The Dynamic Edge of Capability

From Dietitian to Nurse Practitioner to Startup Director

Meet Hannah Lowe

Hannah's energy jumped from the screen, only lessened by the hush we tried to have with her daughter sleeping in the next room. With our time zone differences, Hannah graciously gave part of her evening to our conversation after the long day at work she referred to as “a labour of love”.

Having met Hannah in the Humans in Healthcare community, I was excited to understand why and how a Dietitian became a Nurse Practitioner and then a Director in a health tech startup.

What I discovered was a force of nature, a woman with an unshakable resolve and a heart full of compassion.

Nourishing Interests

Hannah's career began in the world of nutrition, fueled by a fascination with food chemistry and a desire to make a difference in people's lives. She speaks fondly of her time at the University of Tennessee, where she pursued a degree in nutrition and discovered her love for clinical dietetics.

During her dietetic internship in Dallas, Texas, she realised she liked two things: being an administrator, which she found during her food service rotations, and all things critical care nutrition. 

But after landing her first practice role in rural Virginia off the back of the 2010 economic recession, she began to feel a sense of restlessness. She was proud of her work as a Dietitian, but she couldn't shake the feeling that there was something more.

I wasn't challenged. I wasn't great at outpatient dietetics. I was not the sports dietitian. I had always struggled with my own weight. So, I wasn't exactly the role model on TV. But then I loved the ICU.

At this point she considered doing medicine or nursing.

I can sense the weight of this realisation as Hannah speaks. It's a feeling I know all too well, the nagging sense that there’s something more to grow into. It's a feeling that can be both daunting and exhilarating, a call to action that demands to be answered.

Having realised this 'more' within clinical dietetics in many ways, I was curious as to why Hannah didn't pursue the path of a senior specialist dietitian.

She highlights that the difference in scope of practice between states in the USA meant that in the Southeast at the time, there were many more limitations on autonomy and decision-making in patient care, even at the senior specialist level. She would have needed to move to the northwest.

She also indicates the influence of her mum being a nurse.

A Bold Leap Into Nursing

So, for Hannah, answering that call meant taking a bold leap into the world of nursing. She enrolled in one of the top direct-entry NP programs in the country, fully aware of the challenges that lay ahead, including two more years of full-time study.

The mountain of student loan debt, the intense workload of her first NP job, the long hours spent caring for the sickest of the sick – none of it deterred her. She was determined to make a difference, to touch the lives of patients in a way that she hadn’t been able to as a Dietitian.

Her first role as an NP was in a federally funded health centre, specifically within psychiatric primary care, where she saw 26-30 patients per day.

It was so much harder than I thought because in the US, it's basically the sickest people who have zero resources, and you were there to help them. There is no better way to start my career, though, and I had a fantastic physician collaborator.

She highlights the value she gained from working at the top of her scope of practice, utilising much of her clinical dietetics knowledge. But this role left her so emotionally drained that Hannah decided to look for another less taxing role after a short time.

Those decisions are hard. You know you are where people need you, but the strain it places on your well-being makes it so difficult to do long-term or perform at your best all the time.

This meant a retail NP role in a pharmacy store was well suited to a period of reprieve. It served its purpose before Hannah and her now-husband decided on a geographical change, which brought an intentional role change that would suit family planning.

This next clinic role involved better working conditions but also opportunities to develop some skills in business operations, including marketing and leadership, which Hannah took full advantage of for the time she was there. 

Challenges and Adaptations

A familiar feeling of having limited clinical challenge in her role led her to decide to get a nursing practice doctorate. This 'adventure', as Hannah aptly describes it, was a way to discover and fuel her interests in the strategy workstream including systems and innovation with the support of an amazing nurse practitioner mentor. 

But when COVID hit, the ability to adapt was certainly tested.

I was pregnant with my one and only child, and my doctorate work was based in a rural part of Alabama where I live. The goal was to work on some actual nutritional and family lifestyle changes in a rural, underserved school. But I had to pivot quickly, which ultimately helped me graduate, but the project didn't pan out as I'd hoped.

Like so many of us, COVID was a catalyst for change in ways we may retrospectively appreciate but at the time, found very challenging.

Hannah would have ideally gone into teaching and academia post-doctorate. Still, a bias towards earning your stripes through a certain amount of practice years before you're accepted meant that the door was closed where she lived. Hannah’s great speed of professional development, oddly, seemed to have put her at a disadvantage.

So she took time to consider her next moves after putting some roots down with her family. She considered consulting, which she'd dabbled in before, but soon discovered a job posting – a remote diabetes NP position at a metabolic health startup.

Hannah admits she had no idea what she was getting into when applying.

On a whim, I had no clue. There was not an internet presence for this company. But I met the chief medical officer and was like, okay...This is fascinating.

Taking the NP startup role was a leap of faith, a gamble on an unknown company in an unfamiliar industry. However, it was also a calculated risk that Hannah was willing to take because she believed in the mission and the potential for impact. She also knew her dietetics expertise was relevant to infuse into her role given she had still maintained her license.

Within the startup, Hannah quickly established herself as a valuable team member. Her clinical expertise, passion for innovation, and ability to think creatively made her a natural fit for a leadership role.

When a colleague vouched for her potential, Hannah was promoted to a Director role, her most recent position, which allowed her extend her influence, making a meaningful difference in the lives of patients and providers alike.

I directed the advanced practice clinical operations, meaning I ensured that the nurse practitioners and physician assistants had what they needed to succeed. Then I did a lot of cross-collaboration, which has really been what I'm passionate about.

It's a role that has required Hannah to wear many hats – clinician, leader, innovator, strategist. But it's a role that she embraced with enthusiasm and a deep sense of responsibility. The challenges she's faced head-on have included those often associated with startups, such as the incredible pressure to perform and scale at a speed whilst ensuring every clinician 'dances in harmony', so to speak.

Hannah points out how essential it is to factor this in when considering working for a startup.

If you want to do the same thing every day and want the same narrative, it would be a disaster because your day is never gonna be the same as the last. Someone's always going to be a little bit upset about something. So much of your day is spent remembering that shared goal and showing up with your expertise daily.

The Hunt For The Edge Of Capability

As I listen to Hannah describe her work, I am struck by the sense of purpose that infuses every word. This is not just a job for her. She describes her professional life as a hunt for the edge of her capability. For the innately driven, such as Hannah, the edge of capability is not a fixed boundary but a moving target that shifts with every new experience and achievement. 

As Hannah reflects on her own evolution, she speaks about how she's been focusing on crafting a career path that honours her inner drive and expertise. For Hannah, personal growth has been inextricably linked to her professional development. She credits a leadership coach's support to help her discover her strengths and weaknesses, communicate more effectively, and lead authentically.

As she has cultivated self-awareness, resilience, and a commitment to lifelong learning, she has become a more effective leader, compassionate caregiver, and impactful change agent.

It's a sentiment that resonates deeply with me. Growth, after all, is rarely comfortable. It requires us to step outside of our comfort zones, to confront our own limitations and biases, and to be open to feedback and criticism. It's a process that can be painful at times, but it's also incredibly rewarding.

Hannah's desire for growth, excellence and mastery are traits that facilitate the reality the she will never reach the edge of her capability as there will always be something to learn. But that does not deny her and others like her in healthcare the ability to always find meaning and fulfilment in the here and now.

Her journey from Dietitian to Nurse Practitioner to startup Director highlights the impact one can have when one dares to dream big and work hard to make those dreams a reality.

I am grateful for the opportunity to have met Hannah. She offers a great reminder that no matter where we find ourselves on the path of life, there is always room for growth, for learning, and for making a positive impact on the world around us.

Hannah's Wisdom

1. Look inward and be introspective about who you are and what you want at different stages of your life. Take the time to listen to yourself and trust your instincts, even if they lead you down an unconventional path.

2. Find something that brings you joy in your work, even if it's not what society considers the "dream job." True fulfilment comes from aligning your values and passions with your professional pursuits.

3. Cultivate your personal life and interests, as personal development fuels professional growth. Make time for the things that bring you joy and help you to recharge.

If you are keen to explore which direction in healthcare suits you to hunt for the edge of your capability then…

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