Say YES! to opportunities. (The rest usually figures itself out.)

Juli C. Maxworthy | 04/18/2019

Seven important lessons life has taught me.

Juli Maxworthy

Her decision to become a nurse was driven by early exposure to nurses—some great, some not so great. She decided to be part of the solution in providing better healthcare.

Throughout my life, I have said yes to opportunities, even when I wasn’t 100% sure I knew what I had said yes to. My natural curiosity and supportive family, friends, and colleagues have given me confidence to know I could and would figure it out as I went along.

As with many of you, my decision to become a nurse was driven by early exposure to nurses—some great, some not so great. For me, it began when I was 4 years old and had surgery at the local community hospital to repair an unsightly umbilical hernia. Because I was placed in a cage out of concern that I might fall out of bed, I remember the scary experience distinctly. My fear was compounded by the fact that I had a 5-year-old roommate who was vomiting the entire time and didn’t need a cage. Consistent with hospital practices many years ago, my parents weren’t allowed to stay with me, but I was monitored carefully by the nurses.

Thirteen years later, following a skiing accident, I was a patient again—in the same ward. That time, one of my legs was in a full-length cast, but I wasn’t in a cage. Unfortunately, the nurses forgot about me while I was on the bedside commode for over an hour. My roommate, who had just had her tonsils removed, was of no help. These early healthcare experiences made me determined to be part of the solution in providing better healthcare.

First, a Boy Scout
When invited to “tell us something unusual about yourself,” I often respond by saying I was a Boy Scout before I was a Girl Scout. Because I was interested in healthcare—and boys—I joined a search and rescue group affiliated with the Boy Scouts. This usually gets a few laughs and gives me the opportunity to describe how, back in the day, we were allowed to recover human bodies from abandoned mines and participate in simulation activities to help us prepare for the nascent U.S. Emergency Alert System. As high school students, we were moulaged, placed in an industrial park to simulate victims, triaged, placed on gurneys, and often transported by helicopter to a local hospital, all without parental knowledge or consent. Our parents were just glad we were out of the house!

To save money for college, I began working as an administrative assistant at age 14 and became an emergency medical technician (EMT) during my senior year of high school. Moving from administrative assistant to working in an ambulance was very exciting. Serving as an EMT in a community where we needed a police escort because of gang violence provided me with a great learning experience outside my normal comfort zone. Almost 30 years later, I returned to the same area as the district hospital’s vice president of quality, risk, and patient safety to help provide optimal care to that underserved community.

Way outside my comfort zone
Juli Maxworthy with National Student Nurses AssociationDuring my first years of college, I worked in a nursing home as a certified nursing assistant. That provided additional learning experiences—again, way outside my comfort zone. During that time, I become involved with the National Student Nurses Association as a regional representative and later served on the California board. I enjoyed visiting colleges and providing support to nurses who, like me, were challenged with working to pay their own way through their nursing programs.

After college, I became staff and charge nurse in the ICU of the same hospital where I had been a patient at ages 4 and 17. After 12 years of working night shift—and regaining consciousness—I became involved in our hospital’s shared governance program, which led to my nomination and election as chair. Around this time, my first husband was diagnosed with cancer and passed at age 46 with our two children still in elementary school. My mother had died a few years earlier from cancer at age 56, shortly after my son was born six weeks prematurely. These major life-changing events, among others, have helped me realize how precious life is and how important it is to say yes to opportunities.

To have the impact I wanted on patient care, I realized I needed additional education, so I enrolled in the graduate program at Holy Names University where Fay Bower, PhD, RN, FAAN, past president of Sigma, was dean. There I earned two master’s degrees, one in nursing administration and one in business administration.

Sigma and Nu Xi at-Large Chapter
While I was in the graduate program, Bower suggested I become a leadership intern in Sigma’s Nu Xi at-Large Chapter. It sounded interesting and would help me learn more about Sigma, so I said yes. For those of you who know Fay Bower, if she suggests you do something, you should do it. That experience provided me the opportunity to work on various projects, including successfully applying for our Chapter Key Award. I became president-elect in 2007 and president in 2009.

With my additional education and skills, I quickly advanced to director of quality and patient safety at my hospital. But after serving there more than 20 years, I felt it was time to leave and stretch my wings.

In 2008, I received my Doctor of Nursing Practice degree in health system leadership with a concentration in quality and patient safety from the University of San Francisco. From there, I accepted advancing positions in various hospitals in the San Francisco Bay area, including vice president. In 2013, after five years of teaching in an adjunct capacity, I accepted a full-time, tenure-track assistant professor position in the School of Nursing and Health Professions at the University of San Francisco, where I have served as chair of the Healthcare Leadership and Innovations Department and teach in the Doctor of Nursing Practice program. Recently, I received tenure and promotion to associate professor, due in part to my service to Sigma.

Ten years ago, based on my DNP project work on innovation, I started WithMax, a consulting company that assists clients with various quality improvement and healthcare simulation projects. My current husband and I have grown this company into a successful medical writing company, with writers and clients across the country. I especially enjoy working with smaller biotech companies that are developing novel pharmaceuticals for life-threatening diseases.

Losing isn’t always losing
In 2009, while serving as president of Nu Xi at-Large Chapter, I applied for and was accepted to run for the office of treasurer on Sigma’s board of directors. I ran against the incumbent, Richard Ricciardi, who will become president of Sigma later this year. I knew it was a huge leap to throw my hat in the ring—but, as I mentioned earlier, I have a great support network so went for it.

I didn’t win the election, but the opportunity to stand next to Robin Newhouse, PhD, RN, NEA-BC, FAAN, dean of Indiana University School of Nursing, and Robin Toms, PhD, RN, NEA-BC, associate professor at Texas Woman’s University, for two days made the whole experience absolutely worth it! The connections that I made are still intact 10 years later.

If you express an interest in getting involved, Sigma will find a way for you to have an impact. Soon after the election, I was asked to join the board of Sigma Foundation for Nursing as chair of the Fellows Committee. For the next biennium, I was honored to serve as the board’s chair. Working with staff members of Sigma Foundation for Nursing was a great way to learn more about Sigma’s subsidiaries, which has aided me in my current role on Sigma’s board of directors.

In 2013, I ran for Region One coordinator because I wanted an opportunity to work with chapters throughout my region. Two terms in that role taught me that regional coordinator is one of Sigma’s toughest jobs, but it is also one of the most rewarding. Sigma’s chapters are its heart and soul. Great work is occurring at the local level. My hope is that more chapters will engage in the Chapter Key Award process to highlight the work they do for their members and the profession of nursing!

Toward the end of my second term as Region One coordinator, I applied for a position on Sigma’s board of directors, stating that I was interested in a director role but willing to take whatever position the Leadership Succession Committee thought best. They believed I would be a good candidate for vice president, the position I now occupy.

Sigma has a place for you
So, for those of you who can’t decide which position to apply for, recognize that the Leadership Succession Committee comprises amazing nurse leaders who, like you, have the organization’s best interests in mind and will help find a place for you to serve this wonderful organization. The first, and sometimes hardest, part is saying yes and putting yourself out there. Based on my own experience, I know that once you get past the hurdle of submitting your name for consideration, Sigma will find ways for you to serve.

After our youngest child left for college, my husband and I started volunteering for Paw Fund, an animal rescue organization in the Bay Area that provides first aid and low- or no-cost vaccinations as well as spay and neutering services. It treats hundreds of companion animals of low-income individuals at its monthly clinic, and volunteers visit encampments of homeless people. Through Paw Fund, we have fostered more than 50 dogs—many are new moms with pups. We currently have four “failed fosters.” It has been a wonderful way to volunteer locally.

My time on Sigma’s board of directors has been filled with doing valuable work and building relationships, and I feel honored to serve this organization as vice president. In that role, I participate in several key task forces focusing on various initiatives that are shaping the organization’s future. Liz Madigan, PhD, RN, FAAN, has been doing a fabulous job in her role as chief executive officer, and it is amazing how quickly she has become fluent in the workings of Sigma. We are also fortunate to have Beth Baldwin Tigges, PhD, RN, PNP, BC, as president. Her calm, professional demeanor makes her a joy to work with, and her years of Sigma experience have been a great resource. We are working hard to ensure that we will be the global organization of choice for nursing in the years to come.

Seven lessons
My life experiences have taught me many important lessons, including the seven listed below. They are not particularly novel, but they are important to me.

  1. Get to know yourself—if you don’t, you can’t successfully lead others.
  2. Every day is a gift.
  3. Be grateful for even the smallest gesture—and pay it forward.
  4. Spend time with people you care about.
  5. Give back in ways important to you.
  6. No one can take away your education.
  7. Say YES!

When asked “Why Sigma?” I respond that this is the place where I am a nurse first. There are many specialty organizations, but Sigma is the only one where being a nurse is my most important credential. Love, courage, and honor are truly the heart of both Sigma and nursing! RNL

Juli C. Maxworthy, DNP, MSN, MBA, RN, CNL, CPHQ, CPPS, CHSE, FSSH, vice president of the board of directors of Sigma Theta Tau International Honor Society of Nursing (Sigma), is associate professor at the University of San Francisco School of Nursing and Health Professions, San Francisco, California, USA, where she directs the school’s healthcare simulation certification program.

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