Farewell From Mark Holder

I have been in healthcare for over 45 years, nearly 43 of those years here at Ivinson. While working at Ivinson I was able to complete a Bachelor’s in psychology, zoology and physiology, and nursing. I was also able to work on a Master’s in neurophysiology and neuropsychology.

Ivinson has provided me with so many opportunities and avenues of growth from starting off as a certified surgical tech, medical/​surgical tech, Emergency Department Tech/​EMT, to becoming a nurse, educator and leader.

I worked in the Emergency Department (ED) for 30 years. During that time I worked as frontline staff, then becoming department educator, and later becoming the department director/​manager. As the emergency department educator, I was able to become an ACLS instructor, PALS instructor, TNCC instructor, ENPC instructor, CATN and CATN2 instructor, and a CPI and Mandt instructor. I achieved both the Science of Nursing Award and was a Norman S Holt award nominee. I was also given a commendation by the White House for work with the Secret Service in preparation for a Vice Presidential visit.

I was able to work as a co-manager for Emergency Preparedness and was able to work with the State Department and National Preparedness Team to work on a multi-stage, multi-agency Anthrax drill. Additionally, I was able to give community presentations on the swine flu epidemic (for those of you that were around to remember that outbreak).

I transitioned to work as Director/​Manager of the Behavioral Health Unit for nearly 10 years, during which time our unit was recognized nationally by the Joint Commission for the development of a teen suicide text line. I was able to help co-found the Albany County Suicide Awareness Committee/Board-now known as Laramie Cares. I was a member of the Peak Wellness Board, sat on the County Title-25 committee and was able to testify with the Wyoming Joint Judicial Legislative committee about Title-25 legislative improvements. During my tenure on BHS I was also able to become a QPR Suicide Prevention Instructor and regularly lectured with the Laramie Law Enforcement Crisis Intervention Team about crisis de-escalation.

Finally, after a brief hiatus from my liver transplant, I have been granted the opportunity to come back to Ivinson. Doing Clinical Education in the HR/​Education department, I have returned to teaching the alphabet classes (ACLS, PALS, BLS), teaching the EKG class, crisis de-escalation in the GN Residency program, and Mandt. I have also been able to do guest lectures with the University of Wyoming Nursing School and with the WWAMI medical school.

Ivinson has become a home to me. I have hired, trained and worked tirelessly with many colleagues who have become lifelong friends, even family to me. I have had so many friends: physicians, nurses… those who have gone on to be physicians, surgeons, nurse practitioners, physician assistants, nurses, paramedics/​EMTs, pharmacists, and even attorneys. I have worked with physicians that I admire and that inspired me in my own practice as a nurse. 

I have experienced, as have so many of my friends, the untimely deaths of colleagues that I have worked with. Experienced the tragedy of death of our patients from trauma, cardiac arrests, succumbing to cancer and suicide. Yet, I have also seen the triumph of life saving medicine and skill for the healing of both the body and the soul. Healing comes in all sorts of ways, some expected and some unexpected. I have had the great fortune to work with so many patients over the years, such that there is not a day when I go out into the community that I see someone with whom I have worked with either as a patient, a patient’s family member, or a colleague. There is a young man to this day, who I see occasionally in the hospital or in the community. Whenever I see him he will always tell those around him or his children how thankful he is that I saved his life when he was a child. He came to the ED in respiratory failure and I was his nurse. We were able to rescue him from the brink. For this, and so much more, I truly feel blessed.

Working at Ivinson actually saved my life, in that by utilizing the laboratory blood screening provided to all hospital employees, identified a liver problem that ultimately sent me down a pathway that resulted in a life-saving liver transplant as a result of cryptogenic liver disease. I will always be grateful to those of my friends that came to me without any question to offer to be tested for being a living donor. (Dan and Tom), you will always hold a special place in my heart for your altruism even though I ended up needing a deceased donor liver transplant. I will also forever be grateful to Dr. Ullrich, who referred me to the Transplant Center at Anschutz, you truly saved my life. I am also grateful to the many staff that supported me and my wife during this time with donated hours and prepared food brought to our home.

Working at Ivinson also saved my wife’s life twice in the ED as they carefully evaluated her and treated her for what can only be described as life threatening sequelae from COVID. If that were not enough, several months later, they were able to quickly identify a hemorrhagic stroke, treat my wife, and transfer her to the nearest Neuro-Intensive Care unit and then subsequent neurological rehabilitation. Today, she is back home, continuing to improve and thriving.

So what lessons have I learned or what would I want to share as I take my leave? 

The first thing I have always carried with me as I started my nursing career was told to me by a nurse that worked in Refugee Nursing. He told me: 

“Always remember as a nurse to use your assessment skills and to use the scientific method because as a nurse your observations are as important as the physicians in the course of care and treatment of your patient.”

The second thing is:

We need to see our patients through beginner’s eyes. 

I remember early on in my nursing career, I saw a patient that was well-known to us at the time. He had a known history struggling with alcoholism. He came to the ED mid-morning on a hot summer day all sweaty, complaining of epigastric pain. My initial thoughts went to thinking he was suffering from alcohol induced gastritis. The Emergency Department Physician at the time said ​‘let’s take a step back and hook him up on the cardiac monitor.” On the monitor it showed he was having a huge inferior MI (heart attack). His pain was due to his MI, and his sweatiness was really diaphoresis from his MI. Had we not looked beyond our preconceived notions, we would have missed it. We were able to treat him appropriately with fibrinolytic and get him transferred to get some stents placed. Now, I teach every opportunity I get, to start from the beginning and look at our patient’s as if for the first time. 

Third, I always teach in my Mandt class: 

Every patient we see with a physical condition has a psychological condition.

Think, the patient coming in with chest pain, think about their fear of mortality, of their future, of their ability to work or provide for their family. Every patient we see with a psychological condition has a physical component as well-think about a suicidal patient that perhaps has overdosed. 

Fourth, I always like to share with new graduate nurses: 

It takes courage, compassion, and connection to develop your career. Always speak your truth, even when it takes courage. Find that place of compassion for your patient and for yourself. I often can’t imagine what our patients are going through. And finally, make those connections with your colleagues, your patients and your leaders. It will always help you to stay the course. Always look for opportunities to grow and be a life-long learner.

Nicole Rooney (CNO) and I were talking a few weeks ago. She shared a conversation she had with a friend of hers. Her friend said that she noticed that Nicole always introduced herself as a nurse whereas her friend said that she never would introduce herself as an accountant or whatever the job was. I think that is so true. We in the healthcare field identify ourselves by what our profession is not by the job. Even though I will ultimately be leaving my time here at Ivinson, I will always be a nurse and a healthcare professional.

It has been said that if you find something you love to do you will never work a day in your life. It has felt that way for me with my time at Ivinson. I can’t believe the time has gone by so quickly. Yes, there have been hard times, long nights, periods of emotional distress and physical exhaustion but it has never truly seemed like work for it is a profession I truly love!

I will terribly miss you all and my time at Ivinson but am excited about this next phase of my life. I hope by chance that I might see you sometime along with my other friends in the community!

All my best,

Mark