Surgical Oncology Nurse Practitioner, Kim Kish

[00:00] Michelle: "Life is a journey, not a destination."  This quote perfectly describes the path of my guest this week, Kim Kish, a surgical oncology nurse practitioner. 
Kim's journey started as a lab research associate where she learned valuable skills and even got published. From there, she moved into cardiovascular circulatory support, where she found herself observing nurses, doctors, and patients. She was again picking up crucial work and life skills that would prepare her for her next career in business. 
Wait, what? I thought we were moving in the direction of nursing. Yes, but we are enjoying the journey. In her role as a business process design specialist, Kim discovered the joys of traveling, high pay, and process management. But something kept tugging at her, urging her to go around the next bend and discover nursing. So at age 30, she became an adult learner and entered nursing school. 
Kim is passionate about providing quality care to the people she serves. She is a leader among her peers, a mentor to new APRN's, and a published author. She told me she loves being a nurse practitioner and will likely retire from this profession. Does that mean she has reached her destination? Not hardly. Something exciting is right around the corner. She is soon launching her career coaching business to help nurses in their journey to lead fulfilling lives. 
In the five-minute snippet: Got any travel plans?  
Well, hello, Kim. Welcome to the podcast.

[02:06] Kim: Hello, Michelle. Thank you for having me.

[02:08] Michelle: It's my pleasure. Usually, I say good morning, but it is actually noon now. I'm excited to talk to you, Kim. You are doing so much. And then I look at your bio and I go, man, like, she did so much in the past. So I'm just excited because you've had a lot of different roles, and I think that some of them are kind of related to the healthcare field which you are currently in now. Kind of take us on a little history tour, what you've done and where you are now.

[02:47] Kim: I've been listening to your podcast, and I know you kind of like these, the stories of how people land, you know, in their, in their career, in their lives. And, yes, it took me a minute to get to nursing, but I think I have my faith, and I do believe God was sort of guiding me in this direction the whole time. I just didn't realize it in the, in the beginning. And so after my first degree that I got from, from Texas A &M down here in Texas, I did graduate with a science degree it was biomedical science. So I had an idea that I wanted to go into healthcare, but I didn't quite know where I was going to go yet. And if you don't really know, it's probably not a great idea to invest a lot of money in a school that you're not really sure you want to do, right? But I knew I liked science, so I ended up in labs. I did like two, two to three years in science research labs. I did immunology research, cardiovascular research, some really cool stuff, actually, and published a couple times on some research projects. So that was very interesting experience from a scientific type perspective. But I knew that I did not belong in a lab. I knew that I belonged somewhere else. I belonged around more people. I needed to get out and kind of figure it out more because I knew that getting, like, a master's degree or a PhD in science just wasn't going to be my path. I thought graduate school was going to be my path. I'm glad I did what I did, because then I knew that that wasn't it. Because if you get too far into that path, it's hard to kind of stop and turn around. Everyone can. But so then I pivoted a little bit. I stayed in healthcare. We did have a bit of a tragedy in one of the labs, our doctor, our PhD, head of the lab, passed away from cancer. And it kind of happened in under a year. It happened sort of fast in research world. So we were just, me and all the associates were just kind of reeling from that. And each one of us was kind of approached from different people to just try to help us find a place to land. And I had already had some experience with cardiovascular or, like, some of that work in a previous experience in a previous job. And I also had some EMT experience because I got my EMT certification at the end of my first degree. I just never really used it, but I took the class because I thought it was cool. I thought I might go into emergency medicine. So, anyway, I was approached to do this really cool job called circulatory support, and that is where I got my very first taste of bedside care. What that looks like and what it looks like in an urgent situation, what it looks like, quote unquote on the floor, what it looks like in the or what it looks like in the cath lab, what it looks like in just from a nursing perspective, from a family perspective, I was this kind of tech role, but every time I went to a call, we were. We were heart pump technicians, basically. And we worked with the intra-aortic balloon pumps and the actual heart pumps. So every single time I went on a call, I was kind of like this background person just watching everything happen and observing the nurses, observing the doctors, observing the patient, observing the family. And, you know, I was doing my job, you know, running the pump, the machine that actually runs the pump. But I was kind of. I had this kind of view, I guess you call it a bird's eye view of everything. And it just struck me that this is, like, real. I mean, this is it. This is where people live and die, and this is where their families watch all of this. And it just was not lost on me. The seriousness of what you're doing in the hospital room and when you're around the families are, you know, obviously people's lives. I was young. I was in my twenties, so I hadn't really had that kind of experience before. So it just kind of left a very deep impression on me. And it was great. It was good. The stress of the night shift, however, was hard on me. We were staffed by ourselves at night, and it was a little bit scary to be by yourself when you're helping the surgeon run a heart pump on somebody's body. So that, to me, was sort of probably the reason why I started looking outside at something else to do. I still had student loans, I had bills to pay, basically, and it just wasn't, that kind of position wasn't helping. It wasn't helping my case. So I was like, I really kind of need to find, you know, something a little bit different. And this opportunity to work for a business consulting firm kind of dropped in my lap, and they were getting into the healthcare sector. So that's why I kind of took that job. It was a very wonderful pay increase, and I did do that for about four, almost five years. I think I actually hit my five-year mark right before I left. Super cool job. I did get dabbled a little bit. I had a couple of projects in the healthcare sector, but they still were very heavily involved in oil and gas companies. And even though I loved the work itself because I was helping people, I was around people. It was process management, change management, you know, training. So that all was very exciting. And I got to meet new people and I got to travel, but all sort of along the way, there was these little things in my head or little messages that would. That I just wasn't. I wasn't doing what I was really supposed to be doing. And even though I enjoyed the work and I was good at it, I still kind of knew that it wasn't it, and it was, it's just a gut feeling. I think some people have a gut feeling and they have a, some people call it a calling, but, you know, it was just, I kind of knew that I needed to relook at what I was doing and kind of do some self reflection. And usually when I reach those points, it causes a little bit of what I call depression. And that's, that's kind of what I mentioned in my, in my little short, little book. But I didn't feel right doing what I was doing. It made me feel not right. You know, I don't know if depressed is the right word, but I just. So I started self-reflecting. I journaled. I kind of went back to my good memories in the hospital and, you know, did some soul searching, kind of researched some careers. And that's how I was. Like, you know, everything that I'm doing, every job survey I took or every career survey pointed to nursing. It always my personality, my career goals, like what I wanted to do, how I wanted to help people. It all kept pointing back to nursing, the common denominator. So I did it. I just quit my corporate consulting job and went back to school. And I went back to become a nurse. I chose nursing school. I guess I probably could have chosen PA school or medical school, but I just felt like nursing would have offered me a lot of flexibility in a career path, you know, because once you, once you have your rn, you can pretty much do anything that you want. There's so many different directions you can go. So I quit. I went to nursing school and I just never looked back. I loved it. As soon as I got into school, everything felt right. Everything fell into place. I felt calmer. I knew that this is what I was supposed to be doing. I was good at it. I was helping my other fellow students. You know, I had lived a little already. And a lot of these, a lot of my co, my students, my fellow, you know, friends were, like, brand new to college. You know, they were getting their BSN, so they were kind of learning how to study, and I kind of had to learn how to study again. But I had already kind of made some mistakes. So back in my other degree, so I kind of got into a study group really quick. And I just loved, loved nursing school. I had great professors, very supportive. I found mentors in my faculty. And then they kind of helped me when it was time, you know, to find a job, they sort of helped me kind of understand the different job offers I was getting and which one maybe might better fit me as a person because I never worked as a nurse, so I didn't, you know, and they had, and so I had some mentors kind of point me in the direction of where I work now, and that was 17 years ago. I've, I've never left where, where I got my first job. I've whole, I've held different roles while I was here, but I will probably retire here. I will probably never leave where I work. And it's a wonderful place, and, and that, and, you know, that's my little journey. I took a few turns here and there, but once I made it to nursing, I never, never, never looked back. I'll do it forever.

[12:14] Michelle: Well, that's a fantastic story, and it proves so much that our paths are not always linear. They're not always like, here's what I want to do. I'm going to go on this path and I'm going to get to it. And your story has certainly shown a light on that, and I thank you for sharing it. So I'm going to go back to the beginning because you were talking about Texas A&M, and those are the Aggies, right?

[12:41] Kim: That's right. Those are the Aggies, yes.

[12:44] Michelle: Yeah. I have some family in Texas, and they're huge Aggie fans. Wow. A lot there. So you were a business process design specialist, and then you went from that to nursing. So what was that like? Because they seem like they're just two different things.

[13:06] Kim: They are two very different things. The one thing that I will say connected them. And this is kind of something I learned in nursing school, because the nursing process is such a basic foundation of what they teach you. Right. The assessment, intervention, diagnosis, problem evaluation, the ADPIE. I think it's ADPIE that was very similar to what we did as consultants. We went in and we assessed their current situation. We figured out what their problems were, where they were either losing money, losing staff, whatever their problem was. And then usually we had a software or some sort of intervention. Sometimes it was just change management, where you kind of realigned some teams. We, I thought it was the typical, like, oh, well, the consultants come in and people get laid off. Well, nobody got laid off on any of the projects I was on. People might get realigned or reassigned or some skills that were not being used over here can be used here, et cetera, et cetera. And you were there to solve a problem or the client. So. And then you would evaluate the data, you would gather data. Did our interventions work, you know, are they working? There was kind of an ongoing assessment, you know, every quarter, let's say, to see if anything needed to be changed up. So having that kind of background with the consulting company, when I got to nursing school and I figured out, oh, there's a nursing. There's a process to what we do, too. It was a very easy transition because now I was applying the process to something that I truly loved and cared about, taking care of somebody, whatever that may look like, whatever problem they may be having, whether it be psychosocial or health related or physical status, et cetera. So to me, it was an easy transition once I got into nursing school and I realized what the basis of being a nurse was all about. And I think that's something that when you're outside of nursing, you don't really realize that nurses are doing that on a loop all day long. We are doing nursing process all day long, 24/7 for our patients. And I think it's an art that nurses do that.

[15:29] Michelle: Yeah, that's a good point that you make. We are. And to anybody else, they wouldn't see it. And also the correlations that you made between business and nursing, so a lot of those processes are the same. And I could see how having that business mindset would help you in nursing as well. When you went to nursing school, you were 30 years old, so you were coming in as what we would call an adult learner. Right? You weren't doing your undergrad as, you know, a teen, so you had some life skills behind you, and you also had some job skills behind you. But what's that like coming back to a new profession at an older age?

[16:22] Kim: So, yeah, it was a transition. I kind of had to learn how to be a student again, so to speak, which didn't really come that hard because it's kind of fun to be a student, in my opinion, because I love to learn. And I wasn't having to work. I did quit and to go back to school. So my job was school. So I basically applied the work ethic and the energy and the things that I put towards my previous job, all that sort of, you know, eight to five kind of like focused energy. I just turned it into my school. I just focused it on my studies, and I guess I was already in that mode. So from just, you know, leaving a job. So I was kind of already ready for that. So that kind of was an easier transition. What kind of wasn't? Was learning how to study again, you know, learning how to hit the books. So to speak. You know, I hadn't done that for probably seven, eight years. So kind of learning how to hit the books again was a little bit different. And that's when I kind of realized, I want to make straight as. I do not want to be an average student like I was before. I want to make straight a's. That was my goal. And I was like, I got to figure out how I study and how I learn. And there were some friends that I met that were also second degree students and adult students. They were moms. One guy had been a flight paramedic. So there were other students that had kind of already been in healthcare and had kind of already figured out how they learned or how it came easier, so to speak. So that's when I kind of learned about learning styles and, you know, someone who's a visual learner or a book learner or I knew a couple of people in school that had those photographic memories that I was so jealous of, of, but that helped finding people that I could kind of relate to that understood the importance of being in a group, like a study group, and not. Not trying to do this on your own, not trying to be in a silo. Some people do learn better that way, and that's fine, but I did not. I learned by talking to each other, by reteaching the concepts and always having, like, somebody to bounce something off of. So I think that made my transition a little easier. To learn how to be a student again is just to form these relationships with other students and, you know, find out what they did and, oh, what if we just kind of all kind of gave each other different strengths and sort of helped each other in that way and we stuck together the whole time? You know, you kind of find your comradery with people and, you know, it lasted. I mean, I'm still friends with some of them today, so that helped quite a bit to figure out how to take it down from, you know, helping people make money, to just help yourself get through school. I just kind of said, this is my job now. My job is to be a nursing student.

[19:38] Michelle: That relearning is so difficult. I think the older that you get and you have to change up how you learn. I mean, I remember when I went to nursing school, I started my prerequisites for nursing school at 17 years old. So a mere child, right? And then went through the nursing program, graduated, I was 21, a brand new nurse, and had my associate's degree. And when I was in school, I wasn't focused on grades at all. Grades didn't even enter my mind. I just knew that I had to pass. Right. I wanted to be a nurse. I had to pass to get out and be a nurse. And I did that. But when I went back for my bachelor's 27 years later, you know, I was already 45 years old. And it was just so different. I had a different mindset. I had just survived breast cancer. I was a few months out of chemo. I still had chemo brain, and it was so different. And I was like you. I was really focused. I said to myself, I'm going to get straight A's.

[21:04] Kim: That's right.

[21:05] Michelle: And I don't know why that was so important to me later. Right. But it's like your priorities change with age.

[21:14] Kim: Yeah.

[21:14] Michelle: So I love your story.

[21:15] Kim: Yes. Thanks. I was a different kind of student, you know, in my bachelor's, kind of like you, and it's, you're just, your mindset is different. Where you are in life are different. You know, I'd had my fun already, you know, twenties, so I kind of just wasn't in that mode anymore. I was in learning mode. I was in, no, I'm going to do this, and if I'm going to do it, I'm going to do it all the way, and I'm going to do it right.

[21:40] Michelle: Love it. Okay. Before your business job, you were in research. So when you were getting your nurse practitioner, you have to do a lot of research for that. You have to, you know, read a lot of research articles. Do you have to do like a capstone project, things like that? So did your research past help you when you were going through the nurse practitioner program?

[22:08] Kim: I think because I had published before, I would say yes. The research that I did really was scientific lab research where we were doing experiments. I did learn about immunology. I did kind of study in that way. But the fact that they helped me and involved me in some of the actual publications that the lab put out and let me be an author, I think I was third author on a couple of papers that did help me in my research, the classes in APRN or my amp that were more research based. So I kind of got it. I got the fact that this is going to take a group and we, you know, the whole process of research. Right. You have to, you know, assess what's out there, read up the article, do a, you know, a literature review. That's kind of basically how it starts. You know, there's a process there, too. There's a research process. So, thankfully, because I think I had been involved in some publications, it came very easy to me. And I did, you know, I was able to kind of help some of the others that had no clue. Like they, this was all very new to them and they didn't understand. What do they mean by research? I did enjoy that part of it that, hey, I mean, I kind of have these skills from before, so it kind of came easy in that way. It's very different to, scientific research is very different from nursing research, as you know. But the whole process of doing the lit review and coming up with an abstract and a problem to solve again, that problem solving mentality just comes naturally to me, and I loved it.

[23:56] Michelle: Yeah, they are very different, but I would think that you would have kind of a jump on things just because you had that framework to go from. So, all right, we're going to kind of switch to where you are now, and you're a surgical oncology nurse practitioner, and that's a lot. So kind of take us through what you do, who your patients are, where you work, things like that.

[24:26] Kim: Yeah, I work in a pretty large cancer hospital, and it's a pretty large complex. We have clinics, we give the chemo, the radiation, we do the surgery. And I landed in thoracic surgery as a baby nurse, we call it, even though I wasn't a baby. I was 32 or 33 by the time I got my first job. But I knew that I liked cardiovascular medicine, and I knew that I liked oncology. We literally only probably had two or three lectures of oncology in nursing school. And just from those two or three lectures, I thought it was incredibly interesting. And also the impact, I think, of cancer as, you know, on someone's life, that the, just all the areas of your life that cancer can affect, you know, your soul, your, your body, yes. Your family, your way of thinking, like, it changes you. Cancer changes. I would. I would think cancer changes you. And just, you know, I'm so happy that you're, you know, cancer survivor, of course. I just wanted to get that in. I'm very inspired that you went back to school to get your BSN after you conquered that. It's amazing. But thank the, those, being able to marry those two and, and jump into thoracic surgery in an oncology setting was a no brainer to me. When that job was offered to me, I jumped on it and took it, not even really realizing how much I was going to love it. But the thoracic surgery practice treats lung cancer, esophageal cancer and any cancers of the chest, which can include thymomas, solitary fiber tumors, and some type of sarcomas. So we work hand in hand. You probably understand this from your experience, but the surgeons work with the medical oncologist who work with the radiation oncologists and kind of form a team and figure out a treatment plan. So I'm on the outpatient side as a nurse practitioner. I started as a nurse in thoracic surgery. I was inpatient, I transitioned to outpatient. I became a nurse manager in that clinic, and it was all thoracic. It was all in the thoracic department. And then when the position opened as a nurse practitioner in thoracic surgery, outpatient care, that's the one I took because that's the one I kind of wanted. So that's what I do now and again, I love it. The way sort of oncology and cancer is approached here at this institution is amazing. Just treating the patient, not just their cancer, you know what I mean? Treating the person really is the way I like to say it. I don't like to call people patients because they're people. They're your mom and your aunt and your uncle and your dad and your brother and your daughter and your, you know, these are just, I highly respect sort of the way our culture is here and the way we approach care, really just we care about the whole person, including their family. A lot of we have, like, caregiver support groups and, except, you know, all the things. But it's been amazing here, and every day is a little bit different. Every clinic is a little bit different. I think I like that, too, that part of this type of care, that outpatient nursing, and I'm sure as inpatients that way, too, every day is different. You never know what you're going to get. Sometimes you just have to be prepared for all of it. And I think that that quality of adaptability and flexibility is very important in that way. But that's what I do now. I help people before and after surgery, basically.

[28:32] Michelle: Yeah. That's wonderful. First of all, you're absolutely right about cancer changes you. And I can say for myself and my journey, what cancer did for me was wake me up to paying more attention to myself, not putting myself on the back burner, prioritizing myself and what I needed. So in that way, it was very helpful for me. And I love that you said patients are people. I'm hearing that more and more in the nursing community. I think when we talk about patients, there's just kind of like this. It distances them from us. And it's like, you're absolutely right. They are mothers, fathers, sisters. They are people. And I just recently interviewed Susan Davis, and she is the owner of CodePRep, and she helps hospital teams do better with code preparation. And we were talking about outcomes, and that's another word that kind of distances people from us. And she said, outcomes are people. So I love it that you're bringing it back to, hey, these are people. These are not just patients or outcomes. And I think if more of us did that, man, that would kind of change where healthcare is going, and it would be more people-centered.

[30:11] Kim: Yes, I totally agree. Yeah, I very much agree. And that's kind of how I try to approach our visits to our clinic, visits, our new patients, consults, everybody, follow ups. I see the people from the first time, they're understanding that they have cancer, and I'm still seeing some of them ten years later, eleven years later in my long term clinic. So I've seen these people survive this, go through life. They've lost husbands, they've had gained granddaughters, and they're just kind of. It's almost kind of part of my life now, too. I mean, this is the majority of what I do, you know, during my days to be with people going through cancer. And I heard that interview that you just did with her, with Susan, and when she said that, I'm glad you brought that up, too, because I got chills when she said that. I was in the car in traffic driving to work, and I was like, that is so. That is so true that outcomes, to me, it said outcomes is a survivor. Someone survived cancer. That's because I kind of equated it to what I do. And I was like, the best outcome is someone survives cancer. Like, that is amazing. Like, that's. Yeah, like, that's what we're doing. We're not just treating patients. We're. We're helping them survive this and go through it and suffer with it. You know, it's. It could be me one day. I know it's been my grandmother, and it's been a brother in law of mine, and so it hits close to home for me, too. That, and I don't. I don't even like to call. Like, when you. You know, we have to do documentation. We have to write our clinic notes. Right after we see a patient, we dictate our notes. I don't like calling, here's mister so and so. He's a male patient age, blah, blah, blah. I don't even like to use that, I just put the name and say, this was his diagnosis. I just don't like to call people. It just feels too clinical, so to speak. It feels a little sterile, a little. You're right. It kind of separates you from them when you just had this visit with them that they might have shared something, you know, very deep or emotional with you. So, anyway, I was, I was really glad that she said that, too. That, and I know these kinds of nurses are everywhere, all over the world, so that's great that our profession is kind of moving in that direction.

[32:37] Michelle: Yeah, I see a shift. I see a shift. And glad for that because, you know, being in the healthcare business, we're only in the healthcare business because we have sick people. Right. And they're people. So I think that's something that we could all remember and take to heart. Well, another question I have for you, since we did talk about your research and you're published in the research field, but you wrote a book, and it's called Nurse Your Life Back to Health. First of all, I just, I'm amazed at people that can write anything because that's just never been a forte of mine. But how did your writing, I guess, in research, help you write your book and talk about your book?

[33:31] Kim: There's like a handful of things that you can do for improving professionalism, I guess. And one of those is they started a mentorship program here, and there's mentorship programs at all kinds of hospitals, but, and they had kind of been improving on it over the years. And what they do is they pair people like me, who I think you had to have five or more years at years here, and they pair you up with a new nurse or a new nurse practitioner who's just starting, and you get paired up and you have a mentorship relationship. So through this sort of experience of mentoring, I've been doing it for a number of years now. I kept sort of going over the same things, or, which was good. I was, like, talking to. They were having the kind of the same questions and the same fears about their careers and, you know, should I go back to school? And there was all these kind of things. And so over, over the years, I was like, I just need to get this information out. Like, I just, I think I could just get this out on paper, and I wonder if I could just write a, write a, like a paper on it or something, or I don't know where I could do it. And a friend of mine said, well, you know, you could just write a book and put it on Amazon. You could just like, you can self publish your own stuff. And I was like, I don't know what you're talking about. And it's true. You can't, anyone can do this. Michelle, you could write a book about your life and put it on Amazon if you wanted to. And so I kind of learned the process. oh, lord, I don't think.

[35:09] Michelle: Oh, lord, I don't think anybody would want to read it.

[35:11] Kim: Well, like, I just had no idea. And I was like, well, this will be a fun exercise to do. But, yes, in the meantime, I'll be able to get all this, all this advice that I have kind of pent up in me. I'll get it out on paper. And because I was always enjoyed journaling and that always helped me process things to visualize it, write it, get it out. So that's what I, that's kind of what started the process. I didn't really, it wasn't a money making thing or anything. I just was like, well, maybe if this could help somebody who's thinking about going back to school to be a nurse, it might be nice to read about someone who did that and really changed what she was doing at the time, being a business consultant, switching to being a nurse, that it is possible. And you do have transferable skills. And even there's stay-at-home moms, stay at home dads, the amount of skills and work that, that takes to run a household that is transferable, for sure. That's probably, I think, one of the hardest jobs, in my opinion, to raise your family. And so I think a lot of people that were stay-at-home moms at the time that maybe questioned themselves, that imposter syndrome kind of thing, like, oh, I don't think I could do this. I haven't been working in so long. Well, yes, you have been. Yes, you have. You've been working. You've been running a household. So that's kind of why I put the book out there again. I don't market it. I'm not even, it was just a little project I wanted to do. And it's not literary by any, by any means, but it did follow my thought process on how I approached going back to school because I didn't just sort of, you can't just sort of say, decide, oh, I think I'm going to quit my job and go back to school. And then two months later you're in school. No, it took like a year and a half to get into school because you have to take prerequisites and as you know, you had to take prerequisites and, you know, apply to school and that, that's a whole process. And which semester are you going to enter in and which, you know, which degree work in your past is going to qualify and some of it, sometimes none of it did. You kind of do have to start over. But, yeah, it's, it's basically advice and resources. That's what the subtitle is, advice and resources for becoming a second career nurse. And I put it out there and I just thought it would be a lot harder. But it wasn't like it's, I never knew Amazon had this part of their business about publishing books, but that's how it started. I don't know if people may forget that that's how Amazon started as a bookstore. It was never this big, huge thing that it is now. That's how it actually started was a book, was on books. So I thought it was an interesting activity and something I could just do for fun on the side and sort of do that. I've kind of figured out over time, over the years that it's good to have a little hobby on the side that takes you away from nursing and away from like, the stress of the job and focuses your energy on something fun. And not that nursing isn't fun, but we have hard days. We lose patients, we lose people and their families live with us, you know, forever. And so, so it's sometimes that part of me, I have to kind of compartmentalize it just a little bit. I'm good at handling that, but I need my fun. You know, I need to kind of relax a little bit. And writing this book kind of helped me do that as well as some of my other little hobbies. So I went for it.

[38:48] Michelle: That's fantastic. I just, I love your story. It's so inspiring. And you have to have something that lights you up outside of work. You absolutely have to. It's crucial. And I feel like, especially in healthcare, because like you said, it is very stressful, even though it's very fulfilling, you have to have something going on that brings you joy and relaxation. And I'm glad that writing that book did that for you. And I imagine that that book serves as a guidepost for students and other people that are looking to get into the profession. And that's one of the things that you mentioned in your bio, is you are mentor to new advanced practice nurses. And, you know, I'm a big fan of mentoring, but just talk about that relationship and how important that is.

[39:41] Kim: Yeah, it's I had one myself when I transitioned into my role, and I was very kind of blessed in that way because I already worked in the clinic where I was going to get a job. So I already knew all the advanced practice practitioners already. So I kind of knew their role. I understood. I didn't know everything about their role, but I knew their role on the team. I knew that they were involved in helping see the patients and diagnosis and et cetera, et cetera. So I kind of was blessed in that way. So when. When my hospital started this mentoring program, I saw it as a way to kind of give back. And I do love education. I love teaching other nurses things. And so I thought this was a good way that the mentees have kind of a safe place to voice their concerns or so that, you know, it's not their co workers or their supervisor. This is another person that they can bounce ideas off of, like, you know, wanting to maybe change their role or move into a different department and how to navigate that. So it's really just having those one-on-one conversations with them and kind of holding their hand a little bit through it and kind of partnering with them on their thought processes and why and who to talk to and how to network, and they have little events and little presentations about different things, how to, you know, interview well, how to beef up your cv, how to get involved with projects, quality projects, quality initiatives at the hospital. So it's kind of a person that can. Can guide them through all of that because they may have great ideas. They just don't know where to go with them. Or they're brand new. Brand new to nursing, to being a nurse practitioner, brand new to oncology, which is very overwhelming because now you're stepping into a new role. You're not a nurse anymore. It's a different way of thinking. You're still a nurse at heart, but you're now kind of a provider. You're responsible for making decisions about interventions. It's, of course, as a nurse, most of us knew the intervention, but the person that has to write the order now is you, the new APRN. So it's a different role to step into. And then oncology is also very new. So I definitely work with my mentees on where to access our library. Our library is very extensive. It's basically a medical library, but I help them with finding articles. And if they want to learn more about this here, take this course. We have access to all of our CE's, continue education, and all these oncology courses. So I was like, you can do this on demand, on your own time. And so it kind of helps them kind of get through orientation, get through their new role as a nurse practitioner. It takes about a year, I would say, to really be sort of settled. And then, you know, something's going to change in the way we treat patients in a couple of years. So it takes about a year just to kind of get settled in your role. So it's been a really rewarding sort of experience for me to see people grow through that and become very comfortable and confident. And I think it helps us all be better. And I have a mentor myself, and she's a very seasoned nurse practitioner here and she's going to retire next year and I'm just going to totally miss her. But we need those, we need those people in our lives, in our work day to sort of help us work through our decisions. They don't let it make the decision for you, but they can help you think through what you want to do because she's kind of helped me. I have a project idea and she's like, okay, let's think through the project and where we can go with it. And then she'll help me apply. Like, this is the department we're going to go present your project to and do it. So that's kind of what mentoring looks like here. And I love it. I enjoy it.

[43:56] Michelle: Well, again, it's just so crucial. And the role of the nurse practitioner is pretty different from the role of a nurse. And there's an expanded scope of practice. Like you said, you're a provider, you're a prescriber, even though I hate using that word. But those are part of the things that you do and not easy and to have a mentor like yourself. If I were a new nurse practitioner, man, I would be so thankful for that because you have to know somebody. You have to have somebody in your life that knows the ropes that can guide you. Like you said, you're not making decisions for them. You're helping them to kind of figure out the decision making process. So that's wonderful. And, you know, again, I'm going to give a shout out to nurse practitioners because I feel like they're some of the best people on earth. And I can say that because I have experience with that. My primary has been a nurse practitioner for a very long time. And when I was going through the cancer treatment, I had an oncologist, of course, but the oncologist also employed an amazing oncology nurse practitioner like yourself. And I was so happy whenever I got to see her and not saying that I didn't like the oncologist, but it was a different relationship. The nurse practitioner was so much more me-focused where I felt like the oncologist was so much more focused on the disease, the cancer. And, you know, I appreciated somebody taking the time. And again, nurse practitioners are known for being good listeners. They spend time with you. They don't, they're not always looking at their watch like, I got to go see the next patient, at least not visually. But maybe, you know, they're doing that in their mind. Who knows? You could tell me if that's true or not, but they just seem to slow down, take their time, spend time, listen to what is being said between the lines. I think they're so good at that, and I just absolutely love them. And some of my best friends are nurse practitioners, so I can't say enough. And I think that it's great that you're mentoring, and I want to switch now into your exciting piece of news for 2024, which you are launching. So I want to talk about that because you're launching a career coaching business for women in nursing. And again, this has got to be something that is like, it's got to be scary. It's like outside your comfort zone. And I I keep thinking, why are we always, as nurses, jumping outside our comfort zone constantly? It's like we just get comfortable and then we're like, no, I want to do this, but talk about your plans to launch that and how that's going to go.

[47:16] Kim: Yeah. Yes. Plan. I am definitely in the planning stages. There's really nothing live yet, but I have been, I think this little book kind of inspired me to think about, you know, a few years down the road. What are you, what are you going to do? Because a lot of people who retire from where I work, they go, they love it so much. They end up going back and working part-time or something. And I wasn't really sure if I was going to do that, but when I kind of was looking about on career coaching and what does that really look like? And I, you know, I'm doing all my research right now, right? Like, I'm in the process, so I'm in the beginning doing lit reviews, so to speak, quote unquote. So I'm, you know, researching what career coaching really is and taking some. I took a little course on it and, and just a small little thing. It wasn't like a certification-type thing, but just an intro. And I was like, oh, this would be so nice to do for people who want to go back to school to be a nurse or nurses, because going through the process of deciding that you want to go back to school, going back to school, surviving nursing school, which is really not. It can be very scary for some patients. Sorry, some students. You know, it wasn't, like, for you and I, when we went back for our BSN, we had already been working. You were actually already working as a nurse? I was working as a business consultant. So we kind of were a little bit seasoned, but there were some of my fellow students that were deer in headlights, petrified, and we just kind of looped them into our study group, like, come over here. We will help you through this. Just didn't, you know, they were 20 years old trying to figure out how to pass school, how to pass the classes. And these were kind of different. This. There's really almost nothing like nursing school. It's very different than just quote-unquote, regular old college because you're kind of teaching a whole way of thinking. So, anyway, I digress, but that's. That's kind of the thoughts that kept coming to my mind, like, I probably could help somebody, even survive nursing school and just get through it, you know, study tips, you know, putting them in touch with how to pass the NClex. What is the Nclex? I had to figure out what the NCLEX was when I got into school. It's like, what? What are you talking about? Oh, that's. Oh, that's my license. Oh, that's the test that gives me my license. That is the most important thing. You have to be able to practice to be able to work as a nurse in this state. So I didn't know anything about that when I went to school. So, like. And then navigating, like, how to interview, how to write a resume, how to pick, where to work. If I didn't have the mentors that I had, sort of helping me choose and helping me understand what real networking is like and what that is and what that looks like. I'm just. I'm a very big supporter of networking, but it must be genuine. I feel like people, there's an art to it. There's a little bit of an art to networking. And helping students figure that out is very important, too, to getting a job, because it's very competitive. First of all, it's very competitive to get into school. It's very competitive to get the job that you want. There are plenty of jobs, and. And there's, you know, this quote- unquote, nursing shortage everywhere, but so there's plenty of jobs, but I think getting the job that you want is, is more difficult than people think. So I, that's kind of how, how I thought about I could help somebody and I looked into a couple of nurse coaches that are currently, currently had websites and I was kind of checking out what they do and I was like, this is awesome. This is so cool that there's nurses out there that are helping nurses in the profession in any stage that they are. And I think it's great. Nurses are getting doctor degrees now, not nurse practitioners. There's a way to get a doctorate degree as a nurse or a PhD. So it's just an amazing career and I think more people need to come into it and need to understand it and I'm going to see if I can help serve those people in a good way. And I think as a nurse career coach I can do that. And so I'm currently researching and planning and I hope to kind of launch things by the end of the year and at least figure it out on what services I can provide and how I can help, you know, the most people in the best way.

[52:00] Michelle: Well, again, you must know that I am a big fan of nurses helping nurses and I think this is just going to be such a valuable resource for nurses and I think that your, that your mentoring right now that you're doing is only going to just add to your coaching and as a coach because I think those two are really closely related. So I'm excited. It's, it's just fantastic.

[52:30] Kim: Yeah. Thank you.

[52:31] Michelle: So, yeah, you got a lot going.

[52:32] Kim: Thank you for what you said about nurse practitioners. It's a humbling profession for me. It's a humbling role to be in. And you're right. You know, there are some differences between being a nurse. There's a difference. Differences between, you know, the, some of the doctors who just focus on, you know, the surgery or the disease or. Thankfully, I hope some of that changes a little bit where the doctors become a little bit more touchy-feely, too, and a little bit more holistic. Please see the person, not just the disease. Let us spend more time with our, these people, these wonderful people who are going through this. So. But thank you for what you said about that. It's a nice feeling that I get to sort of be a part of somebody's journey, for lack of a better term, through cancer and beyond, because I do see them beyond and I get to know their families and everything. So it's a bond that we form and it's. It's great. It's a great profession.

[53:37] Michelle: Yep. I'm a huge fan. So before we get ready to close here, there's one thing that I wanted to ask you, and it has to do with your faith. Kim, you are a devout Catholic, and I just kind of want to know how your faith has been there for you in all of these transitions through your life and in your practice.

[54:03] Kim: Yeah. So, yeah, I kind of alluded to being guided in some way to nursing all along, and I was born into the catholic faith and maybe wasn't as close to it or, you know, intimately involved in prayer, et cetera, in my younger life. But I think as I started soul searching and things like that, I kind of got a little bit more close to my faith and learned more about it and tried to understand it more and became a little bit more reverent. And it's really only strengthened my life along the way. I just knew there was a higher power. There was God guiding me through all of this. It's helped if my faith has sort of helped me also come to terms with some difficult things that I've gone through in my life and also in my work. It is not, it is still something that I struggle with emotionally when, when we lose people. So I. But I have at least my. In my. In the way that I deal with it is I give it to God literally. I say it is something that is just bigger than me, and I cannot save everybody, and it's just beyond my control. It's bigger than me, and I have to learn that and understand that. And I, you know, I pray about it. I pray for my patients. It's just something that I learned in the inpatient setting. It's when I lost people, I literally lost. They lost, died right in front of me, and I was the nurse taking care of them, so it was a lot harder. And that way, when you're in the outpatient setting in the clinic, it still affects me. But, you know, usually I'm not there, you know, when it happens. But I have lost two close people to cancer, my grandmother and my brother-in-law. It's the only way that I can cope with it is with my faith and with God, and I can't do it any other way. If I tried to do it on my own, I probably would be emotional. I would just be too emotionally distraught. So I have to. There's things that have also happened to me personally that have strengthened my faith and strengthened my, I guess, devotion to my faith as well. So it's. It's. It's an underlying. It's just part of. It's part of this. It's part of my life, and it will be forever. And it helps me get through some of the harder times that, and I'm sorry, but as a nick, you know, I know that you've been through things, too, and it's. I did do a nicu rotation, and I. I was kind of like Susan Davis. Like, I could not hats off to you because it really. It was a very, very hard rotation for me, and I knew that emotionally, I probably couldn't do that for very long if I even wanted. If I went into it. So all kinds of humble respect and honor to NICU nurses. It's amazing what you do. I hope that answers your question a little bit.

[57:26] Michelle: Yes. Thank you so much for speaking to that, because we don't talk about that a lot. And, you know, nurses we know deal with some very heavy things, and I think it's so important that we know that we're pretty small in the whole scheme of things and that divine intervention happens every single day and we're just not aware of it. And I think changing our mindset, having a guidepost that we can rely on whatever we want to understand that to be is just so important. So I really appreciate you talking about that. It's something personal, and I don't usually ask super personal questions like that, but you had kind of put it out there on your bio and things, and I was like, you know what? I want to talk about that. So I really appreciate you kind of opening up to that because I feel like it's very important. Yeah. You spoke about networking earlier, and we all have kind of a network of people that we look up to, mentors, if you will. But is there someone that you recommend as a guest on this podcast?

[58:48] Kim: Yeah. So there's this. I'm on. I've figured out Instagram. I'm very green, but I knew that I had to figure Instagram out because I think it's here to stay as is, you know, other social media. But there is this nurse on Instagram named Nurse Meg. You've probably seen her. She's amazing. She. I think she would be so much fun on your show because her focus is really helping people pass the NClEX. A lot of people have test anxiety, and a lot of nurses were perfectionists, sometimes at heart. And we overanalyze questions, test questions, and we see that there's two good answers, and it's very sometimes difficult for some people to choose the correct one, even though they're both right. I know that sounds funny, but I just like her approach on Instagram. And I like her. I like what she offers. She offers some free stuff and she gets on a call with people. So she makes it very personal. It's kind of hard to be personal with people on social media, especially Instagram. And people say all these things they want to offer you, but it's usually a course or a digital product. But she offers herself. It's really just her. And I think one or two other people, and I just, I love that about her. And she's a nurse helping other nurses, so it's Nurse Meg. I can send you the, I can send you her Instagram, but if you just searched NurseMeg, you will find her. She's very energetic, and I love what she's doing, so that would be kind of cool. And then I know Katie Duke is another one. She's a nurse practitioner. I think she's an aesthetician. And I think you, in a, in a past show, I think you had expressed interest in talking to someone in that field that's getting very big for nurses right now. But her name's Katie Duke, so you might want to look her up, too. And then if I have, I have seen you put out a message for a wound care nurse. And if the wound care nurse that I knew here at my employer retired a few years ago. But if there is someone that comes to mind, I'm going to send them your way.

[01:01:08] Michelle: Oh, perfect. So thank you first for those recommendations, Nurse Meg and Katie Duke. So I will look those up. And I, you know, like you, when I was first learning Instagram, oh, man, so much angst around it. It's like, I don't know how this works. And, you know, what I found is you just have to, you just have to do it and be on it a lot. And in the beginning, I was. And so now I kind of understand it and appreciate it because that's where I met you, and I've met so many of my great guests on Instagram. I just think it's a wonderful platform. So thank you for those recommendations. And I did. I'm actually having a discovery call this afternoon with a wound nurse from Hawaii. So I think I might have found my wound nurse. But, yeah, I love that you guys are all just on it. Whenever I put out my APB's for, like, I'm looking for this type of nurse, I think it's great. And I appreciate all the help. Well, where can we find you?

[01:02:13] Kim: My website right now it's in development, but it is live. It's npforlife.com. My Instagram is KKNP for life, and those are sort of the main places that you can find me. And there's a way to send me an email through the website, of course, but my email is, I don't mind giving that out too, if someone wants to contact me. But it's KimberlyKish 2013@gmail.com, which is the year I graduated as a nurse practitioner. 

[01:02:46] Michelle: All right, well, we've reached the end, so we're ready for the five- minute snippet. Are you ready to have five minutes of fun?

[01:02:54] Kim: Oh, yeah. Bring it on.

[01:02:56] Michelle: Sweet. Okay. What do you feel? People complain too much about? 

[01:03:44] Kim: Money and not having enough of it.

[01:03:46] Michelle: I 100% agree with that. Would you rather have a best friend who is a genius or a millionaire?

[01:03:56] Kim: Oh, okay. That's a hard one. I'll go with genius, because I just said we shouldn't complain about money. But, you know, maybe if they're such a genius, they. They are a millionaire.

[01:04:06] Michelle: I don't know.

[01:04:06] Kim: No, I would like to know someone who's just genius, smart, and, yes, that. That's probably better, right?

[01:04:13] Michelle: I always call that a twofer, because, like you, I would say if this person's a genius, then they're probably also a millionaire. Okay, favorite exercise to do in the gym?

[01:04:25] Kim: Oh, because I don't like the gym. But I tend to like those full body. Like, you do a lunge, and then you have a weight in your hand and you push it up. So it's like a full body, all one exercise. So I'm working multiple muscles at the same time because I want my workout to be short. I don't want to spend hours in the gym. I am not a treadmill. I want one exercise. Give me, like, two or three exercises. I want to whip them out in ten minutes and be done. So the ones that are full body. I'm all about that. I like squats. I'm good at squats. So we'll go there. Squat pus -ups, squat, squat. What do you call, dumbbell raises or something.

[01:05:09] Michelle: I know what you're talking about. We used to do those in Crossfit, and those are hard. And we did so many squats, too. Wow. Power to you. My favorite machine that I'm loving in the gym right now is the elliptical.

[01:05:22] Kim: Oh.

[01:05:23] Michelle: And I put it in hike mode, and it's just fun for me.

[01:05:26] Kim: Yeah, that is fun. Especially the ones with, like, a TV attached. So I'm not okay.

[01:05:31] Michelle: Exactly. Would you rather build an epic sandcastle or just a decent tree house?

[01:05:39] Kim: I think a decent treehouse. If it's decent enough, you can just go up and sit in the tree and watch the birds, and I think that would be very relaxing.

[01:05:47] Michelle: Me too. I love that. Okay, favorite childhood pet.

[01:05:54] Kim: It would have to be all my cats. I didn't have a lot of cats at one time. I just. I had. We always had a cat, and I was the cat person in the family. Like, my sister wasn't really into animal, like, into cats, and neither was my mom. And so the cat would always end up sleeping in my bed. So anytime we had a little kitty, they were. They were with me. So that was fun.

[01:06:17] Michelle: So you're the cat lady.

[01:06:20] Kim: I love cats. I do love cats. I don't have one right now. We have dogs, but. But I had a cat for, I think he was 15 when he finally passed away, and so that was the one that I couldn't get another one after him. It was the end of an era, so to speak, the end of my feline era, because it was hard on me. When he died, he had diabetes, and I took care. I gave him insulin shots and everything.

[01:06:46] Michelle: Wow.

[01:06:47] Kim: So. But wow.

[01:06:50] Michelle: Okay. If I wasn't a nurse, I would be a blank.

[01:06:56] Kim: I think I would be a mom. I think I probably would have ended up being a mom, just a mom for the rest of my life. Yeah. I just. I think moms take care of things. They take care of people, they take care of their babies, they take care of their husbands. They take care of, you know, and that's what nurses do, too, take care of everything. So I think if I wasn't a nurse, I would be, I would just want to be the best mom I could be.

[01:07:23] Michelle: Motherhood is a noble profession. Okay. Convince me to visit your home state.

[01:07:29] Kim: Oh. Oh, that's so easy. Texas? Are you kidding me? There's so much to do here. We have the desert, we have the beach. We have the heat. We have snow. We have maybe a mountain or two, but we have hiking. You can hike in the hill country. You can hike in the desert. You could hike, we have the hills. We have the forest in east Texas. We have, like, four bustling metropolis centers, and we have little, beautiful country towns. So you can pretty much do everything. We probably have the most state parks of any state. I'm gonna. I'm just gonna say that without knowing it for sure. But if you like camping, if you like state parks, we have tons. We have waterfalls, we have springs, freshwater springs. So you name it, we got it. You can go kayaking. You can go, you know, rafting. We have the Rio Grande to the south. I mean, it's. How could you not love Texas so much to do here?

[01:08:35] Michelle: I think you need to be on the state board of tourism. That's pretty convincing. I've been all over Texas, and I didn't know all of that, so that's awesome. Okay, let's see. Last question. What's the most important thing to carry with you at all times?

[01:08:53] Kim: Oh, well, I'm gonna go Catholic on you. It's my rosary and my scapular. I do not leave home with either one of those. I don't leave home without either one of those. I wear my scapular, and I keep my rosary with me at all times.

[01:09:08] Michelle: I love that, Kim. You know, I was like you, born into Catholicism, and once I had my confirmation, I said, I don't know if this is for me, but I am a huge Mother Mary fan, and I have a collection of the Virgin Marys, and whenever I am feeling like I need some inspiration, I need some comfort. I look to that collection, and I realize who Mary's son is, and I respect that, and it just brings me such comfort. So I think those things are so important to us, and not just as Catholics, but. But to people that, again, have a higher power.

[01:10:01] Kim: That's a beautiful power.

[01:10:03] Michelle: So thank you for that.

[01:10:05] Kim: That's a beautiful thing, Michelle. That's wonderful.

[01:10:09] Michelle: Well, this has been super fun and super educational for me. I have learned so much, and I have appreciated you coming on and sharing all your knowledge and your wisdom with my audience. So thank you so much, Kim.

[01:10:24] Kim: Hey, thank you for having me. Michelle. Been humbling, and I'm kind of feeling my own imposter syndrome. Being in the company of all the people that you've interviewed are just. I you know, I guess I'm a little intimidated that I'm amongst them. And you. You allowed me to be on your show, and I think it's amazing what you're doing. And I appreciate you, too. You so much, too.

[01:10:48] Michelle: Thank you so much for that. And you're not an imposter. You legitimately belong here.

[01:10:54] Kim:Thank you. You take care.

[01:10:58] Michelle: Yeah. Have a great rest of your day.