How did you get into nursing?

I was ready to study physical therapy at San Francisco State University when my mother told me if I was going to school in San Francisco, I’d have to live with my grandmother. I wasn’t sure about living with my grandmother, but wanted to stay in health care so I switched to nursing at San Jose.

I’ve been at City of Hope for 17 years, starting out as the director of medical oncology. During the early ’90s, when everything was downsizing and managers were taking on three and four units, I added hematology, oncology and outpatient pediatrics. In 1997, I became the director of ambulatory care and that changed my nursing career.

Ambulatory care nursing was a new experience for me, but it was not the challenges of supervising that drove me into my new position. It was the design of the building, which had numerous workflow issues such as not being able to get a gurney through the door. I got to know the project administration department when I asked for workable changes.

Then when I was looking for something to escape from ambulatory care, they said I’d be perfect for the project manager job because I knew buildings from a nursing perspective.

What do you do?

I’m now a project manager for building a 144-bed, 347,000-square-foot hospital composed of single private rooms with state-of-the-art equipment and technology.

I look at operations, efficiencies in workflow and monitor trends both inside and outside our facility while working with architects, engineers, project mangers and the health care team.

All the furnishings, medical equipment and interior finishes are my responsibility. Sometimes the design is just not possible to build the way it was planned so I give the team input about the change consequences regarding workflow and safety.

Designing this hospital had several phases. The first was to interview everyone to see the functional requirements and how they were connected. The second was to make sure the space was adequate and that necessary equipment, door hardware and sinks were in the correct places. Then the architects and engineers continued with what is called the contract document phase, coordinating the space with medical equipment, furnishings, electrical outlets, gas and mechanical requirements.

We have positive air pressure in our facility, for example, which means two doorways. They wanted to put a 7-foot hallway between the doors. I pointed out that one couldn’t even put a bed into that space let alone a nurse and a bed, so they made it longer.

Part of my role also is public relations, where I can get excited about our cutting edge projects, but sometimes I’ll just hand out earplugs and offer encouragement.

I’ve also been involved in several remodels. Recently, we remodeled the inpatient pharmacy, but above the construction was the pathology department and they couldn’t read the slides because of the vibrations from the remodeling. I worked with the contractor to do the vibration work during off hours so no one was bothered. We had to keep the construction going without interrupting the important work here at City of Hope.

What type of equipment trials have you worked on?
Just about everything: beds, mattresses, anesthesia machines, OR lights, stretchers, chairs. We recently built a cardboard mock-up of a patient’s room and had 150 staff walk through it. We got suggestions on space improvement, one of which was to increase the size of the sink, which they said wasn’t big enough to wash their hands. It was great to get the feedback from nurses and we made the changes before we built the building.

We are now in an ongoing trial testing of specialty mattresses: Accu-Max by BG American and Atmos Air MRS by KCI, among others. That is fun.

What do health care providers most frequently request?
Change, it’s the hardest thing about any building project in that people always think of something they forgot. The biggest challenge is convincing a provider that the way it is being built is fine and that the impact of the change may be too great for the project.

Greatest challenge?

Technology changes so rapidly that we are always behind. It takes about seven years to design and build a hospital in California, what with the permits and all that goes into it. One can never keep up with current technology. It changes faster than we do.

Anything to add?

It is really fun and challenging to make an impact on the nurse’s environment such as having a lot of natural light. It’s important to see what’s going on outside with 12-hour shifts. We want a building that’s flexible enough to survive over the next 50 years.