Authors: Lauren Pulling
Twyila Lay MS, GNP, ANP-BC, ACNP-BC is an Acute Care Nurse Practitioner with the Department of Neurological Surgery at the University of California, San Francisco (CA, USA), and served as the Program Coordinator for the Brain and Spinal Injury Center at San Francisco General Hospital and Trauma Center (CA, USA) for 15 years. Twyila is a renowned speaker with a passion for Neuroscience Nursing, nursing leadership and for the care of the neurotrauma patients. This month, she takes up her new role as President of the American Association of Neuroscience Nurses (AANN). Twyila is married and has three rescue dogs, and in her spare time she enjoys running, hiking, snowboarding and cross-county skiing.
In celebration of International Women’s Day, we spoke to Twyila about her accomplished career, gender challenges in nursing, and finding that elusive work–life balance.
What does your typical working day involve?
I get up at 03.50, out of the house by 04.30, and arrive at work at 05.15. I begin with a pre-round until 06.00, and then start formal rounding on approximately 25–30 patients each day. Throughout the day I consult on patients presenting with acute traumatic injuries or patients presenting to the Emergency Department who need neurosurgical consultation.
Additionally, I manage patients admitted to the Intensive Care Unit and the medical-surgical units. I also meet with families, providing updates and patient and family education. Because we are a teaching hospital, I also provide teaching for the residents, nurses, etc. While managing patients on the inpatient setting, on Tuesdays I see patients in the neurosurgical clinic and on Thursdays I see patients in the concussion/TBI clinic. My day ends around 18.00–18.30 and I get home around 19.15–19.30.
I also have my volunteer work with the AANN and the American Association of Neurological Surgeons, which is completed throughout the day.
What led you to becoming a neuroscience nurse? Did you always want to work in nursing?
As a child, I actually wanted to be a racing car driver. So I guess it is only fitting that I work in neurotrauma. I was the first person in my family to go to college. In fact, not many people that I went to high school with were on the college path.
As I had to work to put myself through, I wanted to enter with a definitive plan. My stepmother suggested nursing. She said, you will always have a job, there is diversity, and you can have a flexible schedule that will allow you to pursue other passions and/or have a family. Prior to her suggestion I never thought of nursing, nor did I really know what the job entailed. However, I knew that I liked the sciences (I had a fantastic but hard advanced chemistry teacher in high school and I remember the best part of the class was when we dissected the frogs and cats looking at the anatomy).
Although I kind of fell into nursing, it was the one of the best choices I could have made. I really enjoy the critical thinking and decision making that comes with caring for very complex patients. But the greatest reward is the opportunity to be with families following an injury to one of their family members. It is such a special and intimate opportunity to share in both their grief and their joy in recovery. When else do you get the opportunity to laugh, cry and provide support during probably one their most vulnerable times in life.
You have worked in nursing, research, and have recently been appointed as the new AANN President – congratulations! What do you regard as your biggest achievement to date?