Doctorate of Nursing Practice student, Carla Stanley

[00:01] Michelle: I had the best conversation with Carla Stanley about her journey as a DNP student. I have to admit I was a little intimidated when I saw all the letters behind her name, but I had no need to be. She's delightfully down to earth. We discussed the types of programs, the application process, and the blood, sweat, and tears required wired to achieve such a goal. My respect and admiration only grew when I learned the why behind her multiple board certifications. Carla strives to be the expert in her field. I love it when she said, "If you can see me, you can be me." And she's using all the tools in her toolbox: her education, certifications, credentials, professional memberships, networking, and very soon, her Doctorate of Nursing Practice degree to improve health outcomes among black, indigenous, and people of color. I can't wait to read her Capstone project publication. In the Five-Minute Snippet: What are sisters for, other than to be spoiled? Here is Carla Stanley.  Welcome to the program.
[01:31] Carla: Thank you so much for having me.
[01:33] Michelle: Michelle, I'm excited to talk to you because you are a DNP student. I just don't know a lot about that process, and I think you can bring a lot of information and insight to me and to our listeners. So I'm just really excited to get started and learn all I can about what it means to be a DNP student and then what your goal is in terms of when you achieve that.
[02:06] Carla: Sure, absolutely. It is exciting and challenging at the same time. As you mentioned, I am a DNP student. That stands for Doctorate of Nursing Practice at UCSF. And so we do a great deal of work with I'm a part of cohort number seven for UCSF, which means that there were six cohorts before me, and there are 28 DNP students in my current class and will be in that program for the next two years. What it means to be a DNP student is for me to enrich my education and my knowledge base, because when you advance to a doctorate degree, which is the highest level of education, then that continues to express not only your commitment to nursing but to whatever healthcare organization or industry that you embark on in your career. I've already gotten my undergraduate degree, so you'll need that clearly, to obtain a doctorate, you'll also need a Master's. And so there are programs that will combine your bachelor's with your Master's, and then you can move into your doctorate. Or if you already have a Bachelor's, you can combine a Master's to move into your doctorate, but you will have to have those credentials before you get started. I also like to let people know that sometimes we mistakenly call the Ph.D. the DNP and the DNP the Ph.D. The Ph.D. student is a student that is all about research. So they're immersed in research. They look at issues in healthcare and they identify where we could do those things better. They research them, and that's how we get best practices, right? What the DNP student does is take that research information, they apply it in the practice setting, which is why it's called a Doctorate of Nursing Practice. They apply it in their setting in order to improve everything from health equity to health outcomes of the community in which they're serving.
[04:28] Michelle: Well, thank you for the distinction there because I think there is a lot of confusion around that and very soon going to be referred to as doctor. And how do you feel about that?
[04:43] Carla: I am extremely excited, number one because my mother has always called me doctor and I've had to say to her, Mom, I am a nurse, I'm not a doctor. And the world needs really great nurses and I want to be that. But my mother has always wanted a doctor and so she is going to get a doctor. But I also have a sister that has her law degree and that is a JD. So she has a Juris doctorate in the family as well. But for me personally, everything that I've done so far in my career has culminated to this point, which is to help improve health equity and health outcomes, especially for disparate populations, right? And so I'll use all the tools that I have in my toolbox, which is my education, my board certification, my credentials, my networking, my professional memberships, all of those things I'll use in order to improve health care and health outcomes among black, indigenous, and people of color. So I'm really excited for my personal accomplishments, but I'm even more excited about the contribution that I'll be able to make or continue to make once I have this doctorate under my belt as well.
[06:12] Michelle: I'm right there with you. I'm excited for you. It's something that obviously a lot of hard work and planning has gone into it. And you started with a goal in mind and you knew what was required to achieve that goal, and then you set out to do it. And very soon it looks like you're going to have that. You talked about some of your certifications, and when I first saw your profile on LinkedIn, I had to take a deep breath because I went, oh, my goodness, this woman is very accomplished. Look at all those letters behind her name. So some of them, honestly, I didn't know what they were about. One of the things I'm interested in is your MBA in healthcare administration. Talk a little bit about that and why you decided to do that.
[07:09] Carla: That's a great question because that is one that I am routinely asked, maybe by every other individual that asks me. And as I was advancing in my nursing career and working in the acute care setting, which I've done for over 30 years in acute critical care setting, I started to advance in my roles, and I obtained my associate's degree in nursing from Purdue, and then I got my bachelor's degree from Valparaiso University. And at that time, I was moving up the ladder, moving my way up in my career. What I learned was that when you have to sit as your positions advance, as your span of control increases, you have to attend meetings where the individuals who are present in the room, they're not all nurses, right? You have the Chief Financial Officer, you have the Chief of Human resources, you have the Board of directors, you have the CEO oftentimes who is not a nurse or a healthcare individual. So what I quickly learned was in order to be able to advocate for the staff and for the units that I had oversight over, I had to be able to speak the language of the individuals who had the resources that I needed. So the Chief Financial Officer, he doesn't want to hear he or she, hey don't want to hear a lot of she-she-fru-fru. They want the numbers. They want to know if it brings value to add. They want to know why it matters, why it should be purchased, why it should be purchased over someone else's purchase. So for me, I thought, well, okay, then I need to be able to speak the language when I have to fill out a rationale, when I have to discuss a budget, when I have to request more FTEs, which are full time equivalent anything at all, I needed to be able to speak the language other than nursing. So I decided that because I was getting where I was going with my BSN, my Bachelor of Science in nursing, I thought, why not? Then get your master's in business. So I then got my MBA, which is my Master's in Business Administration, but it had HCM focused, so healthcare management. So I was able to continue my journey in nursing, but I was able to better advocate for those clinical areas by being able to understand the dollars and cents behind that as well. So that's why I chose that particular degree.
[09:51] Michelle: I will say that as a staff nurse, as a charge nurse, there's a huge disconnect between what nurses do and what executives do. And I love how you saw that and you bridged that gap and said, all right, if I'm going to talk apples and they're talking oranges, I'm going to need to know how to talk oranges. And you did that. You're a bridge. And like you said, you're able to advocate for what you need for your unit, for your nurses, and that's admirable. Talk a little bit about your backstory. I saw that you've been in an RN for 30 years. You have a lot of experience in acute critical care. But talk a little bit about how you got into nursing and your background in nursing?
[10:51] Carla: Sure. So for me, believe it or not, it started at a very young age. My father, who's now deceased, was a minister. So I'm what you would call in our community, a PK, a preacher kid. And so we all had roles in the church. My siblings and I had a little brother. Unfortunately, he's now deceased, but he had an ear for music, so he could play every instrument. So he was the instrumental person. I had a sister, she could sing well, I can't sing my way out of a paper bag, so I wasn't going to be leading the choir. Right. I had another sister who was really good at being an usher, and I had several other siblings who did the same thing. And so for me, I seemed to fall into the customer service, the care delivery part. So I did everything for my dad from I had the head for business as well, so I would keep the church books. I doubled as the secretary and treasurer at the same time as I was going to nursing school and finished. Because that's what got me into caring for people, because I saw the needs of our community and I also saw where the church was filling in the gaps that we see so often in the communities and where to go for resources. And who do you call in the middle of the night for prayer and for other resources as well? And so it is that that drove me into nursing. Once I got into nursing, I realized to advance, you don't typically advance with just an associate's degree. So then I determined if I'm going to be a nurse and if I'm going to be serving in the church and representing the community, then I needed to continue to grow and develop myself as a professional. And so that's why I then got my bachelor's degree as well. Because unfortunately, when I went to school at Purdue, they didn't offer a bachelor's at the time, so they contracted with another university, and that's why I went to VU. Then, realizing that I needed to keep going, then I embarked on, okay, so what else do I need to do to be recognized as an expert and as a professional nurse? I then joined multiple professional organizations, which is how I eventually came to be with the American Nurse Association of California. And for the 2022 cohort. I was named as one of the policy and advocate fellows for the American Nurse Association of California. And so then I said, okay, so I need to continue on my journey. As I was advancing, I would accept new roles, move things around on my plate, take new jobs, greater responsibility, more span of control, allowed me to be creative and to support nursing. Then I thought, okay, so what else is needed? What are they asking for in the job market? And on those applications, what are they looking for? For nurse leaders. And it became the masters, then it became the doctorate. It's quickly becoming the doctorate to hold certain executive positions. And so that is why my education continues, but then I have to look even further and say, okay, what else is needed to be seen as an expert? Also, it's important for me to be a role model for any individual that's looking to go into nursing, especially those who are in disparate populations, those individuals who are vulnerable, and those individuals who struggle to get into nursing school. I also like to think, if you can see me, you can be me. And so then I started on my journey for board certification. And so those are the things that you see behind my name. Those are multiple board certifications where you have to do a lot of things, everything from volunteer to sit for exams that are three, five, or even 7 hours long to get your board certification, which indicates you are an expert in that area.
[15:12] Michelle: Yeah, I'm a big fan of certification, and I came from a unit where I had a manager that was very much like you and set the bar that she required that we're all going to have our board certification in NICU care within the first three years of starting in the NICU. And I'm sure that you've heard that a lot of nurses don't think that these things matter. Thankfully, a lot of nurses do think that they matter, and they are getting their board certification in their specialty. And I think there's a lot of literature that says that it does matter in terms of care on the unit, in terms of the trust of the patients and how you feel about yourself. It feels good to be the best in your specialty.
[16:19] Carla: I'm sorry.
[16:20] Michelle: No, I think nurses should wear those letters very proudly.
[16:25] Carla: They absolutely should. And I won't say that in my career. Probably early on, I did question that. I mean, there is a cost, right? We all realize that there's a cost to being board certified. But what I will tell you is, especially as a DNP student, having to read a lot of articles, a lot of peer-reviewed articles, the data does show and support some of the very things that you mentioned. You do feel good about yourself and what you bring to the table when you do whatever it is you're doing with your nursing degree every day. And that's huge. That's important. It must start there. Do you feel good about the contribution that you're making? The next thing is, where there is education, I believe there's certification, and where there's certification, there are experts, which means you are seen as an expert. For example, I have one daughter, she lives in New York. Her and my son in law, and I only have one grandson. So when she was first born, my daughter and I had a conversation about how to find his pediatrician. And I talked a lot about board certification, and I wanted a board-certified pediatrician in pediatric care. And so now she has a greater appreciation. She loves his doctor. And I do the same thing for nursing. I'll tell you that it doesn't minimize a nurse when they don't have board certification, but I can certainly tell you it does maximize a nurse when they do have board certifications, because it says they went that step further to make sure they were sound in their teaching, in their education, in their advocacy for patients as well. So these are experts, and because they're experts, you can attach that to the delivery of care wherever they are and to the outcomes of the patient population that they're serving. And so me, myself, two of those, what my mother called, alphabet soup behind my name. One is the NEA-BC. And that stands for Nurse Exec Advanced Board Certified. And then the other one is NE-BC, that's nurse exec board certified. That comes from the ANCC. The American Nurse Credentialing Center. So what that tells people is I am board certified. I'm multi-board certified as a nurse exec. And the FACHE is I am a fellow with the American College of Healthcare Executives, which makes me board certified in healthcare management. So I've got healthcare covered from nursing to administration. But I will tell you that board certification is definitely the way to go. And if you don't believe me, take a look at any recent job application or any job description and look down at the requirements. You'll see now that we're seeing the word board certification used more often in those job descriptions.
[19:44] Michelle: Yes, I see that on many of those. And I'd love that you made the distinction that it doesn't minimize the nurse to not have that certification, but it does maximize, and I think a lot of nurses are intimidated by the work involved, by the cost, the upkeep, all of that. And I think your message is so strong to just don't be afraid of it, you're going to need it at some point. You're going to appreciate it. I think that's a great message.
[20:21] Carla: Thank you. And I will add, if you don't mind, I want to encourage nurses to move towards board certification because if you look at the literature, depending on where you read and who you read in 2044, the population in the United States is 50% of the population is going to be either racially or ethnically diverse. And we're going to need a great deal more experts in healthcare. And board certification is what's going to be able to separate the nurse who has her degree and is doing a fantastic job to the nurse who we've identified, who's able to take care of the individuals. So we want to be able to make that happen, and I want to encourage individuals to do that.
[21:17] Michelle: Yes, absolutely. I second the motion. So one of the things that I wanted to talk about. I have two questions for you, and these came from my oldest brother, Chris. And Chris has had his DNP for about ten years. I have so much respect for him in so many areas of his life, his professional life, and his personal life. But we were talking about your interview coming up because of the fact that I was a little bit intimidated by like I said, all the alphabet soup behind your name. And he was very forthcoming. He said, relax, you're a professional. You're going to do great. And I said, well, what would you ask a DNP student since he's already been through it, right?
[22:17] Carla: Yeah.
[22:18] Michelle: And I saw what he went through. I saw the work and the time and the effort and the blood, sweat, and tears that he put in. But I had no idea about the curriculum, or anything like that. And so I said, what would you ask a DNP student? And he had a couple of things that he said he would ask, and I was not aware of these. So one of the things that he said is that nurses entering a DNP program, there's kind of a conflict or I guess a question that should they be bachelor prepared, or is any degree okay? As you said in the medical profession, if you're going to be a medical doctor, you can enter medical school with any degree. You don't have to have your bachelor's in nursing. So what do you think about that?
[23:14] Carla: So that's really interesting, and he's right, and that is a really great question. I'll tell you, there are probably a couple of different schools of thought, and I'm not the expert on that, but this is what I'm seeing, that when it comes to the American Nurses Association, the ANA, they moved were on the journey, clearly from moving from the associate's degree in nursing to the bachelor's degree in nursing. So right there, boom. That tells you they're looking for the BSN to advance in the workplace as well. Nowadays, to be a charge nurse or to move up from there, you certainly need to have a BSN. And I'm not saying we don't see people who are not getting where they want to go or need to go. I'm just saying what the research is showing for me is that the American Nurses Association and other places are looking for the BSN to be the undergrad. And so I do have my BSN, and also UCSF was looking for that as well. Now, I will tell you that I've noticed that they're not so strict, obviously, meaning colleges and universities when it comes to the master's degree because we just discussed a few moments ago that I have an MBA in healthcare. I don't have an MSN. So my journey, I'm still on the same journey with the DNP students because I do have a master's. And it did have a focus in healthcare. And administration, so healthcare management. So there was nursing components still in that MBA for me, but I don't know that they really want to get away from the BSN not being the entrance into nursing. I do think that BSN is probably here to stay, unless he knows something that I don't or he reads different literature. I am certainly open to that conversation anytime, but it seems like the BSN is what's here for right now, and that's the standard of practice to move or to advance in nursing, and that would seem logical
[25:29] Michelle: I turned the question around on him and I said, what do you think? When he said, some think that nurses would be more well rounded with a non nursing undergrad degree.
[25:48] Carla: Oh, wow.
[25:51] Michelle: He's a deep thinker, Carla, let me tell you.
[25:55] Carla: Sounds like it.
[25:57] Michelle: He's a character. I interviewed him on this program, and he was so fun, but like I said, I had to call him and say, hey, this lady is like, really out of my league. You need to help me on this. And he was very reassuring and said, you're going to do fine.
[26:19] Carla: And you are. Just to let you know that, because for me, when I am talking to anyone in healthcare, specifically nursing, for me, I see everyone as a colleague, and so it makes my discussions that much more rich. I can learn from someone, and I try to learn something every day. So you don't have to have my credentials. You don't even have to aspire to have anything more than you have right now. I can talk to anyone in nursing about nursing, and I guarantee you I'll walk away learning something, and I am hoping that I've enriched their lives as well with that conversation. So you're doing a great job, and thank you again for this discussion.
[27:06] Michelle: Thank you, Carla. I appreciate that a lot. One of the things that I saw when I saw your profile, I said to myself, this woman is a lifelong learner. I can see that because of all the steps that you've taken in your education, in your career, in your life, and I'm a big believer in that as well. I know my audience has heard me say this many times on the program that we can all learn from each other and we can all teach each other. And that's been my philosophy throughout my nursing career. I've learned things from nursing students being 30 years in as a nurse that I never knew before, and I've taught things to upper management. And so I just like your philosophy, and I appreciate those words because it's a little intimidating, but you're just a regular person.
[28:13] Carla: I am a nurse just like you. That's it, right?
[28:17] Michelle: And that's what Chris said. You're both nurses. Yeah. So let's get into some of the particulars about the DNP, and what I want to know is, how did you choose your program? Like, why did you do UCSF?
[28:31] Carla: So I looked around and I was accepted in multiple programs. Being a some of them were not in the state of California even. But I decided on UCSF for a couple of reasons their reputation, right? When you say UCSF, everyone knows what you mean. They're not guessing. So reputation was important for me. I then also participated in a call which I thought was really warm and friendly and that was done by Dr. Annette Carly and Dr. KT Waxman. They are professors at UCSF and so they had a call for anyone interested in applying for the DNP program and they took enough time to have other students on that call as well. So it wasn't just coming from the professors but the experiences of actual students. That was kind of the one that sealed the deal for me. Those professors were extremely warm and I've now met them in person and I find that they were not just the representatives but they were actually that warm and friendly in person as well. Another reason is because UCSF also has a campus here in Fresno where I live. And so I thought, well, if I ever need to go to that campus or if I ever need to get anything done, I won't have to maybe not always drive to San Francisco. So this is just me thinking forward. I won't have to always drive to San Francisco to accomplish that. If they say that something has to be done at the school or on the school premises, those were the things that really drove me. And then when I looked at the program, I read through it the requirements, what I was going to bring to the table, what they were going to teach me, all those aligned with what I was looking for in a program, making it flexible, it's hybrid, it's not all brick and mortar. So I don't have to drive to San Francisco for class every other day or so. But we do have immersion courses so we do have to literally go to the campus. So there is again a brick and mortar piece to this component as well. And so those are all things that interest me. And as I got into the program, it's exciting and sometimes it can be challenging or even scary to some. If you're not used to doing things like doing research on policy and advocacy for a healthcare issue, you'll learn that. And you'll be required to learn that in a DNP program like UCSF. If you have never done an elevator speech and taped yourself on Zoom or some other form of media and uploaded that into your classroom assignment, you will be required to learn to do that as a DNP student. If you have never done public speaking, you will be required to do a lot of that. If you don't know your way around a library you will have to get in touch with the librarian and learn because in a DNP program, you're researching a lot, and you need to know what legitimate research looks like. You need to be able to read peer reviewed journals and understand the content of those journals, how to create an aim statement, how to formulate a PICO question. So it is an environment, it's just rich with new and different experiences, and it is a great deal of work, but it's so rewarding when you're done with your elevator speech and you've uploaded it and you're looking at other people's elevator speech and they're looking at yours and critiquing it. So that is, again, why I chose UCSF for my DNP program.
[32:47] Michelle: Okay, well, what was the application process like?
[32:52] Carla: That was a little lengthy, not hard, but it was lengthy. So, for example, there is a standard application, right? And there's a small application fee. But in addition to that, to get into the program, so clearly you must have a master's. And then they want to see how much work you've done and what contributions have you made. And so they give you a template and you constantly repeat the questions asked on the template by filling in the data. So, for example, have you ever done a slide deck presentation? When was that? Have you ever taken a policy course? When and where was that? Have you ever worked with someone on a budget? Where was that? And so mine was pretty extensive. I think when I finished submitting mine, it was maybe about twelve pages long. And then you have to be able to validate that content. So if you said you've done a PowerPoint presentation or a slide deck, then they want to see a copy of that, and your name should be on the first slide when you did that. So it's not like you can make these things up over your career. Another piece of that is they partner with Castle Branch. And Castle Branch is an organization, because I wasn't familiar with them either. But what Castle Branch does is take all the clinical not clinical, I'm sorry, all the healthcare, health, and wellness requirements to get into school, and they then take that off of UCSF plate and they control that. And so what does that look like? Castle Branch wants everything from your most recent flu shot, your TB, your polio, your Diphtheria, your physical, your license, your insurance. There's a whole list of things that Castle Branch will send you. And then you have to upload those requirements into the website. And it's a secure website, but that has to be accomplished. The next thing is you have to be able to commit to the hybrid sessions. And so having to go to San Francisco for an immersion course for, let's say, Wednesday, Thursday, and a Friday. And so you have to have an employer that will also support you in your education, because you will have to commit to that because those immersion courses are already in the schedule. And you must attend those as part of the degree program. So those are like when I can think of the components that really you have to get those accomplished before you get in. And when you get in, those are the things that must take place. And I think it's that piece of the application and getting in all of your experiences, and I said that to say this when you submit all of your experiences and things that you've accomplished, then they use that. There is a committee that meets and they look at every application to see, well, if this person has done all of this in their career, the requirement is that you do 1000 clinical hours and you can get some of that time shaved off if your experiences in your career has been extremely rich. And so the fewer you have to get done when you are admitted into the university, the better for you. And so that's why they want to see that, not just that resume, because that's only one component of it. They need to see the actual work that you did, whether it was across your employment span, across your career, across your job changes. They want to see that because they use those experiences to give you credit against your clinical hours.
[37:11] Michelle: And could you possibly be rejected because you don't have enough of those experiences?
[37:17] Carla: Well, I think rejection is a part of life. And so absolutely, probably it was not my experience. And so you probably have to find a student who was for that reason. And I don't think it's their intention to reject you, but I know that it's important that you have a foundation when you come in there. They're not building the Student from Scratch program. This is their training, future doctorate students. So they need to know that you understand the requirements and that you can meet them because they want you to be successful. And clearly you want to be successful. And so if you don't have those experiences, what I would say to anyone is then go out and seek them. Go out and volunteer when you're at work, raise your hand and say, I'll chair that committee, or I'll be the representative for that committee, or I'll go on that unit, or I'll float sometimes to get a different experience. Or I'll meet with the representatives for this new product you want to purchase, or I'll get this credential. That's how it's done. We're doing it every day in nursing, and that's how it's done.
[38:40] Michelle: Yes, I think there's a slight misconception, maybe at the level that I was on, of that you want to get your DNP, you just apply, pay your money and get into the program. And it's obviously, by your description, not that simple. There's a lot required. And I would think that the program administrators themselves would want the potential DNP nurse to be well rounded and to have those experiences, like you said, that just make everything richer. So thank you for that. That kind of blew me away. I had no idea what was required in terms of just the application process.
[39:28] Carla: Yeah. As a student, I guess I would be concerned. If that's all it takes to get into a program, then how successful will you be? Which then how will that translate when you get that degree and where you choose to serve or work? And so I'd certainly be looking for someplace legitimate, someplace reputable, someplace where I'm going to be proud to put those credentials behind my name and say them in podcasts such as that I'm doing with you right now. So that would be important. It's just not as simple as paying your money and getting accepted, or at least not from very reputable universities and schools of higher learning where you're really going to be challenged and you're really going to learn.
[40:30] Michelle: How long is the program that you're in?
[40:33] Carla: It's two years.
[40:35] Michelle: Two years? Oh, my gosh. It seems so fast to get all of that accomplished.
[40:40] Carla: It does, because you start with the immersion and you're there and you get a chance to meet those students that will be in your class. Many of them become some of your best friends. We talk a lot and we converse a lot and we're on WhatsApp a lot but also the time goes fast because all of the classes are not weeks and weeks and weeks. They've now moved into five week courses. So you get in and you get out. So content becomes really quick and you have to get really focused and you have to be really dedicated and being able to commit the time required to get those assignments submitted.
[41:26] Michelle: Yes, absolutely. And two years goes by in the blink of an eye.
[41:31] Carla: It does. And that's why I encourage people right. With anything that they are thinking about embarking on, whether it's a new job or career or an opportunity of any kind. This is what I say. If not now, when? And if not, then when, then who? So it's important because for what you just said, time goes by really quickly. And in two years, I could be either saying, I wish I had registered for the DNP program, or I can be saying, I'm about to graduate. Time flies by so quickly that you could have accomplished that. Because someone once told me, carla, if you don't go ahead and do it now, even though it's going to take two years, the two years is going to come anyway, will you have completed it or not? That will be the challenge.
[42:28] Michelle: So I just got the chills when you said that because that was honestly my thinking when I went back for my bachelor's. So I had my associates for 25 years, and I kind of had a life changing minute where I got breast cancer and had to go through all that, the mastectomy, the chemo, and I was one month out of chemo and I said, Michelle, you've got to do something with your life. And I said, you need to go back and get your bachelor's. And so the one that I was looking at was an 18 month program from Fresno Pacific University. And my sister had just gone through it and had just talked about how wonderful all the professors were and the schedule was great. It was like one night a week, so I guess it was a hybrid and the rest was online. And I said, the time is going to go by anyway and you might as well spend it getting your bachelor's. And that's honestly how I made the decision. So sometimes I've said this a lot in my interview. Sometimes we go into nursing, we make decisions not really based on anything grand. It can just be something as simple as, yeah, I want to get my bachelor's. This sounds like a good time. It's an 18 month class. The time is going to go by anyway, and so I'm going to just do it now.
[44:12] Carla: And good for you. I am excited that you did. But people tell me all the time that we have more in common than we have not common. And when I listen to you talk about your and thank you for sharing your experience and your journey with breast cancer, because my mother is she was diagnosed in 2007 and she was not given a long time to live, but she is still living today. And I do want to applaud you that you are a survivor and I thank you so much for sharing that, because someone will hear that who's not doing a breast self exams or who's not getting routine mammograms, and maybe they'll hear that and realize that it is real. And breast cancer is one of the leading diagnosis for death in women. And so we really need to be making sure that we are not always don't look to take care of everyone else before you take care of yourself, because the only way you can be of any value to anyone else is if you're around and that means you must be taking care of yourself. So great job, Michelle.
[45:32] Michelle: Well, thank you, Carla. I appreciate that. There's definitely been a change in the self care for nurses, and I think your point I've said many times on this program, you can't pour from an empty cup. And those lessons for me were hard learned because before I was diagnosed with breast cancer, I was burning the candle at both ends. I was not taking care of my health, I was not doing self exams. I 'd had  one mammogram. So those things are important. And breast cancer was sort of a blessing in that it forced me to slow down and take a look at how I wanted to live my life and what I wanted my priorities to be. So it does that for us? Sometimes it does, yeah. What's been the most challenging so far in the program for you?
[46:39] Carla: For me, I think there's the assignments. There is a great deal of work and it requires a great deal of reading. And so couple that demand on your time with working full time and also having other like you shared other things going on in your personal life. I have family who's sick and they rely on me. I'm a consultant, so I am calling people reach out to me and hire me for work often as well. And so trying to balance that, sometimes it feels you want to say, I could be just easy if I just drop out because I'm too busy right now. It's not the work, it's getting the work turned in, which has to do with time management. Right. And sometimes 24 hours in a day just don't seem enough. And so that has been the real challenge for me. The other things have not been I have been, again, a nurse a long time, so I know public speaking. I know how to do an elevator speech. I am talking in public all the time and I'm writing things all the time. So those were not the issues for me. I'm computer literate. It was just getting those things done, getting the reading done so that I could make a contribution during the courses when we're in our Zoom meetings and not just being a silent person in the course, but really making a contribution to the conversation.
[48:31] Michelle: Yes, life gets in the way of all those things. And that kind of leads me to one of my questions, so can I do the program while working full time?
[48:45] Carla: You can. The assumption is that you are working full time. And that's what most doctorates assume. They assume you have seasoned leaders who probably more often than not, more often than not, are executives. So they're leading something or they're in leadership roles. And so you come in with that assumption and you can get it done. I go to class with individuals who have minors who are nurse practitioners. Most of them are nurse practitioners. Only a few of us are. Not me, I am not a nurse practitioner. And so, yes, they realize you are working, but the expectation is you still have to get the work done.
[49:41] Michelle: Well, what about earning potential for having your DNP? Is that something that's increased? Is that better earning potential for that degree?
[49:55] Carla: It's interesting you say that, because while again, I'm not an expert in that area. So I'll just tell you what personal conversations have yielded for me and some of the literature that I've been reading, individuals, for example, myself, what I'm learning is employers nowadays are positioned to advance you or increase your pay if you're already working for them and you embark on a higher degree. Unfortunately, and I say unfortunately because it is people who are getting advanced degrees are having to leave that job and then leverage that doctorate with another organization, then that means the organization that they left, they're the losers, right? Because you are letting a doctorate prepared nurse leave your organization in order to get value out of a degree. And I say get value out of it because that person did have to pay to go to school and it was that blood, sweat and tears you talked about earlier, they had to give all of that to get through that degree and to be compensated for it is one of the reasons we are embarking on it. Yes, we can say altruistically that we're nurses and we want to deliver the best patient care, but we also want to be compensated and we want to be compensated fairly and equitably. So I had a colleague that told me recently that she didn't feel like embarking on a doctorate would get her anywhere or it wouldn't get her any more than what she has now and she's in an executive role. And so I've had those conversations with people, and I certainly can understand where they're coming from. And if where you're working, they're not going to offer you any more except more on your plate or more things to do when they find that you have a doctorate. Then again, that will force some individuals to leverage their doctorate degree somewhere else.
[52:14] Michelle: Well, part of a follow up question would be so when you've gotten to the place that you've gotten to Carla, professionally and in your organization, if getting your DNP was not on your radar, is there pressure to get the terminal degree?
[52:39] Carla: It depends on where you work and it's not really pressure. Now, some organizations several years ago, I worked for an organization that didn't have any in the organization and they were willing to pay for some of us to go. Well, myself, I was anticipating leaving that organization. I knew that I couldn't let them pay for my degree because then that would lock me in and mean I would be committed to staying for a couple of years. And I didn't want to do that, so I could have done this years ago. But I do know that organizations are realizing that the doctorate prepared student does come with an arsenal of education and experience and that they need them on their boards and in the C-suite and in the classroom. In order to teach in university, in the university setting, then you certainly would need to have your doctorate. So right now the pressure is not on. But again, we are seeing that more in job descriptions. We're seeing that more for advanced roles. We're seeing that more if you want to get higher pay, meaning if you come out and leverage it somewhere else, we are seeing it more. And I think that the drum beats are just going to get louder and louder for the doctorate degree.
[54:22] Michelle: That's really interesting. So I'm going to go back to my brother Chris, and also my statement earlier about sometimes we make decisions not based on anything grand or logical. And so he was teaching nursing students at the university level with his Masters, and a very well respected colleague in the university approached him and said, don't you want to get your terminal degree? Kind of like you're going to get your terminal degree. Right. And to which he said, well, it wasn't really on my radar, but it is now.
[55:11] Carla: Right, exactly.
[55:15] Michelle: So I didn't know if there was pressure within organizations to do that. I know organizations, specifically the one that I worked for, and I'm sure this is pretty standard, there is pressure to get associate degree nurses, their bachelor's, especially when we went through the magnet experience. And, yeah, that was a big push. So I didn't know if it was the same for the DNP.
[55:46] Carla: Well, I also know you raised a good point for Magnet, and I worked at a Magnet hospital, and so that's important because when you are going for Magnet, you are required to have a certain number of associates or bachelors prepared and doctor prepared. That is part of the scoring system. Right. And so the Magnet organizations are probably where you're really going to see the encouragement to move towards those higher degrees, because, again, they value that rich experience of having doctorate students and master's prepared students as part of their leadership teams and those individuals who are leading their departments as well. And again, I know to teach, you do need the Masters, but certainly it is becoming the doctorate in academia as well to be able to teach students. So that will be important. But you're right. Magnet is a journey that requires the certification.
[56:57] Michelle: Right. And I love how you kind of change the word 'pressure' to 'encourage.' That was really good, Carla. And I would say my brother would say that he was gently encouraged to get his terminal degree.
[57:13] Carla: Yes.
[57:16] Michelle: Do you think that there's anything missing from the DNP curriculum?
[57:22] Carla: Well, you know what? I can't speak for all curriculums, but I'll tell you this, I am an advocate for diversity, whether that be in academia, in the classroom, or whether that be in the boardroom. So for me, I think it's important that the program also realizes that there needs to be a diverse group who's accepted to the program, because it is that diverse group that's going to translate into a diverse workforce. Right. And we need those individuals. And so anyone who is responsible for admitting or critiquing or evaluating whether or not a student should be allowed into the program, it's important that diversity be one of those. And I say that for this reason. When I went to nursing school, when I first went to nursing school, I went to school, there were 100 students let into the program at a time. And of the 100 students I was the only African American in class. And I'll tell you, there were some lonely experiences there because you just don't look like everyone else. And so the communication wasn't there, the collaboration wasn't there, the camaraderie wasn't there. And so a lot was lost on that experience for me. And I remember it, and I know how lonely it can be. And so what's missing for me is who's ever listening to this podcast, they need to realize that diversity is going to be what supports health care and the health and wellness of our communities. And we need to make sure that we're able to rise to that challenge when the time comes. Because, again, in 2044, 50% of this country is going to identify as either racially or ethnically diverse, and we need to be prepared for that.
[59:42] Michelle: That's a really good point. And your perspective, is that's something that, as you were talking about, being the only African American in your class, I turned it around on myself and said, what if you were the only Caucasian person in your BSN class? That would I could totally empathize with your feeling of loneliness and where are my people? Wow.
[01:00:17] Carla: That's a great way of putting it too, Michelle, thinking of it in that perspective. Absolutely. Because then it makes you more empathetic, right?
[01:00:27] Michelle: Well, absolutely. Well, I was reading about and I think I vaguely remember my brother having this capstone project. And so what is your capstone project? Or are you at that point, have you decided what it's going to be yet? Talk about that.
[01:00:51] Carla: Wow, that is really a great question because, yes, everyone needs to know that the DNP must result in a project. And if you recall when I talked about the Ph.D., they're more about the thesis and the dissertation. And that's another way to differentiate the Ph.D. from the DNP. Ours is about think about the P is also for project. And so everything you learn when you first get into class, everything about how to use the library, how to form your PICO questions, how to go on the IHI website and understand what quality and safety is, how to do a presentation. Everything we're learning is you're dabbling in it and you're picking topics that are interesting to you. So if you know right off the bat, gosh, my project is going to be on this, then you start to let every assignment you turn in be about some component of that. If you don't, you have time, which is where we are. We are still learning all the components. And here, shortly, we're going to be required then to decide, this is going to be my project and this is what I'm going to be working on. But right now, we're still getting the foundation of that.
[01:02:21] Michelle: If you had to think about the future, what do you think you would want to do your capstone on?
[01:02:28] Carla: There are so many things, Michelle. My experience has been so rich, and I've seen so much because I've been licensed in eight different states. So I've seen healthcare on the continuum. Right now, I am in the Correction setting. And the need for people to understand what happens in that environment and how important it is that we contribute to everything from the decrease in recidivism to repatriating them back in the community, to making sure they understand better about their care and how they got there. And that 80% of individuals who go to prison here in California, they arrive with a behavioral health issue or substance abuse issue. So if I had to think about anything right now, my environment is rich with what I'm going to say data, because I work for the state as well, but it also has a population. We really have an audience that can't go anywhere. So you can observe those people and you can review their charts and look at the dashboard. And so it'll probably be something that has to do with that. The other things that are important to me is racism in nursing. I am a fellow with the American Nurses Association in California, and I was on the policy and advocate side. And so racism in nursing is important because I just shared with you years and years ago, I was the only African American student. So that hasn't changed. It's not going away. So we still need to work on racism in nursing. Workforce diversity isn't another important issue for me because we do need to make sure that we know the cultures and we do know how people live and what their needs are and how we can best serve them. And so COVID-19 taught us that, right? That people were hesitant to take the vaccine from clinicians that didn't look like them. And so that's another one that's important for me as well. And then, gosh, there are so many. One more for me is healthcare literacy. I was working in the reading on the IHI website, the Institute for Healthcare Improvement, and found data where only 20% of this country has healthcare literacy. That means about 80% of us. And that's your family. That's my family. That's our friends, that's our neighbors. They don't understand what's being asked of them at any given point along the healthcare continuum, whether that's here's the prescription, start to take this one, don't take that one anymore. Here's your X ray. You need to make sure you have it, because we need to see how that tumor is progressing, if it's turned into cancer, you need to get this colonoscopy. You need to get this solution and drink it. There are so many things people don't understand. I think I spend 99% of my time in the world of healthcare literacy, and as a consultant, I do a lot of that, supporting individuals through everything from prostate and colon cancer to new onset dementia and burns and everything else.
[01:06:12] Michelle: Well, those are certainly three worthy projects that you just talked about. And I know that I can hear the wheel spinning in your head about all the other ones, too, but I can't wait to find out which one you're going to do and to read your publication on it. That's going to be exciting.
[01:06:37] Carla: I am excited because you're right. Sometimes I think there's smoke going on up here at the top of my head. Right. And those wheels are turning because there are so many areas of interest for me, and I've seen so much in my career, and it's been so grateful to be a registered nurse that it's hard to pick one topic because I am passionate about all of them, but I'm passionate about healthcare.
[01:07:06] Michelle: Well, I certainly feel that from you. For the closing question, what advice do you have for nurses who are contemplating getting their DNP?
[01:07:19] Carla: First, I would like to say I welcome those nurses, especially those nurses who are diverse and who have felt discouraged and don't find any value in it or don't know what they'll do with it or where they will go. I assure you that they will be received in many places, and I want to be able to collaborate with those individuals, because when, like mind individuals like nurses get together, we can make things happen. And we don't have enough doctor prepared nurses, which means we won't have enough in the academic setting, which means then we won't have students that we can support throughout their nursing journey if we're not there as well when they arrive. So I encourage them, if they are thinking about it, stop thinking about it and start doing something about it.
[01:08:24] Michelle: That's a great message. The time is going to go by anyway, right?
[01:08:28] Carla: It certainly is.
[01:08:31] Michelle: Well, thank you. I've really enjoyed talking with you. I hear your passion, and it's just amazing to have your perspective, and I just really appreciate you being here today.
[01:08:46] Carla: You're welcome. It has been wonderful talking to you and thank you so very much for the invite.
[01:08:54] Michelle: Absolutely. Well, you know, Carla, at the end, I do this thing called the five minute snippet, and it's just five minutes of fun. It's just me asking you some questions that you know all the answers to, and it gives my audience kind of a chance to see your off duty side. So are you ready for that?
[01:09:17] Carla: I am.
[01:09:21] Michelle: All right. I'm going to start my timer. Okay. It's hard for me to imagine somebody so accomplished as yourself needing help, but who do you go to if you need guidance?
[01:09:38] Carla: So my father was a minister, and I do go to the Lord in prayer first because I do believe prayer changes things. So before I tell everybody my business and get it out there, I usually pray about it and then I'll tell my husband and then I'll talk to my daughter because she has proven to be my best friend and then other colleagues that I've met along the way, and some are nursing, some are non nursing. I run it up their flagpole as well.
[01:10:13] Michelle: I love it. A favorite teacher who made a big impact on your life.
[01:10:19] Carla: A favorite teacher. I have to say gosh. One of them that I can remember, and there are several of them. Ms. Lucas was a teacher in grade school, and she was more like everybody's aunt or mother or great aunt. She talked to you like that, and if you were walking down the hall, she told you to tuck in your shirt or stand up straight or cover your knees with your dress or stop talking so loud. So you just always knew when you were even in school, when Ms. Lucas and another one was Ms. Catherine Robinson. And I think they were very close friends, those two teachers at the school, and they were both African American teachers. And I love Catherine Robinson and Miss Lucas because I just felt the warmth of those teachers when I was in grade school.
[01:11:28] Michelle: Those teachers stay with us for very long time. If you were given $1,000 to spend on your closest friend, how would you spend it?
[01:11:41] Carla: Oh, wow. $1,000 on my closest friend. Wow. My closest friends are really my siblings, and so I would probably take them out to dinner and buy them an outfit. When my sisters come to my house, they always seem to ask me, do I have any bottles of perfume that are almost gone that I want to give to them? So I would buy them some of my favorite perfumes because that's the ones they seem to like. Those are a lot of little things I would do for them to just constantly, every hour, so I'd be giving them something.
[01:12:34] Michelle: I love that you talked about perfume, because one of these questions is, if you were designing your own fragrance to represent you, what would you name it?
[01:12:45] Carla: Oh, what would I name it? Probably Brandeis. That's my daughter's name. Brandeis.
[01:12:54] Michelle: Okay. I love it. Let's see. What is one thing that you'll be really disappointed about if you never get to experience it?
[01:13:06] Carla: For my career as a consultant, to really take off.
[01:13:10] Michelle: What antiquated invention do you still use?
[01:13:18] Carla: Wow, antiquated invention do I still use? Gosh, probably lots of them. One, my daughter says all the time that I need to get my life back because my husband and I don't wear anything that I don't iron.
[01:13:46] Michelle: Oh, yeah. Okay. Yeah. My daughter said, mom, irons are so old school, and she got us a steamer.
[01:13:55] Carla: I have one. My daughter bought me a steamer, and I love my Rowenta  iron.
[01:14:02] Michelle: Oh, my gosh. Okay, well, we are done. And wow, so much fun. I've learned so much, Carla, from you, things that my brother never told me, and I think our audience has just taken away so much value today. I love everything that you stand for, I love everything that you're doing for our communities, for nursing. So thank you so much for being my guest.
[01:14:35] Carla: You're welcome. And I'd like to love what you're doing as well, because having a podcast and talking to people such as myself so that we can get the word out on important issues that involve our community is no small feat. And so I thank you so much for what you're doing as well.
[01:14:56] Michelle: I appreciate that so much. I'm having a lot of fun. You take care.
[01:15:02] Carla: You too. Bye.