Nurse in Tech, Patrick Pickarts

[00:00] Michelle: How do you move from emergency nursing to technology? Well, Patrick Pickarts did it with enthusiasm, his get-out-of-jail-free card, and a smidge of reckless abandon because that's how he rolls. He admits that learning how to tweak an electronic health record is not as easy as caring for a patient with a tweaked back. Patrick's current project involves utilizing technology to assist hospitals in freeing up busy nurses from the tedious task of calling staff for open shifts. Can I get an amen? As someone who values lightning the load for nurses, I deeply appreciate Patrick's contributions. I was smiling and laughing the entire time we talked, and I felt like I was talking with an old friend. Well, not an old, old friend, but a young old friend. He's intelligent, intuitive, and a little bit insane, but some of my best friends are! In the five-minute snippet. Has anyone seen the nursing student? Hey, good morning, Patrick. Welcome to the podcast.
[01:30] Patrick: Good morning, Michelle. Longtime listener, first-time caller. I've been waiting to say that.
[01:35] Michelle: I know, right? I love that. Thank you so much. Well, we met on Instagram, and I've talked about Instagram before a lot of times on this podcast because I think it's a great way for people to meet like-minded people and communities. There's a huge community of nurses, and I've met many of them on Instagram, and I think you started following me, and thank you for that. And I always try to reach out to my followers and say thank you for the follow. Let me know if there's anything that you want to hear. And I think with you, I didn't quite get from your profile that you were a nurse, which is fine. Nonnurses can follow me, too. But I asked you, are you a nurse? And he said, yes, I'm a nurse in tech. And so instantly I was very intrigued about that. And I said we must talk. So thank you so much for being here.
[02:39] Patrick: Yeah, thank you for having me again. And I agree, Instagram is the new platform for nurses, and I'm having to keep ahead of that as well. I think it goes back to a typical nurse in their 20s. Not that I'm in my twenties, I wish I was, who doesn't want to necessarily go into a webinar, but they will look at who's going live on their Instagram, and I'm starting to be more aware of it. And it's kind of neat to see what the next generation is all about.
[03:14] Michelle: Yes, absolutely. It's exciting and the energy is palpable, right?
[03:21] Patrick: Yeah, absolutely. So I feel like a lot more clocked in. I came across probably your profile because I have a business Instagram where I really do more like nurse following and nurse communication. But it's starting to bleed over into my personal because of the robots and such. So I was glad to find you.
[03:42] Michelle: Yes, well, thank you. I'm glad too. So let's just start out by talking about what brought you to where you are now. Give us a little history lesson about your background.
[03:53] Patrick: Sure. Yeah. And I like it, not because I think there's anything super unique about me in this, but I think for anybody listening, it's just neat to see how one thing leads to another in nursing, and before you know it, you're doing something completely different than you ever thought you would. I started nursing in a very traditional career path. My mom was a nurse, which I think is super common among nurses to come from a lineage of them. Started working as a nursing assistant at the local hospital where I grew up in Wisconsin's rural farming community. I had this mentality that I was interested in nursing. I had to get over being a man. And nursing was a little bit different, even though this wasn't super long ago. This was in the early 2000s. But I thought, well, if I take a CNA class that's three weeks long, and if I like it, it's probably going to be all up from there. Right. Because you're kind of at the bottom of the rung of the ladder, so to speak, how we're very hierarchical in health care. I try not to be, but it was like, well if I kind of like doing these basic "helping somebody go to the bathroom type things" if I can handle this, I can handle anything. Liked it. Went on to nursing school. Liked that. Was really privileged to work in the same community hospital that fostered me as a nursing tech and really helped me get the clinical skills really solid along the way. Moved to Chicago because that was just the big thing for me at that time in my life, especially growing up as a country kid. Wanted to work Chicago ER. Very exciting. Had a ball, learned everything I needed to along the way doing that. And then it was like, all right, what's next? What's next? Which I think is also a very ER or ADD personality trait. The hospital system I was working for started transitioning from carbon paper documentation, where you had to push really hard with your pen to get through all the layers of carbon. I know you know what I'm talking about, Michelle. 
[06:02] Michelle: Yes, sir, I do.
[06:04] Patrick: I kind of miss that sometimes, too. You could write your own story. Anyway, it was like, okay, what is this informatics about? What is health? I see everybody doing more with less, for a while it was really cute to do more with less. Now it's just kind of getting more and more unhealthy to do more with less. Really insulting, I think, in healthcare in general, what people are being asked to do. And I looked at it and informatics as like, well, this is one beacon of hope, right? We can use technology, we can leverage it. Candidly, I think that technology can just often be annoying, right? There's a balancing act but started splashing around in its Epic space. I think Epic and EHR implementations are a big area where a lot of nurses get into software and really kind of understand how a different area in healthcare works. And we benefit because we know how healthcare works, we know how hard it is to take care of a patient and we can apply what we know to what we don't know and get to a point where we kind of have a broad knowledge of healthcare delivery and implementing it. Have been doing projects like that for a long time. And then more recently, which I think is interesting for the podcast and maybe just more interesting because it's different. I've been working in software and technology as a nurse and that's really been, we all see with current labor shortages and health care strain that there's all these different myriad of healthcare platforms that are available and out there, and everybody's offering the latest and greatest, next best thing. What I'm really working on is being, again, like a nursing voice of reason. Somebody, to kind of kick the tires on any software or policy or process that we're looking at implementing and think about, is this really helping? What are we really doing? Oftentimes the solutions are actually quite low-tech, but we're using software to help solve them. And it's just been an interesting space where I'm often the only nurse in the room and even doing a call like this, Michelle, is really refreshing to speak with somebody from my own tribe. So I don't really know how I got from being a nursing assistant to working in technology sitting in front of a computer, but it happened.
[08:18] Michelle: That's such an interesting story and there's so many parallels between your story and mine. I too started out at the age of 17 in my local hospital as a nurse's aide.
[08:31] Patrick: Were you a candy striper? Was it called the candy striper then?
[08:34] Michelle: Yeah, candy striper. The whole red and white candy-striped outfit and everything. And then went to a nine-month course to do my CNA and started working in a nursing home, which I really loved. I loved that population. I loved the elderly. I didn't love the nurses in that setting because they were burnt. And so I got out of there pretty quickly. I only worked there for four months and then my friends were telling me, you need to go work at an acute care hospital. And I did and I absolutely loved it. And like you were talking about being a male in nursing. I have three brothers that are nurses and they were my inspiration to be a nurse. And they were male nurses before it was cool. This is like the late 1970s. So I think we have moved great strides in the right direction with recruiting more males in nursing. So I'm really happy to see that. And like I said, my brothers are really inspiring to me. But I want to know how you talked a little bit about your emergency room experience and really loving all that action and adrenaline. And then what happens when you go from that setting to, like you said, sitting in front of a computer? Do you miss that? Or are there still some aspects of excitement in technology? 
[10:15] Patrick: Yeah, I miss it all the time. And back to your brothers in nursing, too. We're going to go backward and forwards. What an obvious solution to a nursing shortage! There's no silver bullet, but if this is a career that's attracting 75% females, can we not tap into all of the males in the population? So I would love to meet your brothers sometime and really kind of like early adopters. And then to your actual question yeah, so I loved being an ER nurse. I still pick up shifts when I can. It's been about a year and a half, so I'm still pretty recent. But I just kind of get to a point where it's like, okay, Patrick, you need to rein yourself in, go back, take care of a patient, push a cart. I was always so perturbed by nursing leaders who are just so far removed or had been working in administration for so long that they just didn't really have a concept of how hard it is to ask somebody to do something. In addition, even if it's just like reading a policy or doing another form, it's like it all just compounds so much. But it was a really hard switch from ER nursing to software. And initially, I think if I could say it in one phrase, I miss the instant gratification and the instant feel-good that you get from nursing. You have somebody who's in pain and you help them feel better. You have somebody who's an extreme case, someone who's dead, and you make them alive, but you often have somebody, it could be something like they have a cough and you help them with a nebulizer or something. And that was just always really good for my mental health, and I didn't realize how that was, replenishing my mental health all the time, just being able to help people day in and day out, and I never stopped liking people, and I never really stopped liking the job. Did I experience burnout from time to time? Absolutely. And I can't imagine how burnt out I would be if I never stopped taking a break. But I had to really adjust my thinking, and I would try to tell myself, okay, well, if you're implementing a new technology, you're implementing a better electronic health record, you're actually helping, like, a whole community of nurses. And I tried telling myself that for a long time. And honestly, even though it's true, it didn't necessarily help. I would be like, oh, I miss the pace and being around people and being around other nurses. So that's where I've tried to do registry per diem nursing when I can as able. I'm actually doing an interview for a registry part-time nursing gig next week and I'm excited to just get in the zone again. I guess another piece now too. With the current work I'm doing in software, it's more like a lot of sales, business development, and looking at new clients. I like the pace and the speed of play with that a lot because it's very much forward-moving, charting unthreaded waters or whatever that phrase is. But you're kind of always driving, breaking a trail and driving new business and it's a quicker cycle and you don't really know what's going to be happening. And I think that that really harkens back to what I liked about working in an emergency department. Just again, I'll say it twice the quick speed of play, but there's nothing like actual nursing. That's been a reality check. 
[13:41] Michelle: I echo that sentiment. And I didn't go into another field of nursing, but I retired. And so that was huge because I went from a busy neonatal intensive care unit to nothing, a very quiet lifestyle, which I worked 40 years for. So I have to keep telling myself that it's okay to not have a schedule right now. Michelle, you had one for a very long time and it's okay to sleep past 05:00 a.m. But yeah, we have to tell ourselves those things, right?
[14:21] Patrick: Yeah. Or did you think about doing like, what made you go from working full-time to retired? Or did you wean yourself off? Did you go part-time and then registry, or did you think about doing those things?
[14:33] Michelle: I did, and I talked to my employer about it and my job was such a niche job and it really needed to be full-time. And she just kept saying, my manager, she just kept saying, no, we really need to have you full time. And this was towards the end of the pandemic when we were all really burnt out, right, it was overload, especially in our hospital. It's sort of a rural hospital here in central California, and we were getting these alerts through an eight-hour shift, we would get five or six alerts of like, this is how many COVID patients we have now and this is how short-staffed we are now. And my job just kept changing and changing because we had a lot of staff out with COVID and we had some people leave during that time and a very high census. And so all of those things mixed together made for just kind of a bad scene towards the end of my career. And I had been thinking about retiring before that, but I wish I would have been able to kind of do that, to go part-time. But it took me about a good six months of retirement before I settled into saying, it's okay, this is your time, you've earned it. And of course, I was developing the podcast, developing my website, so I was definitely staying busy with all of that. And that was hard. That was a learning curve that I did not expect. And I'm wondering if you had kind of the same feeling of going to another, I guess, specialty where in ER nursing you knew exactly what to do all the time. It was kind of just automatic and then you're learning something totally new and different. And how did you manage that?
[16:45] Patrick: Such a good question. Yeah, it feels really good to know that you are at the top of your game. To know like, you're a really great ER nurse or NICU nurse or any type of nurse. So it was like learning to walk again. Right? Because I sucked for a long time. I will say it. My name is Patrick Pickarts and I sucked at working in it. And Informatics didn't need the language for a long time and I never became a savant or anything with it. I got good enough, but I've always had to lean on my soft skills and I'm a personality hire, Michelle. But I think that it feels really good to be good at something and to know that you're just the shit at it. Somebody told me recently that if nursing was the type of job that we would all be able to master in two weeks, we'd be bored and over with it. And that's been kind of resonating with me lately. And I think another time I was listening to a podcast, Condoleeza Rice's podcast and she's just, aside from politics, a very multi-talented woman and she had a kind of a question about how do you go from being a pianist to a politician to you're into sports, to this and that. I just think it's always interesting to challenge the status quo. It is exhausting. I've now been like an ER nurse working in, I would say, Informatics and Tech, and then also the sales biz dev side of it is another total career change. I didn't really realize it was until I started doing it, otherwise, maybe I wouldn't have. But yeah, it's gratifying to know that you're at the bottom of the mountain again and working your way back to the top. It's humbling. I think the older we all get in our career, it's humbling and good for us to learn from people that are younger because the older anybody gets, it's only going to be more people younger than you working in your career. So that's I didn't know how I would feel about it at first. And then I luckily realized that my opinion is as long as I think that somebody is smart and has something to say and I can learn that it's wonderful. And if I don't really respect somebody, it usually has nothing to do with how old or young they are. But, yeah, learning new things is a bitch, Michelle, it is so true. 
[19:13] Michelle: And for people like us, I would think you're probably a little bit of a perfectionist. And I certainly am. And I like to do things right the first time. And when you're learning something new, that's just not possible. And failure is always something that's on the table and uncomfortable. So, man, I'm with you there. And just when I start thinking, like, okay, now I know everything about podcasting, then I belong to a lot of different podcasting groups and newsletters and all that. Then there's all this new stuff. Like, now the new thing is video and podcasting. I'm like, oh, my God, people don't want to see me on video.
[19:58] Patrick: I didn't know if you'd have a video. I made sure and wore a shirt with sleeves on it in case this in.
[20:02] Michelle: Thank you so much. And I made sure, I thought you were probably thinking that there was a video. So I'm sitting in my closet right now, and it's kind of a hot California day, so I am wearing clothes because I thought, he's probably going to think it's video. What I want to know is, did any of your emergency room skills transfer over to tech?
[20:27] Patrick: Yes and no. And also back to changing things up or learning new things. And I love this about nursing. I love knowing that I could just say effort. This has been a great ride, but I'm going to be an ER nurse for six months or a year or five years or the rest of my life or whatever you want or whatever anyone's specialty is, or any part of nursing. I just think it's such a great get-out-of-jail-free card that makes us as nurses able to jump into new things. The tech market is really strange right now. A lot of people are getting laid off, really talented, good people and my heart goes out to them, but they can't just jump into a hospital that is like, do you have your RN and a pulse? We'll take you. So that helps. Michelle, while I was rambling my stream of consciousness, I forgot your question. You asked how are the ER skills helping it.
[21:23] Michelle: Yeah, anything transfer over into your tech job?
[21:26] Patrick: I feel like a lot of times the mindset doesn't help me. Here's an example. I will be in a meeting with really intelligent people, and we will just scrutinize over. This is a real story, a business card. And should the business card be that color or this derivative of the color? And how do we feel about how one side looks from the other side? And it's really important. It's marketing. Everything marketing. It's how we distinguish ourselves. But that is a complete antithesis of an ER mentality where you have to think a lot of times about what's good enough. Even if you want anything to be perfect, just, like, juggling any patient load, it's like, okay, what's safe versus perfection? So I catch myself oftentimes thinking, like, okay, why are we talking for 40 minutes about a color palette? And then I have to remind myself, like, this is a different industry, this is a different game, and these are, like, the terms of engagement for it. So I like having the perspective. I like always knowing that I kind of feel like I have a better overall awareness of what's actually important in life right? When you're taking care of patients or people that are having the worst day of their life, but it doesn't always help. 
[22:47] Michelle: Yeah. I would imagine myself sitting in a meeting like that, being an ER nurse and saying, oh, my God, you guys, this guy is bleeding out, and you're talking about a damn business card.
[23:02] Patrick: Right.
[23:04] Michelle: I might just yell that out during the meeting.
[23:06] Patrick: And then, of course, I think about the movie Devil Wears Prada when Andy, have you seen the movie, Michelle? No. Put it on your list, please. But a lot of the people listening will see it. It's just like this intern. She's, like, kind of poking fun at this group of fashion designers, how they're really scrutinizing over a color, and then she just gets schooled about how important it is. And that's sort of the that I go back to. It would be more fun to listen to if you'd seen the movie, Michelle.
[23:41] Michelle: I know, I'm so sorry I'm being such a downer right now. I know the theme of it, and I know it stars, don't tell me, Meryl Streep. And then the young girl is Anne Hathaway. Natalie okay, I'm going to watch it and then we'll talk about it some more. Let's just have a whole episode on breaking down that movie.
[24:07] Patrick: I would love that.
[24:09] Michelle: Okay, well, one thing I wanted to know, because you're in tech, how do you innovate? You're working in the emergency room and you're seeing something that could be better, and you go, wow, this could be so much better. This is what I would do, or, this is what I would do with the EMR, or maybe I would design a product. So how do you actually do that?
[24:46] Patrick: Yeah, and it's so frustrating. What my flavor of the week is now is I'm thinking about all of the complex things that a nurse needs to save their brain for and how can tech make anything more automated or help that nurse not have to think about things that they don't need to be thinking about. And an example for this is the technology that I'm working on right now.  And for all the nurses on the call, if you think about what can really make a shift, head south, other than your patient crashing. It's usually your staffing, right? There's like, call-ins all day, every month. It's always the name of the game. Like, how do you fill your staffing? How do you call someone in? When can you call someone in? So these really smart nurses are spending a lot of their days being telephone operators and just doing these manual processes and asking people on Facebook if they can come in and work. There's a lot of brains out there now to help make this better.  But it takes a concept like that of, like, why are we still doing this? And why are we still contacting people the same way, essentially, that we did, like, 50 years ago? I mean, we add in texting and a few things, but the process is kind of the same. So then the software is like, all right, let's load your NICU nurses, all of them, into our database. Let's encourage the staff to download an app on their phone. They can get a gentle push when there's open shifts available. You can make it kind of like the Uber of nursing, as we all say. Maybe it's not, like, remarkable to NICU nurses that there's a shift available, because there's always a shift available, but if someone's offering it to them at double time, they might jump at it. So I'm really enjoying taking anything that's like manual and making it so that the charge nurse that day doesn't have to call 30 different NICU nurses or just kind of go through these age-old exercises of trying to get people to come in and work that don't really yield much value. So anything like that is like a gold mine for me. If there's something that's being done without a process that you can make a process or something that has a process and it sucks and you can automate it, that's money to me. I think an area where it can start to be bad is healthcare oftentimes doesn't know where the delete button is. So you can't implement the software, but then also have people still making phone calls or texting or things like that. But my money market is, who's doing a really bad job of something and how can we fix it and make a nurse not have to think about it? 
[27:50] Michelle: I think that the company that you work for is revolutionary and not really in other industries besides nursing. So my daughter worked for many years for a chain restaurant, and they had something called Hot Schedules, and I found out about it because I was so frustrated. I was a charge nurse at the time, and I was doing exactly what you described. We're short tonight. Here's the list of people that you need to call. You need to take time out from whatever you're doing and spend an hour, an hour and a half on the phone, going through the phone list, calling everybody hearing the no's, leaving messages. And I remember asking my daughter, what do you guys do? Well, she would say, I picked up a shift. And I'd say, how did you do that? And she's like, oh, it's really cool. And she showed it to me. It's an app. And they just show all these open shifts and you can pick it up, or if you need to drop a shift, someone else can pick it up. And I thought this is brilliant. And I even went to my organization and said, look what other industries are doing. Why can't we do this? Why are we taking time out of our day using highly educated, highly skilled practitioners to be clerks? It's ridiculous. And the responses that I got were very similar to what happened so many times in nursing. Well, that's the way we've always done it. And you're absolutely right. It goes back 50 years. And when are we going to stop that in nursing? When are we going to innovate? When are we going to progress to keep up with other industries besides healthcare? It's got to end somewhere.
[30:02] Patrick: And that's interesting. That's something Michelle and you probably hear, like, the inflection change in my voice. Like, I do get revved up about it. It can be really neat to work with people outside of the nursing industry because they can very quickly see things that we do and it's like, oh, my God, why are you doing that? That being said, I think we always need nurses, right? I'm very pro-nurse, making changes for nurses. I'm not wanting a tech company to take over what should be a nurse's turf, but it was a colleague friend of mine, totally outside of the world of clinical health care. But I'm always impressed by how quickly nonnurses can learn about nursing processes and really catch on to the industry. But the comment she made was like, sending a nurse an alert to their phone is totally disruptive to the market, and those of us outside of nursing. Or you're kind of like a techie geek. I mean, let's be honest, you're running a podcast, and you're more comfortable with these kinds of things. But in nursing, doing something that is like going from a post-it note to a phone push, is totally radical and it's kind of depressing that it is, but it's an operational reality.
[31:21] Michelle: Yeah. Wow. Well, let's talk about your LinkedIn profile for a moment, because it's wonderful. And I went on there and scooped up everything that I could about you, and I saw that you define yourself as a healthcare leader. So talk about what defines a leader. 
[31:39] Patrick: Thank you. I'm really kind of trying to figure out what my LinkedIn personality is sometimes so gratuitous on there. I'm trying to think about what can be a little bit funny and a little bit serious and not put a bee in anybody's bonnet.
[31:57] Michelle: I like your post from yesterday at your grandma's house. I was chuckling about that.
[32:03] Patrick: Thank you. First, you get them to laugh, then you get them to listen. That's what Michelle Obama says.
[32:11] Michelle: Love it.
[32:12] Patrick: For me, pragmatically, I probably say healthcare leader on my LinkedIn because I've done a lot of different things and I don't want to get boxed into, like, Patrick is a nurse and nothing more than a nurse. Or Patrick does Epic and nothing else than Epic. So I do have a method to my madness there. But, I mean, trying to answer the question more like Miss America healthcare leader. For me, it's just somebody who stays rooted and it becomes such a buzz term. I feel like people just say patient care, patient care, but somebody who really does understand and takes the time to truly understand how difficult it is to take care of patients. Walk a mile in anyone's shoes when able. I'm not a doctor. I can't walk a mile in a physician's shoes, but I can walk a mile in, I could register a patient or pick up the phone that's answering, take someone to their X-ray, or push their wheelchair. But just understanding and knowing the intimacies of healthcare and really how it works and then taking that and working to make meaningful change or just being a good soldier within. I think that healthcare doesn't lend itself to project plans and change the same way that most other industries do because we're always ramping up or down depending on volume or census or staffing. It's just more of a bendy, flexi universe. And of course, patients are people. I'll say it twice. Patients are people. And things can happen at any different time. So for me, the best healthcare leaders are people that have made a point to stay close to the work and know the patients, know the staff, know the game, and not just preach over it.
[34:00] Michelle: Yeah, I think the credibility comes from having done the job, having walked a mile in the shoes and knowing exactly what's involved and then maybe stepping out of that into another realm and taking all those skills and credibility with you into that new role.
[34:25] Patrick: Yeah, thank you for that. It's hard and helped her, too, Michelle. Right, because I think, especially in nursing, there's such a mentality that the nurse manager or director or CNO should also be the best nurse and the best IV starter and the best at this and that. I would love for that culture to change a little bit along with our leadership, adding a little bit of realistic expectations for these poor leaders.
[34:52] Michelle: Yeah, I hear you. And I've said this before with guests. Hospitals are really good at recognizing nurses that are leaders. So they're great nurses clinically, they have great leadership skills, and then they say, you would be a great manager. But those two are not always synonymous. And then they pull them into these leadership management roles without any training, without any mentorship, and expect them to be good leaders, good managers, and managing patients, managing census, all that stuff. It's so much different than managing people. 
[35:48] Patrick: And it never stops, right? If you or I were to work a clinical shift, I can expect to work like a Hebrew slave for those twelve or 13 hours, but when I'm done, I'm done. When you're in those positions of leadership, you're never done. So I honestly think that the only harder job oftentimes than being a nurse right now is being a nurse, charge nurse, manager, or director.
[36:17] Michelle: I hear you. Yeah, it's tough, for sure. So in your job, do you create software? Like, do you have to know code? That's something that I've wanted to know for a long time. Do you have any part in that?
[36:36] Patrick: So the short answer is no, I don't code and I don't know how to create software. And I know what I'm good at. And I feel like there's always not to give myself a hall pass, but I know that there's people that are just really talented and brilliant that are going to go much further faster. And I'm working top of license. If I keep up to date with what the trends are, what the concepts are, what feedback I'm getting from different nurses, and my contribution to that process would be adding that information to our product roadmaps or pushing for really triaging and prioritizing. Just like how we triage and prioritize patients triaging and prioritizing enhancements and requests and pushing different things up or down in project plans. So I guess that's a good example of nursing impacting tech too. I kind of said it derails me earlier in the podcast, but hindsight.
[37:36] Michelle: Let's talk about EMRs for a moment. Is there any EMR that you just really love and anyone that you hate? Are you an expert in any certain EMR? Talk about that.
[37:48] Patrick: Thanks. I would consider myself an expert. I'm always hesitant to say I'm expert in anything, right? Because any of us, I think, who are humble people are a little bit shy to say that we're an expert in anything. But I'm expert in Epic because I have used it, I've implemented it many times, and I've supported it. I think the more it's a whole universe. So those of us who really understand Epic know that there's always more to learn and more change coming. And I'm also from Wisconsin and went to the University of Wisconsin for nursing, so it's always a hometown hero. I would have to say Epic because it's the obvious answer, but also because I feel like right now EHRs are at a point where they've been up and live enough that we're really starting to get better automation and less button and pointing and clicking actions. And Epic is at their best position to take the lead in that coming wave of change. This is more like punchy, but I for a long time worked out of Meditech the old magic EMR dos. And sometimes when I work at hospitals that don't have very much money, they still have it. And it's like it looks completely from 1980 and it is. You use the function keys, hopefully, this will like I don't know if it resonates with you or anyone who may listen, but I really like that one because it just does what I tell it to do. Right. It doesn't talk back to me. It doesn't. So sometimes, although it's wonderful to get alerts and things, you can very easily build a Frankenstein of a system, a total balancing act. So there's something pleasant about a system that just kind of does what you tell it to do and sits quietly.
[39:50] Michelle: Yes, you're absolutely right about that. And for us, we went from paper and our first EMR was Centricity Perinatal. Do you have any experience with that one? Well, because I work in Maternal-Child.
[40:06] Patrick: Health, not too much. I know that a lot of the Centricity products, like the pieces have kind of become what we call orphaned products, but not being updated or maintained. That's too broad of a statement, right? Because there's some really great Centricity monitors and technology out there. 
[40:28] Michelle: Yeah, I think it was the GE product. And we loved it because I feel like it was very easy to use, it was very easy to implement, it was super easy to change anything. And so I got in with the IT department, like, really early on. I was a super user and I really fell in love with all these IT geeks who would teach me certain things about the EMR. But we eventually abandoned that one because it was probably going by the wayside, but it was just too easy to change anything. Like I could call my favorite IT person and say, hey, this isn't working. Right? Here's where we chart. We need to change this part of the assessment, or we need to add this, or we need to delete this. And he would do it in like 30 seconds. I loved it because I loved, like, you were talking about the instant gratification earlier. I loved the instant gratification of that, being able to change that right away. But then there's a piece to it that I was missing, the education piece of the staff. It's like, yeah, I could go through and change all kinds of things in the EMR, but I was not really good at telling people.
[41:53] Patrick: It was kind of like a nice early playground. Maybe this was around I can think of maybe 2010, 2011. You would make a change and there would be a request and you would just put it in. Sometimes my friends in the ER would say that they were documenting in their screen change, like mid-assessment or something. I just feel like, well, we didn't know what we didn't know. And everyone's EHR is much more mature and there's policy and process and changes are much more scheduled but it was kind of exciting times for those of us in the industry.
[42:32] Michelle: Yes, it was. And I have to say that I have Epic envy. We work with hospitals around us, and so these different organizations and nurses that worked there were talking about Epic and how epic it was. And when we were getting ready to onboard with a new EMR after Centricity Perinatal, we wanted Epic. And so we were going to our higher-up saying, oh man, Epic is so cool. And for whatever reason, and I think it was a financial reason, they did not choose Epic, they chose Cerner. And so Cerner is like the redheaded stepchild of Epic and we had to learn that whole thing. Again, I was a super user with that and it was really difficult because they didn't even have a NICU module. They had to totally build our NICU EMR around the ICU one, which it's so different. And so that was really frustrating. And then during that time, I kind of had that niche job where I was a developmental specialist, lactation specialist for the NICU. Again, they had nothing in their framework, so we had to build that from the bottom up. And it was really challenging and not fun. Not fun at all. And we couldn't change anything. So after we implemented it, we couldn't change anything for at least one year, which I thought was just so ridiculous. So I have never used Epic. But I do have Epic envy.
[44:25] Patrick: Yeah. Everything you described, can very much happen in Epic or maybe more in the past, right? There's a module for everything. But like what you described going live and not being able to change anything for a year, that's very common for a health system that's maybe doing a tiered rollout of a new enterprise, EHR, conceptually, it makes sense, right, that you have to get everybody up and running on the platform and then make enterprise changes. But if you're working for Sutter or Kaiser, like a really big system, I'm trying to give you some local ones. It's like, well, that might take years and years. So that goes back to our earlier conversation of trying to be a succinct leader and understanding leader and understanding that if you are a lactation consultant and you have to answer like 50 questions that mean nothing about your assessment, and what you're doing to then get to the ten things that you actually need to do. And then that person is juggling multiple patients, and you're taking away minutes from their day. Is minutes away from patients. It's just such a game of chess. 
[45:46] Michelle: Yeah. And what it was forcing nurses to do naturally when something doesn't work. We are really good at creating a workaround.
[45:56] Patrick: I love a nursing workaround. It's probably my favorite thing about the whole thing. We do love them, the nursing workarounds. Work outside of nursing. Right, Michelle?
[46:07] Michelle: We love a good workaround. Management does not like workarounds. And so there was this constant conflict between management and It and nursing, but our message with that was like, this is a piece of crap. If we had a better mousetrap, we wouldn't have to create workarounds. So I don't know if they ever got that message or not, but that's what it was. All right, well, let's see.
[46:44] Patrick: I was just thinking for a minute how many nurses must be doing like, workarounds just in the time of us speaking.
[46:52] Michelle: A lot. A hell of a lot. So take us through a day in your life as a tech nurse. What does it look like?
[47:02] Patrick: Okay, sure. So let's see. I'm working on a business development team, and sales team, and also plugged into an implementation team for a product. So what that means is a typical day for me. I'm looking at who my prospective clients might be who are different nursing leaders that I'm already communicating with about how our software offerings could help them. Just like what they say, the art of a deal. How are you communicating with people and kind of pushing your offerings and solutions without also annoying the living shit out of really stressed, busy nursing executives? So it's always a lot of relationship management and networking that's on you're never really off of that game throughout your whole work day, you're always trying to stay top of mind and keeping up to date on current events. Then there's tactical pieces of the day where you're implementing the software. I'm not a lead implementer anymore, but I'm always just kind of looking at what are the needs of the nursing community. Is the CNO happy? What are we doing that we could be doing better? And again, maintaining that relationship, looking at different upcoming events, different conferences like Magnet Conference or ANOL, thinking about what are going to be worthwhile places to travel to or have like a conference presence to grow brand awareness and marketing. And in between, just again, just kind of spending a lot of time with live sites and live clients, asking for feedback, making sure that people are happy with the software that they have, making sure that they're getting real. Answers for things that are on the wish list or at least understanding and having the breadth of knowledge for how things are being done the way that they are. So I guess that way it's similar to nursing that you're always juggling different things, or you have a busy client here, or you have a strategy to prepare for, or you're wondering how you can meet somebody without doing anything borderline stalking. You're just always multitasking and juggling. And I think that that's where I'm really glad to have been still be a nurse, and where I'm also really glad that I've been a bartender. 
[49:35] Michelle: Oh, yeah, we're good at multitasking, right? And so we're bartenders, so that helps. What do you think is the most stressful part of your job? I imagine it's a different stress than emergency room nursing. What's the stress with what you do now?
[49:56] Patrick: It is a different stress. What's stressful to me now is, and I only knew about this just kind of like anecdotally or if I were watching a show about anybody selling anything, maybe like a real estate type of show, it's like you're only as good as, you might hear my dog coughing a little bit now, too. She's got like a hairball. She's 15. But you're just kind of constantly being judged on what is in your direct pipeline, what deal is in the works, what deal is heading south? So just kind of that constant pressure that people are looking at you or it was said to me by a boss, and it's true if you're doing anything that's sales or biz request related, business development related, it's like you can very clearly tell if you're doing it well or not. Are you getting demos? Are you meeting new people? Is anything closing? Whereas being an analyst or working on a project or other things like that, the line and the sand between what's good and bad isn't as easily there. So that's a quick way of saying that I think you can get fired much easier, much more easily.
[51:16] Michelle: I can't imagine, I'm the worst salesperson. I do not like to sell anything. Asking for money or asking to buy a product, it just makes me feel super uncomfortable and I don't know if that's just me or if that's a lot of nurses. I think selling is just kind of really foreign to us as nurses. So that would be really something that I would have to get used to.
[51:48] Patrick: It does make me wish for a stronger business acumen for nurses in general, and I certainly didn't come with that originally myself. Even if it's just asking for more money for your shift or yes, I will do this, but then I can't do that.
[52:06] Michelle: Along those lines, do you get any special business training?
[52:13] Patrick: I did not. I think that I have some good instincts in it and then I've had some really talented business leaders that I've kind of done the monkey see, monkey do approach in right. It's something that I've fallen into would be great to have had. I probably would be better at what I'm doing. But the opportunity landed. And this was a good use case because I knew nursing, because I knew software, because I knew how to implement something, because I know what nurses need to take care of a patient, then I could use all. Those things that I was really good at, to become proficient at, things that I either knew nothing about or just only had some good horse sense about.
[53:01] Michelle: Do people in the business sector look at you differently in terms of that you're a nurse and not kind of an equal on their level, or how does that work?
[53:13] Patrick: Both ways to me, nursing. We all talk about how nurses are trusted, and that's like a trust that I didn't fully see until I started working more in business development and sales, that people are more apt to listen to me because of that credibility. But also I'm very respectful of that. I don't want to give nurses a backpack name or manipulate people outside of nursing, I've seen it more like at the sideline. So I'm sure that it's also how they've judged me as well. I will oftentimes hear people think that the CNO is not equal to the other C-suite leaders. And in my mind, the CNO is the direct peer of the CFO and the COO. And I do agree that the chief executive officer is at the top of the pyramid. But I think that different healthcare leaders see the nursing pyramid as a bit more relegated, and that pisses me off. And I do everything I can to show that. That really is like the lifeblood of a hospital. Right. People go into the hospital they need inpatient nursing care. 
[54:31] Michelle: Yeah, absolutely. What's your schedule like?
[54:37] Patrick: Well, the pros are that I can usually be anywhere. Right?
[54:46] Michelle: So you can work remotely?
[54:48] Patrick: Yeah, I get into the office and do regular office hours often or go to conferences. You're kind of always on. I always have to be ready to flex up and know that if I'm doing a week where I'm working 65 hours, there'll be another week in a summer low that will go way down. The biggest thing for me is it's just always a little bit of on-call, depending on what sort of a deal might be happening or what's active in the pipeline. But besides, that probably pretty typical of a remote schedule. I get up and do my work day and then I'll take a break for dinner and go to the gym. And then I'll do kind of my quiet activity in the evening, build a slide deck, or respond to emails.
[55:36] Michelle: Okay. Wow. That sounds like a full day. For sure. So what advice do you have for nurses that are contemplating going into tech?
[55:48] Patrick: I say do it. Absolutely do it. This is the easiest question of the interview, because here's the thing. If you do it and you love it or like it, that's great. And if you do it and you don't like it, or you're like, what did I get myself into? I guarantee you that your nurse job is still waiting for you. Right. So there's really no risk. I mean, a little bit of emotional risk or turmoil that you might put yourself or your family through. But I feel like it's like a no worst-case scenario situation, practically.
[56:18] Michelle: Well, that's definitely great advice. And kind of as we wrap up, what do you say to those people that say, you're no longer a nurse because you work in tech? Besides, screw you.
[56:36] Patrick: I haven't gotten to screw you quite yet, but maybe we've spoken it into existence. This is not my own original idea, but I've read different blogs and editorial pieces by nurses where really, it's really a challenge to the whole industry. And this is something I would have told myself like 15 years ago. Being a nurse does not equal that you're a hospital nurse or the clinic nurse or the school nurse. It's like what I'm doing is a part of nursing. Being a nursing school generator is a part of nursing. It's like they're all different pieces of the career that we are incorporating differently, and it should be really celebrated more, right, that we're using our footprint. Otherwise, you know it and I know it. Other people from other industries will be more than happy to take over those roles from nurses.
[57:29] Michelle: Sure. Yeah. That's great. Well, what's in your future, Patrick?
[57:35] Patrick: I have no idea. I'm kind of thinking about maybe doing a podcast now because I've enjoyed this a lot and I think it's, you need to think about a piece. So I know that I'll always be clocked into patient care and working in a hospital. I take little breaks here and there sometimes because I don't even want to, but just because maybe if you're working like 50 hours a week at your day job, you just can't bring yourself to go in and work a shift. I have no idea how I got to where I am right now. So then I, therefore, have no idea. I feel like it would be naive for me to say that ten years from now I will be doing X-Y-Z but it'll definitely be related to nursing, related to healthcare. And my dream right now, I think, would be really fun to see what different virtual nursing opportunities come into the playing field for all of us, because that would be a neat way to be using technology and still doing the care that we miss when we're not doing it. 
[58:37] Michelle: Well, whatever you do, I think your future is bright, and I think you're just in the perfect spot where you need to be right now. I've enjoyed our talk today. You've heard me chuckling throughout the whole thing, and my face actually hurts because I've had a smile on my face the whole time. You're hilarious. You're so genuine and authentic, and I just so appreciate you saying yes to will you be my guest?
[59:12] Patrick: This is the most exciting thing I've done all week. A counter thing. And again, it's like as a nurse, you don't think that part of your job is ever going to be running a podcast or podcast to me. I might as well be on the Oprah show right now.
[59:32] Michelle: Oh, you're so sweet. Okay, well, you know, at the end, we do the five-minute snippet.
[59:39] Patrick: I'm ready.
[59:41] Michelle: It's so fun. I think we've already gotten to see a little bit of your off-duty side today, so we'll just keep it going. I'm going to put my timer on it's just five minutes. So let's go. So this is a this or that question. Empanadas or eclairs?
[01:00:07] Patrick: Empanadas. 100%.
[01:00:09] Michelle: Oh, wow. Okay. They're good. I love both of them. But I just started making French macarons, and the next thing that I want to make are eclairs. I'll let you know how it goes.
[01:00:21] Patrick: I have a Cuban mother-in-law, so that is kind of game changer.
[01:00:27] Michelle: Okay, so you said you have a Cuban mother-in-law, so would you ever sign a prenuptial agreement or have you signed a prenuptial agreement?
[01:00:35] Patrick: I have not. I would if I had a much higher net worth. I would not if I had a much lower wet worth.
[01:00:45] Michelle: I love it. Okay. What's the most creative excuse that you've used to get out of doing something that you didn't want to do?
[01:00:54] Patrick: Oh, gosh. Let me think. I have a good one, and it relates to nursing too. So I had this nursing clinical that I really hated, and the instructor, I will say was a total bitch. It was a big hospital. I would say every day that I had something in my contact lens and I needed to go back to my nursing locker to go get my contact solution. But then I would turn it into, like, a 35, 40-minute break. And because it was always a busy nursing unit, nobody and I was a nursing student. Right. Nothing was revolving over no one ever noticed.
[01:01:28] Michelle: Where's the student?
[01:01:30] Patrick: Exactly.
[01:01:31] Michelle: Oh, my God, I love that. What's the best present you've ever received?
[01:01:37] Patrick: When I'm at my grandparent's house right now. My grandfather died last year. It was an untraumatic death, but he was a woodworker, a carver, and I asked him for a sailing carving from him when he was in his early 70s because I knew I would appreciate it and like it and be sentimental, and he still had all his dexterity, and it's my cherished possession.
[01:02:01] Michelle: That's so special. If you were the boss of many, would you want them to fear you or love you? 
[01:02:09] Patrick: Oh, love me, absolutely.
[01:02:12] Michelle: How could they not?
[01:02:13] Patrick: Exactly. How could I be fearful? Being a bitch like that would just be so exhausting.
[01:02:21] Michelle: What do you consider yourself an expert at?
[01:02:25] Patrick: Oh, gosh.
[01:02:28] Michelle: Where do I start?
[01:02:31] Patrick: I think I'm an expert at taking good care of myself. Maybe it sounds selfish, but I really prioritize what I need, what I want to do. I don't do things that I don't want to do unless it's like, work or something. I stop and smell the roses when I can. I do things like get a massage and treat myself to a nice trip. I'm the person who's buying the business class upgrade, so I'm an expert at that self-care piece. It's come down.
[01:03:02] Michelle: God, that's a great message. We need more people to do that, right? So here's some would you rather, would you rather do 100 jumping jacks or 100 push-ups?
[01:03:14] Patrick: 100 push-ups. I am from the country, and my brother and I would do a lot of push-up contests together.
[01:03:20] Michelle: Okay. How fast do you think you could do 100 push-ups?
[01:03:24] Patrick: I could do two sets of 50. I do it right now if we were on the camera, but we're not.
[01:03:29] Michelle: Right. Okay. Would you rather skinny dip in the ocean or in a neighbor's pool at night?
[01:03:37] Patrick: Neighbor's pool at night sounds more taboo.
[01:03:42] Michelle: I love skinny dipping. Okay. Would you rather have a serious fear of the dark or an exaggerated fear of heights?
[01:03:51] Patrick: Exaggerated fear of heights.
[01:03:54] Michelle: Really?
[01:03:55] Patrick: Okay.
[01:03:57] Michelle: All right. Do you have a fear of heights?
[01:04:01] Patrick: No, I think only maybe, like, a healthy one. I love being in a high rise. I love times when I've lived in a high rise. If I'm in a high rise for work, I always feel like a grown-up.
[01:04:12] Michelle: Okay, well, this is the last one, and we have 40 seconds. Would you rather drink Tang or Kool-Aid with your friends?
[01:04:23] Patrick: Koolaid. Lots of flavors, and it harkens back to my childhood memories.
[01:04:29] Michelle: Yeah, Tang is gross, and my mom used to make us pitchers of Kool-Aid. They'd always be in the refrigerator. I grew up with seven brothers and sisters, so we drink a lot of Kool-Aid.
[01:04:43] Patrick: Too much added sugar for 2023.
[01:04:45] Michelle: I know. Yeah. I would never drink it now. Wow, that's been so fun. And we've gotten another picture into your life, Patrick, and I thank you so much for sharing so much of your professional life and your personal life, and your humor today. It's been super, super fun.
[01:05:05] Patrick: Thanks a million, Michelle. You're the best.
[01:05:08] Michelle: Well, you're very kind, and I wish you a great rest of your day. 
[01:05:13] Patrick: Thanks. Bye. Bye, everybody. In podcast land.