A bit ago, I wrote a piece on my time walking the halls of Hollywood Presbyterian Medical Center, chronicling the hospital environment during a Paragon® Denali go-live. I teamed up with Geoff Nau, Paragon’s Chief Nursing Officer, and shadowed him as he met with and worked alongside clinical and administrative users, ensuring they had all they needed to continue the good work with this updated system.

I’d known Geoff before the hospital visit, and had worked with him on blogs and other supporting pieces. But that day in the hospital, our conversations were splintered by opening elevator doors and clinician-focused problem solving. I got fragments about who he is and a wide-scale view of his philosophy on nursing and how health IT can help keep clinicians functioning at optimal levels. All these tessellated pieces finally came together when I hopped on the phone with him. Below is our conversation.

Alex Berge: As you might remember, when we were at Hollywood [Presbyterian Medical Center], I saw you and your team in action, but you and I never seemed to complete a conversation.

Geoff Nau: That whole trip was a whirlwind. A good kind of whirlwind, but still. We got a lot done. We’re extremely proud of that team.

Alex: I remember you starting to tell another nurse about your experience as a nurse, and I sadly didn’t catch it all. Can you please tell me a bit about how you got into nursing to begin with?

Geoff: Let’s go back a bit, then. For a long time, I was a photographer. I lived all over the country, from Alaska, to Brooklyn, to Tempe, Arizona. I was living paycheck to paycheck. That lifestyle worked for a while. I have no regrets. But then 9/11 happened.

A lot of people talk about that day, but for some reason, 9:03 a.m. is embedded in my mind. That was the time the second plane hit, and I’ll never forget it. At that moment, I knew I needed to do something. I didn’t know what that something was going to be, but I knew the life I was living wasn’t going to continue to work.

Alex: It was that stark? Like a switch flipped for you?

Geoff: Absolutely. Exactly. I remember as I drove home that day, I heard on NPR that pediatric patients were being sent to Canada because there was a shortage of nurses. I remember exactly where I was when I heard that. I remember exactly how many clouds were in the sky. I thought, “I wonder what it would take to be a nurse?”

That night I shared that thought with a friend of mine named Doug. He’s not the type to normally give life-changing advice, but he said, very plainly, “Why don’t you just go volunteer at the hospital?”

So, I walked into a local hospital, said I wanted to volunteer, filled out some paperwork, got a polo shirt. Three days later I was pushing patients through the halls. That Saturday I was rocking babies in the NICU.

That Sunday morning, I went to the emergency department and was helping in triage. A patient came in, and a male nurse met him at the door. He took him back to what I would later learn was a trauma bay. I watched that nurse and thought, “This is exactly what I want to do.” That was it.

On November 16, 2001, I quit my job. On November 18, I put my house up for sale, moved into a van, and applied to nursing school.

Alex: Wait, a van?!

Geoff: Oh yeah. One hundred percent! Of course, eventually I got out of the van, but I tell you that because that’s just how I am. I’m all or nothing.

Alex: What I really like about your story is that, looking back, you embraced many of the core values Altera talks about today. You saw something that needed to be done, took action, contributed, gave your time. And it sounds like you found a lot of fulfillment through that process.

Geoff: Without question it was the right move. It honestly felt automatic. Being a nurse, specifically a pediatric nurse, truly informs who I am today. I know how that sounds, but I can’t lie.

Alex: Eventually you end up working for Altera. Where did the shift happen from working at the bedside to recognizing that healthcare IT could have a broader impact? How did your experience as a nurse drive your move toward what you’re doing now?

Geoff: I never looked at it through the lens of IT. I always looked at it through the lens of bedside nursing. I still do. Nursing allowed me to concentrate on one patient at a time. During that same period, the hospital was transitioning from paper records to electronic systems.

I never looked at it through the lens of IT. I always looked at it through the lens of bedside nursing. I still do.

Alex: What did you see during that transition?

Geoff: In a word: Gaps. The technology was helping us care for individual patients, but it wasn’t necessarily helping us care for populations of patients. We were approaching things with a one-size-fits-all mindset, and patients were starting to fall through the cracks.

For example, there’s a significant difference between caring for a four-year-old Type 1 diabetic and a sixteen-year-old Type 1 diabetic. Yet the workflows didn’t always recognize those differences.

I kept seeing situations where I thought, “We’re dropping the ball.”

People would explain how the system was supposed to work, and I’d respond, “That’s not actually how it works in practice. This is how we have it built. This is how we use it. This is what pharmacy does.”

Alex: You got to interact with the software company? Like, you had that kind of access?

Geoff: I interacted a lot with the vendor. And, luckily, there was a vice president from the vendor who listened to me over and over. He finally said, “You should be working with me.”

I thought he was joking.

Then on July 2, 2010, he called me and said, “I was serious. Why aren’t you here yet?”

I started the next day.

Alex: And you’ve been doing this ever since.

Geoff: I have. It’s been a fantastic journey, too. It’s amazing to see everything come full circle.

I’ll leave you with this last thought: What gives me confidence about what we’re doing across all of Altera is that we are able to visit our clients. We are onsite to identify a problem or recognize an opportunity, and immediately call someone on my team or elsewhere to explain, in real time, what I’m seeing and trust that they’re going to take ownership and work toward a solution. Accountability is still our number-one priority.