"As far back as I can remember, I was always interested in science, but nursing was never part of my vocabulary," Fong said. "Growing up, I had a complete lack of understanding about the multifaceted world of nursing. It’s almost embarrassing to admit, but when my mom tried to get me thinking about becoming a nurse, I was completely turned off by the thought. I remember telling her, 'I don’t want to just give shots and empty bedpans'. Boy, was I clueless."
Fong, who was raised in the heart of Los Angeles, California, noted that interestingly enough, her great aunt and the mother of one of her best friends were nurses, yet she never asked about what the content of their roles entailed. Her own mother remained a constant source of encouragement.
"When I moved to Fresno to start nursing school, I was driving around the neighborhood close to campus," she said. "Out of the corner of my eye, I saw the Kaiser Permanente sign on a building. It was comforting to see something familiar. My parents had health insurance through Kaiser, so I went to a Kaiser pediatrician for my care. I clearly remember sitting in a waiting room wondering what happened behind the closed doors. In addition, I remember my pediatrician telling me something about there being a lot of opportunities at Kaiser Permanente. I would never have guessed that there was a Kaiser in Fresno, and later learned that the facility offered outpatient services only. I went to the Personnel department, and looked over the list of job descriptions. Of course, most were clinical positions that required experience, but then I saw the job description for a part-time position as a Messenger/Driver in Material Services. This sounded like a great job to me – delivering supplies, lab specimens, medical records, and mail to the various Kaiser clinic office buildings throughout the area, and the hours would fit with my school schedule. I got the job as the only female driver in the department, and loved every moment. I got to drive a delivery truck with a lift gate on the back, and I remember getting a lot of stares from other drivers when they saw me behind the wheel."
To Fong, the job became more that just delivering supplies. As a new Kaiser Permanente medical center was being built in the Fresno area, she was actually participating in the start-up of the facility's ambulatory clinics by accomplishing tasks such as setting up the supply closets and exam rooms. These foundational tasks were also giving Fong a valuable foot in the door advantage for furthering her own career.
"When my school schedule changed, I transferred to a job as a file clerk in the medical records department," Fong said. "As the last two semesters of school were nearing, I had to make a decision between transitioning to work experiences in a hospital setting or continuing to work as a file clerk at KP, but I had a slight dilemma. I knew that the new hospital was going to open a couple of months after my graduation date, and I definitely wanted to be a part of that start-up. After my pediatrics rotation, I got a job working the night shift as a pediatric nurse intern at the local Children’s Hospital. Since I also knew that I would probably have a better chance of getting hired as a nurse for KP when the hospital opened because I was already in the system, I continued to work at KP as well."
Looking back, Fong said it is hard to believe all the progress she has made in knitting together the fabric of her career. Much of the clarity she gained about nursing was learned on the job.
"Throughout nursing school, the instructors always stressed the importance of getting a solid background in Med-Surg," Fong said. "While many of my classmates already seemed to know what specific area of nursing they wanted to go into like OB or Peds, I didn’t. I had some pretty unique experiences during all of my clinical rotations – always learning something, even if it was learning that I probably didn’t want to work in that area. I had some great role models at Kaiser Permanente, and did know that I eventually wanted to work in an administrative capacity."
While most of Fong's classmates were working as nursing assistants or student interns at the local hospitals, she continued in her capacity at Kaiser Permanente.
"Some of them, as well as my boyfriend at the time questioned my choice in work, and even tried to convince me to get a ‘real’ job working with patients," Fong said. "I figured that once I graduated from nursing school and started my nursing career, I would have plenty of opportunities to work with patients. Besides, I really wanted to get my foot in the door at the organization that I had heard so much about. During the summer breaks from my undergraduate studies in Biological Sciences at UC Davis, I worked the night shift at a small animal emergency hospital. This fit in with most of the other extracurricular activities during those first three years of college that revolved around animals, such as large animal radiology and research in rabbits on animal viruses. During my last year, however, I signed up for a volunteer internship at a local hospital in the Oncology unit where I would be able to spend time with the patients, and run small errands for the staff. The thought of working with human patients versus animals was a little out of my comfort zone, since I was pretty quiet and shy…..and my biggest anxiety was about not knowing what to talk about. Some of those patients taught me to just be myself, and at the end of the internship, I discovered that I was able to talk with people after all."
Fong took advantage of other opportunities to hone her interpersonal skills during her nursing studies, and credited a special nurse with opening her eyes to the multi-faceted world of working nurses.
"Towards the end of the year of my graduation from college, I volunteered with Hospice in Davis," Fong said. "Ardys was the registered nurse I was linked up with for my first patient. She completely changed my paradigm for what nursing was all about and the opportunities that the profession offered. She told me about flexible hours, opportunities to work whenever I wanted in whatever setting I chose, ability to change specialties if I got bored with one or wanted to expand my knowledge, and most importantly, about being able to touch the lives of people in their most vulnerable moments."
Fong also acquired the skills to facilitate the nuances of communication and building rapport with patients. By her own admission, Fong's grandparents spoiled her and spoke mostly in English to her and her siblings. She later found that her latent bilingual capabilities would be put to the test.
"A patient I was assigned to [at Hospice] spoke very limited English," she said. "I had to learn what methods of communication worked best…..and got a lot of giggles from her two young kids as I tried to muster up enough of my broken Chinese to ask whether I could make her some soup. What I discovered along the way, was that silence was ‘ok’, because actions translated without language. I only had about a month to work with her entire family in getting financial assistance, making funeral arrangements, and finding other support resources. I remember getting the late night call from Ardys that my patient was moments away from death. She told me, 'your patient is dying and her family wants you there'. I was present during the wailing cries of my patient’s sister and husband at the bedside, the portable oxygen machine motor humming loudly, the commotion of her sister and kids trying to get the clothes and shoes the patient would be wearing into the afterlife onto the quivering body. I cried along with the family at the time of her death. Throughout the entire time, I watched Ardys in action, calm and in control, taking charge with her clinical expertise when the time was right, and providing comfort care for the patient and compassionate support for the rest of the patient’s family. I think it was at that moment when I made up my mind to become a registered nurse."
When it came to balancing her work at Kaiser Permanente with her nursing studies, Fong took on the characteristics of an acrobat performing on the high-wire: attempting the difficult task of balancing it all and living to talk about it.
"Life was a little hectic at that time, and it seemed as if I was living out of my car going back and forth to school, work, and the library," she said. "My managers in Material Services and Medical records were pretty accommodating for my school schedule. Because my job posting was for part-time and on-call hours [which were] not set hours, I was able to pick up extra hours during the summers and holiday breaks, and adjust some of my days when I needed time off for exams. My schedules never really seemed to clash that much. I was fortunate that I was able to work my school schedule for lectures and clinicals around my work at KP. I also took advantage of the tuition reimbursement program that KP offered to all employees, [which] definitely helped with tuition and books. After graduation, I got a full-time staff nurse position at the Children’s hospital in Med-Surg/Oncology, but I still kept on-call hours as a file clerk at KP. People thought I was nuts – they could not understand why I remained in Medical Records when I had my nursing license. The new Kaiser hospital opened in 1995 with a Med-Surg unit that could accommodate both adults and pediatrics, I was hired to be a staff nurse primarily for Peds, but was cross-trained to take care of adults. I was still working for the Children’s hospital, but soon had to make the choice between the two. As I became increasingly involved in new hospital activities such as JCAHO preparation, I eventually made the decision to quit the job at the Children’s hospital to devote all my time to KP."
After about a year and a half in the role, Fong transferred to the Outpatient clinic as the Charge Nurse for Adult Medicine and Urgent Care. She then transferred back to the inpatient setting and became the Assistant Nurse Manager for Med-Surg, eventually becoming the Director of the Med-Surg units.
"I then found a new opportunity at the Northern California regional level as a Nursing Outreach Manager for the Central Valley service area," she said. "This unique job revolved around nurse retention at KP.
My next job was as a Project manager for Northern California Kaiser Permanente HealthConnect, involving the implementation of the electronic medical record system across the organization."
Fong noted that while her greatest support came from the Kaiser Permanente organization, she also benefited from the intangible support of the people she worked with there and her loved ones.
"Having all healthcare services under one roof allowed me to meet and interact with people from all areas and professions, [from] marketing to administration to physicians to nurses to medical assistants to pharmacy to lab," Fong said. "There was such a variety of role models that I got to interact with throughout the medical center. I received a huge amount of moral support and motivation from those that knew I was in nursing school. The mail clerk was my personal cheerleader and introduced me to other staff going to school; the librarian was my literature search and nursing text guru; the nurse managers kept asking when I would be done and whether I needed any help; and the medical group administrator let me practice taking blood pressures on him and introduced me to leadership/management activities. Kaiser has provided the foundations for many of the skills I have today ranging anywhere from basic computer software classes to Epic certification; new manager training to leadership academy events; legal and compliance inservices to mock survey techniques; the list goes on and on. With the national offices being in Oakland, and my home being in Fresno, my work takes me all over the place. It's been hard to go back and forth, and my husband's had to be very supportive. It's not easy. We both golf, so we go together on weekends and socialize with other friends who golf. This renews us."
Throughout the course of Fong's career with Kaiser Permanente, she said she has changed from being "pretty shy to a couple of marks above shy," and recognizes that while some of her experiences were not comfortable, it has been necessary to take a risk to do some tasks that could further enrich her goals.
"Because of the various roles I have had at KP, not only did I get to find out what happens behind the closed doors, but I have gained knowledge and skills unique to operating in a large and complex organization," she said. "Knowing when to listen and when to speak, and learning that if you hold on to your dreams, anything can happen. I have fine-tuned my people skills and have been able to acquire a vast repertoire of role-modeling behaviors. Most importantly, I have gained a ‘big picture’ perspective of the power of being a registered nurse, and a great appreciation for the uniqueness of all the peers, colleagues, and patients that have influenced me along the journey. I know that all the jobs I have held at KP have incrementally built upon each other to successfully launch me to my current position as the Patient Care Services Practice Leader for KP HealthConnect at the National level. As we are moving towards uncharted territory into a high-tech world of electronic documentation, knowing operations from the ground up put me in a position to really influence the nursing and ancillary practice strategies and standards of tomorrow. In the 15 ½ years I have spent at Kaiser Permanente, I have been in eight different job roles. There is just a wealth of opportunities for nurses out there – exactly as Ardys had explained to me previously."