TCNP turns ONE!

[00:00] Michelle: Hi. Welcome to the Conversing Nurse podcast's anniversary episode. Today marks a year since we started this journey, and it's been an incredible one, full of challenges and accomplishments. This year has reminded me of the first year after losing my husband over seven years ago. Trying to navigate the world without my person created anxiety and sadness. But with every small accomplishment, hope for my future, I learned new skills like how to drive his truck and fix things around the house (my secret: YouTube). This year in podcasting has been full of firsts creating a website, managing social media oh, my goodness. Recording, publishing, and just all the techie things in general. After retiring from 36 years in nursing, it's been important to me to stay connected to the nursing community, and after this year, I feel more connected than ever. It has been a blast to bring you insights and knowledge from my guests every week for the past 52 weeks. Today's episode will feature some of my most memorable guests, including the most downloaded episode, the most emotional (you guys are going to have to get out your Kleenex), the most educational, and the most humorous. I hope you enjoy listening to this episode as much as I've enjoyed this entire year. Go back and listen if you missed some and subscribe so you don't miss any. And thank you for being on this journey with me.
To start off this episode, we will talk about the most downloaded episode. And my guest for that one was episode one, nurse educator Dianthe Hoffman. Is this just beginner's luck? Doubtful. It's easy to see why Di's episode was the most downloaded. She's a doctorally prepared educator of BSN pre-licensure students who is intelligent, well-spoken, and compassionate. Listen to her impactful message to her students.
Dianthe: If you're struggling or you're feeling overwhelmed or whatever, think about your family members being in the hospital and you want the best care for them and you need to think about that patient in the bed. They are someone's mother, someone's daughter, someone's sister, those kind of things. And so you really need to keep that at the center of all of your and I think that'll keep us motivated and be better nurses and better people in general.
Michelle: Yeah, as one of my upcoming guests, Patrick Pickarts, a nurse in tech, told me, patients are people. And he said, I'll say it twice, patients are people. They're not the MI in bed nine or the gallbladder in bed 56. And that's what Di is communicating to her students. Patients are you and me and the neighbor down the street. I agree with her when she said nursing is more than a job, it's a calling. And her work truly embodies that. I'm so fortunate to have worked beside her for years. She is so totally deserving of the most downloaded episode,  nurse Educator Dianthe Hoffman.
The next category is guests I learned the most from and there were a couple of guests that I learned a ton from. First, Informatics nurse Taofiki Gafar-Schaner in episode 17, I thought I had a good idea of what Taofiki's position entailed but he taught me everything about informatics. After what he called the boring part, which wasn't boring by the way, he then told me what really excites him about the future of informatics in healthcare.
[04:25] Taofiki: The part of informatics that excites me is what we are going to be doing or what we should be doing in the next 15 to 20 years. As opposed to focusing primarily on the EHR system and focusing within the hospital, it's what are we going to be doing for patients? When you look at things such as the ECG devices in our wearables and all the other things that are going on in the consumer market, how can those things apply to patients and how can nurses make sure that those tools are optimized for patient care? Those tools are optimized for preventative care and not a lot of informatic schools are talking about these things. Not a lot of healthcare systems are putting nurses in jobs that look at these things. And to me, that's a full-blown industry on its own that is not being tapped. And that's kind of what excites me is that if we have the right tools outside the hospital, we can prevent diabetes and CHF patients and our dialysis patients from getting worse, and then they don't end up in the hospital for five-plus days. So that's what really excites me.
[05:27] Michelle: Me too Taofiki! The possibilities really are endless. And he should know. He's an innovator who co-created a product called Safe Seizure which is currently exploding on the market and he helps nurses do their jobs better every day by improving processes.
Up next is Leah Elliott from episode 16. Leah wears many hats. She's a midwife, a nurse educator, and a legal nurse consultant. Again, I thought I knew what the position entailed but Leah explains it really well here.
Leah: People find me and I don't exactly know how it first started happening. I think it was from my LinkedIn profile and then I was approached by an organization that houses experts and their CVS and background and experience. And then if there's a case that meets my profile, they'll ask me if I want to offer an initial opinion. And then the attorney will look at my answers to it, usually four or five questions in the beginning. And I think it's really maybe a weed them out process to try to determine if I do, in fact, have some experience in that field. And so then after we've gone through that initial process, we usually have an interview, and they will give me some just very specifics of the case. I have to make sure that I don't know anyone or have never worked with anyone or at any of the facilities that are being represented because that's a conflict of interest and I have to abstain at that point. And so then after that point, I'm retained and I'm sent the medical records. And it's a little like piecing together a mystery, a puzzle, trying to determine what happened at what time. And of course, I have the benefit of knowing what the end result of the situation is, but I kind of work backward. And so for me, I pretend like I'm the nurse caring for that patient. I take all the information. I give myself a little report by going through the medical record, and then I will actually evaluate the fetal strip all the way up to the point of whatever the condition or incident is if there is any. Sometimes there isn't an actual point that we know something went wrong. And then I will either give a verbal or written opinion to the attorney and then if I am asked to, I will provide a deposition and or become a witness in a court proceeding.
Michelle: I think the legal nurse expert job is great for someone with a lot of experience in their field, very analytical, and loves dissecting things and putting them back together. Someone, too, that has an interest in law, although Leah said it's actually preferred that you don't have a legal background. So now you see how Taofiki and Leah taught me so much about their fascinating nursing specialties.
Next up is the category for most interesting nursing specialties. Kirby Williams from episode 29 is one of them. I met Kirby on Instagram. Her IG handle Is @your PMHNP mentor, and it immediately caught my eye. I started following her right away. So a PMHNP is a psychiatric mental health nurse practitioner. Didn't even know one could specialize in this, and Kirby's been doing it since 2012. I guess I've been living in a NICU bubble, but here's a little bit of our conversation. 
[09:22] Kirby: So, a psychiatric mental health nurse practitioner. Some people might see the acronym PMHNP. And what we do is that we are advanced practice nurses. So we are nurses who have a master's degree in nursing with a focus on psychiatric and mental health conditions. And so what I do, more generally speaking, or what we do as a collective in our careers, is that we treat mental health conditions, and that is with medications or with nonpharmacologic treatments as well. And so that's what we do, kind of more generally speaking.
[10:06] Michelle: Okay, well, that is a very good overview. So I know that there are some kind of subspecialties within this specialty, some of those being, like, addiction treatment, but yeah, tell me about some of these subspecialties.
[10:25] Kirby: Yeah, there are a lot of subspecialties. The one that I feel is growing or has been growing recently has been the perinatal mental health specialty or subspecialty. And that is a really special one because there are a lot of providers who are nervous when they have to manage the medications of a person who's pregnant because they have to think about the health of the pregnant person and then also the health of the fetus and when the child comes out. And so that's one specialty. Another specialty is addiction. And so those psychiatric mental health nurse practitioners or other providers in mental health who focus on addictions are focused on recovery, are focused on helping people continue their recovery from different types of addiction. And sometimes in those cases, they're using medications to help kind of supplement their efforts to recovery, so to speak. And then there's also when you look at the inpatient side as far as a subspecialty, there it's called consult and liaison psychiatry. So those are specialists who have a really good background in medical as well as psych. And what they focus on is being able to go to medical units and do consults on medical units. And sometimes even in the ER, if there is a case that is maybe a little bit more complex and they're trying to differentiate from is this a psychiatric illness or is this a physical health illness or is it a mix of both? Because sometimes it can be something like that as well. So those are just three of the specialties. I probably could talk all day about the specialties, but those are just three of the probably more common specialties.
[12:25] Michelle: Can you hear from her description of why I find this one of the most interesting specialties? I mean, if I were aware of a PMHNP in 2012, who knows, I might be one today. I was also intrigued by another guest from episode 21, transplant nurse Annette Needham. I mean, I knew what a transplant nurse did, as in taking care of patients who've had transplants, which Annette has done, but now she's a transplant coordinator and there's so much more to her position. Take a listen as she differentiates the roles.
Annette: There are lots of different roles within transplant. And as you know, in nursing, there's kind of not one size fits all and transplants are no different. So a transplant nurse could take many forms. Typically, most people think of a transplant nurse based on their experience, so patients would think of them as probably a transplant coordinator or a nurse that they meet in the transplant clinic. Whereas obviously, the inpatient side is very important. Once they get their transplant, then they realize, oh, this is the transplant nurse. So I think we take on many different roles. But basically, a transplant nurse really could be any person from the clinic itself checking patients in, and educating them in the clinics. It could be someone in a dialysis unit that they've hired to work with their transplant patients. Or it could be an inpatient transplant nurse working on the floor, taking care of post-transplant patients and living donors a little offshoot is the transplant coordinator, and those people typically coordinate the whole entire thing. And depending on the place that they come from, the transplant center, it could range from just a very narrow role. If it's a very busy center, such as they work in pretransplant or they work in loving donation or they're a post-transplant all the way to a small center where a transplant coordinator could do the whole entire thing, including beyond call for organs. So it's like a huge world, actually.
Michelle: Yes, a huge world, and a fascinating one at that. So happy to have talked with Annette.
Okay, next up, the most relatable there was one guest that I found the most relatable to me, that is, and she is Kathleen Wardell from episode six. I say relatable to me because Kathleen is a NICU nurse, and I had the pleasure of working with her for several years before I retired, even though I had many more years of experience than Kathleen. She taught me so much because, in her previous jobs, she cared for much higher acuity infants than I did. I came to have great respect for her because of her teaching style. Kathleen also played a key role in implementing primary nursing in our unit. She recognized the numerous advantages it offers to infants, families, and staff, and she talks about it here.
Kathleen: Primary nursing is something I only found out about when I worked at UCSF, and it's basically kind of a nursing model that's used in hospitals to keep continuity of care between patients families and a nurse. If you're in the hospital for a while and you get used to certain nurses, you kind of want to keep that same know the families will ask, hey, are you know, that's kind of a typical response you get. And so I noticed at UCSF, they had this really great program where these nurses would days of the week, they'd fill out what days they're working for these certain babies. And they were like part of this care team of nurses that knew the baby really well. And I thought that was brilliant. I hadn't seen that in my first job at Fresno, and I just thought that was cool. And I really looked up to these nurses who had established such great relationships with the families, and it was kind of a big deal. Like, if you had done a primary case, you were looked at well at work. Good for you. Those are hard, but good for you for establishing that rapport and helping basically it helps improve outcomes because you know that baby well, so you're not getting a new nurse every shift. But I was still at the baby stage of understanding primary nursing there, and I only did one or two there, and they were hard primaries, and I struggled with it and kind of didn't love it, but I saw the big picture of it in the unit and saw that it was really beneficial. And so I eventually brought it to when I came to our hospital here, I brought primary care nursing because I saw that it was a need. And I had too many families asking for not just me, they would ask, oh, my God, that night shift nurse. I loved her. And I had families actually recommend, like, if there is a way that we could get the same nurses or if you guys could change something, that's something I would recommend. I mean, I remember one specifically when I first came, and so I was like, well, this is hard to not want to fix because I actually have a tool and resources to implement it. And I felt kind of like a calling to do it. And it wasn't even a personal reason. I was not the primary nurse girl. I was pretty insecure myself. I just wanted to help implement it because I saw it for the betterment. Yeah. And I'm still struggling with a like I said, it's a fine-tuned thing. But I think overall, it does have huge benefits.
Michelle: I'm so happy that Kathleen introduced our unit to primary nursing. As nurses, we experienced the benefits, but it also positively impacted the babies and families. This is a great step forward.
Larry Lodsdon from Episode 13 also makes the list of the most relatable. Larry was so much fun, and I feel bad that he never got the Joe Rogan experience he was expecting. A longtime nurse, Larry transferred to NICU from adult nursing. Here, he talks about what he loves about the NICU population and how there are some similarities in working with adults.
[18:50] Larry: It's just an amazing experience that it's a feeling that I still haven't been able to verbalize with it. The NICU itself encompasses everything from premature infants to full-term infants with it. But to see their growth and development, having some adult experience, the way that I kind of relate it with them is it's looking at a premature infant or any infant that's had a struggle progress and go from not being able to PO or take a bottle or breastfeed to slamming 2oz is just an amazing feat. And so, just like the adults that have a stroke, seeing them progress and have minimal residuals or adapting to any deficits that they have, it's just that again, not sure how to put it in words, but their growth and their achievements, their strides that they make from how debilitated they technically are to being this little bundle of joy and fun and the portion that you get to interact with the parents with it too, and see their love and the excitement. And so then that excites you. And so it truly is just one of those areas that can give you the biggest joy, but it will also give you that biggest heartache that you're going to have as well. But in general, sticking with NICU, it's that again, can't put into words just yet that keeps me motivated. And the difficulties of their care. Because even though things are standard, their progress in the development of education or new treatment plans is limited. Because who's really going to let a hospital or a facility train on their kid, right? So there's a little bit of a delay in that. And so that scientific medical portion of it is also very intriguing.
[21:01] Michelle: I love Larry. He is a highly skilled nurse with a very tender heart and currently living his dream. As a NICU clinical nurse educator, I am very sure he is positively impacting the lives of NICU professionals and the families they care for every day.
Okay, up next are the most emotional episodes. Yes. Get out your Kleenex because these two guests will really get to you. Monty Anderson from episode 34 is not only a longtime nurse, but also a longtime friend. I started my nursing career as a pediatric nurse on the night shift with Monty. He quickly became a mentor and friend. I learned so much from him, not only about being a nurse but how to be a good human. Monty is one of the most compassionate people I know now a pediatric hospice and palliative care nurse, or as he likes to say, a pediatric complex care nurse. His impact on the children and their families is profound, and I have a feeling it goes both ways.
Michelle: One of the things that you deal with all the time in your profession is children dying. So I want to talk for a moment about what does that mean for you as a nurse, as a person, to be with this child and the family at the end of their life?
[22:39] Monty: Oh, there's so many things, I think, as nurses that we go through. I think the first is recognizing, especially if it's a new patient that's coming on, that they have never met us before, and they're pretty much just kind of handing over the most precious thing in the world to us. So it's a humbling thing when you walk into that and you realize it. So you recognize that first. And then you also have to recognize that the emotions that are going on, yes, they're real to us, and we know what's coming. We know what to look for. We know those things the family doesn't. And so how do you, without just being blunt and noncompassionate, how do you keep them informed of those things? So you can kind of point out, some families just want to know outright, what am I looking for? So, okay, easily you can go down the list, but as they occur, you can point them out. But trying to make sure that you know that your emotions don't become part of their emotions, being very aware of, I can go to my car and I can cry, but I don't need to be doing that in there. That's not to say that you and the whole family will have a good Christmas in place just because the moment happens to be right for it. We're human, they're human, we're all human, but our emotions don't take over for theirs.
[24:15] Michelle: So emotional, right? I tear up every time I listen to him, and I really do believe his entire nursing career prepared him for where he is now, where he is meant to be.
In episode 40, Cydney Alvarado, a hospice nurse, is equally emotional when she talks about the gift of being with someone at the end of their life.
Michelle: One of the things that came up in your bio that caused me to get very emotional was how you described hospice. And I just love it. You said that it's your heartbreaking joy. Can you talk about that?
Cydney: Probably not without crying. I think a big part of it is because of my faith also. And so because I truly feel like God uses me in this area and I take it as such a privilege. This is like the most fragile parts of people, and I'm invited in and you build relationships, you get to know the families, the family dynamics. Oh, goodness. I get to sit on the floor with their dog, right? We become part of their family. And so there's joy in the fact that I know every time I leave a situation, I've given them a bit of peace, a bit more understanding, a bit more empowerment, a bit more permission to feel. Grief is such a crazy thing that makes no sense. And I think that it's so easy to push past it because you have to take care of your loved one or take care of other family members, or you're still working or just taking care of your home or whatever the case may be that we don't give ourself enough space and permission to grieve this. And it's like, it's okay. Grief is okay. It's part of the process. It's okay to be angry. It's okay to be angry at God. It's okay, or whatever is your higher power, right? It's okay to be angry at the disease. It's okay to say, I don't want my loved one to give up. And this feels like they're giving up. All these things are okay to feel, but then what are we going to do with it? So that's the joy that I get to come in and I get to just be invited into this really personal space and leave them better, I hope. But then the heartbreaking piece is that eventually, they do die. And I've had some really amazing relationships with people, and I've had to really find boundaries because a good portion of them become my family, at least for that time being on service. But it's like, it was like my grandpa died, but he wasn't my grandpa. And I would feel all these emotions and then it's like, who am I to be this attached to this person when you've had like 30 years with them and I've had three weeks. And yes, I was in this really precious moment with you, but at the end of the day, they're your family. I just had the gift of being there for a short period, so it takes a piece of me each time, but I'm so grateful for just the overall experience and how God uses me in each of these moments. There's some really cool moments where we share the same faith and, oh, it's so powerful. And then there's moments where we never talk about faith, and it's equally powerful because it's just humans loving humans.
Michelle: It takes a very special person to be a hospice nurse. And I would say Cydney and Monty are definitely those people and my kind of people.
As we move into the next segment, Patient and Family Perspectives, let's take a moment to remember why we are here in the healthcare industry: for the patients. And it's important to recognize that these patients are real people. In episode 31, Adam Wood shared his unique perspective on the nurses he observed while spending 135 days in the NICU as the parent of his premature son, Brady. Adam is a special person with valuable insights to share.
[29:34] Adam: A lot of times it was the nurses and the staff there that got me through it. They would physically, actually hold me up when I would break down. And I'm kind of a big guy, so it might take two or three nurses to kind of hold me up and stroke my pride and my ego and all of that and help me get through that day in that moment. And they were very personable, and that's what I always loved about a lot of the nurses and the staff. They kind of knew how to read you. And that's a trait that I think in healthcare. Being able to read people and have the social intellect and the emotional intellect on how to act around certain people is something that you can't teach. You either have it or don't. Some people are really great and they'll tell a dirty joke to a parent as an example on the side, and it makes them chuckle. And the other person that they might walk up to, they won't say anything. They'll just go in, do their job, and they know that's not what they need. And I think sometimes I joke around with doctors and other people that I know. Sometimes they lack that ability to have that emotional intellect, to be able to talk with people, and they look at it from a very clinical perspective. They look at it and I get it. They have to detach quite a bit and they have to try to focus on a lot of things. But I think that's where a lot of the other individuals that run the day-to-day of hospitals and NICUs, they just get it. They know that sometimes it just takes a funny story or taking you down and picking you up a coffee from the cafeteria on their way back from break. They can just read people in a way that not a lot of people can do. And I think that's a skill set that just goes unnoticed by a lot of people. But I definitely noticed that, and I know that it's an important thing for them to be able to do their job effectively is to be able to find out I know what I need to do for baby. I'm skillful in my job. I'm experienced. But in the back of my mind, how do I help that mom or dad? Maybe I do a little extra for them. Maybe I do, like, a footprint or I leave behind something for them because they've been having a rough time or whatever it might be. I think that those are all the things that we appreciate as well as parents. And I'm getting a little off topic, but I can't communicate that enough. It's the little things that have gotten us through the NICU more than most people realize. And I think that just being a good human being and being compassionate goes a long way in helping us get home and our babies get home.
[32:23] Michelle: Hearing Adam recount his observations of NICU nurses makes me really proud to be one. I mean, he gets us! He had 135 days to observe us, and it's a reminder to us as health professionals that families are always watching and observing. He is just spot on.
The next perspective comes from a patient. Episode 42 is Christina Gagnon, a now 36-year-old woman who was born extremely premature at 25 weeks gestation with only a 14% chance of survival at that time. Here she tells us about some important relationships with her caregivers.
Michelle: Tell me about her.
Christina: Well, her name is Dr. Kathleen Meyer, and she is someone who is very near and dear to me. When I graduated high school in 2006, I went up to Massachusetts, where I was born, and I went to the hospital where I was born, and I got to see my NICU nurse, and I got to see Dr. Meyer. And when I got up to tell the receptionist who I was, she was there. And she said, can I help you? And I said, yeah. And I told her my name, and she goes, oh, my God, I know who you are. I helped you. And so it was her and another doctor that helped me in the NICU and my NICU nurse, Michelle. And we lost contact for a few years. And back in I want to say it was 2018, I gave her a call, and I told her who I was, and she remembered me. And we've been close and because we talk to each other on a regular basis, my NICU nurse, she said, Dr. Meyer is retiring. Is it possible if you could come and surprise her? So the day of her retirement party, I went there with my mom, and I surprised her, and she gave me the hugest hug imaginable, I couldn't even breathe, the hug was so tight. And so at the retirement party, I got to meet other doctors that took care of me, and I was the only former patient there. And this was about a room of like, 150 people, and these were all successful doctors from the New York, Massachusetts area. And here I am making a speech, and they're getting to look at their end result, which they don't get to see, because when you have your baby, either the baby passes away or they go to their families and they're never seen ever again. And I wanted to do something different. I wanted to know my doctor for who she was because, to me, she's more of someone with a white coat and a clipboard signing prescriptions. She's someone who has a family and she has hobbies. She runs, she spends time with her granddaughter, and there's so much more to her than her being a NICU physician. And so her and my nurse Michelle and another doctor, Dr. Shaw, they're all very important to me. And there are other nurses I got to meet that took care of me, and they all knew exactly who I was. And they were coming up at me with shock and awe on their faces, saying, I remember helping you, and you were a baby, and I remember you.
Michelle: It's so nice to be remembered, right? I think it was interesting that Christina made the observation that the NICU professionals who cared for her are people. She described her neonatologist as someone who has hobbies and grandkids. They're people like you and me. They're not just a white coat with a clipboard who write prescriptions all day. And we as medical professionals could take a lesson from Christina. These patients are people who have hopes and dreams. They're loving and grieving and living and dying, and we need to remember that. So she kind of turned it around on us. And I just had so much fun interviewing Christina. I think she's a fantastic person, and she has persevered through so much and really thrived.
Okay, next up are the most fun interviews. I laughed a lot during many of our conversations because nurses are just naturally funny and we like to have fun. But there were two that really stood out where we just had a lot of fun and got silly. And these are Christine Daniel, a labor and delivery nurse from episode eleven, and then a nurse you haven't even met yet. His interview is coming up, but he is a nurse in tech, and his name is Patrick Pickarts. When you meet him, oh, my gosh, you're going to immediately fall in love like I did. But he absolutely takes the cake for the most fun interview yet. So first up, Christine Daniel, a longtime L&D nurse who I had the pleasure of working with for many years. And we had this crazy discussion about a training tool called a vagina in a box. Listen.
Michelle: So from a NICU nurse working with you for many years and going to deliveries and c-sections and all that, when I would walk in the room and I would see you or one of your colleagues, like, doing a vag exam, and you're like, she's minus three station, she's this much dilatation, he's effaced this much, I saw this halo around you guys, and I felt like you guys were just, like, magicians of how you could yeah.
Christine: It does seem very mysterious, I guess you could say. It's definitely a skill that took a lot of practice in the beginning because it's hard to learn, and it is hard to teach it because you obviously both can't be checking at the same time. And so it's a blind skill that you have to figure out, what do you guys practice on other than I know you get real practice as you examine the patient, but do you have, like, simulations or how does that work? We do. I think we have always had a vagina in a box. Wow. That paints a picture, right? And so it's just this square little box that has this rubbery I don't know, it's even hard to describe, but it gives you that feel for where the cervix is at. And then based on what you're feeling there, we have a little plastic chart, I guess, and that you have all these little circles from 1 you can kind of compare as you're doing the exam on the practice vagina. It's kind of a feel-and-look type of teaching at the beginning, but still, it's very subjective. Everyone's two centimeters, and three centimeters are slightly different than the next person. But, yeah, you have a vagina in a box that you get to put your fingers in and try to figure out what they're dilated to. Michelle: Wow. I'm just chuckling here every time I hear you say vagina in a box, do you see what I mean? And I've seen it. It's exactly as described,  a vagina in a box. I'm still chuckling.
Up next is the talented and hilarious Patrick Pickarts. Patrick's episode hasn't even been released yet, but I had to include it because he is, along with Christine, one of my funniest guests. Patrick is a reformed ER nurse who is now in tech, and, of course, he told us a ton about what he does, and there was just this thread of humor weaved all the way through our conversation. Here are a few clips.
Michelle: Hey. Good morning, Patrick. Welcome to the podcast.
Patrick: Good morning, Michelle. Longtime listener, first-time caller.
Michelle: 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?
Patrick: Such a good question. Yeah, it feels really good to know that you are at the top of your game. To know like a really great ER nurse or NICU nurse or any type of was like it was like learning to walk again. Right? Because I sucked for a long time. I will say my name is Patrick Pickarts and I sucked at working in informatics didn't need the language for a long time and I never became like a savant or anything with it. I got good enough, but I've always had to lean on my soft skills. I'm a personality hire, Michelle. Learning new things is a bitch, Michelle.
Michelle: So what I want to know is, did any of your emergency room skills transfer over to tech?
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 F it. 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 now, 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.
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 know, 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 it would be more fun to listen to if you'd seen the movie Michelle.
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 Natalie. Oh, 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.
Patrick: I would love that.
Michelle: 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?
Patrick: This is the most exciting thing I've done all week. Thanks. 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 on a podcast. To me, I might as well be on the Oprah Show right now, Michelle:
Michelle: So this is a this or that question. Empanadas or eclairs?
Patrick: Empanadas. 100%.
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 is eclairs. So I'll let you know how it goes.
Patrick: I have a Cuban mother-in-law, so.
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?
Patrick: I have not. I would if I had a much higher net worth. I would not if I had a much lower wet north.
Michelle: I told you guys these were just a few snippets. When you hear this whole episode, your face will hurt at the end from smiling, which is not a bad thing. And yes, Patrick, I did watch The Devil Wears Prada, and we need to dish on that very soon. Be looking for Patrick's episode in the next few weeks. I can't wait for you to hear him. There are two episodes that I did this past year that I will classify as the most special, and that's because I had the pleasure of interviewing two of my siblings who are both nurses. Episode three is my sister flight nurse Jennifer Caposella and episode four is my brother, nurse researcher, Chris Patty. Jennifer is someone who is truly fearless, as in if I opened Webster's Dictionary and looked up the word fearless, her name would be there. There are two clips here. The first one is Jennifer revealing her childhood dream. And the second is from the five-minute snippet, also flight related.
Jennifer: Getting my pilot's license was something that I had wanted to do for a very long time since I was a teenager. I was very interested in aviation. I was very interested in aviation. And after becoming a mom and working and all the reasons why we don't go back to school or we don't do something that we've been waiting to do is we put other people before us, right? And so taking care of all those things that I believed needed to be taken care of with priority. Started looking at it, I think, 2019, and the world was just getting ready to change at that point. So I like to refer to myself as a pandemic pilot because I did all of my flight training during a period when work was very slow. And I mean slow slow as in a lot of telehealth and not being in contact with people if we didn't have to. And most of my customers and contacts became remote. And so a lot of the time that I spent staring at the windshield and in the car, driving back and forth all over the place, that wasn't happening. And it was like, wow, maybe I can switch gears and make something out of this time that I have. And so I did my flight training in 2020 and received my private pilot's license. So it was something that I had wanted to do for a decade and very proud of all the things that I've been able to do. It's one of the big ones for me that I was able to do that.
Michelle: If you could add one feature to airlines, what would it be? I want to hear the answer to that.
Jennifer: Okay, so if I could add one feature to airlines, it would be I want to hear what's going on in the cockpit. Yeah. I hate not knowing.
Michelle: Do they have apps that you can with your knowledge as a pilot, can you creep on them? Like, could you walk into the cockpit and be like, hi, guys?
Jennifer: No, they probably tackle me.
Michelle: Air marshals would get you. Do they still have air marshals?
Okay, you guys go back and listen to Jennifer in episode three. You'll see what I mean about fearless and really look her up in the dictionary, she's there. She's amazing.
Last but never least is my brother Chris from episode four. He's as equally amazing as Jen, but he's in a different part of the dictionary. If you look under humor, that's where he'll be, definitely the dry humor section. Like, sometimes his jokes actually slip by you, they're that subtle, or maybe I'm just thick. That's probably what Chris would say. You've heard me say many times that we don't always become nurses for lofty reasons, and Chris's story proves that in an interesting and funny way.
[50:55] Chris: I came from a family where mom left nursing school, essentially to get married and have me in 1961. I don't know that that was a strong influence in my life. Early on. In my early teens, I helped take care of my grandfather and was taught at about age 14 or 15 how to irrigate a Foley catheter and get people up off the floor which may have had something to do with it. I kind of took a gap year between high school and college, and in that year, I was looking for something to do, even a way to make money, maybe. And I happened upon an ad in a local newspaper for a little trade college here in Visalia, and it was advertising a program about surgical technologists. And of course, the ad, as ads do, made it seem much more glamorous than it really was. But I called them. I went down and interviewed. I think the program cost $2,400. It was a nine-month program, and I completed it and went to work in the operating room as a surgical technologist, or they also called an operating room technician, scrub in, hold, retractors, suction, pass instruments, that kind of thing. And that's where I met the people that I would surround myself with to this day, doctors, nurses, et cetera. This was an operating room back in '81, actually, when I came to the operating room, where many operating rooms were still all RN staff. In the bigger cities, certainly, but in this small city had a staff of nurses for the circulating role and technicians for the scrubbed role. And I, as the scrubbed person, was standing there, feet hurting, back hurting. Now, this is in my 20 years old, and I look across the room, and there's a guy sitting down reading Mad magazine, making three times what I was making. And I went and talked to him. I said, how do you get that job? He goes, well, you got to become a registered nurse. Well, how do you do that? Well, you got to go over to College of the Sequoias, and you got to go talk to Dr. Merviss or Dr. Havard and apply, and if you're lucky, maybe you'll get in. So I saw the writing on the wall pretty early. I said, well, I got to do this nursing thing. And my first nursing job was about three years later, in 1984. And I went up to the big city in the valley, which is Fresno, and it wasn't all RN operating room staff, so I already knew the scrubbed role pretty well, and so I fit in okay. And then the rest, as they say, is history, my history. Spent 20 years in various operating rooms in various roles.
[54:18] Michelle: It's pretty dry. Did you catch it? He is always thinking outside the box, and he's such an advocate for nurses. Here he is speaking about how nurses can get involved in research.
[54:32] Chris: Doing good research, doing rigorous research, doing research that's powered at the level that you can generalize findings and say, if it worked here, it'll work there. They have to be set up right. They need to have subjects in the study to detect differences or relationships, all that kind of stuff. You have to have biostats. You have to have an institutional review. You have to have places to keep data. You have to have people who can go out and do field work and collect data. And sometimes that's hard to do, particularly in the COVID environment. So it costs money and human resources to do good research. And so it's not within the possibility of every nurse to do a vaccine efficacy study with 44,000 participants, but every nurse can discover, be an investigator and lead a research study, even though the educational hierarchy of degrees would say that they're not prepared for it until the graduate level, generally speaking. But my experience has been with mentorship and with simplification of the process. Every nurse can get engaged in discovery. Every nurse could be a researcher.
[56:08] Michelle: I love that every nurse can discover.
[56:10] Chris: Every nurse is discovering all day long.
[56:15] Michelle: I had so much fun talking to Chris. He is a genius in so many ways, and he's been there for me throughout the years as my brother, my mentor, and my friend, and I truly appreciate him.
Well, that's it for my one-year anniversary episode. If you've listened to the end, thank you. I appreciate you. It's been my honor and privilege to talk to so many great nurses and other healthcare professionals and to hear what they do and why they love it. So what is the future of the Conversing Nurse podcast? Well, let me get out my crystal ball. Just kidding. I don't have one of those. First up is a well-deserved vacation. So I'm taking the entire month of August off. But take this opportunity to go back and listen to some episodes that maybe you missed or listen again to some of these fantastic guests in today's episode. Never fear. I will return on September 6 with an episode of a compassionate and experienced oncology nurse practitioner. You guys are going to love her. She's also a legal nurse consultant and very accomplished in that field. I told you about the talented and hilarious nurse in tech, Patrick Pickarts. He's live on September 13, so do not miss him, period. And then I interviewed a fantastic licensed vocational nurse that's talented in so many ways. He'll be coming up on September 20, so stay tuned for those guests and more.
I had a great time creating the Florence Nightingale minisodes throughout the year. I learned a lot. And I want to extend my gratitude again to my brother Chris for lending me the book Notes on Nursing: What it Is and What it Is Not. You guys, sadly, no one claimed the book during my last giveaway. I know, right? So as a result, I have decided to donate it to my local hospital's medical library so that nurses there can benefit from it. It's a fantastic book and I highly recommend it. It's in my bookstore on Bookshop.org. The link is always in my show notes, so you can check it out there as well as all my guests' bookstores. 
I'm going to continue creating these minisodes that highlight nurses who have made significant contributions to the profession. So let me know if there's a nurse that you would like me to spotlight. 
And before you know it, Veterans Day will be here and I'm really excited to speak to several veteran military nurses. I don't know what they do. I have no clue. So I'm excited and I think I'm going to be inspired too. 
I'm eager to hear more from you this year! I'm planning an episode on burnout, and I want to invite a panel of nurses to talk about this really important and timely topic. Burnout is something that can affect all of us at some point in our careers, and there's different levels of severity. So if you are currently experiencing burnout, if you've recovered from it, or are concerned about it in your future, please share your experiences with me. There are several ways to get in touch: Instagram, my website, my email. So please reach out. I'd love to hear from you. 
I am feeling all the feelings right now. I'm proud. I'm amazed. I'm delighted and hopeful. And I'm excited about what the future will bring for me and for you. Thank you, guys, so much for being with me this year. I'll talk to you soon.