The Break Nurse, Alex Whitefield

[00:00] Michelle: In 375 BC, the ancient philosopher Plato wrote, "Our need will be the real creator." But over time, the phrase has been condensed to its current form,  "Necessity is the mother of invention." 
Alex Whitefield, aka "The Break Nurse", is an innovator and nurse leader who identified a need: hospitals were using an outdated break system which was making it difficult for nurses to get breaks. So he co-invented Breakalgo, a software program that optimizes break performance through smart scheduling in real-time.
Why do we need breaks? Consider the cognitive, emotional, and physical load nurses endure in a typical twelve hour shift. Now add to that little time to pause from witnessed trauma, nourish the body, or rest, and recover. Numerous studies show our ability to critically think diminishes with physical, mental, and emotional depletion. But our nursing culture continues to view breaks as a luxury, not a necessity. Alex has made it his mission to change this narrative and is proving to us that over two millennia later, Plato's axiom still holds true.
In the five-minute snippet: Alex, you need a raise. Well, good morning, Alex. Welcome to the podcast.

[01:46] Alex: Thanks for having me.

[01:48] Michelle: Well, thank you for saying yes to coming on. I saw you on LinkedIn and immediately I was intrigued because you are known as The Break Nurse, and I love that because we all need a break. But you're an innovator and a creator and a co-founder of Breakalgo, so I want to hear all about that, but just start by giving us a little bit of history. 

[02:16] Alex: Yeah. So I started my career in the emergency department. I worked in a local community emergency department. Really good experience. I was so fortunate to have some experienced charge nurses and mentors who helped me throughout that. Again, kind of going back to my tying it back to our conversation here today, but breaks were hit and miss. We did have some processes, they were somewhat broken, and in the worst times they failed, but we were able to get those going. I switched from that community facility over to a Level II trauma center here in Tacoma. And obviously it was a different change of pace, and breaks were something much different. We only buddy- breaked. There wasn't a system, there wasn't a process. And in many cases, those breaks were, I would even say, weaponized. Where some people would get them, some people wouldn't. I worked mid shift, so day shift didn't really claim me. Night shift didn't claim me and often myself and all my colleagues, we were in very busy time and would rarely get our breaks. And so it was always an issue and a pain point. And even so, I think it kind of pointed to the moral duress. When you have a patient critical, you get them up to the ICU, you come back and there's a patient already back in your room. You bring a patient to the morgue after a coding of death, you come back and the patient's already in your room. So really no opportunity to take those pauses to process what's going on and move forward. So it's regretful, and something that I thought was a major issue that we faced, I pivoted over eventually into leadership. And I was so fortunate to have a director that made it an imperative that all of our staff receive breaks. And it was her leadership and her commitment to our culture to assure that we were going to do that. And so I went from needing and talking about them to then being assist nurse manager and having to manage them. We developed a really great process, and I say we. I mean, really, our staff, we developed a really neat process where we had a schedule, it was realistic, and we had a paper plan every single day that the team tried their best to stick to and move forward, but it still required a tremendous amount of operational work to make that happen. And so I ended up getting into the mix of it, or just kind of having to hear about the failures of having the static scheduling plan. As time went on, I continued in my leadership pursuit, and a friend of mine at a barbecue, he's a computer engineer, and I pitched the idea of having a program that would manage these breaks and evolve, and a program that would specifically address the difficulty of operationalizing breaks in healthcare. What we see in the private, in other sectors just doesn't apply. Nurses can't just walk off the floor. Nurses have a legal and ethical moral duty to our patients. And unfortunately, your hunger or desire to take a 15 minutes break is in conflict with that. So it really does require something greater. So that's kind of my background of what led me to where I am today, but really proud to be a nurse. And again, even though my journey as a leader, I still manage today. And it's just an honor to work amongst so many tremendous healthcare workers. The entire team is inspiring, and all the hard work and innovation and their ability to overcome obstacles, create solutions, is really remarkable. And we see that every day here in clinic and across healthcare, people are doing remarkable things. So it's really an honor to be a leader in this sector as well.

[06:06] Michelle: Wow, that's an amazing story. And you're absolutely right. People and nurses were doing amazing things, and you in particular are, I guess you'd say, a forward thinker, an out-of-the-box thinker, an innovator, and I think some of the best ideas come from the pain that we experience in our jobs, in our lives and wanting to kind of eradicate that for ourselves and our colleagues. And I've seen so many nurse innovators do that by creating products or processes that really lighten the load of the nurse. And I think that's exactly what you've done, as you were recounting some of the stories of kind of the history of breaks when I was in the NICU the last few years. So during COVID I mean, we always had breaks, but we kind of changed our processes because we went from an open bay NICU to a single family room NICU, which was, we were really spread out. And so our process was, there was a clipboard in the morning and out of report, everybody signed up for their breaks, and they started at 11:10, and they ended at 3:00 p.m. And with my position in the NICU, I was a developmental specialist and a lactation specialist. So I had what you call more, I guess, free time because I wasn't at the bedside and I wasn't driven by all these tasks that required them to be done at a certain time. So my work day was more fluid. So what happened was a colleague of mine and myself, we became the break nurses because, yeah, I'm fortunate to live in California and work in California, where a year in Washington and Oregon, and we have some mandates for breaks, but we knew every day that's what we were going to do. And so the process was, I felt like it was a little archaic, but it did work for our unit. But I know other units, they didn't have what we had. So I know they were suffering and they definitely could have benefited. But this is going to seem like a really simple question, but why do nurses need breaks?

[08:45] Alex: I was going to say we got to talk about the importance of breaks. I think first and foremost, we need to acknowledge cognitive load, and there's plenty of studies that have shown that even after there was a study out of, I believe it was the UK, maybe Australia, and they looked at, and again, I apologize, I'm going to butcher these numbers. I'm going to acknowledge that. But no, more or less, the message is the same. And they analyzed triage nurses and taking in phone calls, and then the outcome or results of that. And they found after a break, more or less your day would start and their performance after, I believe it was after an hour started, there was basically a precipitous, or I shouldn't say precipitous, but an ongoing decline in their performance. And as time went on, the triage nurse became more and more conservative in the way they processed the thing, so they sent more people to the hospital later on because again, their ability to critically think through these processes continued to diminish. The study then found once that break was given, that performance improved and it kind of went back and down, up and down. And so obviously we see a cognitive decline and we do such high-stress work that requires us to think at the top of our game. You can imagine as time goes, the ability to critically think and process these really important decisions diminishes. So just from that standpoint, hugely important. The other one is obviously burnout and associated with the trauma and all of the traumatic events. Obviously, you were in the NICU, and when you have twelve and a half hours of continuous work and you have a horrible situation, or just somebody who's mentally and emotionally taxing to you as a nurse if you continue to bathe in that toxicity, not have the ability to detach process and have some space and time to do that, it becomes more and more caustic to that individual. So really we're talking about how do we protect our mind to make the right decisions, and then how do we protect ourselves against that other component, that psychosocial burden that we carry as nurses as well. So there's two of those. There are good studies to show. I think it was 84% of sentinel events or major adverse events were related to fatigue. And the list goes on. It doesn't take very far to realize that you probably don't want a surgeon working on your family member that is on hour eleven and a half, especially if hour and eleven half has no breaks. And I know there's plenty of nurses and I've talked to them, oh, I'm going in for a procedure. When's that? Oh, Monday morning, first thing. Because they know that end of shift, end of day, people's performance goes down. And again, that performance gets even worse factors worse when we think about not having adequate breaks, not even taking 15 minutes here and there, but just continually stacking that cognitive load and decreasing their performance. So from that standpoint, it's grossly important. Obviously, we have a compliance standpoint as well. And yes, California Oregon, and Washington are quite stringent in that. I would back up even further. There's about 17 states in the nation that have some form of break legislation. I would encourage everyone to search their own state, understand what those laws are, and start asking questions. It's kind of odd, where you see states that you think would have break laws don't, and vice versa. But if you are legally entitled to a break, you need to be asking your employer what they're doing to facilitate that, because again, it is a state law, and this isn't something that the electricians union would stand for either. And so if we're entitled to something legally, we need to be exercising that muscle and making sure that we're requiring that.

[12:50] Michelle: Yeah, I couldn't agree with you more. You know, I just read that some nurses from Kaiser San Francisco are suing because of missed breaks, and you see it all the time. And I believe that your data from those studies is kind of replicated in the airline industry with airline pilots. Right. It's like I always want to get the 06:00 a.m. Or the 07:00 a.m. flight, of course, because I know my sister is a pilot and she tells me those are the most rested pilots that you want.

[13:35] Alex: And you know, what's mind-boggling, too. And I never really thought I would be this far into breaks and the whole labor and work conditions aspect. And I did a post on this and it was more or less what's killed more patients. An open coffee cup at the nurse's station or a nurse that's worked twelve and a half hours with no breaks. And obviously, that's a facetious kind of play at the lack of regulation for us as workers. But it's wild to think that, again, going back to the airline stewardess can only work so many hours per day without a break. Once you max out on that, it's no more a pilot. The same way a pilot doesn't get to work 18 hours. A nurse in a NICU can work 18 hours with no breaks and nothing like that. And so I just find it appalling that we have regulators, national and state regulators, who seem to be fixated on some small things, when in reality these much bigger ones, like the state of our workers, is completely ignored. My ultimate moonshot is a national standard on breaks from twofold. Right. One, nurses across the nation should be entitled to the rest. They need to perform at the top of their game. They need the time to detach and process the emotional and psychological toll that every day takes on them as well. And so we need that for our community. We need it but one step further. My grandmother lives in a state that has no break laws. God forbid she ends up in an ICU. I want her team as rested and prime as anyone else in states that do have labor laws. So our patients should be advocating on this, our nurses should be advocating on that, and then physicians and the rest of the team as well. When you have disengaged, unhappy, unrested, tired, exhausted staff, you cannot perform. And it really does erode some of that workplace camaraderie and continuity and engagement that we know results in better outcomes for our patients.

[15:47] Michelle: I'm really happy that you included all the allied health professionals. Yeah, we're all in it together, and we all need rest and recuperation. And I don't know if you're familiar with Debriefing the Front Lines. It's an organization that provides therapy for nurses, and first responders, but that's what they call cumulative caretaking trauma, right? It's that death by 1000 cuts. It's all those things. And I have to wonder if sometimes nurses are implicit in a lot of times, as a break nurse, I would approach a nurse and they would say, well, I don't want to take my break right now because this kid is doing things and I really want to keep an eye on him. And I'd say, okay, I'd go to the next person, and I'd go back to that person, no, I'm not ready yet. I need to do this or that. And some days, actually, it was like, shit just hit the fan. And that person never got a break. Yeah, and I've done it myself. I've done it myself where I've said, you know what, I'm just not going to take a break right now because I got too much to do. How can we impart, I guess, the importance of taking a break to those nurses who seem to be resistant?

[17:17] Alex: Yes, actually, we've dealt with this again, when we developed this kind of rigid, static plan. It really is going to require a transformation of our culture from a couple of standpoints. Number one is we need to step back as a culture, and again, allied healthcare as well, all of us, and we need to stop thinking of breaks as a luxury and start thinking of them as a necessity. Again, if a surgeon was going to go in for another surgery, and you said, man, if this patient is going to benefit from them resting more, would you ask them to take a ten-minute break in between cases? Of course you would the same should hold true for nurses. We need to be taking those times again to be at the top of our game for our patients and for our team. And so we need to shift that culture, and again, we own that. But we need to shift from the idea that breaks are a luxury to a received. I've been a. You need a break, Alex. I'm like, okay, all right, I'll go back. Thanks for telling me that. I don't need a. There is, there is that horizontal violence that we see amongst nurses where I don't need it. Therefore, you don't. And we have to break down that barrier as well. And then we need to have trust and faith in our colleagues to say that, yes, Michelle is a qualified NICU nurse. She can watch my patients. She continues it on. I have faith and trust in you as an individual and vice versa. But again, when we come from a lineage of buddy breaking where, no, you know what? You don't need to give me a break because I know you're not going to carry my patients and your patients forward. I understand that reluctance, but we need to transform that. And I think all in all as a whole, we need to be advocating on our behalf and asking for these things. Even if you live in states or units or hospitals, these are not entitlements, ask, bring it up. It is not a problem unless you make it a problem. Or I should say it's not going to be a problem that's going to be solved if you leave it on your shoulders. And, yes, we all should take ownership, moving it forward. But also speak your mind, let people know that, yes, I would love a break right now, and at least hear them say no, because if you don't, then there's an assumption that nothing's wrong. So I would encourage everyone, if you're out there to make those statements and make those requests so that we can gain more and more traction moving this forward as a national effort.

[19:54] Michelle: Yeah, I love that. And I think a lot of it has to do with nurses giving up control. Right?

[20:00] Alex: Yes.

[20:00] Michelle: It's like we're really into our patients, especially critical care nurses. And I'm not saying that other nurses are not, but it's a different world, and we don't like to give up control. And we had a great nurse manager and a management team that said, like, handoff, when you go on your break should be no longer than five minutes.

[20:27] Alex: Yes.

[20:27] Michelle: And it's like, here's what's going on. Here are the vent settings. Here's your RT's number. Here's what's running in the IV and then boom, you're out of there. So that's great. So I want to get into some nitty gritty because I'm kind of like a tech nerd. How does it work, Alex?

[20:49] Alex: Yeah, so one of the big problems here is going back to BreakAlgo, what we do differently than anybody else, and what we've done is create a dynamic tool. Right? And so, you know as well as I do that NICU plan you had where breaks start at ten and move forward. That's great. Until you have a kiddo crash, an emergency admission, a sick call, the surgery gets delayed, surgery gets pulled, all of those things, any sort of rock in the road in healthcare. I mean, it's littered with them. And again, breaks are going to be the last or they're going to be the first thing that's going to be affected from that, because obviously, we have a duty to our patients, both legally and ethically. And so there are things that we got to shift around and adjust. So what we've done is created a dynamic tool and what you do is we have all the information in the background as far as when and where the break windows should occur. You put people onto the schedule and then what it basically does is it starts populating the plan and you'll have your break nurse. So, for example, if you were covering brakes, you would have a mobile device and it would tell, you know, Alex is up next. If you skip over me, because again, I'm in the middle of a procedure or busy or off the floor, that engine in the background is going to be updating and making a new plan. And that's really where we're taking the thought load off of the frontline team, off of our charge nurses and letting the patented technology there move that process forward and always have the best-optimized plan. Some floats are phenomenal at it and they can work five different things at the same time and have it lined up perfectly and they've kind of mastered that art, but not everyone has. And again, we're trying to create a plan and a process that takes that burden off of our frontline charge nurses and break nurses to get a good plan. So, like I said, you're going to come up and you'll have a queue. We also have a dashboard that kind of looks like a TV guide. We call it either a TV guide or MAR but you'll have a unit view and it'll have all of your different breaks where they're scheduled and you can see that in real time. So as a charge nurse or house supervisor or assistant nurse manager, you can take a quick, brief look, and see where all the breaks are at, where they're scheduled. And then again, those breaks are adapting by the moment, trying to optimize when those can be completed with the least number of resources. The last component that we have is data and nursing. We should be guiding our principles by scientific data. And right now, we really don't have any data on breaks. Right. All we really know is that Karen punched out without two breaks. When do they happen? Why do they happen? There's no data on that. And so what we've created is a real rich dashboard where you can drill back, take a look at the break data, and take a look at trends as far as when breaks are being missed. Do we have more resources here? Do we have less resources on the other side? And so now you're empowering your frontline team, your charge nurses, your assistant managers, to say, all right, what are our opportunities? Hospitals are not going to just throw labor for the sake of it, but now you're going to have some rich data to say, you know what, maybe we need to add an eight-hour shift from three to eleven. And look, I have data that supports this need for this resource to justify it. And again, right now we literally have notebooks, spiral notebooks, three-ring notebooks, and all sorts of stuff documenting some of this data. But really it's not actionable because it's dead data sitting in a binder somewhere if they're even getting it. Again, part of this is breaks are important. They're tremendously important, and something I've obviously dedicated my effort towards pushing. But we also have to realize that a brake nurse and these resources are expensive and not infinite, and we have to be respectful of that as well. So that's where our program is trying to strike that balance. We want everyone to get their breaks and we want it to be done as efficiently as possible. And so we're trying to kind of split that line in between management and frontline staff where, yes, we are going to drive transparency and we are going to see where breaks are happening, where breaks are not happening. And hopefully, through that transparency, we're going to come to an overall transformation in the way we approach breaks to make it a regular process that, again, these are a necessity, not a luxury. And I think our program is going to help drive that and help take the burden off of frontline staff to organize all that as well.

[25:40] Michelle: It sounds like it's working really well, and I love that. You have the data piece in there because as you know, as a manager and a leader, whenever you go to hire somebody and add another FTE or whatever, it's like they want the data to be able to know that it's going to be justified. So I love that you have that in there. And on your website, I saw that BreakAlgo can be used as a marketing tool to gain an edge over competing hospitals. So if I'm a nurse and I know this hospital uses this breaking system, I feel like I would be more attracted to work there because I know I have more certainty that I'm going to get breaks.

[26:29] Alex: To me, if you get your breaks, it is a pretty good indicator of a lot of things. It tells me a couple of things. It tells me that you're staffed enough to get breaks. Number one, that's a big selling point right off the bat. If you're looking at places to work, if you're applying, and like when's the last time you got a break? Was the last time somebody got all their breaks, then you're probably stepping in a unit that's grossly understaffed. And so there's that. I think the second part is if there are consistent, normal breaks because it really does take a culture within that unit dedicated to, again, the reality that brakes are a necessity, not a luxury. And so you're going to step into a unit that has that. I spoke to, again, going back to my previous role, and they still hire some travelers and they still have a robust system and they're still getting their nurses off for breaks. And again, they're not using Breakalgo, but they're using a static process. And I spoke to their manager and she basically said I have my pick of travelers that want to come back here because they know they're going to get breaks and it's a Differentiator when they get to say, all right, I have three units, I'm going to make more or less the same one unit. I'm going to have time to process and get my breaks. I'm not going to leave after 12 hours with that silent ride home trying to process why I come to work every day. But again, just having those moments through the day makes the work so much less exhausting. And I do believe in the future, I hope that people would say, all right, well, what are your break percentages? Are you using Breakalgo? All those sorts of things. Because again, nurses care about work conditions and they want to know that they're going to be supported through their work.

[28:15] Michelle: Yeah. Wouldn't that be great if it was on everyone's radar where a nurse interviewing could say in the interview, what kind of system do you use for breaking? Because breaks, to me, are very important.

[28:28] Alex: Yeah, absolutely. Just as we're negotiating any sort of how many days you have off, how many days you want. I mean, that's important to suffer.

[28:35] Michelle: Exactly.

[28:35] Alex: Folks. Why aren't we asking questions like, how often are your staff getting all their breaks?

[28:41] Michelle: Yes. And I want to see the data. Absolutely right.

[28:46] Alex: Or down the line, even for marketing our company where, yeah, you're a super break standout organization or something like that. But what a great to have that signifier and be like, you know what? This is a unit. This is a unit with a culture that realizes the importance of work conditions and rest. I would love that in the future. I mean, ultimately, that's my moonshot. Right. We have to have these natural standards and we have to have a systems approach towards doing.

[29:22] Michelle: That. I love that, the idea of having an award for a hospital because we have Daisy Award, which I will say that you have received. Congratulations.

[29:33] Alex: Oh, thank you.

[29:34] Michelle: But there's so many awards for hospitals, and I think if that were one of know, it would make people kind of stand up a little bit. And as far as the culture of breaks, I was fortunate in the NICU that we had a management team that really felt that breaks were important, and we really worked on that and making that a priority. And when we started getting travelers just right before the pandemic, we were shocked to hear all their stories of not getting breaks. And they absolutely loved our unit because that was one of the things we had some travelers that were there for two years that kept extending their contract because they're just like, I love working here. It's an amazing place, so it makes all the difference.

[30:27] Alex: Well, let me share with you the opposite story. And I get all sorts of random messages. I conversed a little bit back with this nurse, and she then one evening sent me a just absolutely horrific story. She is a trauma surgical nurse. And again, I don't think this is isolated. She went to her manager. She's a traveler. She went to her manager and said, I need to use a restroom. I need somebody to cover me. I need to go back and take care of my personal items. Right. And obviously, we can read in between those lines. And the manager said, sorry, I have nobody to cover you. You got to take this case. She went into the case with, obviously some reservations. She bled through.

[31:21] Michelle: Oh, my gosh.

[31:22] Alex: Blood ran down her leg, I believe, almost into her shoe. She finished the case with her scrubs completely saturated in blood. And just an absolutely horrific example of the result of not allowing people those opportunities to care for themselves.

[31:43] Michelle: That's abuse.

[31:45] Alex: Absolutely. This is not isolated. And again, I think it's a horrific story. And again, what is the engagement of that employee? Do you think she feels valued as a registered nurse in the United States? Absolutely not. If that was me, I would be looking for an exit. I would be saying, you know what? This career obviously isn't for me, because the humiliation of something like that is nothing any industry that has any respect for me would carry forward. And so things like that are not isolated, and they do happen. And I've since said that I've heard other, not quite as egregious, but other situations that are similar. And so it is grossly important that we provide people with these opportunities. And not providing them opportunities to care for themselves is driving people out of our field. And we talk about the hemorrhage of nurses, we talk about the shortage of nurses. And actually, I should say this, the conversation is about shortage, and the solution is all about filling more. But we're hemorrhaging nurses out. And it's actions like that that are driving nurses from the bedside. And when you have 18% turnover or 18% loss in the first year, this is completely unsustainable. And so we have to look at how we keep and retain our great, talented nurses at the bedside. And again, it goes back to even something as simple as breaks going there, because the other component here, and I think more broadly, everybody should be attuned to the fact that as we have this hemorrhage of nurses, we are losing so much knowledge. I look back at the start of my career I mentioned I had a couple of nurses, 20-30 year veterans in the ER, that kept a close eye on me. Yeah, I'm sure, NICU, you as well. And I remember once coming up, one nurse coming up to me and saying, hey, you need to go into room seven. I'm like, why? They're tucked in. Doesn't look good. Go in there. Get the doctor. Go in there now. Okay. Surely that patient was decompensating. She saw something that my eleven months of experience didn't see. Losing that in the NICU, I'm sure. And I worked in pediatrics. These kiddos fall off the cliff. And if you're not as sharp as attack to see that, you don't have it. And these nurses that we're losing, we're losing that information. We're losing that collective knowledge both for nurses and physicians in allied forces or the allied healthcare staff as well. But we have to realize that the loss of nurses is the loss of our knowledge. And again, I feel bad, and I know there's some amazing two-year nurses out there, but I'm sorry you don't stack up to somebody who's been in the game for 25 years and seen everything and wrote the book on it. There's just some knowledge there that takes more time to absolve or to absorb. And so I think that's a huge risk that we're running by not addressing again the hemorrhage of nurses.

[34:59] Michelle: Yeah, mentorship, so important, right? It's everything. And there have been some conversations lately about, is there really a nursing shortage. And I've heard both sides of it that, yes, there is a nursing shortage in that droves of nurses are leaving the bedside because their worth is not being recognized by the institutions that they are working for. And they're fed up with it. They're just like, I'm not going to take this anymore, and I'll go into innovation or I'll go into a different specialty or I'll become a nurse entrepreneur. And I've had many of those nurses on this show. So I absolutely agree. It's a big problem, and it's going to take a lot to address it. But I think with your program, what you're saying is to nurses everywhere and to institutions is that, hey, we have a moral, ethical responsibility to care for ourselves, to care for our colleagues, this is one of the ways that we're going to do it, by providing those breaks that give us a mental and a physical respite from the constant trauma that we are enduring.

[36:22] Alex: Yeah, I want to be empathetic to the leaders that are in states that don't have these rules, that are not staffed differently, but even just to go out and have a conversation with your staff and reiterate the importance of supporting each other, providing these opportunities for that respite and to analyze it, I think, would even go a long way. Progress over perfection, ultimately, I can tell you the way I think breaks should be done. But I think in light of that, even just starting to transform everywhere, transforming that culture from luxury to necessity is a huge step in the right direction.

[37:02] Michelle: You're doing it one person at a time, and bravo. So I want to talk about VIVE because you were just at VIVE and you were there in very good company. I had the pleasure of interviewing several of the nurse participants who were there with you. Tamara Al-Yassin and Hannah Berns from The Nursing Beat, Savannah Arroyo from the Nursing Beat and InvestHealth, and then Taofiki Gafar-Schaner from SafeSeizure. So they were all fantastic guests. So you are joining them in great company.

[37:39] Alex: Such an honor to be part of that group.

[37:42] Michelle: Oh, man, I loved seeing all your posts on LinkedIn and social media. It looks like a really great group. But for those of us who don't know what VIVE is, talk about that and what you did there.

[37:55] Alex: Yeah. So it's a national healthcare IT conference and I believe, and again, I'm going to mess up my numbers, I apologize. Rebecca Love was there, I think, two years ago and going to mess this up. I think there was only a handful, maybe less than ten or 15 nurses representing in this entire healthcare IT conference. And I know Rebecca, together with Bonnie Clipper and some other kind of national nurse leaders, really advocated to VIVE, to create a nursing innovation pavilion. Bring nurses there, present our solutions, present our innovations, and get us there. Because again, there are so many technological things that are presented to us in the hospital and so many of them fall short and often that's because there's not nurses engaged in that process. And so it was a really great opportunity to bring nurses and showcase them on that stage and help move forward our ideas and obviously show that we need a continued presence in the IT stage and the healthcare innovation stage as well.

[39:08] Michelle: Yeah. It made me so proud to be a nurse and to see all of you and what you're doing for the nursing community. And I don't know, it just gets me when nurses innovate and create to help other nurses to lighten their load. I just love that so much.

[39:33] Alex: And I would say, too, it's not been an easy battle to get where I, or obviously get a program off the ground. But I would say if you have an idea, there are a lot of different things you can do. If you have an idea, and I think there are tons of people with ideas. If you've worked at the bedside and you have made something work that doesn't work, you got an idea. And so there are hackathons, there are innovation meetings, there are all sorts of things. I know the ANA has one. Johnson & Johnson, get out there. You're not going to go out. Well, somebody might. Hats off to them. But it really does take a network of folks around you to help get something like this off the ground. And there are initiatives and projects that really kind of cultivate some of that so if you have an idea, search, hackathon, or any of those innovation things and go and talk about the problem and your solution. And there are most likely other people that have had that same problem and would love to collaborate with you. So think about the problems you face and let's fix them.

[40:47] Michelle: I love it. Every solution starts with a problem, right? That's the mother of invention, I guess, when they say there's a problem and you want to fix it. So I'm still thinking about my dream of creating the nurse's little helper in the NICU. We have those babies that are, as they get older and they're more awake and they're more active. And some of our drug-exposed infants love to be rocked. Right. But we don't always have people to rock them. And I want to invent something to put on the side of the bassinet that just gently rocks it. So I got my thinking cap on.

[41:39] Alex: Yes.

[41:40] Michelle: But you've been a great guest, Alex. You've brought so much value to my audience, and I thank you for that.

[41:47] Alex: Absolutely, absolutely.

[41:48] Michelle: Yeah. Is there someone that you recommend as a guest on this podcast?

[41:53] Alex: I have a whole list. Well, I will connect with you afterward and I'll send you some names. I'm going to plug Breakalgo as well. So we are continuing to look for organizations to partner with. So if you're interested in learning more, we are still looking for some partners to get our program out there and do some testing. So if you're interested, reach out. I'm on LinkedIn, very active on LinkedIn, but, yeah, send me a message, and let's see if we can collaborate to bring this into your organization and again, streamline your break process and get it squared away. So if you're interested in that. But, yeah, absolutely. Let's connect afterward. There are so many tremendous nurses out there doing such great things, uplifting each other and really pushing it forward. So if you have an idea or if you're down, reach out. There's a whole team and network behind us, behind you, and behind all of us because the nursing community is strong.

[42:50] Michelle: Yeah, I feel that every day the nursing community is strong. So thank you for that message, and I definitely will include those links, your LinkedIn, and breakalgo.com in the show notes. And, you know, at the end, we do the five-minute snippet. So are you ready for that?

[43:11] Alex: All right, let's do it.

[43:13] Michelle: Five minutes of fun, Alex. Okay, here we go. Favorite movie theater. Candy.

[43:26] Alex: Popcorn. I know it's not candy, but it's the most appropriate thing to eat at a movie theater.

[43:32] Michelle: Yeah, I love it. Snack, right?

[43:34] Alex: Yes.

[43:35] Michelle: What was the oddest job you ever took to earn a buck?

[43:41] Alex: I grew up on a farm, and one day we had a grain silo that had a hole in it, and this is kind of sick. Anyways, there was a hole in it and rain and mice got in, and I got the awesome pleasure of crawling into that grain silo and shoveling it out.

[44:03] Michelle: Oh, my gosh.

[44:05] Alex: You can figure that one out.

[44:06] Michelle: Yes.

[44:07] Alex: I'm like, man, this is a pretty tough day. I think of shoveling grain with mice in it, out of a grain silo back when I was 17.

[44:23] Michelle: I hope you were paid accordingly.

[44:25] Alex: I was not.

[44:27] Michelle: Oh, no. Okay, here's. Would you rather write greeting cards or obituaries for a living?

[44:36] Alex: Oh, greeting cards.

[44:38] Michelle: Yeah. You seem like such a happy person.

[44:43] Alex: Yeah. I mean, it's great to reflect back on a. Yeah. I think. Greeting cards.

[44:51] Michelle: Favorite adult beverage?

[44:54] Alex: Casa Amigos tequila.

[44:56] Michelle: Oh, I haven't heard of that one. 

[44:58] Alex: It's George Clooney's tequila. Delicious.

[45:02] Michelle: Yes. Okay. My son-in-law drinks that.

[45:06] Alex: Yeah.

[45:06] Michelle: Okay. What do you think is one of the biggest downsides to being famous?

[45:12] Alex: I would think the lack of privacy, and I don't think that's a blessing.

[45:18] Michelle: Yeah. Being in a fishbowl all the time. Right?

[45:21] Alex: Yeah. No. And everybody looking to catch you in your worst moment. Not something I would want.

[45:27] Michelle: Yes. Would you rather learn how to decode Morse code or learn how to read Braille?

[45:35] Alex: Probably Morse code.

[45:37] Michelle: I was thinking you were going to say that just because of your IT mindset.  Favorite breakfast cereal when you were a kid?

[45:47] Alex: Cinnamon toast crunch.

[45:49] Michelle: Really?

[45:50] Alex: Yeah.

[45:52] Michelle: All right.

[45:53] Alex: What's better than 30 grams of sugar?

[45:58] Michelle: Exactly. Mine was Cap N Crunch. Yeah. Can't bring that in the house. Can't ever bring that in the house because the whole box will just be gone.

[46:08] Alex: Yes. Dessert.

[46:10] Michelle: Yeah. What gives you butterflies in your stomach?

[46:15] Alex: Seeing people accomplish things that they didn't think were possible.

[46:19] Michelle: Such a great dopamine hit. Yeah.

[46:23] Alex: That is, I think, just absolutely remarkable. And I love to see stories of perseverance and struggle and overcoming. That's what gets me going.

[46:33] Michelle: Would you rather find a fingernail or a worm in your salad?

[46:38] Alex: Fingernail.

[46:40] Michelle: Really?

[46:41] Alex: Yeah.

[46:44] Michelle: I don't know why I was like.

[46:46] Alex: I don't want either one in my salad. But I think if I had to pick, maybe they wash their hands.

[46:52] Michelle: I don't know. See, that's the thing. I was like, nah, lots of stuff grows under fingernails. Okay, you are in Tacoma, Washington, right?

[47:01] Alex: Yes.

[47:02] Michelle: Do you have a favorite local cuisine?

[47:05] Alex: Know, I love little taquerias and so we have one by my work, and it's El Grande.

[47:15] Michelle: Yeah, yeah. My daughter and I went to Seattle in September, and it was fantastic. Just the food selection.

[47:23] Alex: Absolutely.

[47:25] Michelle: Okay, last question. Would you rather always have a pebble in your shoe or an eyelash in your eye?

[47:36] Alex: Oh, that's a tough one. I would probably go pebble in my shoe.

[47:40] Michelle: Oh, man. And walk on that for 12 hours?

[47:43] Alex: I just don't like anything in my eye. I can't even wear contacts very well. My eyes are so irritated by everything.

[47:51] Michelle: Yeah, well, time's up. You did great in the five-minute snippet. And thank you, Alex, for letting us see your off-duty side.

[48:00] Alex: Absolutely. Well, reach out. If there's anything I can do for now, please connect with me. Share your stories. I love hearing about either break failures, or break successes. It is such important information. I love to share back. Obviously hear people's stories as so. And thank you for hosting this and elevating the nurses' voice out there.

[48:22] Michelle: It's my pleasure. It really is. I love what I'm doing, and I've just loved every one of my guests. And you're no different. I have a lot of love for you too, so thank you so much. Absolutely.

[48:33] Alex: Thank you so much.