I thought of retiring 10 years before I did. Although my work as an advanced practice nurse in critical care was mentally, physically, and emotionally challenging, I loved it-and most of the people I worked with. On balance, I got enough out of working to continue. I did, however, note instances when people I admired held on to their positions until coworkers wistfully discussed their leaving. I didn't want to be that person who "needed to go," and I made a pact with myself to stay vigilant for clues that it was time.
Several factors prompted me to set a date: a need to commit to extensive and expensive training to keep up with ever-changing clinical developments, pending changes in institutional leadership that lent uncertainty to the future direction of the workplace, a growing frustration with my inability to quickly process and retrieve information, and the arrival of two adorable grandchildren. And, although I could never prove it, I suspected my younger coworkers sometimes deferred to me as much for my seniority as for the merit of my contributions.
I knew how I wanted to leave. I was the type of worker who wouldn't do well with a phased-out departure. Adhering to a part-time schedule would be like trying to eat half a cookie. I wanted the minimally acceptable interval between announcing my departure and departing. It would be disheartening to be a lame duck and marginal to important work. Finally, I didn't want the customary going-away reception that would be planned to recognize my tenure at the medical center. I had attended too many of these to pretend that it wouldn't feel forced and awkward. In truth, I believed that the person leaving should take the opportunity to recognize those individuals who made the work so personally rewarding. For me, physicians and nurses would be almost equally represented in that group of special colleagues.
I decided to leave at the end of May 2011 and happily anticipated the first carefree summer since childhood. I planned and hosted a celebratory dinner the evening before my last day. It was all I had hoped for-a mostly lighthearted evening of humorous anecdotes and sincere expressions of appreciation for colleagues. I received many gracious tributes that night, but the one that meant the most to me came well after I was gone.
Nurses and physicians in critical care make scores of critical decisions every day. A major quality improvement initiative is a push to make decisions as evidence based as possible. Nevertheless, care delivery remains an art as well as a science. Sorting through options to identify and apply whatever is optimal is a constant challenge. A few months after I left, I received an e-mail from the ICU team of physicians, nurses, pharmacists, and nutritionists. They sent a message that they missed me and included a photo of the team on morning rounds. In the photo, they were all wearing buttons with my picture on them and the letters WWED (What Would Ellen Do?). It was the best tribute ever!