Beth Sanford is known as the "Sunshine Nurse" for two reasons. First, she is a doctorally-prepared nurse who has conducted extensive research on the importance of vitamin D in improving patient outcomes. Her studies have explored how vitamin D levels affect ICU patients, long-term care residents, and global maternal health. Beth is passionate about addressing vitamin D deficiency in clinical practice, population health, and policy.
Did you know that vitamin D is both a nutrient and a hormone essential for nearly every cell in the body? It plays a crucial role in hundreds of processes every day. Deficiencies in vitamin D are now recognized as a risk factor for many chronic diseases, including osteoporosis, impaired cognitive function, various cancers, pregnancy complications, and cardiovascular disease.
We explored how low vitamin D levels impact nurses and other healthcare professionals who work night shifts or are exposed to artificial light for over 12 hours a day. Beth compares the effects to pseudodementia, which can slow response times and hinder the ability to make critical decisions. If you are a nurse experiencing profound fatigue, run, don’t walk to get your levels checked!
Now, back to why Beth is known as the "Sunshine Nurse" for the second reason. She can literally light up a room. With her beautiful smile, positive outlook, and generous spirit, Beth reminds us all that we could use a little more light in our lives.
In the five-minute snippet: North Dakota is nice!
Sperti Vitamin D Lamp
Vitamin D Calculator
Why Fear the Coming of Winter in Game of Thrones? The hypovitaminosis D hypothesis
Substantial Vitamin D Supplementation Is Required during the Prenatal Period to Improve Birth Outcomes Hollis & Wagner, 2022 A call to action for maternal health
How Vitamin D Changed Hospital Patient Outcomes: An Interview with Dr. Leslie Ray Matthews - GrassrootsHealth
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[00:00] Michelle: Beth Sanford is known as the Sunshine Nurse for two reasons.
[00:05] First, she is a doctorally-prepared nurse who has conducted extensive research on the importance of vitamin D in improving patient outcomes.
[00:16] Her studies have explored how vitamin D levels affect ICU patients, long-term care residents, and global maternal health.
[00:26] Beth is passionate about addressing vitamin D deficiency in clinical practice, population health, and policy.
[00:35] Did you know that vitamin D is both a nutrient and a hormone and it's essential for nearly every cell in the body?
[00:43] It plays a crucial role in hundreds of processes every day.
[00:48] Deficiencies in vitamin D are now recognized as a risk factor for many chronic illnesses, including osteoporosis, impaired cognitive function, various cancers, pregnancy complications, and cardiovascular disease.
[01:06] We explored how low vitamin D levels impact nurses and other healthcare professionals who work night shifts or are exposed to artificial light for over 12 hours a day.
[01:20] Beth compares the effects to pseudodementia, which can slow response times and hinder the ability to make critical decisions.
[01:31] And if you are a nurse experiencing profound fatigue, run, don't walk to get your levels checked.
[01:39] Now back to why Beth is known as the Sunshine Nurse for the second reason.
[01:45] She can literally light up a room.
[01:49] With her beautiful smile, positive outlook, and generous spirit, Beth reminds us all that we could use a little more light in our lives.
[02:00] In the five-minute snippet: North Dakota is nice.
[02:21] Well, good morning Beth. Welcome to the podcast.
[02:24] Beth: Thanks for having me Michelle. I'm happy to be here today.
[02:27] Michelle: I am happy you're here too. I think I am going to learn a ton today, so I'm excited to get to it.
[02:35] First, I want to start off with an introduction of who is Beth Sanford?
[02:42] Beth: Well, I was born and raised in North Dakota. I lived outside of the US for five years. I lived in China, so it gave me kind of a different perspective, I think on healthcare, just on life, living cross-culturally.
[02:55] I think I learned a lot during that time. Came back to the US, been working in nursing education.
[03:01] I'm also the upcoming President of the North Dakota Nurses Association. I'll be starting that role in January.
[03:07] Very excited about working on advocacy issues for nurses and also some recruitment and retention.
[03:15] I'm also the President-Elect for the North Dakota Center for Nursing. So I love to be outside. I love nature. I love taking walks, drinking tea, spending time with family and friends.
[03:29] So that's me in a nutshell.
[03:32] Michelle: It's kind of hard to condense yourself into a couple minutes, right?
[03:36] Beth: Yeah.
[03:39] Michelle: You did really well. I have a great picture of you now. And man, congratulations on everything that you're doing with the North Dakota Nurses Association. That's awesome. So you're doing a lot. Beth, do you ever rest?
[03:53] Beth: I do. I'm kind of a busy brain person, you know, so I need to have things to keep me busy, and a recent empty nester. My kids are both in college outside of the house, so I think it makes you find new things to keep your busy brain busy.
[04:07] And yeah, I'm just really passionate about nursing and passionate about taking care of the people in our state. North Dakota is a small state, you know, when there's only 700,000 of you, I think you can have a little, little vision.
[04:19] It's easier to have vision for, to take care of the needs of your people. And so I love that.
[04:24] I don't know, it's just fun.
[04:26] Michelle: Yeah. Very cool. Okay, well, I'm curious as to why nurses get their doctorate. So tell me about that journey.
[04:35] Beth: Well, I really, I have to say it. I had some really fantastic professors at the University of North Dakota when I was an undergraduate in my BSN program.
[04:44] And they really, I think, cast a vision for all of nursing, like bedside nursing, academia, research, you know, anything we could dream nurses could do. And I really appreciate, you know, back them saying that to me.
[05:00] I think even since the time that I've been a nurse, which is, you know, 25 plus years, the roles of nurses have expanded and it's, I'm so thankful that I got my master's degree actually very early.
[05:12] At that time, 20-year-olds were not getting a master's degree. And so I was kind of the baby in the class getting my master's degree. But that has served me well.
[05:22] I, so I, I finished with my master's degree when I was 24 years old and in 1998, like that was a really unheard of, I think especially in my part of the US Now I would encourage anybody to get their master's early.
[05:36] I think that it helps you to really just expand your ways of understanding how what roles nurses can have in our, in our state, in our nation, in our world.
[05:46] And so I decided to go back and get my doctorate. I'd always wanted to. It was one of those things on my bucket list, you know, just like all the other things on my bucket list that I know enjoy doing.
[05:58] I wanted to get a doctorate. It was on my bucket list. But you know, when you're looking at the massive student loans from getting a good doctorate, I, or any doctorate, it was really a barrier for me.
[06:09] And so I was especially, you know, when I, when my marriage ended, I became, you know, a single mom taking care of two kids. It really didn't seem feasible for me to get my doctorate.
[06:20] And I'm really thankful that I worked for an organization at that time that they were starting a new doctoral program. And so I had already decided I was going to get a doctorate.
[06:28] And so I had applied at a couple of schools and I just decided I was going to eat the cost. I was looking at a dual PhD nurse practitioner program that would have ended up costing me $70,000.
[06:40] And I was just choking, thinking, I mean, I was debt-free at that time. Thinking about going into debt was really, really making me nauseous. And I'm just so thankful that I held off.
[06:53] And when I found out that we were going to start this doctoral program, of course, I ended up getting a huge tuition discount, you know, to teach and serve and serve at my own school and get my doctorate.
[07:04] And so my doctorate is in a doctor of nursing practice in public health and policy.
[07:10] And I have to say, I think the curriculum was really great. It was at Rasmussen University.
[07:15] And it really prepared me for the role that I am in now with policy, working with the North Dakota Nurses Association and looking at supporting the North Dakota Center for Nursing.
[07:26] And then some of the legislative work I've done over the last couple years, getting a few bills passed, we have a few more that we're putting forward this upcoming legislative session.
[07:36] And just to really think from a more global perspective, just the opportunities I've had, I really would never have done those things. You know, I took part in Sigma Theta Tau International Global Health, a global advocacy cohort.
[07:51] I would have never done that. I would have never thought outside of my own little box. And so I'm really thankful for the opportunities that I've had in academia, in practice, in research, which is what we're here to talk about today.
[08:04] But I would have never taken those opportunities had not I got a doctorate. And so I would really love it if we could make doctoral education be more affordable for nurses.
[08:13] I think it helps elevate nursing to a completely different level. And I think just my own journey of having it be such a barrier that I didn't get a doctorate until I was almost 50 years old.
[08:25] It was a huge barrier for me. And I would like, I always encourage my students to go on and get additional education and why can't we have doctoral-prepared nurses working at the bedside?
[08:34] If that's what people want to do, then they can just be involved in different committees and different quality improvement things in their own facility. Like, we don't have to pull people out and have everybody working in academia either.
[08:45] But I just think it gives us a bigger vision for nursing. So that would be my wish. If I could have two wishes today, that would be one of the two.
[08:53] Michelle: That's something really great to wish for. And I echo your sentiments on that exactly. In terms of the financial burden that that presents. And it sounds like it was just really meant to be and really a no-brainer.
[09:09] Right.
[09:10] And your story is very similar to my brother Chris. I've had him on the program a couple of times. He's also a doctorally prepared nurse and researcher and got in at a grassroots level in a brand new doctoral program and had some of those cost-saving benefits.
[09:30] And man, I love your idea of why can't we have more doctorally prepared nurses at the bedside. That would change the whole landscape. And you're right. We are here today to talk about research.
[09:41] When I came across your LinkedIn profile, the Sunshine Nurse, I was immediately intrigued.
[09:50] And then I started reading a little bit more and saw all the research that you've been doing on vitamin D.
[09:57] And so we're going to talk about that today. One of your recent presentations, Enhancing Patient Outcomes: Insights from year one of a vitamin D quality of improvement initiative in critical care.
[10:12] That was really, really interesting.
[10:14] And in the presentation you highlighted the work of Dr. Leslie Ray Matthews, just an advocate for vitamin D. And I learned a lot.
[10:24] I did not know that vitamin D is a hormone and not a vitamin and that it's the most common nutritional deficiency in the world. So I did not know that.
[10:36] But talk about this study and this presentation and some of the highlights from it.
[10:44] Beth: This presentation was the result of some, just some preliminary data we've gathered from a quality improvement project. And through my work at NDNA and through advocacy in nursing recruitment and retention, I've of course made some friends with some of the other nurses in North Dakota.
[11:00] One of the relationships I've built is with the chief Clinical officer of Vibra Hospital in Fargo, and Bonnie. If you met Bonnie, Bonnie is incredibly innovative.
[11:13] She, she's really, if it's in research, she is willing to give it a try. And so after she and I had worked on this recruitment retention committee, I said, Bonnie, you know, I'm, I'm really concerned about the vitamin D levels of people in our state.
[11:26] You know, they come into the inpatient setting already depleted. From the research that I've been doing in the community, our overall levels were so low, the average level was 20 nanograms per mil.
[11:38] And we had a very high percentage of people below 20, which is really not where we want to be. It's considered a deficient state. And so, you know that one of my understandings about the physiology that happens in the body during times of stress, during times of infection, that makes our hospital patients even more at risk for poor outcomes and then increased health care costs.
[11:59] Right. And then it's a, it's a negative to the facility, the family, to everybody. Right?
[12:04] Michelle: Yeah.
[12:04] Beth: And so I, so I was just sharing this with Bonnie and she said, well, I don't, I don't know if we have a problem with vitamin D in our facility. And I said, well, why don't you check?
[12:13] And so, you know, we just started with a very small, just a very small sampling of a few of her people that were coming in like as they came in from other facilities because it's a long-term critical care hospital.
[12:24] So they are in a different, usually in other facilities first.
[12:29] And she found some extremely low vitamin D, like 4 nanograms per mil, 6 nanograms per mil. And when you're, when scientists recommend that your level is between 40 and 60, you can see that 4 is very low, the 6 is very low, even the 12, 14, 15 are very low.
[12:45] And then she did see some, some levels where it was clear that somebody knew about vitamin D and the levels were much higher. So they were, you know, 40 and above.
[12:54] And so but we were very concerned about the percentage of people that were below, you know, below 10. And so that's where we got the idea to do this, this project.
[13:04] And so what we did was we drew the levels of everyone coming into the facility and then we used an evidence-based vitamin D calculator. Now this is a really great E tool.
[13:19] I think a lot of providers out there, as I've been doing my presentations just on advocacy or continuing education about vitamin D providers are not, they don't know how to vitamin D dose, they're not comfortable with it.
[13:31] You know, they, they tend to give really low amounts and they aren't familiar with like the really big amounts, like what was used at, with like Dr. Matthews, for example, used in his research where he was using about 50,000 a day for inpatient care.
[13:45] And so, you know, people are very nervous about that and so we use the E calculator. So it was made by an organization, a nonprofit research institute called Grassroots Health Nutrient Research Institute.
[13:56] And they have a team of vitamin D scientists and they years ago made this calculator. And so you can put in either your current vitamin D level or you can put in the patient's weight and it will pop out a recommended loading and maintenance dose for your patient.
[14:12] And so that's what we used at Vibra. We used that tool so that they could feel confident when they were making doses that they were staying within the recommended recommended loading dose and maintenance dose for their patients.
[14:24] And so then we did follow-up testing, so we did follow-up testing at 25 days and then at 90 days. And the results were so phenomenal. I think some of the things that were really exciting to us was the decrease in hospital-acquired infections.
[14:39] So decrease the C. Diff, Clabsi, Cauti. They actually got a letter from the State Health Department of North Dakota congratulating them on their 0 or less than 1 sir scores because their results were so phenomenal.
[14:53] So we were sharing that preliminary data at this conference and then two, we had two really other unusual cases that even kind of were surprising to us. And, one of the reasons I love working with the staff at Vibra is because they're, they're just so excited.
[15:08] You know, they, they're a small hospital, they only, they have 30, so they're very in tune to their patients. And they.
[15:15] One day I was up there for something and one of the nurse educator, or Bonnie, I don't remember which one of them is very experienced critical care nurses came to me and said, we had a patient who was in a coma wake up.
[15:30] The patient was not expected to wake up. The patient was expected to have very poor prognosis.
[15:36] And the patient woke up and the patient went, went to rehab, you know, and it, this was, this was not what was expected for this patient. This patient was, that was expected to go to a long-term care facility and be unresponsive for the rest of this person's life.
[15:55] And instead the family got this person back. And it didn't just happen once, it happened twice.
[16:01] And then we dove into the literature, but I, I said, you know what, I'm gonna look around about this because I'm, I'm actually not an inpatient nurse. My special public and community health, you know, I, we were doing this project kind of as a branch between precision public health and precision medicine.
[16:15] And so I dug into the literature and I said, oh my Goodness, you guys. This is not uncommon in Dr. Matthew's work. He had this happen many times with patients that weren't expected to have different health outcomes.
[16:29] Because vitamin D is so. Vitamin D is a vitamin, nutrient and hormone. There's. It's a complex. There's actually a lot of different forms of vitamin D. Once it gets into the body and the body starts to utilize it and maneuver with it.
[16:41] It's a cell signaling molecule. It tells the cell what to do. It's an NRF2 stimulator. So it bring. It's about cellular health. I mean, it's just so many things, but it decreases inflammation in the brain.
[16:54] And so how exciting. And I thought, what, you know, if I had another wish, I would say, everybody that comes into the ER, let, let's administer. Check and administer vitamin D and see, you know, and check, track those outcomes.
[17:08] Other studies have tracked phenomenal outcomes with checking levels in the ER and having, you know, especially things like for head injury patients. And so there's just so much research out there.
[17:20] It's so exciting that I'm just really passionate about. Let's get that research out of PubMed and pull it into practice. And I think that is what.
[17:32] That is what nurses are good at doing. We're looking.
[17:35] We're good at saying, hey, why don't we give this a try for our patients?
[17:40] And, you know, and I. And I think it. A lot of times the research just sits there and nobody does anything with it, you know, and then it passes five years and we don't even allow our students to cite it in a paper anymore.
[17:52] You know, and so why don't we start using that research to impact lives of people? And that's what I'm passionate about. You know, I love that fun. I mean, it's just a preliminary outcome.
[18:03] They're going to keep moving and doing it. We're going to have more data to share. The wounds were just healing right up. Like, whoop, you know, so, I mean, so many good outcomes.
[18:12] We're seeing shorter stays. But you know what? All that's already in the literature, you know, and so we're. It's really. We're not doing anything new here. This is already in the literature.
[18:21] And why aren't we all doing it?
[18:25] Michelle: That's the $64,000 question. Right? And I think that's what frustrates nurses and clinicians so much, is, you know, we get excited, we join journal clubs, we start, you know, dissecting the literature.
[18:43] We start at the beginning, just learning how to read a study because most of us don't have that, you know, that study speak or research speak. You know, we can't decipher things.
[18:55] And so we start learning that and then we really start diving into the research and we see research that's 20 years old, that is solid, that we are not using in our practice and we're all looking at each other and saying why aren't we using this?
[19:15] It's so obvious, it's so beneficial.
[19:20] I think a lot of nurses kind of lose interest and initially we get so passionate and then like you said, why can't we get that out of PubMed and into practice?
[19:32] That's a great question to delve into.
[19:36] It's a great, it's just something that we need to really dissect and look into further and make that happen. And I see your passion, I hear your passion.
[19:50] And how do you think that we're going to do that? How do you think practically we're going to be able to put that research into practice?
[20:01] Beth: I think one of the best ways I found is really continuing education and then also having nurses and healthcare professionals check their own vitamin D status. So do just, just pull a 25oHD, a serum concentration and see where do they fall.
[20:19] Right. Because unless people can make it personal to themselves a lot of times they won't make it a life change. Right.
[20:27] One of the other big issues is that is that advocacy within the hospital systems to charge less for the test. So I found out through reading the literature and from a lab tech who was actually working as a CEO of a hospital that the lab test is really inexpensive, like $5 but in some places they charge $300, in other places, the country they charge $600.
[20:53] And so why are we charging so much for a five-dollar nutrient test that really should be drawn just as easily as drawing a hemoglobin?
[21:05] And so that's, that's one of the things that I guess I, I don't have the answer for but I think the more we educate and the more we talk to providers, the more we show that science.
[21:15] I have two huge books that are the brand new Feldman and Pike's Vitamin D textbooks are out like the new edition that was just published this year and it's full of research.
[21:26] And so you know, I, here's like I can give you an example for hand washing.
[21:32] There's lots of evidence that hand washing decreases infection. We would never dream of stopping washing our hands.
[21:38] True, we would, we would never dream of telling someone else, oh don't bother to wash your hands.
[21:43] Why are we, something that is evidence-based, why are we not doing it? You know, I mean, I do remember seeing pictures of hospitals, like, back a hundred years ago in the US not even maybe 80 years ago, 60 years ago, where they.
[21:59] They had UV lights on people in the ICU.
[22:03] It's the same science. Why are we not doing it? You know, in other parts of the world, they have open-air gardens and hospitals and get patients outside to get sunlight.
[22:15] Why is this? This shouldn't be anything new.
[22:18] It's common sense, and that's why I love it. You know, I feel like North Dakotans love common sense, and I love common sense. It's common sense.
[22:27] Yeah, it is.
[22:29] Michelle: And it's so easy that I think sometimes in medicine, we get.
[22:36] It's like we're thinking at a certain level, and when something comes along that's so basic, so easy, so inexpensive, we disregard it because we're always thinking at this level that it has to be higher and higher and more technological and more this and more that, and we overlook the little things like fresh air, sunlight.
[23:07] You know, this is all what Florence Nightingale was about right back in the early 19th century. So it's like, yeah, why do we do that to ourselves?
[23:22] That's a really good question. I think there is a trend that we're starting to see, not just in our everyday lives, but in nursing. Like, here's an example.
[23:34] Using honey on wounds, right? So, you know, there's millennia of evidence that says, you know, honey is good for healing all sorts of things. You know, it's an antibacterial, it's an antifungal.
[23:51] You know, it's an antiviral, all of these things. And now we're kind of going back to that. So hopefully with the vitamin D, we can see that it's simple and it's okay to embrace that.
[24:06] Beth: So some things are timeless. Yeah. Sunshine and fresh air are timeless.
[24:13] Michelle: Yep. So true. So again, I was reading some of the work by Dr. Matthews, and one of the things that he was talking about is sort of in my realm, you know, NICU nurse, longtime NICU nurse.
[24:28] And so he was talking about that he has a problem with OB-GYNs because they won't check vitamin D levels in pregnant women.
[24:38] And he even said that vitamin D is a bigger problem than folate deficiency was years ago when they were having all the neural tube defects.
[24:49] And he attributes the low vitamin D levels in pregnancy of, you know, to some of these things like postpartum depression and congestive heart failure, seizures, preeclampsia, eclampsia, all that stuff.
[25:06] So talk about that because I know you've also done some research in that area.
[25:11] Beth: I'm really passionate about vitamin D and maternal health.
[25:15] I, it's very interesting. So even my first pregnancy, I, you know, I was a nurse and had really bought into the kind of, you know, stay out of the sun between 10 and 2, you know, you don't want to get, be risky for skin cancer and you don't want to look older.
[25:33] So I was putting on the chemical sunscreens and you know, I was doing that in my early 20s and you know, I, I got pregnant with my first child and I I had a miscarriage first and miscarriage is very common in women with vitamin D deficiency.
[25:48] Now remember, I live in the way north, right? We can't generate our own vitamin D six months out of the year. So we're are, we are reliant on supplements or UVB devices for six months of the year.
[25:58] And also I was hiding from the sun because I wanted to be a good steward of my skin, right? And so I was hiding from the sun. So I was hiding and I was not generating my own for six months.
[26:14] So when I ended up having, being very sick when I was pregnant with my son, I ended up having really borderline preeclampsia. I gained 60 pounds of fluid. I was on bed rest, was in preterm labor and it was very, very serious.
[26:33] After I gave birth to him, I hemorrhaged.
[26:36] My hemoglobin was 7 and I also diurised then over the next 10 days all that fluid and was at risk for seizures. And so I was walking on little fluid packets on my feet, very, very ill, very ill.
[26:53] Like, was looking very yellow.
[26:56] Although my labs remained really within, I mean, I don't know how close to normal they were, but they were within normal range. But I was very, very ill. It took me a year or more to recover from that.
[27:10] And then subsequent, subsequently, then I got pregnant after when he was about a year old and a little over a year, maybe 13 months, I got pregnant again. And then, but I think I was maybe outside a little bit more because I had a little toddler.
[27:29] So I didn't, I didn't have the same issues. But my daughter has had multiple breaks before the age of 18 and had mega problems with her teeth, which is also in the literature.
[27:39] Of being vitamin D deficient.
[27:41] Michelle: Wow.
[27:42] Beth: And so, you know, all the symptoms that I had of vitamin D deficiency in pregnancy were many. And also in my family history, one of my great-grandmothers was a midwife.
[27:58] And so that was. Is really interesting to hear the stories of her in the prairie, you know, riding her horse and buggy around to help birth babies. And one of my other great-grandmothers died in childbirth.
[28:09] So in my family history we have this story of my grandfather's mother who died in childbirth. So I've always been interested in maternal things and I think that's honestly one of the reasons why I became a nurse and why I specialize in community maternal health.
[28:25] And as I want to, when I start doing this research with vitamin D and I started reading the articles about how you can reduce risk of maternal death, like, it really impacted me at a really personal level because of that story of my great grandmother and how it impacted my grandfather and all of us really, because of the stories of how what happened, you know, just what happened with losing a mother.
[28:48] I mean, in the, in across the world, if, if families lose a mother, we're more likely to have female children, be married off early, the family's more likely to be in poverty.
[29:00] You know, all these things. Human trafficking is more. So the death of a mother is really serious. And we know the U.S. of course, is one of the, has the poorest maternal outcomes among the industrialized nations.
[29:12] So what are we missing here in a, in a, in a community where, or a nation where we have very advanced healthcare, we, you know, we do have some maternal deserts where they're like in my state, that's a frontier state where women have to drive really far to get, you know, maternal health care.
[29:30] But overall we have an abundance of food and resources and we have other projects that can work on getting those food and resources to the right people. But if you look in the literature, vitamin addressing vitamin D deficiency in pregnancy is really a low-hanging fruit.
[29:45] So some of the research done by Dr. Matthews and then by some of the other really big powerhouses in the US of maternal vitamin D research is Hollison Wagner from the Medical University in South Carolina.
[29:58] And they really reduced the risk for preterm birth by almost 60%. So, you know, between 40 and 60%. And among African American women, they reduced it even further. So if somebody was really low vitamin D got up to 40, they were really in a good space of not going into preterm birth, I mean, and, and not getting preeclampsia and reducing type 2 diabetes, all the complications, all the concerns, all the things.
[30:33] And when I read in the literature, one of the major things that was impactful to me too was that how vitamin D is part of helping the endothelial lining of the vessels be stable so that it prevent, you know, that prevents tearing and ripping and bleeding of those vessels, which is very impactful during childbirth because I had a hemorrhage after birth and my great grandmother died from a maternal hemorrhage after birth.
[30:58] And in the third world, that is one of the leading causes of women dying in childbirth is hemorrhage.
[31:04] And so I just feel like all the way around, you know, I would really just like to do a call to action for all the midwives out there and all the family nurse practitioners doing primary care and all OB-GYNs in the US let's start looking at vitamin D.
[31:19] Do you need advocacy in your hospital to decrease the cost of a, of the initial test?
[31:26] Let's get those women up to where the leading scientists recommended the 40 and 60 and then track those outcomes. This is an easy quality improvement study to do.
[31:35] Even just do what they did in Vibra. See if you have a problem, just do a few screen, just throw out a few screenings out there to see what your women are coming in with.
[31:43] Right?
[31:44] Michelle: Yeah.
[31:45] Beth: I mean, this isn't difficult, Michelle.
[31:48] Michelle: Yeah.
[31:49] Beth: It's people choosing to put research into practice. It's 20, 24. This is 30 years of vitamin D research and pregnancy. It's time to put.
[31:59] Michelle: Time.
[32:00] Beth: It's time. Let's go.
[32:02] Michelle: Right.
[32:02] Beth: Do we care about the women in our community? I mean, all the NICU nurses, all the OB nurses, do we care about the women that we serve and their families? Let's do it.
[32:11] Like, let's go here. Let's put this research into action. I mean, us being apathetic, we are accountable when we know the truth and we don't put it into practice. You know, go read, you know, I just challenge people.
[32:25] Go read the works of Hollis and Wagner. Read what happened at MUSC and how they reduced all the preterm births, the preeclampsia. One of their articles, I can't remember which one it is, but it says that vitamin D is the only known substance that can prevent preeclampsia.
[32:41] I mean, point blank, like, come on, everyone, let's go, right? What are we doing for our women? And so I, as you, you know, you can hear like, it's so personal to me.
[32:52] Michelle: You know, because it has touched you and your family.
[32:55] Beth: Yeah. And nobody checked, you know, in the year 2000, nobody knew to check vitamin D for me. Right. But we know now. We know how many.
[33:06] Michelle: Yeah. How many moms have we lost to this thing that is preventable? And you know, I'd say in my 36 years, I remember distinctly losing at least four women to postpartum hemorrhage.
[33:26] The last just being within the last five years of my practice. And, and it, I found myself saying, really, in this day and age, women are still dying of postpartum hemorrhage, really?
[33:40] You know, leaving husbands and kids behind and families. And it's like, why can't we get this right? Why can't we get this right? And like you said before, it's low-hanging fruit.
[33:55] And I'm just sticking with that. I think that we're missing.
[34:00] What is it?
[34:03] We're not seeing the forest through the trees or whatever the saying is. You know, it's like we're cutting off our noses to spite our faces. It's like it's right there in front of us.
[34:12] But we're always thinking, like, it needs to be more complex than it is. It can't just be this easy. You know, we have to make it harder than it is.
[34:23] And it really is this easy. And so, you know, I love that you're getting the word out there. Oh. So I'm going to talk about one more thing that Dr.
[34:34] Matthews talked about that was super interesting.
[34:37] His work with patients who suffered traumatic brain injury and the, how he used vitamin D in the ICU. So do you want to talk about that?
[34:50] Beth: I think that goes back to the story that I said earlier about the patients, that they weren't expecting these people to be alert and interactive and have a life again.
[35:04] What I love about it is the staff is so excited about it because they, and, and when I, I did a debrief with the staff, when I talked to, you know, had a meeting with them, and I just said, to my knowledge, they are the only hospital in my state doing this protocol.
[35:25] Like, I was so proud. They gave these families back their children, you know, not adult children, but yet, you know, you gave parents back their children. I don't know if, these people had children or not, but you gave this family back their loved one.
[35:40] Like, it's really, it's, it's really touching. This is the best that we can do in healthcare. It is the best. And it Was it is an easy no-brainer. And to know that it, and what they said, you know, the nurses said to me, you know, we really didn't do anything different.
[35:55] This was really the only thing different than what we've ever done before was this, you know, because it's looking at the internal terrain of the person, right? If they don't have the nutrients needed to support, you know, the metabolic health of the patient, how is the patient going to recover?
[36:18] You know, how can they have healing, how can they make sure to have, you know, all the inflammatory processes in the body balanced? You know, it's, it's really inspirational.
[36:29] Michelle: Yeah, it really is. And I was reading all the, as I was reading all the research that you sent me, you know, one of the things that popped into my mind because we had, we had our own dedicated dietitians in the NICU and I know ICUs pretty much everywhere have their own dedicated, their own dedicated dietitians.
[36:52] And this is something that I would think that dietitians have in their arsenal and also in their knowledge base of how important vitamin D is for so many things.
[37:04] So what, what's happening within that community or do you know, in terms of advocating for better vitamin D therapies?
[37:17] Beth: So I work the NDNA works pretty closely with ndand, so that's the North Dakota Academy of Nutrition and Dietetics. And I have to say we have very forward-thinking nutritionists and dietitians in the state of North Dakota.
[37:32] And the NDAND is, they know this and they are partnering with us to educate and communicate more and to teach the other staff in the facilities and just bring this research to the forefront again.
[37:45] You know, maybe it was in the early 2010 to between 2010 and 2015 people were talking about vitamin D and there was a lot of research that was done. The VA did a study in 2008 and published it showing a 40% decrease in healthcare costs if people were just above 20.
[38:07] They just cut off the marker at 20. So we know not only does it improve patient outcomes, improve population health, but it decreases healthcare costs. I mean, wow, like the trifecta.
[38:18] And then you know what, I tell you what, it improves provider satisfaction and healthcare professional satisfaction. So it's really, you know, it's really got all four right.
[38:30] I really appreciate the dietitians in my state and I really challenge dietitians that are hearing this.
[38:36] Check in with some of the recordings of the conferences that we've done in North Dakota at both the NDAND and then some of the grassroots health does a lot of postings of, you know, the videos like that.
[38:48] They just did a huge expert panel and they, they have those recordings on their website just to really educate yourself. I mean, I think the challenge for us as nurses and dietitians is educating ourselves so that we can educate the inner disciplinary team.
[39:04] And if we can get, if we can share the vision and share the passion, you know, then our other healthcare providers will become passionate about it too.
[39:11] Michelle: Yeah, I think that is so true. And you know, if it starts with us, which I feel like it does, then we need to, we really have a responsibility to first of all educate ourselves and to believe it.
[39:28] Right? To believe what, what we're reading to, to, you know, with a, obviously with a scientific eye. There's lots of research out there. Learn how to read it, learn how to replicate it.
[39:43] Maybe at your institution.
[39:46] You know, I've been a big fan of professional organizations, certifications, you know, my whole career. I'm always talking about it.
[39:57] So there's so many avenues out there that nurses can access to gain knowledge from everything that we're talking about today. So let's talk about night shift workers. If you think of nurses, you know, many of us have worked night shift at one time or another in our life.
[40:18] I was fortunate to only have worked the night shift for two years.
[40:23] And I can honestly say that I think during those two years I was pretty much a zombie all the time. I was a new mom, so I was recovering from that, you know, single, unmarried Catholic mom.
[40:38] The trifecta of all the sins, right?
[40:43] And working, working night shift. Horrible, Horrible. So talk about night shift workers and just how the lack of vitamin D can affect them.
[40:55] Beth: So one of my favorite analogies to use for talking about vitamin D in general is to. There's an article by a French researcher called Anhyler named Anhyler and he compared vitamin D deficiency to the coming of winter in the Game of Thrones.
[41:11] Okay, so if you, if anybody's a Game of Thrones fans, picture the army above the north of the wall, right?
[41:19] Their mannerisms, their, their brains aren't thinking clearly. They have, they are slower to action. Right. They can't fight as, they're not as swift in war. Right. And I like to use that analogy when I talk to people who work night shift about their decision making abilities.
[41:37] If they are low vitamin D and they are working a night shift, it really, the research shows that it really results in like pseudo dementia. If your vitamin D is really low, especially when you get in that levels below 15, really pseudo dementia so you can't make good decisions in effect impacts your executive function.
[41:58] It impacts your ability to even respond quickly in the time of a crisis. And so that's one thing I'm really passionate about too is educating night shift workers to really be on top of their vitamin D and really stay on top of that when they're on their days off.
[42:17] If they are in a state where they, they have UVB rays hitting the earth at that time, which is not North Dakota right now, get outside and get some UVB rays so that you can generate your own vitamin D really, really will make an improvement.
[42:31] And on fatigue, fatigue alone. I've been seeing lectures online about combating nurse fatigue and I want to raise my hand and be like, vitamin D, hello. Make sure your vitamin D levels are robust.
[42:42] You know, keep them between 40 and 60 like it recommends in research.
[42:46] I mean that's a personal story for me. I not even a night shift worker, but when I kept my level between 40 and 60, my brain was so much sharper and I not only slept better, my brain was more sharp, I was less achy and I felt like I just could, you know, was had more motivation to do things, you know, and so that's all in the literature too.
[43:10] That article by Anhyler is really good. AnHyler, Grant and Hollock I think are the authors of that. It's really fantastic article.
[43:17] Michelle: I would love to put that link in the show notes. So send me that. I will after. Yeah, that's awesome. Yeah. And you know, just as you were describing all of the symptoms, I was like check, check, check.
[43:30] You know, and it was so sad because I feel like I lost those years of my life. Just, you know, I look back on just interacting with my daughter, my young baby and just the lack of it, you know, and I'm like, this is not right.
[43:47] And you know, I have a personal story as well. A few years ago I was diagnosed with Hashimoto's thyroiditis and my vitamin D levels were in the teens.
[43:59] And first thing the endocrinologist did was put me on brand name Synthroid, not the generic levothyroxine and vitamin D2, 50,000 units a week.
[44:14] And I'm telling you, within days I was like, wow, this is what it feels like to feel normal, to just feel normal, to not ache all the time, to not feel like I have this black cloud hanging over my head, to not feel like I'm sloshing through quicksand every day.
[44:37] So huge, huge benefits, man. I can't, I can't stress it enough, but I want to talk about the differences between vitamin D2 and vitamin D3, because I thought, oh, you know, you can go buy vitamin D3 at Costco and I can take, you know, 5,000 units a day.
[44:58] And he was like, no, it's, it's, it's different. You need to be on D2. So talk about those for a moment.
[45:06] Beth: Actually, most of the research that's been done in the last probably 20 years has been done on vitamin D3. And they've actually found that that's, that is the recommended, that is the recommended form for supplementation.
[45:18] And because. And that is one that we have seen incredible patient outcomes within the research. And so Grassroots Health has a really good blog, I think, on the difference between D2 and D3, if people are interested.
[45:31] But that's a really, it's, it's some, it's, it's something to talk about because, of course, D3 is not the prescription kind, but it actually is very effective. And our body uses D3 specifically to go into the cell.
[45:45] And so, you know, if the cell receptor is a circle, you know, maybe a stop sign would fit in there too, but you want the one that's the circle. Right.
[45:54] And so D3 is what the scientists recommend. And another thing that I find out, I find this really interesting, is that, you know, some of the literature, if you see studies where vitamin D was not effective, what they did was they gave people a bolus dose of a hundred thousand, and then they didn't give them a maintenance dose.
[46:12] So then the body just really yanked up the level and then enzymes degraded it really fast. And then there was a rebound hypo, vitamin D. If you're going to increase the level, it's best to do it.
[46:26] Like what then? To continue to give it so that it mimics what the sun does if a person is outside.
[46:32] And so that's why scientists now recommend a loading and then a continual maintenance dose to keep the level the same in people. And so that is really, in our study of Vibra, that's what we did is we did a loading dose.
[46:48] Every other day we did 25,000, or every other day we did 50. And then depending on what the calculator recommended, then we had a maintenance dose based on the weight of the patient.
[47:02] Michelle: Okay, well, thank you for that. That was a very succinct description of the differences. Thank you.
[47:09] Okay. One of the big questions I had, and you may have kind of delved into this a little bit is, you know, like questions that I've had in the past about, gosh, we have all this evidence, we have all this literature that this is so beneficial, like why aren't we doing this?
[47:29] So what do you think is the barrier to providers for first just routinely checking vitamin D levels and then prescribing or treating to get to therapeutic levels? What's the disconnect there?
[47:47] Beth: I think, number one, I think providers are really busy if they don't spend time. The ones I know have said, you know what, they haven't really spent a lot of time in the literature since med school because they're so busy.
[48:01] And that they really just take whatever the recommendations are of the leader of the unit or whoever their supervisor is or whatever their chief of staff is saying. And so that's where you can see leadership matters and that people who are in leadership take that time to really understand what is the literature saying and to like you said, how do we know how to critically appraise research to know why one study maybe demonstrates that it's effective, but then another study shows that it's not effective.
[48:29] What are the differences between those two studies? Are they were they designed the same way? Do they both monitor pre and post-levels? And that's what I found really in the literature is that we have a huge amount of differences in how studies are designed and that you can you to just read the abstract is remiss.
[48:48] We are not doing justice if we just read an abstract. You have to take the time to learn how to critically appraise the literature. And actually Grassroots Health has a phenomenal blog on that as well.
[48:59] They actually have a little infographic to show you the steps in how to critically, critically appraise nutrient based research. Because you really have to do that pre level because everybody, it isn't like a drug test, right?
[49:13] Like if we do a drug study for example, and you and I and everybody else, we all take 25 milligrams of a pill, we know that we're not getting any of that substance anywhere else.
[49:22] It's not the same for vitamin D because you have it in foods, you know, you have maybe have fortified foods, you have it in naturally occurring foods and then you're going to be everybody's outside.
[49:32] And then other things like what, what medications are we taking that might deplete vitamin D from our body? Which antidepressants leach vitamin D from the body? Which is fascinating to me because is anybody Repleting it.
[49:45] If we had a drug that leached iron, we would give iron. Why are we not giving vitamin D when we are giving drugs that lead to vitamin D?
[49:52] So that's just another side note. A great article from. Yeah, I mean, I'm telling you, let's just get fired up here. We could talk all day, but I could, I really could talk about this all day.
[50:04] Michelle: I know. I see your passion and, you know, I, I. Man, that really resonated with me, what you said about, like, if we're just reading the abstract, that's not doing it justice.
[50:15] Right?
[50:16] Here's kind of how I think of an abstract in relation to our, I guess, our daily lives. Like, I feel like it's almost like clickbait. It's like, you know, it just gives such a small synopsis and we can really quickly, like, dismiss it or just believe it a hundred percent without investigating further.
[50:41] Like an article that we read. You know, it's like in the newspaper, if anybody reads newspapers anymore. But, you know, they, they have this title and, you know, it's like, just from the title, you're going to see what, what the article said.
[50:56] It's like, no, you got to, you got to really read the entire article. You can't just believe the headline. And I feel like that that's kind of what abstracts do.
[51:06] I know I'm going to piss off a lot of people, and I apologize for that. One of them will probably be my brother, who is a researcher, and I'm going to bring him on.
[51:14] I actually talked to him last night, and I said, let's do a series of like, Research 101 for just, you know, the everyday nurse that maybe has been intimidated by reading research or you know, maybe was tasked with doing a quality improvement project.
[51:36] And now they go to the hospital librarian and they get, you know, a list of 200 research studies, and they're like, oh, my God, like, I don't even know what this means.
[51:49] What is a P-value? What is this?
[51:52] So Chris is going to come on and we're going to talk about Research 101, and I'm sure you could do that as well. Yeah. Yeah, we'll have fun with it.
[52:01] Chris is a little bit crazy.
[52:04] Ah.
[52:05] Takes one to know one, right?
[52:07] Okay.
[52:09] As we start to close here, as I told you earlier, I'm really a big fan of professional organizations. And you are the president-elect, soon to be president of the North Dakota Nurses Association.
[52:23] So tell me, what are you doing within that Organization and what, what's some of the things that you're working on, what's to come with that?
[52:33] Beth: So some of, some of the things that are important to us is of course, workplace violence. Bill. Right. I could, I could do another whole hour-long show about workplace violence and.
[52:41] Michelle: That we're gonna do it. I'm gonna talk to you about it. Yes, I've been waiting.
[52:45] Beth: I got somebody else who's, there's other people that are better at talking about this than me, but I'm still really passionate about it. I think that, you know, we, we really need to take care of our staff.
[52:54] It's really important. Otherwise we won't have people wanting to go in the field. And so just to make sure that our staff are taken care of and that, that the public is aware that we won't tolerate violence against our staff is really important.
[53:08] You know, I know nurses who've been very injured, you know, in the workplace, and I, it, you know, it impacts some of them, it can impact their life for the rest of their life.
[53:18] And so that's really important.
[53:21] Of course, nursing recruitment and retention we are always talking about, because, you know, we're a rural state, we're very dependent on having a workforce. And so we're looking at things even from, you know, how do we create a warm culture in North Dakota?
[53:36] How do we create an environment that, you know, we, we have small towns, we have safe environment. We have a lot of positives for us in North Dakota. And, you know, just to do a shout-out.
[53:45] If you, if you are looking for a safe place to raise a family, come to North Dakota. Looking for a safe place to retire, you know, with low overall cost of living.
[53:53] Come to North Dakota. We know we've got some of the most beautiful, rugged, small badlands mountains in the west of our state that you've ever seen. It's just beautiful. And so North Dakota is a great place to live and raise a family.
[54:05] But, you know, I think people don't know that.
[54:08] Michelle: Right.
[54:08] Beth: You know, when people think about, oh, where do I want to live? I mean, you know, North Dakota typically isn't the first place to come to mind, but we don't want it to be the best-kept secret anymore.
[54:18] We want it to be a place where people come and choose. And so we really are working on, you know, marketing, you know, public relations, you know, all the things that make people interested in coming to check out your state and seeing what you have to offer.
[54:30] You know, we are looking at things like how to support nursing Education and so looking at helping people to jump into being a nurse, working at the bedside and then having skills for education and leadership and research as well.
[54:44] And so that's really exciting to me. We're, we are also starting more associate's degree programs, so kind of more of that, the tech school level of nursing, so people can just jump quick, right into being an RN and that they can help meet the nursing shortage that we have in our state.
[55:02] You know, we're trying to make our climate wonderful for travelers so that they cease to be a traveler and become a North Dakotan and stay forever, you know, so I think we're doing a lot of fun things.
[55:12] You know, I, I doing things that are fun and motivating and high energy is important to me. And just, you know, how can we make the climate better? We got incredible researchers.
[55:25] Dr. Rhoda Owens from the University of North Dakota, talking about professional identity. I heard her speak at our conference and it was really, it was really motivating me. How do we get young nurses to really grab onto the essence of who, what nursing is and what they can become, but yet see it big enough that they realize they could be a nurse entrepreneur?
[55:44] Right? They could be, they could be involved in business, they can be involved in other fields, even law, you know, as a nurse, if they decide to go on and do other certifications and things.
[55:55] So I think the sky's the limit for nursing. And so, you know, part of the NDNA is, you know, how do we make people passionate about nursing and how do we take care of our nurses?
[56:05] Well, we also have a new initiative for 2025 that is on maternal health. And so that's one of the reasons I'm excited to talk about this low-hanging fruit of vitamin D deficiency and maternal health.
[56:15] But also, you know, how do we make sure that we have all the bases covered in our frontier counties and in our rural areas and have everybody train what they need for if they need a long ambulance ride or, you know, to get more providers.
[56:29] I'd love to see more nurse-midwives in North Dakota and be able to be anywhere in the state that they could support primary health care for women and as well as, you know, the childbearing timeframe.
[56:42] But I think there's a lot of room for nursing and, you know, how are we, how do we stay excited about that, motivated about it, and encourage our young people to become nurses?
[56:51] Michelle: Yeah, that's so important. And man, you guys are doing amazing things there.
[56:58] And you know, in your work with nursing students, what are you hearing from them as far as, like, their concerns for the future of nursing?
[57:08] Beth: I think one of the things that I hear from students most is, you know, and you can probably say this too, Michelle, I think the expectations on new grads have changed that we, you know, if you look at Banner's novice to expert model, we are not allowing students to be a pre-novice anymore.
[57:28] We are expecting students to hit the ground running, even as students, and perform at a much higher level of expectation. And so that's one of the things that I've really been pondering.
[57:40] How can we stay current and meet that challenge, but also support the learning of the student? Because I think what I'm hearing from students is that they're so discouraged, they don't want to stay in nursing.
[57:50] I had a brand new grad call me a few weeks ago, only been a grad for a year, and saying, I'm done. I don't want to be a nurse anymore.
[57:56] And I said, I mean, I was her mentor. So I said, oh, no, we're not nursing a new job. Right. Like, there's a point where you might just need to move on and find something else that you're passionate about.
[58:07] Michelle: Sure.
[58:08] Beth: But there's a point where we just all need to evaluate whether where there we are the top of the organization or we're the first brand new nurse stepping foot on the floor today.
[58:18] How are we coming to the challenge? Are we coming with our best self? Are we coming with bringing some joy to the atmosphere that I'm excited to be here, take care of patients today.
[58:31] They are growing, they are learning, they are building themselves as an individual. Let's bring some joy in the room. Right. Because to stay in nursing for 30, 40 years, there's gotta be some joy involved.
[58:42] Otherwise nobody's gonna stay. Right?
[58:45] Michelle: So true.
[58:45] Beth: It's important we feel that passion for people and, you know, create some vision. And so I think some of these pieces, you know, like, I'm just thinking about, right? So pulling in the professional identity.
[58:57] Right. Pulling in some of the. Choosing civility.
[59:00] I love the Keith RN series has a great chapter in their first book on choosing civility. And it is really one of the best things I've read. I absolutely love it.
[59:11] One of the other things that there is in that first book of, there's this, a whole little area on men in nursing and how do we get more men in the field?
[59:18] I mean, I, I love that. And so I'm loving just helping people from that community find their passion nursing. Where do they want to work? Do they want to work at or do they want to work ICU?
[59:28] Do they like long-term care, community health, you know, what's their passion? And just really support those men in nursing so that we can leave some of those catty attitudes that we've had in nursing behind.
[59:38] Right. Eat our young. Like, I don't like that. Nobody wants it. Let's not have North Dakota. Like I always say, let's, you know, we always, we have a saying, North Dakota, nice.
[59:49] Well, let's really be nice, right?
[59:51] Nurse and nursing, you know, we can be forward-thinking, innovative, but we also need to be caring, right? And that means caring about each other too. Not just caring about, not just caring about the patient or say that we're caring by providing good care, but are we still caring for each other?
[01:00:09] And I think that's something that all of us are still learning and growing about. And how do we handle conflict better? How do we handle ourselves better? How do we grow?
[01:00:17] It's a journey, right? None of us arrives, but how do we continue to walk on that journey of just becoming a better place to work? And that's, that's the real challenge for nursing workplaces.
[01:00:28] Because when, you know, when I hear from new grads, I mean, the eating, your young is alive and well, right? And it's better still be better. But you know what, it could still be better, right?
[01:00:40] We can still grow. How do we bring a little more joy in the journey? And I think some of that falls on us that are in leadership and management.
[01:00:48] How do we care for those that, how do we shepherd people better? I think that we don't really talk about this as a leadership role of being a shepherd. And a lot we talk about using other things, but you know, like, we have to, we have to be present, we have to be visible, we have to be role modeling how we want to talk to others.
[01:01:06] And if we're so overwhelmed with our job or if we're really doing the job of three people, then we're just sitting in front of our computer all day and we can't be out and about and setting the tone.
[01:01:15] Right. And so that's why I think all of us in management and upper management really need to look at are we giving our leaders the space to be servant leaders and having their presence be seen?
[01:01:27] Michelle: Yeah, that leadership is so important and I've spoken to so many nurse leaders that just echo everything that you've said.
[01:01:35] And sadly, I think that's not the norm in leadership. But hopefully, as we get the word out it soon will be.
[01:01:44] And I might add, earlier you were saying about caring, and we have to bring the caring, and not only for our patients, but also for each other. And I would add to that to ourselves, too.
[01:01:57] Right? Because I came from a generation of nurses that, you know, it. It was like we put everybody else before ourselves, you know, in our professional lives and in our personal lives, and we kind of put ourselves on the back burner and really didn't care for ourselves.
[01:02:14] And, you know, it caused a lot of us to burn out and to be kind of cynical and jaded. And we don't need that in nursing, and we don't want that in nursing.
[01:02:27]I love your joyful tone, and I love that you want to bring joy back to nursing.
[01:02:38] And you are the sunshine nurse. And so, you know, that's a huge responsibility. But I think you have brought a lot of joy to this conversation today, Beth, and it's just been such a stimulating conversation, and I've learned so much just learning about you and everything that you've done.
[01:02:59] I wish you continued success in everything that you're doing.
[01:03:03] Beth: Well, thanks, Michelle. I mean, I have to say, you know, to God be the glory. Right?
[01:03:07] God's always making me a better person, and I think my faith has really been the foundation of who I am as a person. And, you know, even through the darkest times, you know, I've.
[01:03:17] I've. He's always walked with me and helped me to come out of those things and to see that what we bring to the table is important. We only get so many days on the earth, and, you know, how the impact that we make can last for eternity.
[01:03:33] So we all have a responsibility to how we walk and that what we do with our time is important.
[01:03:39] Michelle: And you are making a huge impact. And I think that's what's so attractive to nurses everywhere, is that, you know, every day in some shape or form, we make an impact or we want to make an impact, or we strive to make an impact.
[01:03:56] And you've certainly done that today. So thank you so much again for being my guest.
[01:04:01] And now I'm going to ask you if you. If there's someone you recommend as a guest on this podcast.
[01:04:08] Beth: Ooh. Um, So a mentor of mine, Karen White Trevino, would be a great guest for you. She has been a mentor of mine. I did the American Nurse Association mentoring program a few years ago.
[01:04:22] So I mentored someone and was also mentored, and she mentored me, and it's been very impactful in my life. I mean, I just think she's just her. Just the heart of caring that she brings to the table and just the wisdom.
[01:04:37] I think everybody needs a mentor. And I just appreciated her wisdom and her caring so much in my life. And then she also works with students and has also been the chief nursing officer of a very large hospital.
[01:04:48] So just has so many insights on. On shepherding people in her life and mentoring others and just bringing caring. So she's. I would say she's my person I would recommend for you to visit with.
[01:05:00] Michelle: Very cool. Okay, you need to introduce us, so.
[01:05:03] Beth: Sure.
[01:05:04] Michelle: I'm excited to talk to her. Okay. Well, we've reached the end, so, you know, at the end, I do the five-minute snippet and I gave you a little warning about that.
[01:05:14] And it's just fun. It's five minutes of fun, which I know you are fun because I've seen that today. So I've been looking at your beautiful smile the entire time and just feeling your joy and your enthusiasm coming through the airwaves.
[01:05:30] So are you ready to play the 5-minute snippet?
[01:05:33] Beth: Let's do it.
[01:05:36] Michelle: Okay, here we go.
[01:06:18] You did a little bit of this earlier but convince me to live in North Dakota.
[01:06:24] Beth: Oh, I tell you what, there's just more time in the day when you live in North Dakota. Life isn't so busy here. I think you could probably get back, you know, 10 hours in the city working.
[01:06:37] You can just feel like you have an additional five hours in the day here. Like life is just. It's just.
[01:06:44] It just moves at a different pace.
[01:06:46] Michelle: Well, that sounds amazing. We all need extra time in our day and for things to slow down a little bit. So that would be a great reason to live there alone.
[01:06:56] Do you have a pet peeve?
[01:07:00] Beth: I think my, my biggest pet peeve is when people are rude.
[01:07:06] Like rude to waiters. And that's very. I. I really am a pretty tolerant person. Like, I don't care if you don't put the top back on the toothpaste. Like, I don't care about those kind of things, but I.
[01:07:17] I care about how you treat others.
[01:07:19] Michelle: Well, that's big. That's huge. Yeah. Yes, I share that.
[01:07:22] Beth: I get a little about that one.
[01:07:25] Michelle: As we should. There's no place for that. Okay. If you could only take one book with you on a remote island, which would it be?
[01:07:35] Beth: Oh, the Bible.
[01:07:36] Michelle: Sure.
[01:07:36] Beth: Hands down.
[01:07:37] Michelle: Okay. All right. That's cool. Okay, Favorite board game.
[01:07:43] Beth: Ooh, I'm really loving Triaminos these days.
[01:07:47] Michelle: What's it called?
[01:07:48] Beth: Triaminos.
[01:07:49] Michelle: Okay.
[01:07:50] Beth: I haven't heard that's real easy, but it's kind of a no-brainer. You know, instead of dominoes, they're. They're like a little triangle.
[01:07:56] Michelle: Okay.
[01:07:57] Beth: It's a really easy game to play with other people and just talk while you play the game.
[01:08:01] Michelle: Okay.
[01:08:01] Beth: So I'm like. And Rummy Cube. I like the easy games where you can just chit-chat while you do it.
[01:08:07] Michelle: Okay. That sounds fun. I think there's been a resurgence of board games or just game night in general.
[01:08:14] Very cool. Okay, we're in your home and there's a picture on your wall of your favorite travel destination.
[01:08:23] Where is it?
[01:08:25] Beth: Oh, okay. I've been to a lot of countries, so I've been to 27 countries, I've been 46 states. So I would say of the nations I've been to so far, I really love Israel.
[01:08:39] I don't know that any. Maybe you don't want to go there right now, but when things calm down, Israel has a lot going for it. It has the beach, it has mountains, it has prairies, it has little lakes.
[01:08:50] Like, I really enjoyed Israel and I went to the west bank and went to Bethlehem. It was really meaningful to me. I love it.
[01:08:56] Michelle: That sounds beautiful. Yeah. And I've heard that from so many travelers that they've. They really love Israel and, you know, whether they're a religious or spiritual person or not, they did.
[01:09:08] They love the landscape, the people, so. Yeah, that sounds amazing.
[01:09:13] Beth: Oh, the countryside is absolutely phenomenally gorgeous. Like, I'm a native person.
[01:09:18] Oh, the foods just stop right now. I mean, if I. One food to eat my whole life, like one nation's food. Load me up, man. Yeah, that Middle Eastern food, it's good stuff.
[01:09:32] Michelle: Okay, a favorite item on your desk.
[01:09:35] Beth: I have a little mug that I just bought at a little store downtown in Fargo called Olive and Rust. And it's so. It's really, you know, functional. Art. I'm just loving it right now.
[01:09:47] Michelle: That's cool.
[01:09:48] Beth: Drinking my favorite tea in there.
[01:09:51] Michelle: Oh, yeah. I've seen you drinking your tea. Okay. A food you could eat every day and never get tired of it.
[01:09:59] Beth: Well, previously I would have said eggs, but I just found out about two months ago I'm allergic to eggs, so. Can you believe that it was my favorite food?
[01:10:07] Michelle: No way.
[01:10:11] Beth: I really. I honestly, really like chickpeas. I could eat chickpeas in any shape or form any day. And it doesn't bother me because I really like the Mediterranean salads. I can eat Mediterranean salad, you know, with a little cucumber, tomato, slack and salt, a little olive oil.
[01:10:29] Throw some chickpeas in there every day.
[01:10:31] Michelle: Have you done the roasted chickpeas?
[01:10:34] Beth: I do. I like where they're, like, crunchy.
[01:10:36] Michelle: Oh, those are.
[01:10:36] Beth: Yeah. I like them when you're traveling. Right. Because then if you're getting tired when you're driving. Because in North Dakota, we have to drive. You know, it's far to drive anywhere, so I like the little snacky.
[01:10:46] The roasted chickpeas are a great snack.
[01:10:48] Michelle: Yeah. And they're so helpful. Yeah.
[01:10:50] Beth: Carrot sticks, too.
[01:10:52] Michelle: Okay. A perfect Saturday is. What's a perfect Saturday for you?
[01:10:58] Beth: I really like to go spend a little time out in nature, like, just go to a. You know, some kind of a nature park and go walk. I usually like to drive out of the city a little bit.
[01:11:08] I'm from a rural community, even though I live in an urban area now, so I do prefer to go drive out and just hear some wind and some silence and hear the birds and like to do that.
[01:11:20] Michelle: That's my kind of thing, too. Yes. I love it. Okay. Favorite show or series on Netflix?
[01:11:29] Beth: I really love anything that's a true story, so I wouldn't say it's a series or. But anything that's true, like, there's a movie. The Boy Who Harnessed the Wind.
[01:11:39] Absolutely phenomenal.
[01:11:41] Michelle: I just watched that out.
[01:11:42] Beth: I just watched a true story last night called The Stone of Destiny, about four college students who stole the Scottish Stone of Destiny from Westminster Abbey in 1950. So I just love true stories.
[01:11:55] So anything that's true, I love it.
[01:11:57] Michelle: Okay. I'm gonna have to check those out.
[01:12:00] Beth: Yeah.
[01:12:01] Michelle: Okay. My purpose in life is, I would.
[01:12:05] Beth: Like to say, to bring others joy, even though I'm sure my children wouldn't say that.
[01:12:10] Michelle: That's always true. We can't judge ourselves by our children. Right.
[01:12:17] Beth: Well, you know, I just really wish life could be about 99% joyful. Things, you know, and every once in a while, you have to have a 1%, like, smackdown, right? Like smackdown or like some kind of, you know, serious, serious conversation.
[01:12:36] You have to have some conflict resolution. But I really, you know, I think my personality really likes to.
[01:12:43] Likes to play. Like, I'm a playful person, and I like to experience joy, and so I like to keep it that direction. And then if it's getting out of control that it's not joyful, like, let's have some conflict resolution and bring it back there.
[01:12:55] Like. But don't, you know, probably a little selfishness in there. I don't want other people stealing my joy either. So, you know, we're all. I mean, no matter what, we're all selfish people.
[01:13:04] And probably my selfishness is I don't want other people stealing my joy.
[01:13:07] Michelle: So I. Oh, man. Can we just replicate you, Beth, and just replicate you and have just millions of Beths throughout the world? I just love it. I love your outlook.
[01:13:18] Beth: And you need a lot of everything, right? Like, because you can't have too much of anyone.
[01:13:24] Michelle: That's.
[01:13:24] Beth: I mean, right. We in diversity, we have beauty. So, you know, you love your soulful thinkers, too, right?
[01:13:31] Yes, I love people of all different kinds of personalities. Everybody has a gift. Everybody has something to bring to the table. Let's just harness the best of ourselves and grow and continue to grow and learn.
[01:13:41] And, you know, I'm still definitely in that space of growing and learning. So you know what?
[01:13:47] Michelle: It never. It never ends. I'm a few years older than you, so I'm 60, and I'm still learning all the time and hopefully growing. So. And I hope when I say, you know, I'm 70 or 80, that that's still happening, because I just feel like that's the one constant in life that we have is change.
[01:14:09] And I'm trying to embrace it and not be afraid of it and grow through it. So, Beth, thank you so much for coming here today and sharing your joy and your knowledge and your expertise and your research and your passion.
[01:14:24] I have really appreciated having you on.
[01:14:28] Beth: Thank you for having me. It's been fun.
[01:14:30] Michelle: Yes. Well, you have a great rest of your day. You too.