An exclusive interview: The nurse leader advocating for meaningful innovation in healthcare

It's funny, nursing wasn't in my initial career paths growing up. I wanted to be a pediatrician, because being the eldest of five boys you kind of grew up taking care of your younger brothers, whether that's rescuing them with Heimlich’s maneuver or carrying them home from a fall or an accident at school. Interestingly enough, as I was thinking about career paths my junior/senior in high school, my mom told me a story and said, “gosh, if I wasn't so busy raising five boys, my dream would have been to go into nursing,” and that planted a seed in my head. So in looking into it - you get to spend more time with patients, it was certainly less school and at the time you don’t want to spend too much more time at school. This was the mid- to late-90s. There weren’t a lot of men in nursing. I only had six men in my whole nursing school class, so it was still an emerging population. Growing up you're already caring for your siblings, and now I can actually get paid for it, so it just felt natural and I’ve been blessed ever since. My first foray into the career was in emergency nursing, so that's my background, but I like to tell people specialty-wise, nowadays there's the experience side of it, and the clinical-ness of it, but a lot of it is what matches your style, your personality. The emergency department matched my personality and my work style, because I'm kind of all over the place. Again, raising five siblings means you're ready for anything, so it felt very natural being in that setting. What I tell people who want to come into the emergency department is that your hardest shifts are often your best shifts, because that's when you really come together as a team, and figure it out. I spent almost 12 years in the emergency department in various roles ,from frontline ED nurse to educator and management, and really fell in love with the educational pieces of it. One day while teaching a class - I think it was a charge nurse class or an ACLS class - somebody said, “gosh, who would be crazy enough to lead the implementation of this electronic health record in 21 hospitals?” And when people want crazy and daring, I guess they come to the emergency department. My adventure in nursing is fascinating, because I find myself being at the right place at the right time, so I had the opportunity to help co-lead the Epic implementation in 21 hospitals starting in 2006. It was going so well, the reward for good work often is more work, so it was, “hey, let's go twice as fast now that we've gotten on a roll.” That's when my career went from what was emergency nursing into what we now call nursing informatics, because initially, it was just going from paper to the computer, but then you start realizing, “wow, this is a lot of data we're putting into the system. What can we do as far as outcomes, quality, safety?” Look at what Amazon, Google, Facebook is doing with data and information - what if we could do that in healthcare and turn our data into good, and predicting falls or injuries? That was exciting for me, and that's what really brought my academic career in.

Dr. Rayne Soriano is a registered nurse, educator, and nurse leader with a lifelong career in healthcare. He currently serves as the regional director for operations and nursing professional practice at Kaiser Permanente Hawaii promoting professional development, innovative informatics, and co-leading the Magnet journey. He earned his doctorate in nursing science and healthcare leadership from U.C. Davis in California. He’s taught at several institutions, and right now works as an adjunct professor at the University of San Francisco and a visiting professor at Chamberlain University teaching master’s level informatics courses. His career started in the emergency department, and he brings those foundational skills to his everyday work and leadership style.

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