{"version":"1.0.0","segments":[{"startTime":0.66,"endTime":1.74,"body":"[Music]"},{"startTime":34.88,"endTime":35.88,"body":"[Music]"},{"startTime":35.88,"endTime":40.98,"body":"Welcome to this episode of the NLN podcast "},{"startTime":35.88,"endTime":40.98,"body":"Nursing EDge Unscripted the Surface track  "},{"startTime":40.98,"endTime":46.44,"body":"and thank you for joining us. This episode "},{"startTime":40.98,"endTime":46.44,"body":"is entitled Fostering Well-being in the  "},{"speaker":"Nursing Community","startTime":46.44,"endTime":51.9,"body":"Finding our Voice to Ask for "},{"speaker":"Nursing Community","startTime":46.44,"endTime":51.9,"body":"Support, where we will discuss the current state  "},{"speaker":"Nursing Community","startTime":51.9,"endTime":58.38,"body":"of well-being in nurses and nurse educators on "},{"speaker":"Nursing Community","startTime":51.9,"endTime":58.38,"body":"the heels of a pandemic, nursing strike, debates  "},{"speaker":"Nursing Community","startTime":58.38,"endTime":63.48,"body":"on staff and ratios and many other topics "},{"speaker":"Nursing Community","startTime":58.38,"endTime":63.48,"body":"that impact how we perceive our role and  "},{"speaker":"Nursing Community","startTime":63.48,"endTime":68.7,"body":"state of wellness within these roles. With that, "},{"speaker":"Nursing Community","startTime":63.48,"endTime":68.7,"body":"we will also discuss the stigma associated with  "},{"speaker":"Nursing Community","startTime":68.7,"endTime":73.38,"body":"mental health and the importance of finding "},{"speaker":"Nursing Community","startTime":68.7,"endTime":73.38,"body":"our voices to advocate for help when needed.  "},{"speaker":"Nursing Community","startTime":73.92,"endTime":81.3,"body":"To help us today we have a very special guest, Dr. "},{"speaker":"Nursing Community","startTime":73.92,"endTime":81.3,"body":"Cynda Rushton. Dr. Ruston is an Ann and George L.  "},{"speaker":"Nursing Community","startTime":81.3,"endTime":86.76,"body":"Bunting professor of clinical ethics at the "},{"speaker":"Nursing Community","startTime":81.3,"endTime":86.76,"body":"Johns Hopkins Berman Institute of Bioethics  "},{"speaker":"Nursing Community","startTime":86.76,"endTime":93.24,"body":"and School of Nursing and co-chairs John Hopkins "},{"speaker":"Nursing Community","startTime":86.76,"endTime":93.24,"body":"Hospital Ethics Committee and consultation service.  "},{"speaker":"Nursing Community","startTime":93.96,"endTime":100.44,"body":"Dr. Ruston has a rich and extensive experience "},{"speaker":"Nursing Community","startTime":93.96,"endTime":100.44,"body":"that includes co-leading and co-chairing several  "},{"speaker":"Nursing Community","startTime":100.44,"endTime":106.56,"body":"national initiatives to transform moral distress "},{"speaker":"Nursing Community","startTime":100.44,"endTime":106.56,"body":"into moral resilience and contributes to expert  "},{"speaker":"Nursing Community","startTime":106.56,"endTime":111.84,"body":"panels to initiate cultures of ethical "},{"speaker":"Nursing Community","startTime":106.56,"endTime":111.84,"body":"practice. She is the editor and author of  "},{"speaker":"Moral Resilience","startTime":111.84,"endTime":118.14,"body":"Transforming Moral Suffering in "},{"speaker":"Moral Resilience","startTime":111.84,"endTime":118.14,"body":"Healthcare. Welcome Cynda, thank you for joining us.  "},{"speaker":"Moral Resilience","startTime":119.46,"endTime":124.5,"body":"Well I would like to get us started just "},{"speaker":"Moral Resilience","startTime":119.46,"endTime":124.5,"body":"talking about the words we use because  "},{"speaker":"Moral Resilience","startTime":125.34,"endTime":130.86,"body":"as we've mentioned sometimes the vocabulary "},{"speaker":"Moral Resilience","startTime":125.34,"endTime":130.86,"body":"can get conflated and it's important that we  "},{"speaker":"Moral Resilience","startTime":130.86,"endTime":135.6,"body":"recognize that the words we use matter and they "},{"speaker":"Moral Resilience","startTime":130.86,"endTime":135.6,"body":"have implications that we may not recognize. So  "},{"speaker":"Moral Resilience","startTime":135.6,"endTime":142.38,"body":"Cynda, do you mind starting us off with unpacking "},{"speaker":"Moral Resilience","startTime":135.6,"endTime":142.38,"body":"for us a little bit about the lexicon around  "},{"speaker":"Moral Resilience","startTime":142.38,"endTime":151.2,"body":"well-being and mental health and mental illness? "},{"speaker":"Moral Resilience","startTime":142.38,"endTime":151.2,"body":"That's a great question and I would add one more  "},{"speaker":"Moral Resilience","startTime":151.2,"endTime":160.74,"body":"to that list, which is the issue around resilience "},{"speaker":"Moral Resilience","startTime":151.2,"endTime":160.74,"body":"because these are all terms that are part of our  "},{"speaker":"Moral Resilience","startTime":161.46,"endTime":172.32,"body":"narrative right now and they are words that "},{"speaker":"Moral Resilience","startTime":161.46,"endTime":172.32,"body":"have strict meanings that somehow have,  "},{"speaker":"Moral Resilience","startTime":172.32,"endTime":180.54,"body":"in many instances, been corrupted in one way or "},{"speaker":"Moral Resilience","startTime":172.32,"endTime":180.54,"body":"another and have kind of drifted far from their  "},{"speaker":"Moral Resilience","startTime":180.54,"endTime":188.52,"body":"original meaning. So to me, the well-being umbrella "},{"speaker":"Moral Resilience","startTime":180.54,"endTime":188.52,"body":"is a is an umbrella that encompasses all parts  "},{"speaker":"of ourselves","startTime":188.52,"endTime":195.36,"body":"our physical, our psychological, our "},{"speaker":"of ourselves","startTime":188.52,"endTime":195.36,"body":"spiritual, our moral well-being, how we can be whole  "},{"speaker":"of ourselves","startTime":195.36,"endTime":204.12,"body":"people in a way that reflects who "},{"speaker":"of ourselves","startTime":195.36,"endTime":204.12,"body":"we really are and how we want to be in the world.  "},{"speaker":"of ourselves","startTime":205.44,"endTime":213.78,"body":"The other topic of course the word that "},{"speaker":"of ourselves","startTime":205.44,"endTime":213.78,"body":"is used a lot and we certainly are using it is"},{"speaker":"of ourselves","startTime":213.78,"endTime":219.96,"body":"resilience, which has many meanings. There's "},{"speaker":"of ourselves","startTime":213.78,"endTime":219.96,"body":"not one unifying definition of resilience,  "},{"speaker":"of ourselves","startTime":220.68,"endTime":229.08,"body":"but there's a way in which certain parts "},{"speaker":"of ourselves","startTime":220.68,"endTime":229.08,"body":"of those definitions have been sort of  "},{"speaker":"of ourselves","startTime":230.52,"endTime":236.28,"body":"created as memes. The idea of "},{"speaker":"of ourselves","startTime":230.52,"endTime":236.28,"body":"resilience is about bouncing back but actually  "},{"speaker":"of ourselves","startTime":236.28,"endTime":244.02,"body":"that is only one small dimension of what it means "},{"speaker":"of ourselves","startTime":236.28,"endTime":244.02,"body":"to be resilient. It means our ability to meet  "},{"speaker":"of ourselves","startTime":244.02,"endTime":252.54,"body":"challenges in ways that are healthy, that allow "},{"speaker":"of ourselves","startTime":244.02,"endTime":252.54,"body":"us to create meaning and learn from them and to  "},{"speaker":"of ourselves","startTime":252.54,"endTime":260.1,"body":"grow as opposed to be overwhelmed and degraded "},{"speaker":"of ourselves","startTime":252.54,"endTime":260.1,"body":"by them. So if you think about that word  "},{"speaker":"of ourselves","startTime":261.84,"endTime":269.46,"body":"sometimes they can become weaponized where there's this this sort of narrative of  "},{"speaker":"of ourselves","startTime":269.46,"endTime":275.58,"body":"don't tell me to be resilient because "},{"speaker":"of ourselves","startTime":269.46,"endTime":275.58,"body":"that puts all of the responsibility on me as an  "},{"speaker":"of ourselves","startTime":275.58,"endTime":284.76,"body":"individual. In fact, nurses are already resilient "},{"speaker":"of ourselves","startTime":275.58,"endTime":284.76,"body":"and they wouldn't be nurses if they weren't.  "},{"speaker":"of ourselves","startTime":284.76,"endTime":296.16,"body":"I mean just surviving birth is a resilient "},{"speaker":"of ourselves","startTime":284.76,"endTime":296.16,"body":"process so I think it really matters how we sort  "},{"speaker":"of ourselves","startTime":296.16,"endTime":303.06,"body":"of set up this conversation the dichotomy of "},{"speaker":"of ourselves","startTime":296.16,"endTime":303.06,"body":"on the one hand we say either you're burned  "},{"speaker":"of ourselves","startTime":303.06,"endTime":310.02,"body":"out or you're resilient and what we know is "},{"speaker":"of ourselves","startTime":303.06,"endTime":310.02,"body":"that those are actually two distinct concepts  "},{"speaker":"of ourselves","startTime":310.56,"endTime":320.1,"body":"that the absence of resilience is not necessarily "},{"speaker":"of ourselves","startTime":310.56,"endTime":320.1,"body":"burnout and the converse is also true that if  "},{"speaker":"of ourselves","startTime":320.1,"endTime":326.94,"body":"you are burned out doesn't mean that you are not "},{"speaker":"of ourselves","startTime":320.1,"endTime":326.94,"body":"resilient. It may well mean that the circumstances  "},{"speaker":"of ourselves","startTime":326.94,"endTime":333.66,"body":"have exceeded your capacities to meet those "},{"speaker":"of ourselves","startTime":326.94,"endTime":333.66,"body":"challenges, not because you're deficient or  "},{"speaker":"of ourselves","startTime":333.66,"endTime":341.94,"body":"lacking but because they're exceeding anyone's "},{"speaker":"of ourselves","startTime":333.66,"endTime":341.94,"body":"abilities to sort of stay healthy and whole.  "},{"speaker":"of ourselves","startTime":341.94,"endTime":347.94,"body":"Then we sort of drill down even further on "},{"speaker":"of ourselves","startTime":341.94,"endTime":347.94,"body":"the mental health / mental illness continuum.  "},{"speaker":"of ourselves","startTime":348.54,"endTime":359.22,"body":"One of the things we often see is we conflate "},{"speaker":"of ourselves","startTime":348.54,"endTime":359.22,"body":"our biases, our understanding of mental illness  "},{"speaker":"of ourselves","startTime":359.22,"endTime":366.9,"body":"with the concept of mental health and when we "},{"speaker":"of ourselves","startTime":359.22,"endTime":366.9,"body":"do that there's an opportunity where there's a  "},{"speaker":"of ourselves","startTime":366.9,"endTime":373.14,"body":"lot of projection of stigma and assumptions "},{"speaker":"of ourselves","startTime":366.9,"endTime":373.14,"body":"about what it means to be mentally healthy.  "},{"speaker":"of ourselves","startTime":374.7,"endTime":385.86,"body":"The mental illness frame I think leads us "},{"speaker":"of ourselves","startTime":374.7,"endTime":385.86,"body":"down a path where it can really reinforce some of  "},{"speaker":"of ourselves","startTime":385.86,"endTime":394.08,"body":"our biases about being able to be honest about "},{"speaker":"of ourselves","startTime":385.86,"endTime":394.08,"body":"our limitations about where we're struggling,  "},{"speaker":"of ourselves","startTime":394.74,"endTime":400.8,"body":"where we might need support in a more "},{"speaker":"of ourselves","startTime":394.74,"endTime":400.8,"body":"proactive way versus the diagnosis  "},{"speaker":"of ourselves","startTime":402.0,"endTime":407.52,"body":"that requires a different kind of "},{"speaker":"of ourselves","startTime":402.0,"endTime":407.52,"body":"intervention. It is  "},{"speaker":"of ourselves","startTime":407.52,"endTime":412.74,"body":"being really specific about where we're "},{"speaker":"of ourselves","startTime":407.52,"endTime":412.74,"body":"locating ourselves in the conversation.  "},{"speaker":"of ourselves","startTime":414.42,"endTime":421.14,"body":"I really appreciate that and two things that are "},{"speaker":"of ourselves","startTime":414.42,"endTime":421.14,"body":"running for me as I'm hearing all that one is that  "},{"speaker":"of ourselves","startTime":422.34,"endTime":430.14,"body":"being burned out and being resilient are not "},{"speaker":"of ourselves","startTime":422.34,"endTime":430.14,"body":"mutually exclusive and I also hear in that is that  "},{"speaker":"of ourselves","startTime":430.14,"endTime":437.22,"body":"an individual can in terms of their mental health "},{"speaker":"of ourselves","startTime":430.14,"endTime":437.22,"body":"can be unhealthy  "},{"speaker":"of ourselves","startTime":438.12,"endTime":443.58,"body":"but they're not it's not a mental "},{"speaker":"of ourselves","startTime":438.12,"endTime":443.58,"body":"illness, correct? Exactly and I think  "},{"speaker":"of ourselves","startTime":444.36,"endTime":452.04,"body":"being able to sort of see that "},{"speaker":"of ourselves","startTime":444.36,"endTime":452.04,"body":"continuum can help us shift from this  "},{"speaker":"of ourselves","startTime":452.82,"endTime":465.48,"body":"stigma that goes along with the whole idea. I mean, "},{"speaker":"of ourselves","startTime":452.82,"endTime":465.48,"body":"as a as a culture we have so much bias about how  "},{"speaker":"of ourselves","startTime":465.48,"endTime":472.26,"body":"we think about mental illness even within nursing. "},{"speaker":"of ourselves","startTime":465.48,"endTime":472.26,"body":"If you can't see that you have an injury  "},{"speaker":"of ourselves","startTime":472.26,"endTime":481.74,"body":"or an illness then there's all "},{"speaker":"of ourselves","startTime":472.26,"endTime":481.74,"body":"these questions that come up about well,  "},{"speaker":"of ourselves","startTime":483.36,"endTime":491.82,"body":"why don't you just take care of that? Can't you "},{"speaker":"of ourselves","startTime":483.36,"endTime":491.82,"body":"just control that or can't you fix that? Instead of  "},{"speaker":"of ourselves","startTime":491.82,"endTime":500.16,"body":"applying the very same compassion and "},{"speaker":"of ourselves","startTime":491.82,"endTime":500.16,"body":"curiosity that we would for a person who had  "},{"speaker":"of ourselves","startTime":500.16,"endTime":509.1,"body":"heart failure or cancer to a person who may "},{"speaker":"of ourselves","startTime":500.16,"endTime":509.1,"body":"be struggling with mental challenges  "},{"speaker":"of ourselves","startTime":509.1,"endTime":517.62,"body":"of depression or anxiety or in our workforce "},{"speaker":"of ourselves","startTime":509.1,"endTime":517.62,"body":"right now, PTSD. I think it's a real opportunity  "},{"speaker":"of ourselves","startTime":517.62,"endTime":523.98,"body":"especially right now in our profession that "},{"speaker":"of ourselves","startTime":517.62,"endTime":523.98,"body":"we really pay attention to those distinctions. "},{"speaker":"of ourselves","startTime":525.12,"endTime":531.24,"body":"It's so important and Michelle, I "},{"speaker":"of ourselves","startTime":525.12,"endTime":531.24,"body":"was curious to hear Cynda's thoughts on  "},{"speaker":"of ourselves","startTime":531.84,"endTime":536.82,"body":"putting our lens on the the nursing workforce "},{"speaker":"of ourselves","startTime":531.84,"endTime":536.82,"body":"in terms of well-being. You think we should  "},{"speaker":"of ourselves","startTime":536.82,"endTime":543.48,"body":"transition to that? Absolutely. Excellent. So "},{"speaker":"of ourselves","startTime":536.82,"endTime":543.48,"body":"I'm wondering, I'd like us to put our lens of  "},{"speaker":"of ourselves","startTime":543.48,"endTime":549.12,"body":"this conversation on the nursing workforce right "},{"speaker":"of ourselves","startTime":543.48,"endTime":549.12,"body":"now in terms of well-being and resilience.  "},{"speaker":"of ourselves","startTime":549.12,"endTime":555.54,"body":"I think there are a lot of factors at play "},{"speaker":"of ourselves","startTime":549.12,"endTime":555.54,"body":"both for academia and practice that can really  "},{"speaker":"of ourselves","startTime":555.54,"endTime":563.82,"body":"impact resilience and overall well-being. I think "},{"speaker":"of ourselves","startTime":555.54,"endTime":563.82,"body":"about the pandemic. I think about this increased  "},{"speaker":"of ourselves","startTime":563.82,"endTime":570.3,"body":"spotlight on litigation for medical errors "},{"speaker":"of ourselves","startTime":563.82,"endTime":570.3,"body":"and the impact it has on systems thinking.  "},{"speaker":"of ourselves","startTime":570.3,"endTime":578.82,"body":"I think about the nursing staff shortage and both "},{"speaker":"of ourselves","startTime":570.3,"endTime":578.82,"body":"on academic faculty shortage and bedside practice.  "},{"speaker":"of ourselves","startTime":578.82,"endTime":586.56,"body":"All of these factors I see having a significant "},{"speaker":"of ourselves","startTime":578.82,"endTime":586.56,"body":"impact on well-being and resilience and so I'm  "},{"speaker":"of ourselves","startTime":586.56,"endTime":591.96,"body":"curious to hear your perspective on what is the "},{"speaker":"of ourselves","startTime":586.56,"endTime":591.96,"body":"state of our well-being as a profession both in  "},{"speaker":"of ourselves","startTime":591.96,"endTime":602.04,"body":"academia and in clinical practice? Well, it's not "},{"speaker":"of ourselves","startTime":591.96,"endTime":602.04,"body":"great. Let's just sort of tell the truth here.   "},{"speaker":"of ourselves","startTime":602.88,"endTime":613.32,"body":"It's not as if these are new problems. They have "},{"speaker":"of ourselves","startTime":602.88,"endTime":613.32,"body":"been present for as long as I've been a nurse. The  "},{"speaker":"of ourselves","startTime":613.32,"endTime":619.8,"body":"the pandemic has really intensified them though in "},{"speaker":"of ourselves","startTime":613.32,"endTime":619.8,"body":"ways that  I've not seen in my profession.  "},{"speaker":"of ourselves","startTime":621.54,"endTime":630.6,"body":"It's like we know from lots of "},{"speaker":"of ourselves","startTime":621.54,"endTime":630.6,"body":"data that nurses are experiencing  "},{"speaker":"of ourselves","startTime":630.6,"endTime":638.76,"body":"high degrees of depression and "},{"speaker":"of ourselves","startTime":630.6,"endTime":638.76,"body":"anxiety, PTSD, we're seeing more  "},{"speaker":"of ourselves","startTime":639.54,"endTime":649.5,"body":"of an uptick in suicide among nurses, which is "},{"speaker":"of ourselves","startTime":639.54,"endTime":649.5,"body":"a very extreme response to a sustained  "},{"speaker":"of ourselves","startTime":649.5,"endTime":657.24,"body":"and often unrelenting stress that nurses are "},{"speaker":"of ourselves","startTime":649.5,"endTime":657.24,"body":"experiencing along with the general public.  "},{"speaker":"of ourselves","startTime":657.96,"endTime":665.94,"body":"In my work we've seen you know evidence that "},{"speaker":"of ourselves","startTime":657.96,"endTime":665.94,"body":"alongside all of these things the levels  "},{"speaker":"of ourselves","startTime":665.94,"endTime":676.56,"body":"of burnout are very high. Before the pandemic "},{"speaker":"of ourselves","startTime":665.94,"endTime":676.56,"body":"they were hovering around 40, 42 percent. We've  "},{"speaker":"of ourselves","startTime":676.56,"endTime":682.8,"body":"heard of levels of 60 or 80 percent of "},{"speaker":"of ourselves","startTime":676.56,"endTime":682.8,"body":"nurses demonstrating symptoms of burnout  "},{"speaker":"of ourselves","startTime":684.12,"endTime":692.94,"body":"and a moral injury and moral distress. In one of "},{"speaker":"of ourselves","startTime":684.12,"endTime":692.94,"body":"our studies four in ten nurses in our sample had  "},{"speaker":"of ourselves","startTime":692.94,"endTime":699.96,"body":"clinically significant symptoms of moral injury. "},{"speaker":"of ourselves","startTime":692.94,"endTime":699.96,"body":"That tells you that there are extreme stressors  "},{"speaker":"of ourselves","startTime":699.96,"endTime":707.76,"body":"everywhere and it's not just in nurses who are "},{"speaker":"of ourselves","startTime":699.96,"endTime":707.76,"body":"delivering direct care. It's in leaders, but it's  "},{"speaker":"of ourselves","startTime":707.76,"endTime":718.74,"body":"also in faculty and students who are in this "},{"speaker":"of ourselves","startTime":707.76,"endTime":718.74,"body":"milieu of trying to respond to this  "},{"speaker":"of ourselves","startTime":718.74,"endTime":727.74,"body":"overwhelming and unrelenting pandemic that we've "},{"speaker":"of ourselves","startTime":718.74,"endTime":727.74,"body":"been in. I think that it is important for us  "},{"speaker":"of ourselves","startTime":728.58,"endTime":736.32,"body":"to pause and to say, you know, probably about "},{"speaker":"of ourselves","startTime":728.58,"endTime":736.32,"body":"half of us have symptoms of depression. That  "},{"speaker":"of ourselves","startTime":736.32,"endTime":744.6,"body":"we are anxious and that it's not a moral "},{"speaker":"of ourselves","startTime":736.32,"endTime":744.6,"body":"failing that we are experiencing these  "},{"speaker":"of ourselves","startTime":744.6,"endTime":751.38,"body":"kinds of responses to a situation that "},{"speaker":"of ourselves","startTime":744.6,"endTime":751.38,"body":"really has exceeded all of our capacities.  "},{"speaker":"of ourselves","startTime":753.24,"endTime":759.12,"body":"Some of us look like we're doing okay "},{"speaker":"of ourselves","startTime":753.24,"endTime":759.12,"body":"but truth is none of us have been through this  "},{"speaker":"of ourselves","startTime":759.12,"endTime":768.0,"body":"experience unscathed. There's "},{"speaker":"of ourselves","startTime":759.12,"endTime":768.0,"body":"I think an invitation for us to to step back  "},{"speaker":"of ourselves","startTime":768.72,"endTime":777.72,"body":"and to ask ourselves what's missing from "},{"speaker":"of ourselves","startTime":768.72,"endTime":777.72,"body":"our repertoire? I do believe that it is  "},{"speaker":"of ourselves","startTime":778.56,"endTime":788.88,"body":"on the one hand the lack of resources that "},{"speaker":"of ourselves","startTime":778.56,"endTime":788.88,"body":"individuals have themselves to meet these  "},{"speaker":"of ourselves","startTime":788.88,"endTime":797.94,"body":"challenges but that is not sufficient to actually "},{"speaker":"of ourselves","startTime":788.88,"endTime":797.94,"body":"address the system contributions that create the  "},{"speaker":"of ourselves","startTime":797.94,"endTime":803.94,"body":"conditions where this extreme stress and "},{"speaker":"of ourselves","startTime":797.94,"endTime":803.94,"body":"distress and moral injury is occurring."},{"speaker":"of ourselves","startTime":806.58,"endTime":815.52,"body":"So this is really important. I'm hearing really "},{"speaker":"of ourselves","startTime":806.58,"endTime":815.52,"body":"two levels of a concern. There's probably more in  "},{"speaker":"of ourselves","startTime":815.52,"endTime":822.42,"body":"there that I may not be picking up right away,  but "},{"speaker":"of ourselves","startTime":815.52,"endTime":822.42,"body":"there's sort of this individual moral distress or  "},{"speaker":"of ourselves","startTime":822.42,"endTime":828.9,"body":"experience of moral injury that I also feel like "},{"speaker":"of ourselves","startTime":822.42,"endTime":828.9,"body":"is quite, I'm going to use the word contagious for  "},{"speaker":"of ourselves","startTime":828.9,"endTime":835.26,"body":"a lack of better words, but if you're experiencing "},{"speaker":"of ourselves","startTime":828.9,"endTime":835.26,"body":"moral injury or or moral distress you're going  "},{"speaker":"of ourselves","startTime":835.26,"endTime":841.44,"body":"to be sharing that unconsciously or consciously "},{"speaker":"of ourselves","startTime":835.26,"endTime":841.44,"body":"with other people. So when I think about faculty,  "},{"speaker":"of ourselves","startTime":841.44,"endTime":848.16,"body":"if we're experiencing this kind of distress, "},{"speaker":"of ourselves","startTime":841.44,"endTime":848.16,"body":"it's going to be projected and shared  "},{"speaker":"of ourselves","startTime":848.16,"endTime":854.7,"body":"and leaked out maybe even without "},{"speaker":"of ourselves","startTime":848.16,"endTime":854.7,"body":"our intention, in the classroom, in clinical. If  "},{"speaker":"of ourselves","startTime":854.7,"endTime":859.92,"body":"we're feeling anxiety it tends to and I just even "},{"speaker":"of ourselves","startTime":854.7,"endTime":859.92,"body":"think about that personally as a mother, if I'm  "},{"speaker":"of ourselves","startTime":859.92,"endTime":864.6,"body":"feeling some stress at work and I walk in the door "},{"speaker":"of ourselves","startTime":859.92,"endTime":864.6,"body":"and I don't clear that space I mean everybody's  "},{"speaker":"of ourselves","startTime":864.6,"endTime":871.26,"body":"gonna get some of that whether it's "},{"speaker":"of ourselves","startTime":864.6,"endTime":871.26,"body":"just snapping or being short-tempered...  "},{"speaker":"of ourselves","startTime":871.86,"endTime":877.8,"body":"And if you think about a nurse feeling "},{"speaker":"of ourselves","startTime":871.86,"endTime":877.8,"body":"that in the context of patient care, how  "},{"speaker":"of ourselves","startTime":877.8,"endTime":883.68,"body":"serious that can be for one another from the"},{"speaker":"of ourselves","startTime":877.8,"endTime":883.68,"body":"morale of the unit and then for the patient care  "},{"speaker":"of ourselves","startTime":883.68,"endTime":890.16,"body":"and family care directly? So that's concerning "},{"speaker":"of ourselves","startTime":883.68,"endTime":890.16,"body":"to me just the ripple effect and then I also  "},{"speaker":"of ourselves","startTime":890.16,"endTime":895.86,"body":"heard you mention systemic, right, systemically "},{"speaker":"of ourselves","startTime":890.16,"endTime":895.86,"body":"if we're not addressing some of the systemic  "},{"speaker":"of ourselves","startTime":897.66,"endTime":906.06,"body":"barriers or challenges then it's just all "},{"speaker":"of ourselves","startTime":897.66,"endTime":906.06,"body":"going to continue to be experienced.  "},{"speaker":"of ourselves","startTime":906.06,"endTime":912.54,"body":"I think that's a really good point. The "},{"speaker":"of ourselves","startTime":906.06,"endTime":912.54,"body":"sort of moral suffering that people experience  "},{"speaker":"of ourselves","startTime":913.38,"endTime":921.24,"body":"often is related to the gap between what they "},{"speaker":"of ourselves","startTime":913.38,"endTime":921.24,"body":"think they ought to do and what they are actually  "},{"speaker":"of ourselves","startTime":921.24,"endTime":928.26,"body":"doing and I think this is also a time when "},{"speaker":"of ourselves","startTime":921.24,"endTime":928.26,"body":"we again, back to your point about language,  "},{"speaker":"of ourselves","startTime":929.04,"endTime":933.96,"body":"the reason that we're distressed "},{"speaker":"of ourselves","startTime":929.04,"endTime":933.96,"body":"about staffing is because  "},{"speaker":"of ourselves","startTime":934.92,"endTime":942.96,"body":"not having the resources to provide care that we "},{"speaker":"of ourselves","startTime":934.92,"endTime":942.96,"body":"know we could under other circumstances creates  "},{"speaker":"of ourselves","startTime":942.96,"endTime":949.08,"body":"this dissonance and distress that somehow "},{"speaker":"of ourselves","startTime":942.96,"endTime":949.08,"body":"I'm not fulfilling my ethical obligations  "},{"speaker":"of ourselves","startTime":949.08,"endTime":956.34,"body":"to my patients or to my students. That "},{"speaker":"of ourselves","startTime":949.08,"endTime":956.34,"body":"is a kind of moral residue that stays with  "},{"speaker":"of ourselves","startTime":956.34,"endTime":965.58,"body":"us and it begins to accumulate and we begin to... "},{"speaker":"of ourselves","startTime":956.34,"endTime":965.58,"body":"our integrity begins to be degraded and it has  "},{"speaker":"of ourselves","startTime":965.58,"endTime":971.46,"body":"physical and psychological consequences. "},{"speaker":"of ourselves","startTime":965.58,"endTime":971.46,"body":"And what you're talking about Michelle I  "},{"speaker":"of ourselves","startTime":971.46,"endTime":978.0,"body":"think if you think about it from our nervous "},{"speaker":"of ourselves","startTime":971.46,"endTime":978.0,"body":"system, we resonate with each other's energy  "},{"speaker":"of ourselves","startTime":979.32,"endTime":987.72,"body":"and our nervous system is oriented toward threat. "},{"speaker":"of ourselves","startTime":979.32,"endTime":987.72,"body":"So when we come in with negative energy we're  "},{"speaker":"of ourselves","startTime":987.72,"endTime":992.76,"body":"more likely to start resonating, everybody else "},{"speaker":"of ourselves","startTime":987.72,"endTime":992.76,"body":"is going to start resonating with that as well  "},{"speaker":"of ourselves","startTime":993.36,"endTime":1002.18,"body":"and you know you put on top of that if you think "},{"speaker":"of ourselves","startTime":993.36,"endTime":1002.18,"body":"about the features of burnout, emotional, exhaustion  "},{"speaker":"of ourselves","startTime":1002.18,"endTime":1010.52,"body":"cynicism, lack of personal accomplishment, one of "},{"speaker":"of ourselves","startTime":1002.18,"endTime":1010.52,"body":"the things that's happening and an unconsciously  "},{"speaker":"of ourselves","startTime":1010.52,"endTime":1021.98,"body":"the spread of this negative narrative "},{"speaker":"of ourselves","startTime":1010.52,"endTime":1021.98,"body":"is that our cynicism about our work has been  "},{"speaker":"of ourselves","startTime":1021.98,"endTime":1029.12,"body":"fueled again and again and again by repeating the "},{"speaker":"of ourselves","startTime":1021.98,"endTime":1029.12,"body":"negative disempowering narrative about burnout.  "},{"speaker":"of ourselves","startTime":1030.56,"endTime":1040.82,"body":"So we're we're inadvertently reinforcing in "},{"speaker":"of ourselves","startTime":1030.56,"endTime":1040.82,"body":"our nervous system this fight or flight freeze  "},{"speaker":"of ourselves","startTime":1040.82,"endTime":1048.92,"body":"kind of responses that don't actually help us to "},{"speaker":"of ourselves","startTime":1040.82,"endTime":1048.92,"body":"be able to connect to each other to connect to  "},{"speaker":"of ourselves","startTime":1048.92,"endTime":1056.9,"body":"ourselves and to connect to the resources that "},{"speaker":"of ourselves","startTime":1048.92,"endTime":1056.9,"body":"we might need to help us to navigate through  "},{"speaker":"of ourselves","startTime":1056.9,"endTime":1065.06,"body":"this particularly challenging time. I think "},{"speaker":"of ourselves","startTime":1056.9,"endTime":1065.06,"body":"what's interesting too is the probably people's  "},{"speaker":"of ourselves","startTime":1067.52,"endTime":1074.72,"body":"I don't want to say lack ,almost lack "},{"speaker":"of ourselves","startTime":1067.52,"endTime":1074.72,"body":"of skill or awareness to talk about  "},{"speaker":"of ourselves","startTime":1075.62,"endTime":1084.68,"body":"moral distress and discomfort and so when "},{"speaker":"of ourselves","startTime":1075.62,"endTime":1084.68,"body":"I'm  experiencing this nervous system  "},{"speaker":"of ourselves","startTime":1086.72,"endTime":1091.34,"body":"disturbance, we'll just call it a fight "},{"speaker":"of ourselves","startTime":1086.72,"endTime":1091.34,"body":"or flight, or this elevation,  "},{"speaker":"of ourselves","startTime":1092.6,"endTime":1098.18,"body":"it's felt by others and then people don't know "},{"speaker":"of ourselves","startTime":1092.6,"endTime":1098.18,"body":"how to respond to it so people will then"},{"speaker":"of ourselves","startTime":1098.18,"endTime":1105.32,"body":"either shut down or they may even say, are you okay? "},{"speaker":"of ourselves","startTime":1098.18,"endTime":1105.32,"body":"I'm usually...I'll be honest. I'll say I'm fine.  "},{"speaker":"of ourselves","startTime":1105.32,"endTime":1112.4,"body":"I'm fine because I'm just trying to like keep "},{"speaker":"of ourselves","startTime":1105.32,"endTime":1112.4,"body":"it together or keep it down. I've learned to say  "},{"speaker":"of ourselves","startTime":1113.18,"endTime":1119.96,"body":"to stop when I get that kind of input to stop "},{"speaker":"of ourselves","startTime":1113.18,"endTime":1119.96,"body":"and check myself. Am I feeling fine? Where am I not  "},{"speaker":"of ourselves","startTime":1119.96,"endTime":1129.8,"body":"feeling fine? Why am I not feeling fine? But that "},{"speaker":"of ourselves","startTime":1119.96,"endTime":1129.8,"body":"took some time and intention and a long history of  "},{"speaker":"of ourselves","startTime":1129.8,"endTime":1138.02,"body":"experiencing burnout and distress to navigate "},{"speaker":"of ourselves","startTime":1129.8,"endTime":1138.02,"body":"that space. But if"},{"speaker":"of ourselves","startTime":1138.02,"endTime":1143.42,"body":"we don't have the language, if we don't have the "},{"speaker":"of ourselves","startTime":1138.02,"endTime":1143.42,"body":"skills, we're not going to connect. We're just  "},{"speaker":"of ourselves","startTime":1143.42,"endTime":1148.4,"body":"going to separate and I think I've experienced "},{"speaker":"of ourselves","startTime":1143.42,"endTime":1148.4,"body":"that many times personally, but I'm worried more  "},{"speaker":"of ourselves","startTime":1148.4,"endTime":1154.7,"body":"again about the profession at this separation "},{"speaker":"of ourselves","startTime":1148.4,"endTime":1154.7,"body":"that we're experiencing and seeing  "},{"speaker":"of ourselves","startTime":1154.7,"endTime":1162.5,"body":"and that's concerning. Yeah. If you think "},{"speaker":"of ourselves","startTime":1154.7,"endTime":1162.5,"body":"about one of the consequences of the pandemic is  "},{"speaker":"of ourselves","startTime":1163.22,"endTime":1170.54,"body":"in part because everybody was in PPE, "},{"speaker":"of ourselves","startTime":1163.22,"endTime":1170.54,"body":"we're masked up, we are not in our usual  "},{"speaker":"of ourselves","startTime":1171.98,"endTime":1178.94,"body":"settings that many people in the midst of "},{"speaker":"of ourselves","startTime":1171.98,"endTime":1178.94,"body":"feeling challenged emotionally and physically  "},{"speaker":"of ourselves","startTime":1178.94,"endTime":1187.28,"body":"they're also socially challenged of isolation. "},{"speaker":"of ourselves","startTime":1178.94,"endTime":1187.28,"body":"And one of the consequences is we begin to  "},{"speaker":"of ourselves","startTime":1187.28,"endTime":1194.18,"body":"question - do I belong here? Do I belong in this "},{"speaker":"of ourselves","startTime":1187.28,"endTime":1194.18,"body":"profession? Do I belong in this organization?  "},{"speaker":"of ourselves","startTime":1194.18,"endTime":1204.62,"body":"It's part of that cascade of how "},{"speaker":"of ourselves","startTime":1194.18,"endTime":1204.62,"body":"when these kinds of experiences accumulate that if  "},{"speaker":"of ourselves","startTime":1204.62,"endTime":1215.3,"body":"we're not able to notice, as you said Michelle, , am I really okay? And how do they  "},{"speaker":"of ourselves","startTime":1215.3,"endTime":1222.8,"body":"then ask for and receive support and resources? "},{"speaker":"of ourselves","startTime":1215.3,"endTime":1222.8,"body":"I feel like this is one of the big issues in  "},{"speaker":"of ourselves","startTime":1222.8,"endTime":1232.22,"body":"nursing right now. One is who are we now and the "},{"speaker":"of ourselves","startTime":1222.8,"endTime":1232.22,"body":"other one is how  do we create an environment  "},{"speaker":"of ourselves","startTime":1232.22,"endTime":1243.56,"body":"where asking for and receiving support is a norm "},{"speaker":"of ourselves","startTime":1232.22,"endTime":1243.56,"body":"that we all uphold and honor and how we then can  "},{"speaker":"of ourselves","startTime":1245.12,"endTime":1253.88,"body":"create systems that make it easier for us to "},{"speaker":"of ourselves","startTime":1245.12,"endTime":1253.88,"body":"do that so that the the kind of stigma that  "},{"speaker":"of ourselves","startTime":1253.88,"endTime":1262.34,"body":"we often associate with mental health and that  overlap I'm mentally ill now because I'm  "},{"speaker":"of ourselves","startTime":1262.34,"endTime":1270.14,"body":"feeling so sad today, that I'm depressed or I'm "},{"speaker":"of ourselves","startTime":1262.34,"endTime":1270.14,"body":"so anxious I can't focus. The labeling of those  "},{"speaker":"of ourselves","startTime":1270.14,"endTime":1280.88,"body":"experiences as somehow bad or wrong I think "},{"speaker":"of ourselves","startTime":1270.14,"endTime":1280.88,"body":"is something we have to really pay attention  "},{"speaker":"of ourselves","startTime":1280.88,"endTime":1288.8,"body":"to in nursing because we've got a culture where it's"},{"speaker":"of ourselves","startTime":1280.88,"endTime":1288.8,"body":"the survival of the fittest and"},{"speaker":"of ourselves","startTime":1288.8,"endTime":1295.94,"body":"we do not have a lot of tolerance if you "},{"speaker":"of ourselves","startTime":1288.8,"endTime":1295.94,"body":"seem to be struggling. We're like, well,"},{"speaker":"of ourselves","startTime":1297.68,"endTime":1304.04,"body":"that's not how to  be in our "},{"speaker":"of ourselves","startTime":1297.68,"endTime":1304.04,"body":"profession and so I think that's that's a  "},{"speaker":"of ourselves","startTime":1304.04,"endTime":1310.76,"body":"place where we we need to spend some time "},{"speaker":"of ourselves","startTime":1304.04,"endTime":1310.76,"body":"examining how we're all contributing to that."},{"speaker":"of ourselves","startTime":1313.1,"endTime":1319.16,"body":"As I hear this and I think about this it "},{"speaker":"of ourselves","startTime":1313.1,"endTime":1319.16,"body":"makes me think about who I consider might be  "},{"speaker":"of ourselves","startTime":1319.16,"endTime":1324.38,"body":"our most vulnerable in the nursing profession "},{"speaker":"of ourselves","startTime":1319.16,"endTime":1324.38,"body":"and I think about our new grads those who are  "},{"speaker":"of ourselves","startTime":1324.38,"endTime":1327.38,"body":"transitioning to practice whether they're "},{"speaker":"of ourselves","startTime":1324.38,"endTime":1327.38,"body":"transitioning to practice at entry level  "},{"speaker":"of ourselves","startTime":1327.38,"endTime":1332.3,"body":"or transitioning to practice an advanced "},{"speaker":"of ourselves","startTime":1327.38,"endTime":1332.3,"body":"practice level and we know the rates of  "},{"speaker":"of ourselves","startTime":1332.3,"endTime":1336.08,"body":"retention. We know the risk to leave"},{"speaker":"of ourselves","startTime":1332.3,"endTime":1336.08,"body":"the profession especially in the first one  "},{"speaker":"of ourselves","startTime":1336.08,"endTime":1342.08,"body":"to two years and then you layer on that all of "},{"speaker":"of ourselves","startTime":1336.08,"endTime":1342.08,"body":"these other stressors and factors and it makes  "},{"speaker":"of ourselves","startTime":1342.08,"endTime":1347.18,"body":"me wonder are we doing enough on the academic "},{"speaker":"of ourselves","startTime":1342.08,"endTime":1347.18,"body":"side when we talk about readiness to practice,  "},{"speaker":"of ourselves","startTime":1347.18,"endTime":1351.44,"body":"our lenses usually do they have the knowledge the "},{"speaker":"of ourselves","startTime":1347.18,"endTime":1351.44,"body":"skills abilities to be safe and competent nurses? "},{"speaker":"of ourselves","startTime":1351.44,"endTime":1359.36,"body":"Add to that, are we really doing enough to help "},{"speaker":"of ourselves","startTime":1351.44,"endTime":1359.36,"body":"prepare them with the language, the reframe, the  "},{"speaker":"of ourselves","startTime":1359.36,"endTime":1365.96,"body":"skill set to be able to take on these stressors "},{"speaker":"of ourselves","startTime":1359.36,"endTime":1365.96,"body":"and build resilience and focus on well-being?  "},{"speaker":"of ourselves","startTime":1365.96,"endTime":1373.04,"body":"My gut intuition is thinking I don't think "},{"speaker":"of ourselves","startTime":1365.96,"endTime":1373.04,"body":"we're doing enough, no, I don't think we are and  "},{"speaker":"of ourselves","startTime":1373.58,"endTime":1378.98,"body":"you know it's interesting if you "},{"speaker":"of ourselves","startTime":1373.58,"endTime":1378.98,"body":"think about all of our DEI efforts  "},{"speaker":"of ourselves","startTime":1379.94,"endTime":1387.32,"body":"this is another area where there is a lot of "},{"speaker":"of ourselves","startTime":1379.94,"endTime":1387.32,"body":"diversity but also a lot of stigma and bias  "},{"speaker":"of ourselves","startTime":1387.32,"endTime":1393.74,"body":"that goes along with it. If we were to think "},{"speaker":"of ourselves","startTime":1387.32,"endTime":1393.74,"body":"about how we create an environment of inclusion  "},{"speaker":"of ourselves","startTime":1393.74,"endTime":1402.44,"body":"we have to also think about this issue -"},{"speaker":"of ourselves","startTime":1393.74,"endTime":1402.44,"body":"how stigma's perceived - that a  "},{"speaker":"of ourselves","startTime":1402.44,"endTime":1413.48,"body":"person who's struggling is somehow irrational "},{"speaker":"of ourselves","startTime":1402.44,"endTime":1413.48,"body":"or not real, not reliable, and I've learned so  "},{"speaker":"of ourselves","startTime":1413.48,"endTime":1419.54,"body":"much about this from my colleague Elena Bergman "},{"speaker":"of ourselves","startTime":1413.48,"endTime":1419.54,"body":"who's a doctoral student here at Hopkins and Katie  "},{"speaker":"of ourselves","startTime":1421.16,"endTime":1430.58,"body":"Boston Leary who has done a lot of work in "},{"speaker":"of ourselves","startTime":1421.16,"endTime":1430.58,"body":"this area of of stigma. So how we even  "},{"speaker":"of ourselves","startTime":1430.58,"endTime":1440.0,"body":"explore that and from those biases how we "},{"speaker":"of ourselves","startTime":1430.58,"endTime":1440.0,"body":"internalize the message that I should be  "},{"speaker":"of ourselves","startTime":1440.0,"endTime":1447.2,"body":"able to you know pull myself up by my bootstraps "},{"speaker":"of ourselves","startTime":1440.0,"endTime":1447.2,"body":"and meet this challenge. I think inadvertently  "},{"speaker":"of ourselves","startTime":1447.98,"endTime":1454.7,"body":"we may be in academia giving the message "},{"speaker":"of ourselves","startTime":1447.98,"endTime":1454.7,"body":"that if you you can't make it here  "},{"speaker":"of ourselves","startTime":1456.14,"endTime":1462.2,"body":"and follow the the path that we've set "},{"speaker":"of ourselves","startTime":1456.14,"endTime":1462.2,"body":"out for you probably don't belong here.  "},{"speaker":"of ourselves","startTime":1462.92,"endTime":1469.94,"body":"Then you add on to it the anticipated "},{"speaker":"of ourselves","startTime":1462.92,"endTime":1469.94,"body":"stigma - what are people going to think about me"},{"speaker":"of ourselves","startTime":1469.94,"endTime":1477.98,"body":"if I ask for help and and then how do leaders "},{"speaker":"of ourselves","startTime":1469.94,"endTime":1477.98,"body":"and faculty members respond when students say  "},{"speaker":"of ourselves","startTime":1477.98,"endTime":1487.52,"body":"I'm really struggling. Do we accommodate, to "},{"speaker":"of ourselves","startTime":1477.98,"endTime":1487.52,"body":"what extent, how do we really  "},{"speaker":"of ourselves","startTime":1488.78,"endTime":1494.96,"body":"respond to that. Then the"},{"speaker":"of ourselves","startTime":1488.78,"endTime":1494.96,"body":"the last part is really sort of enacted stigma  "},{"speaker":"of ourselves","startTime":1494.96,"endTime":1501.44,"body":"it's what happens and what the experience is "},{"speaker":"of ourselves","startTime":1494.96,"endTime":1501.44,"body":"when you actually take the risk to ask for help.  "},{"speaker":"of ourselves","startTime":1502.34,"endTime":1511.4,"body":"Do people gossip? Do they respond with compassion? "},{"speaker":"of ourselves","startTime":1502.34,"endTime":1511.4,"body":"Do they label certain individuals in a way  "},{"speaker":"of ourselves","startTime":1511.4,"endTime":1523.64,"body":"that is really unjust and and potentially "},{"speaker":"of ourselves","startTime":1511.4,"endTime":1523.64,"body":"disrespectful? I think in academia it is  "},{"speaker":"of ourselves","startTime":1525.08,"endTime":1531.32,"body":"for one thing we have to look at ourselves and "},{"speaker":"of ourselves","startTime":1525.08,"endTime":1531.32,"body":"how we are showing up in the classroom and in  "},{"speaker":"of ourselves","startTime":1531.32,"endTime":1539.72,"body":"our own work, how we are with each other. Students "},{"speaker":"of ourselves","startTime":1531.32,"endTime":1539.72,"body":"are watching. They're watching how we are together  "},{"speaker":"of ourselves","startTime":1541.76,"endTime":1546.38,"body":"and I think until we do that work  "},{"speaker":"of ourselves","startTime":1548.84,"endTime":1555.56,"body":"there's a risk that our engagement "},{"speaker":"of ourselves","startTime":1548.84,"endTime":1555.56,"body":"with students can sound kind of hollow."},{"speaker":"of ourselves","startTime":1556.34,"endTime":1564.08,"body":"I think we have to really pay attention to "},{"speaker":"of ourselves","startTime":1556.34,"endTime":1564.08,"body":"how we approach those issues together and in our  "},{"speaker":"of ourselves","startTime":1564.08,"endTime":1573.02,"body":"schools but also then how do we prepare them? How "},{"speaker":"of ourselves","startTime":1564.08,"endTime":1573.02,"body":"do we incorporate content like this into an over-  "},{"speaker":"of ourselves","startTime":1574.58,"endTime":1581.12,"body":"stuffed curriculum already. Everybody's like, I "},{"speaker":"of ourselves","startTime":1574.58,"endTime":1581.12,"body":"don't have time. We don't have time. And so then  "},{"speaker":"of ourselves","startTime":1581.12,"endTime":1588.14,"body":"we end up doing these sort of superficial things "},{"speaker":"of ourselves","startTime":1581.12,"endTime":1588.14,"body":"that don't have a lot of impact and I think these  "},{"speaker":"of ourselves","startTime":1588.14,"endTime":1598.58,"body":"are the kinds of behavioral tools and skills "},{"speaker":"of ourselves","startTime":1588.14,"endTime":1598.58,"body":"that need experiential learning. We need to have a  "},{"speaker":"of ourselves","startTime":1598.58,"endTime":1609.2,"body":"place to practice the skills. Michelle mentioned "},{"speaker":"of ourselves","startTime":1598.58,"endTime":1609.2,"body":"we've been implementing this resilient nurses  "},{"speaker":"of ourselves","startTime":1609.2,"endTime":1618.86,"body":"initiative R3 in in Maryland and one of the "},{"speaker":"of ourselves","startTime":1609.2,"endTime":1618.86,"body":"things that we did we've created first 28 modules  "},{"speaker":"of ourselves","startTime":1618.86,"endTime":1626.42,"body":"that address various aspects of resilience and "},{"speaker":"of ourselves","startTime":1618.86,"endTime":1626.42,"body":"ethical practice. Then we collaborated with  "},{"speaker":"of ourselves","startTime":1626.42,"endTime":1635.24,"body":"our nurse residency collaborative, which is "},{"speaker":"of ourselves","startTime":1626.42,"endTime":1635.24,"body":"36 hospitals, so this new nurse transition piece  "},{"speaker":"of ourselves","startTime":1636.14,"endTime":1645.38,"body":"and we asked them where the gaps were based on "},{"speaker":"of ourselves","startTime":1636.14,"endTime":1645.38,"body":"what we'd already developed. One of them was  "},{"speaker":"of ourselves","startTime":1645.38,"endTime":1651.98,"body":"around asking for and receiving support. So we've developed a module for new nurses  "},{"speaker":"of ourselves","startTime":1651.98,"endTime":1660.8,"body":"and arguably for students about how to work "},{"speaker":"of ourselves","startTime":1651.98,"endTime":1660.8,"body":"with noticing their own limitations  "},{"speaker":"of ourselves","startTime":1660.8,"endTime":1670.64,"body":"and symptoms that require attention and how "},{"speaker":"of ourselves","startTime":1660.8,"endTime":1670.64,"body":"do they bring those concerns to faculty or to  "},{"speaker":"of ourselves","startTime":1670.64,"endTime":1678.02,"body":"their nurse manager if they're in a practice "},{"speaker":"of ourselves","startTime":1670.64,"endTime":1678.02,"body":"environment. We included in that a script  "},{"speaker":"of ourselves","startTime":1678.98,"endTime":1685.1,"body":"for how they could be sure that they're "},{"speaker":"of ourselves","startTime":1678.98,"endTime":1685.1,"body":"having a psychologically safe conversation  "},{"speaker":"of ourselves","startTime":1685.94,"endTime":1696.08,"body":"before they talk about their concern because "},{"speaker":"of ourselves","startTime":1685.94,"endTime":1696.08,"body":"there is a risk that when you..."},{"speaker":"of ourselves","startTime":1696.08,"endTime":1704.0,"body":"have the courage to bring that up that the person "},{"speaker":"of ourselves","startTime":1696.08,"endTime":1704.0,"body":"receiving it may not be skillful. We don't want  "},{"speaker":"of ourselves","startTime":1704.0,"endTime":1710.9,"body":"to create unsafe situations for students...or new nurses for that matter but  "},{"speaker":"of ourselves","startTime":1710.9,"endTime":1717.44,"body":"this is where I think practice in advance "},{"speaker":"of ourselves","startTime":1710.9,"endTime":1717.44,"body":"of normalizing this is something you're going  "},{"speaker":"of ourselves","startTime":1717.44,"endTime":1726.86,"body":"to need to have some skills in and dedicating "},{"speaker":"of ourselves","startTime":1717.44,"endTime":1726.86,"body":"time to practice so that it's not a new idea."},{"speaker":"of ourselves","startTime":1729.14,"endTime":1735.56,"body":"We want to be conscious of our time boundaries. "},{"speaker":"of ourselves","startTime":1729.14,"endTime":1735.56,"body":"This conversation could go on and it will. We  "},{"speaker":"of ourselves","startTime":1735.56,"endTime":1739.58,"body":"will pick up with our conversation with "},{"speaker":"of ourselves","startTime":1735.56,"endTime":1739.58,"body":"Dr. Cynda Rushton on the next episode."},{"speaker":"of ourselves","startTime":1742.46,"endTime":1747.5,"body":"Thank you for joining us on this episode "},{"speaker":"of ourselves","startTime":1742.46,"endTime":1747.5,"body":"of NLN Nursing EDge Unscripted Surface.  "},{"speaker":"of ourselves","startTime":1747.5,"endTime":1752.78,"body":"We hope you join us next time. Until then, "},{"speaker":"of ourselves","startTime":1747.5,"endTime":1752.78,"body":"remember, whether your water is calm or choppy,  "},{"speaker":"of ourselves","startTime":1752.78,"endTime":1757.16,"body":"stay connected, get vulnerable and "},{"speaker":"of ourselves","startTime":1752.78,"endTime":1757.16,"body":"dare to go beneath the surface."}]}