Meet Kirby Williams

From a young age, Kirby knew she wanted to be a nurse. Her childhood experiences with caring nurses during hospital visits left a lasting impression on her. Those moments of kindness and compassion were lifelines during difficult times and she was determined to make a difference in people's lives, just as those nurses had done for her. "I want to do that for someone else," she remembers thinking as a young girl, her heart set on a path of care and service.

From Childhood Dreams to Nursing Reality

For many of us in healthcare, the call to serve others runs deep. It's a spark that may have ignited in childhood like Kirby or much later, propelling us through years of rigorous education and training. But as we all know, the reality of working in healthcare is often far more complex and challenging than our five-year-old selves could have imagined.

As a young nurse, Kirby thrived on the fast-paced intensity of medical-surgical units and trauma care. She loved being there for patients in their most vulnerable moments, offering not just clinical expertise but also comfort and compassion. Yet amidst the adrenaline and action, she couldn't shake the feeling that something was missing. There was a deeper need she yearned to address, a part of patient care that seemed overlooked.

"That's what leaned me into doing psychiatry and focusing on that," Kirby explains. “You could focus on many different areas as an NP, but I decided I was going to get my NP but focused on psychiatry and mental health."

It was a decision driven by a keen awareness of the gaps in care she witnessed every day – the trauma patients whose psychological wounds were left unaddressed, the revolving door of readmissions without adequate mental health support. Kirby knew she wanted to be part of the solution, to fill those gaps and provide holistic care

Catalysts for change in our healthcare careers often stem from encountering problems that we feel compelled to solve. With endless issues to address, it's an overwhelming reality that our ability to identify these problems grows with exposure. 

Narrowing the Caring Focus

So Kirby enrolled in a Master's degree program to become a Psychiatric Mental Health Nurse Practitioner (PMHNP). She continued working as a registered nurse while attending school, juggling two 12-hour shifts a week with her studies. "I was able to make it work," she recalls, "I worked on the weekends so I could leave the weekdays open for school." It was exhausting, but her passion kept her going.

After graduating and becoming certified in 2011, Kirby faced her first major challenge: finding a job as a new NP with no experience. She applied to numerous positions, even considering relocating for work, but most employers were looking for candidates with prior experience. Each rejection stung, chipping away at her confidence.

Undeterred, Kirby persisted in her job search, and after six months, a former classmate reached out with a lead. "I just got a job at this other place, and they're looking for another person. Do you want me to connect you with them?" her classmate asked. Kirby jumped at the opportunity and soon landed her first NP position in an inpatient psychiatric unit.

Working in the inpatient setting was a steep learning curve. Kirby managed a heavy caseload within the geriatric psychiatry unit. I was curious about her role within an inpatient multidisciplinary team so I asked how an NP functioned within this setting. In Australia, we have Clinical Nurse Specialists (CNS) and fewer NPs. Kirby explained,

She also reminded me that each state has its own rules and regulations for the scope of practice of a PMHNP, influencing the expectations held by both the Psychiatrist and other team members.

It's a dynamic that I've seen play out in various settings – the delicate dance of collaboration and autonomy, the push and pull of different roles and responsibilities. It's not always easy, but when it works well, it can be a beautiful thing – a team united in their commitment to providing the best possible care.

As a new graduate, Kirby was drawn to the idea of working in an inpatient setting. She believed it would afford her more time with patients, allowing her to learn on the go and reflect on her experiences.

Unlike the rigid time allowances of outpatient settings, the inpatient environment seemed ideal for her growth and development. It was a place where she could immerse herself fully in patient care, hoping to make a profound difference in their lives.

However, the demands of the inpatient setting soon revealed their downsides. Scheduling flexibility was nearly nonexistent, and Kirby often found herself "begging" for a day off. Additionally, she felt there was a ceiling to her career advancement within her organisation, and the realisation that her growth would likely be limited was disheartening. 

After three and a half years, Kirby realised a change was necessary. Seeking a better work-life balance, she decided to transition to outpatient roles, hoping to find more flexibility and new opportunities for professional growth. The decision was bittersweet, marked by the fear of the unknown and the hope for a more balanced life.

Kirby's first outpatient position was at a community mental health centre in Washington, D.C. She sought out this role because it offered a high-acuity patient population similar to what she had experienced in the hospital, but with the added support of a multidisciplinary team.

Yet even as Kirby found fulfilment in her work, she grappled with the systemic barriers that made it difficult to provide the care she knew her patients deserved. Limited time, scarce resources, and the constant battle with insurance red tape were realities that weighed heavily on her mind. "It was frustrating to see how these barriers impacted patient care," Kirby reflects, her voice tinged with the quiet frustration that so many healthcare professionals know too well.

As I listen to Kirby describe these challenges, I find myself nodding in recognition. These are the daily struggles that so many of us in healthcare face – the constant disparity between what we know our patients need and what the system allows us to provide. It's a tension that can leave even the most dedicated among us feeling burnt out and disillusioned.

After 14 months in the community mental health centre, Kirby decided to move back to her hometown to be with her now-husband. She took a position at a private practice, where she was the first and only psychiatric NP working alongside a team of therapists. 

While Kirby appreciated her work at the time, which had a medication focus where therapy was done by other therapists, she also missed the ability to dive deeper with patients and provide more comprehensive care. “I'd say outpatient has these challenges because when something abrupt or urgent happens in the hospital, everything's there that you need. In outpatients, you spend a lot of time connecting people to resources.” A familiar feeling for many who work in fragmented systems.

Balancing Professional Growth and Personal Life

Kirby's passion for precepting and mentoring NP students led her to briefly explore a role in academia. However, the heavy workload and long hours proved unsustainable. She found herself working 60-hour weeks, juggling multiple responsibilities. The exhaustion was overwhelming. After 14 months, she had to face the truth: "This isn't it."

It highlights what so many of us do. When one path doesn't quite fit, we find another way to make a difference. Kirby's resilience shines as she pivots yet again.

Kirby returned to clinical practice, working part-time at another community mental health centre. She gradually transitioned to full-time work and remained in this role for several years throughout the COVID-19 pandemic. The idea of starting her own business to support new psychiatric NPs continued to grow in the back of her mind, fueled by her own experiences and the desire to create a supportive environment she once yearned for.

Also during this time, Kirby became a mother, which brought about a profound shift in her priorities and identity. She found herself having to say no more often and prioritise her family's needs over work. 

Working a reduced number of days back from maternity leave became essential.

Kirby felt a mix of guilt and uncertainty as she navigated the new terrain of working motherhood. The guilt of leaving work early to be with her child, the uncertainty of whether she was doing enough at both home and work.

Balancing her dedication to her patients with the desire to be present for her child was an ongoing struggle. She also wrestled with the difficulty of taking time for herself when there was always more work waiting. "There were days I felt like I was failing at both," she admits, her voice softening with emotion.

But amidst the challenges, Kirby also found clarity. She realised that being a good mother and a good NP weren't mutually exclusive – in fact, they could inform and enrich each other. The empathy and patience she cultivated as a parent made her a better practitioner, and the fulfilment she found in her work made her a more present and engaged mother. "I learned that I could be both, and that realisation was incredibly freeing," she reflects.

It's a lesson that I've learned in my own journey – that the different roles and identities we hold don't have to be in competition with each other. They can coexist and even strengthen one another, if we allow ourselves the grace and the space to embrace them fully. Kirby's journey embodies this truth beautifully.

Yet even as she found her footing, Kirby couldn't shake the feeling that there was still more she could do to support her fellow NPs. She remembered all too well the sense of isolation and uncertainty she had felt as a new graduate, and she saw those same struggles reflected in the students and new NPs she mentored. The memories of her early career struggles were still vivid, and she was determined to ease that path for others.

Pioneering a Mentorship Program

And so, in late 2022, Kirby began to take concrete steps towards making her business idea a reality. She started offering paid individual consultations to NP students and new graduates to gauge interest and better understand their needs. The positive response she received confirmed that she was on the right track.

During this time, she also started seeing private patients about half a day a week in addition to working in the Community Health Centre one day a week. But as her business plan took shape, Kirby made the difficult decision to leave her community mental health center job and fully focus on her entrepreneurial venture. Her was voice tinged with both regret and resolve.

She continues seeing patients part-time in her private practice to stay connected to clinical work. But since October 2023, her primary focus has now been facilitating a mentorship program and professional development resources tailored specifically for new psychiatric NPs. 

Launching a business is never easy, and Kirby has faced her fair share of challenges along the way. From learning to create content and build a website to figuring out how to market her services, there's been a steep learning curve.

One of the biggest challenges Kirby faces as a new business owner is learning to set boundaries and protect her time.

Despite the challenges, Kirby remains committed to supporting and empowering new psychiatric NPs. She finds joy and fulfilment in seeing her mentees grow and succeed in their careers and in making a positive impact on both their lives and the lives of their patients. "I'm trying my best to help those PMHNP’s have a more confident start, a more supported start, a more encouraging start than I had," Kirby reflects. "Because even though I didn't have that, I realise what a difference that could make in a career."

As I listen to Kirby's story, I'm struck by the common threads that weave through so many of our journeys in healthcare: the idealism that draws us to this work, the challenges that threaten to dim our spark, and the resilience that helps us find new ways to shine.

For Kirby, the key lay in redefining her understanding of success and impact.

This shift in mindset was transformative, not just for Kirby's personal life but also for her career aspirations. She began to view her work through a new lens—not as a race to achieve some arbitrary metric of success, but as an opportunity to make a meaningful difference, one patient and one colleague at a time.

The impact of this approach ripples out in ways both seen and unseen—in the confidence of a new NP as they navigate their first job, in the renewed passion of a seasoned practitioner who has rediscovered their sense of purpose, and in the countless patients who will benefit from the skilled and compassionate care of the NPs Kirby has mentored.

Kirby’s Wisdom:

1. Don't do this journey alone - Find people, a community, and colleagues who are open to dialogue, connecting and even venting about the obstacles with you.

2. It's okay if you change your mind - Be open to the possibility that your goals and interests may evolve over time, and be willing to adapt your career path accordingly.

3. There is more than one way to have the career you want - There is no singular way to achieve career success. Explore various options, such as part-time work, passion projects, teaching, consulting, or running your own practice, to find what works best for you. This is your journey and your career, so it does not have to look like anyone else’s.

PMHNP Source Mentoring Program

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