From IT to RN

If computers haven't quite taken over our lives, they have taken over our jobs. Computers transfer orders and often fill them. We have automated monitoring and billing, and the bills themselves are paid by electronic fund transfer. A 2007 report from Maxima Medical Centre in the Netherlands indicated that computer programs could replace physicians and nurses for most patient counseling.

Most of us know someone who started in a conventional healthcare career and shifted over to information technology, but Bruce Ryon, now with Kaiser Permanente, went in the opposite direction. After a career in computers, he returned to school to become a nurse.

Bored by the required courses for his MBA in arts administration, Ryon began taking courses in computers. His career in technology changed with each major advance: He was involved with personal computers in 1978; LANs in 1979; voicemail in 1981; email in 1982; voice recognition in 1985; graphic design on PCs in 1986; online services in 1987 (when he started his own online service); multimedia in 1989; the internet in 1991. When the online service failed, he went to Apple, and then to Media Metrix, as a VP. The company, Ryon explains, helped to fuel the dot-com boom and bust. It was involved in web ratings, and provided investment banking companies with ratings that influenced decisions about which companies to take public. But when investors decided that it was about making money, not about audience, the companies that looked good, but had little revenue, "went belly-up."

So in 2001, Ryon found himself, aged 50, unemployed in an industry that focuses on youth. And he was job hunting at a time when the entire technology field was going through a shake-up – there were few jobs around, and many were being closed out, or downgraded. Even in good times, he found the average job duration of a Silicon Valley VP was about 18 months, with six months to a year between jobs. That was when Ryon realized it was time to leave.

Reinventing Himself as a …

"For a bunch of different reasons I looked at getting into medicine," he says, "I had always kept up with the latest developments in medicine, so I had had a continuous interest and curiosity about it since childhood."

But nursing also seemed a good fit. "My interest in nursing started in high school when I was in the first male candy striper group at San Jose Hospital in 1967. I was pulled to work in surgery as a volunteer orderly. I developed an early interest in becoming a surgeon, but I thought the surgeons I worked with were arrogant and humorless. But I loved the nurses because of their compassion and intelligence. And people I knew in medicine said nurses did a wide range of things, not just at the bedside."

Also, jumping forward from the late 1960s to 2003, it had become much more acceptable for men to become nurses. Career opportunities for nurses were growing as nursing found its professional base. And Ryon noted that the nursing shortage shows no signs of abating, there is less ageism in healthcare than in tech, and nurses earn a decent living in his home state of California.

So Ryon decided on nursing, and enrolled in the UCSF's Master's Entry Program in Nursing (MEPN), which is a program for people with Bachelor's degrees. Students go through an accelerated RN process, and then into the Master's program.

While in his RN prep year, Ryon became fascinated with neurology and spent clinical time on a neurology floor. At the end of his first Master's year, he worked at the UCSF Memory & Aging Clinic. His focus was on the genetics of dementia, and his goal was to become a clinical nurse specialist in gerontological genomics.

Blending Computers and Nursing

But at the beginning of his second Master's year, Ryon's advisor received a call from Kaiser Permanente, asking for a graduate nurse with database management experience. In the computer field, Ryon's experience made him overqualified for the jobs that were open. But for Kaiser, he was an unexpected and very welcome find. Ryon's familiarity with computers, particularly with demographics database mining, meant that Kaiser could not only proceed with the project, but also upgrade it.

Kaiser's study database consists of patients suffering from dementia, and is mainly concerned with the care of dementia patients. Because Kaiser is an HMO, the medical histories on the patients are particularly complete, so this may be the most thorough study of dementia yet performed. For example, Ryon reports that 60% of the dementia patients have hypertension, 25% have diabetes, and 20% have heart failure – all factors that lead to poor neuron perfusion (oxygen and glucose exchange within brain cells). They hope that their work may lead to improvements in inpatient management of patients with dementia, who typically have a much higher incidence of confusion, delirium, and behavior episodes.

"You've seen the stuff in the magazines: 'walking prevents dementia,' 'reading prevents dementia,' 'education prevents dementia'," Ryon says, "I'm coming to the conclusion that brain activity prevents dementia, but you have to use every part of your brain. It's a matter of making sure that the whole brain gets an adequate blood supply, and if any section of the brain doesn't get an adequate blood supply, that's how dementia starts. That's a guess, of course, we haven't got enough to reach a conclusion, but it's where I think we're heading."

When asked about his former and current fields, Ryon says, "Do I wish I had made a billion dollars in technology? Yes. I didn't, but it was fun and very exciting while it lasted. I was there for one of the great changes in the way we live and the way we interact with each other. But nursing is rewarding in other ways, as well as being a lot steadier work, and if we can find some clues to the causes of dementia, and find some ways to prevent it, that will be at least as exciting as streaming video or voicemail. At least!"

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