Melissa Hayden, MSN, CRNA: Embracing the Challenges of Moving from the Head of the Table to Head of the Department

Melissa Hayden, MSN, CRNA, Executive Director of Surgical Services at Jackson-Madison County General Hospital in Jackson, Tennessee, has a unique perspective on moving from her previous role as Director of Nurse Anesthesia/Chief CRNA to Executive Director this past June.

“I chose to practice anesthesia as it is truly an honor and a privilege to care directly for people during one of their most vulnerable times.  That is one of the main things that drew me to the profession,” says Hayden, a CRNA for 11 years. “My role has changed now in that I am able to care for our department so they can better care for others.”

Hayden still gives anesthesia as her schedule allows, but on a much more limited basis. “Not giving anesthesia was non-negotiable for me at this stage of my career,” she says. But there are only so many hours in a week, and six months into her new role as head of Surgical Services she still finds herself fulfilling the role of Director of Nurse Anesthesia/Chief CRNA.

“Our organization had a hiring freeze on director-level positions that was not anticipated. Serving simultaneously in two higher-level positions while still striving to be in the OR as much as possible has been challenging to say the least, especially in my season of life,” says the mother of two young children. “But I have been able to find balance with the help of the amazing members of our anesthesia department who are always willing to pitch in to make things work.” She admits to sometimes feeling like she’s “not doing either role the way that I would really like to in a perfect world” since her attention is divided between the two positions, but she is confident that she “will be able to make progress for both departments in the coming year once the Director of Nurse Anesthesia role is filled.”

“Most CRNAs are type A, and I’m no different,” she says. “I want to do both jobs well and represent our profession well. I like a challenge.”

A self-described “Enneagram type 1, wing 2” (i.e., personality test lingo for “a type A with a penchant for helping others”), Melissa decided to pursue a career in nurse anesthesia because “I have always loved helping people and thinking out of the box, solving puzzles. Anesthesia uniquely combines those two strengths,” she says.

Melissa credits a number of CRNAs for being key influences in her professional life. One in particular was Pam Austin, CRNA. “Pam is the mother of my husband’s childhood friend and was gracious enough to allow me to shadow her while I was in undergraduate nursing school at Union University in Jackson,” Melissa recalls fondly. “She showed me what anesthesia could be like with my admittedly limited nursing lens and perspective at that time.” Fast forward to the present: “It’s funny how things turn out.  I have had the privilege of practicing anesthesia alongside Pam for over a decade now.  I cannot overstate how impactful CRNAs like Pam are who take the time to give nursing students a glimpse into the world of anesthesia or to pour into new CRNAs to ensure that they have the opportunity to grow into their professional potential,” Melissa says.

After earning her BSN, Melissa worked in the critical care unit at Parkwest Medical Center in Knoxville while putting her husband Chris through law school at the University of Tennessee.  Melissa intentionally chose this unit as it allowed her to care for patients immediately post-CABG, which would provide helpful experience should she pursue a career in anesthesia.  The time spent at Parkwest in the CCU only solidified Melissa’s planned career path. “I have always enjoyed a challenge and anesthesia provides that in spades.  However, in addition to that, the autonomy, critical thinking, and single patient care really appealed to me,” she says.

Since becoming a CRNA in 2012, Melissa has worked at Jackson-Madison, a 621-bed hospital serving the greater community of West Tennessee. Her first position was as a staff CRNA taking call and providing anesthesia for cardiovascular surgeries. She gratefully credits Molly Wright, DNAP, CRNA, for being “another role model along the way both in practice and in education.”

“I absolutely loved that season of my career and intended to continue providing anesthesia in that role until I retired,” Melissa says. “I only moved out of that role because I felt like I could help our department by stepping up as a manager to solve some of the problems we were experiencing at that time. I firmly believe that there are times in life in which we are directly called to step up and be a part of the solution instead of waiting around for someone else to do it.  Also, have I said that I love a challenge?”

Today, as Executive Director of Surgical Services, Melissa oversees anesthesia at Jackson-Madison’s 62 anesthetizing locations, including 47 operating rooms across the main hospital, orthopedic hospital, and surgery center, as well as numerous perioperative and sterile processing areas.  “I enjoy working with other leaders in our organization to work through opportunities, advocate for change, and represent our profession well while serving our patients efficiently and effectively,” she explains.

When asked if it was always her aspiration to one day go into the business side of the profession, she replies bluntly, “Never! I would have never dreamed or picked this. I’ve always loved numbers, math, and problem-solving but planned to stay in anesthesia proper for my entire career. But never say never. I love seeing how all the pieces line up—expenses, charges versus revenue, payer mix, stipends, etc. It’s fascinating! Every professional experience that I have had has shaped me into a better provider and leader.”

Melissa also loves having the opportunity to continue providing anesthesia and hopes to do more of it once she completely relinquishes her responsibilities as Chief CRNA. “I feel like giving anesthesia puts everything in perspective, realigns priorities, brings issues to light, and allows for necessary organic conversations with surgeons and staff,” she says. “Getting to care for patients is refreshing and keeps me current. It’s why I am ultimately here in this space.  As weird as it is to say, a day of providing anesthesia completely recharges my batteries.”

Her advice to nurses deciding whether to pursue a career in anesthesia is to “really look into your ‘why.’ What is your motivation? Why do you want to pursue anesthesia? Will that still ring true for you in 10 years? 20 years? 30 years? Shadow and truly understand the good, the bad, and the ugly.”

And for CRNAs interested in moving to the business side of the profession, her advice comes from an equally introspective place. “Be more intentional than me!” she enthuses. “I plan to pursue my MBA or MHA once I have fewer work obligations. However, I think the details truly matter. Be faithful in the little things, be fair, and be transparent whether to colleagues or business associates.”

Melissa and Chris, who is a civil defense attorney, live in Jackson with their two “strong-willed” children, Max (5 ½) and Blythe (3). “Having them keeps me honest with my time management which truly helps with my work-life balance,” Melissa says. She enjoys making art, dabbling in design and interiors, attempting to garden, and cooking in her spare time.

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