and how they just wanted the best for patients. 

On patients: 

The most important piece of (the patient relations) role is really being able to listen to the patients…for most patients they just often felt unheard and most of them felt that they weren't treated well in the sense that “they didn't hear my story,” or “I had to repeat my story a lot.” 

We're really good at single system issues but I don't know if we often see the whole patient. I know it's hard when you're limited for time but we do need to take more time to get to know our patients. I think it tells you all about the patient: their picture, their story--how big is your world? 

On work: 

I think my most stressful role was the admin. coordinator role because 70 per cent of the time I was the only manager on site so I handled everything from floods to staffing issues and all patient flow. It might have been the most stressful, but it was the most rewarding of my career. I loved it. I loved the challenge because every day it was like a big puzzle and the great satisfaction making everything work. I’m really proud of the work I did as part of that team. 

I think I did the best I could with the tools I had. I know technology is really seeping into things but in my rules I think your personal relationships were a lot more important than what the technology offered. You had to build that trust, the friendships. That’s what made things happen, is that people trusted what you were saying. You had a relationship. 

I knew everyone: I knew all the surgeons; I knew all the docs; I knew the residents—which I loved, working with the residents—I knew all the staff, all the charge nurses, all the managers, all the directors and I made such great friends. They weren't just colleagues—they were people I cared about. Still do. You know when you're in the trenches of sorts you learn to be compassionate and kind to your coworkers and build relationships. 

On frailty: 

Frailty is all about your vulnerabilities but it's also about your strengths—it tells us what can you still do, so when you add that to the picture it just creates a lot of complexities for the system. 

You need to ensure that people maintain their functional baseline. We know at a level five (on the frailty scale) you can still walk on your own. You can do things for yourself we shouldn't do for you in the healthcare system: get you up, get you moving, get you mobilizing. You don't lay in bed all day; you can do all your personal care in hospital there's certain things that we need to keep you doing that mimic your home environment so we can get you home. 

On life: 

Life is short. Everybody would probably say that but a close friend died--Kitty Connell (a director at the QEII) passed away two years ago. It will be two years this summer, and you know these are lessons that make you realize that if you want to do things you need to get out there and do them. Life is fleeting. Anything can happen. I saw that in the ED: we would say it to each other often, “Ohh that person got ready for work, shaved or did their hair, and they're not going home today.” It's a big reminder that anything can happen on a day-to-day basis so that's how I live my life now. I don't take it for granted, because it's easy to do that. 

On retiring: 

I had great joy in my job. I found joy every day and enjoyed that bit whether it was with the housekeeping staff or the VP level…I think everybody deserved unconditional positive regard and I tried to bring that to the role. 

This has just been my day-to-day for so long. And I know good things are coming: I'm going to art school and I'm going to the American Culinary Institute to do some cooking and baking classes. I've got a lot planned, but I will miss everyone.  

Photo of Karen Nicholls.