{"version":"1.0.0","segments":[{"startTime":8.32,"endTime":15.36,"body":"Hello everyone. Welcome to another episode of "},{"startTime":8.32,"endTime":15.36,"body":"the NLN podcast, Nursing EDge Unscripted. I"},{"startTime":15.36,"endTime":20.24,"body":"am your host today, Dr. Kellie Bryant, and I "},{"startTime":15.36,"endTime":20.24,"body":"am the director of the Center for Innovation"},{"startTime":20.24,"endTime":26.48,"body":"and Education Excellence at the National League "},{"startTime":20.24,"endTime":26.48,"body":"for Nursing. In this episode, we have a very,"},{"startTime":26.48,"endTime":31.52,"body":"very important topic to talk about. We're going to "},{"startTime":26.48,"endTime":31.52,"body":"be discussing black maternal health crisis because"},{"startTime":31.52,"endTime":39.44,"body":"the statistics show that black women die at 3 "},{"startTime":31.52,"endTime":39.44,"body":"to 4% higher rate than their counterparts. So,"},{"startTime":39.44,"endTime":44.64,"body":"we need to talk about it. What are the reasons "},{"startTime":39.44,"endTime":44.64,"body":"for that health disparity and what can we do as"},{"startTime":44.64,"endTime":50.48,"body":"nurse educators to help educate our future nurses "},{"startTime":44.64,"endTime":50.48,"body":"and health care practitioners on how we can reduce"},{"startTime":50.48,"endTime":57.2,"body":"that gap? So, our guests today, I'm really excited "},{"startTime":50.48,"endTime":57.2,"body":"about our guests. We have Dr. Kandis McLean. And"},{"startTime":57.2,"endTime":62.64,"body":"we are also joined by Dr. Marie Wilson, who is "},{"startTime":57.2,"endTime":62.64,"body":"the regional director of nursing for New York"},{"startTime":62.64,"endTime":69.28,"body":"City Health and Hospitals Gotham Health. I want to "},{"startTime":62.64,"endTime":69.28,"body":"give a warm welcome to our two wonderful guests."},{"startTime":69.28,"endTime":77.28,"body":"Thank you for joining us, Marie and Kandis. Thank "},{"startTime":69.28,"endTime":77.28,"body":"you. Thank you for having us. Oh. So, I want to"},{"startTime":77.28,"endTime":81.76,"body":"start just by if you can give us a little bit of "},{"startTime":77.28,"endTime":81.76,"body":"background of some of the work that you're doing"},{"startTime":81.76,"endTime":87.04,"body":"both at your where you work but also I know that "},{"startTime":81.76,"endTime":87.04,"body":"you're also doing a lot of work in organizations."},{"startTime":87.04,"endTime":91.44,"body":"If you can just give us a brief overview of some "},{"startTime":87.04,"endTime":91.44,"body":"of the wonderful work you're doing in this area"},{"startTime":91.44,"endTime":99.04,"body":"and I'll start with you Marie. Okay. Hi everyone. "},{"startTime":91.44,"endTime":99.04,"body":"So as you stated I'm regional director of nursing"},{"startTime":99.04,"endTime":106.48,"body":"for New York City Health and Hospitals Do Health "},{"startTime":99.04,"endTime":106.48,"body":"Manhattan. I oversee six ambulatory care sites. So"},{"startTime":107.36,"endTime":114.8,"body":"my job is the largest FQHC in the United "},{"startTime":107.36,"endTime":114.8,"body":"States. So it's amazing to sit in this role"},{"startTime":114.8,"endTime":122.48,"body":"and to provide care and oversee operations and "},{"startTime":114.8,"endTime":122.48,"body":"nursing leadership for you know communities for"},{"startTime":122.48,"endTime":129.36,"body":"nurses but also for the communities that we serve. "},{"startTime":122.48,"endTime":129.36,"body":"As far as work, I have been a long-term advocate"},{"startTime":129.36,"endTime":134.16,"body":"for for black maternal health is my passion. "},{"startTime":129.36,"endTime":134.16,"body":"I'm also a doctorally prepared woman's health"},{"startTime":134.16,"endTime":140.16,"body":"nurse practitioner. So, this is my core passion "},{"startTime":134.16,"endTime":140.16,"body":"at heart. I've worked everything from labor and"},{"startTime":140.16,"endTime":146.4,"body":"delivery to outpatient, inpatient, I've seen "},{"startTime":140.16,"endTime":146.4,"body":"a lot. So, you know, seeing the disparities"},{"startTime":146.4,"endTime":152.08,"body":"ignited that passion like, hey, I have to do "},{"startTime":146.4,"endTime":152.08,"body":"something about this. So, that's my day job."},{"startTime":152.08,"endTime":157.6,"body":"As far as my weekend in community service, I am "},{"startTime":152.08,"endTime":157.6,"body":"literally doing community service almost every"},{"startTime":157.6,"endTime":164.96,"body":"weekend and I am also the chair for greater "},{"startTime":157.6,"endTime":164.96,"body":"New York City Black Nurses Association for"},{"startTime":164.96,"endTime":169.28,"body":"the Women's Health Committee. We do a lot of "},{"startTime":164.96,"endTime":169.28,"body":"work in the community. We serve New York City,"},{"startTime":169.28,"endTime":175.2,"body":"all the five boroughs and put on a lot of "},{"startTime":169.28,"endTime":175.2,"body":"community events, speaking engagements, forums"},{"startTime":175.2,"endTime":180.08,"body":"where people can be educated, the communities "},{"startTime":175.2,"endTime":180.08,"body":"could be educated so that they know how to"},{"startTime":180.08,"endTime":184.8,"body":"advocate for themselves and to you know ultimately "},{"startTime":180.08,"endTime":184.8,"body":"protect the themselves, their families, ensure"},{"startTime":184.8,"endTime":191.36,"body":"that their families are thriving. In addition to "},{"startTime":184.8,"endTime":191.36,"body":"that, I'm also part of the health committee for"},{"startTime":191.36,"endTime":196.64,"body":"Alpha Kappa Alpha Sorority Incorporated and we "},{"startTime":191.36,"endTime":196.64,"body":"do a lot as you guys know. If you may not know,"},{"startTime":196.64,"endTime":202.56,"body":"Alpha Kappa Alpha is the first black Greek "},{"startTime":196.64,"endTime":202.56,"body":"sorority over 118 years. And this is the core"},{"startTime":202.56,"endTime":211.44,"body":"of our mission is providing care and education to "},{"startTime":202.56,"endTime":211.44,"body":"humankind to everyone. So through volunteer and"},{"startTime":211.44,"endTime":216.32,"body":"through a lot of work and other organizations "},{"startTime":211.44,"endTime":216.32,"body":"I'm part of as well. But those are some of my"},{"startTime":216.32,"endTime":222.96,"body":"core passion where I'm constantly giving back "},{"startTime":216.32,"endTime":222.96,"body":"to the community. Again, I feel like as if,"},{"startTime":222.96,"endTime":228.16,"body":"you know, having this education, also being able "},{"startTime":222.96,"endTime":228.16,"body":"to be on platforms where I'm able to give back"},{"startTime":228.16,"endTime":233.28,"body":"through education, through mentorship, through "},{"startTime":228.16,"endTime":233.28,"body":"leadership, through, you know, through everything"},{"startTime":234.96,"endTime":240.32,"body":"is important to me. So, I'm excited to be here. "},{"startTime":234.96,"endTime":240.32,"body":"Thank you. Thank you. Thank you. And Kandis,"},{"startTime":240.32,"endTime":243.76,"body":"tell us a little bit about your background. "},{"startTime":240.32,"endTime":243.76,"body":"Yes. I just want to say thank you. It's a"},{"startTime":243.76,"endTime":248.96,"body":"pleasure to be on this podcast and to deliver this "},{"startTime":243.76,"endTime":248.96,"body":"knowledge regarding maternal disparities, right,"},{"startTime":248.96,"endTime":253.44,"body":"that are plaguing us and are still at the height. "},{"startTime":248.96,"endTime":253.44,"body":"This was very passionate to me as a mother of"},{"startTime":253.44,"endTime":258.96,"body":"four and being part of New York State and having "},{"startTime":253.44,"endTime":258.96,"body":"all my children here. I always talk about how I"},{"startTime":258.96,"endTime":264.56,"body":"had three C-sections on my fourth child, I had a "},{"startTime":258.96,"endTime":264.56,"body":"vaginal birth due to the failure of the hospital"},{"startTime":264.56,"endTime":270.8,"body":"not listening to me. When I approached this "},{"startTime":264.56,"endTime":270.8,"body":"institution and I walked in and I said, \"Hey,"},{"startTime":270.8,"endTime":277.04,"body":"I know I'm about to deliver. I've been vomiting "},{"startTime":270.8,"endTime":277.04,"body":"all night, regurgitating.\" I was told that I'm not"},{"startTime":277.04,"endTime":283.68,"body":"crying and have a seat in a chair. I told them "},{"startTime":277.04,"endTime":283.68,"body":"I'm a nurse practitioner. I'm fully dilated. I"},{"startTime":283.68,"endTime":289.84,"body":"checked myself at home and I was still placed in "},{"startTime":283.68,"endTime":289.84,"body":"a waiting chair. I was then later 15 minutes after"},{"startTime":289.84,"endTime":296.08,"body":"arriving at this premises, ushered into a room "},{"startTime":289.84,"endTime":296.08,"body":"and placed on a fetal monitor. Didn't have an IV,"},{"startTime":296.08,"endTime":301.44,"body":"but I kept feeling constant pressure and I "},{"startTime":296.08,"endTime":301.44,"body":"was shaking and I still wasn't very verbal."},{"startTime":301.44,"endTime":306.16,"body":"So, I want to advocate for black women now for "},{"startTime":301.44,"endTime":306.16,"body":"us to be heard and listened to when we go into"},{"startTime":306.16,"endTime":312.08,"body":"these birthing spaces. Several nurses would keep "},{"startTime":306.16,"endTime":312.08,"body":"telling me to wait. Nobody would check me. It took"},{"startTime":312.08,"endTime":317.2,"body":"me to communicate with an African-American doctor "},{"startTime":312.08,"endTime":317.2,"body":"in the triage who did not know me. And I said,"},{"startTime":317.2,"endTime":321.44,"body":"I just need someone to listen to me and help "},{"startTime":317.2,"endTime":321.44,"body":"me. And I end up delivering my fourth child"},{"startTime":321.44,"endTime":326.72,"body":"via vaginal birth. And I bring awareness to "},{"startTime":321.44,"endTime":326.72,"body":"this that black women do VBAC, right? But we"},{"startTime":326.72,"endTime":330.8,"body":"need to also take care of us when we go into "},{"startTime":326.72,"endTime":330.8,"body":"spaces and make sure that we're being heard."},{"startTime":330.8,"endTime":335.36,"body":"So using the New York City maternal mortality, I "},{"startTime":330.8,"endTime":335.36,"body":"bring highlights to these injustices that we face"},{"startTime":335.36,"endTime":342.8,"body":"when we go into triages and not being listened to "},{"startTime":335.36,"endTime":342.8,"body":"and how it's a common theme. Also part of AWHONN,"},{"startTime":342.8,"endTime":348.0,"body":"I like to bring awareness through simulation. That "},{"startTime":342.8,"endTime":348.0,"body":"is my great work. I got introduced to this work"},{"startTime":348.0,"endTime":353.36,"body":"and I cannot be on this podcast and not mention "},{"startTime":348.0,"endTime":353.36,"body":"my great directors and leaders and vice presidents"},{"startTime":353.36,"endTime":357.76,"body":"Michael Muga Chaden and Kimberly Campbell "},{"startTime":353.36,"endTime":357.76,"body":"Taylor at New York City Health and Hospitals"},{"startTime":357.76,"endTime":363.6,"body":"who introduced me into simulation. They helped me "},{"startTime":357.76,"endTime":363.6,"body":"get certified but we did it in a special strategic"},{"startTime":363.6,"endTime":369.28,"body":"way right we had a grant program that addressed "},{"startTime":363.6,"endTime":369.28,"body":"maternal mortality growing across this 12 hospital"},{"startTime":369.28,"endTime":374.64,"body":"system and just training through manikins so I "},{"startTime":369.28,"endTime":374.64,"body":"still carry this journey now into AWHONN, the"},{"startTime":374.64,"endTime":380.32,"body":"Association of Women's Wealth and Neonatal Care, "},{"startTime":374.64,"endTime":380.32,"body":"in which I now take simulation internationally."},{"startTime":380.32,"endTime":386.16,"body":"I use it to train international midwives and nurse "},{"startTime":380.32,"endTime":386.16,"body":"practitioners through simulation but using themes"},{"startTime":386.16,"endTime":392.72,"body":"of disparities and constant scenarios that black "},{"startTime":386.16,"endTime":392.72,"body":"women face such as assumptions that we are induced"},{"startTime":392.72,"endTime":397.76,"body":"or inebriated when we have a placenta abruption. "},{"startTime":392.72,"endTime":397.76,"body":"Placenta abruption is attributed to other causes"},{"startTime":397.76,"endTime":402.8,"body":"beside cocaine. We may have preeclampsia and just "},{"startTime":397.76,"endTime":402.8,"body":"be high risk. So these are what I incorporate in"},{"startTime":402.8,"endTime":407.52,"body":"scenarios not to foster stereotype and stigmas "},{"startTime":402.8,"endTime":407.52,"body":"but to bring awareness to these disparities"},{"startTime":407.52,"endTime":412.4,"body":"that still plague us and constantly that we "},{"startTime":407.52,"endTime":412.4,"body":"still face unfortunately. Oh goodness. Well,"},{"startTime":412.4,"endTime":416.72,"body":"thank you both for the wonderful introduction "},{"startTime":412.4,"endTime":416.72,"body":"and for the wonderful work that you're doing."},{"startTime":416.72,"endTime":421.76,"body":"And Kandis, thank you for sharing your personal "},{"startTime":416.72,"endTime":421.76,"body":"story. Also, for those of you that don't know,"},{"startTime":421.76,"endTime":425.92,"body":"everybody thinks of me being in simulation or "},{"startTime":421.76,"endTime":425.92,"body":"nursing education, but my love and my background."},{"startTime":425.92,"endTime":429.92,"body":"I'm a women's health nurse practitioner. So, I "},{"startTime":425.92,"endTime":429.92,"body":"spent my whole nursing career in women's health,"},{"startTime":429.92,"endTime":434.32,"body":"labor, delivery, postpartum, and also as a woman's "},{"startTime":429.92,"endTime":434.32,"body":"health nurse practitioner. So, this is an area"},{"startTime":434.32,"endTime":440.48,"body":"that's near and dear to my heart also. and being "},{"startTime":434.32,"endTime":440.48,"body":"someone who was in practice, I saw a lot of these"},{"startTime":440.48,"endTime":445.2,"body":"health disparities play out right in front of my "},{"startTime":440.48,"endTime":445.2,"body":"eyes. So, let's talk about it. And I also want to"},{"startTime":445.2,"endTime":449.84,"body":"make a note that, you know, it's common for us to "},{"startTime":445.2,"endTime":449.84,"body":"say pregnant women, but I do want to make a note."},{"startTime":449.84,"endTime":455.76,"body":"We're talking about birthing people. We want to "},{"startTime":449.84,"endTime":455.76,"body":"be mindful, you know, not every person that has"},{"startTime":455.76,"endTime":461.76,"body":"a child is identifies as a woman. So, just to make "},{"startTime":455.76,"endTime":461.76,"body":"that statement here that birthing person, birthing"},{"startTime":461.76,"endTime":467.84,"body":"people we're referring to when we have our "},{"startTime":461.76,"endTime":467.84,"body":"discussion here. So first question I have for both"},{"startTime":467.84,"endTime":473.2,"body":"of both of you or either one of you to answer. "},{"startTime":467.84,"endTime":473.2,"body":"Why do we have this disparity? What are the most"},{"startTime":473.2,"endTime":479.28,"body":"evidence consistent contributors to the fact that "},{"startTime":473.2,"endTime":479.28,"body":"black birthing people have a three to four times"},{"startTime":479.28,"endTime":484.24,"body":"higher risk of dying than than white women? Can "},{"startTime":479.28,"endTime":484.24,"body":"you give us a little bit of the background of"},{"startTime":484.24,"endTime":493.6,"body":"the as to the why? I mean that we can go back to "},{"startTime":484.24,"endTime":493.6,"body":"history, right? We talk about the the godfather"},{"startTime":493.6,"endTime":499.44,"body":"of gynecology. We speak about experiments on "},{"startTime":493.6,"endTime":499.44,"body":"black women without anesthesia. So that whole"},{"startTime":499.44,"endTime":504.64,"body":"notion of the strong black woman came about from "},{"startTime":499.44,"endTime":504.64,"body":"that. They were do performing all type of type of"},{"startTime":504.64,"endTime":509.68,"body":"experiments, medical experiments on black women "},{"startTime":504.64,"endTime":509.68,"body":"without anesthesia. So that's one thing. So they"},{"startTime":509.68,"endTime":515.12,"body":"feel as if we don't have the same pain. So things "},{"startTime":509.68,"endTime":515.12,"body":"like when we do report, hey, I'm having pain,"},{"startTime":515.12,"endTime":519.44,"body":"often dismissed or saying that we're drug seeking "},{"startTime":515.12,"endTime":519.44,"body":"or we're being a little bit extra and say, oh,"},{"startTime":519.44,"endTime":524.56,"body":"it's normal versus our white counterparts. "},{"startTime":519.44,"endTime":524.56,"body":"I mean, everything stops and and like again,"},{"startTime":524.56,"endTime":530.72,"body":"patients are coming up with PCA pumps versus "},{"startTime":524.56,"endTime":530.72,"body":"black women coming out of L \u0026 D with PCA pumps,"},{"startTime":530.72,"endTime":535.84,"body":"whether they can control their own anesthesia "},{"startTime":530.72,"endTime":535.84,"body":"versus black women, this their third C-section,"},{"startTime":535.84,"endTime":540.48,"body":"and they still have to take PO medication, "},{"startTime":535.84,"endTime":540.48,"body":"Percocet, things like that. So, better control,"},{"startTime":540.48,"endTime":544.88,"body":"things like that. But we're often dismissed, you "},{"startTime":540.48,"endTime":544.88,"body":"know, delayed recognition of signs and things like"},{"startTime":544.88,"endTime":550.8,"body":"that, kind of like waiting and seeing and things, "},{"startTime":544.88,"endTime":550.8,"body":"you know, things of that nature. And again,"},{"startTime":550.8,"endTime":555.76,"body":"some of the implicit biases that have been "},{"startTime":550.8,"endTime":555.76,"body":"structurally ingrained in our health care systems,"},{"startTime":555.76,"endTime":561.6,"body":"even in our education, we look at things like even "},{"startTime":555.76,"endTime":561.6,"body":"the pulse oxometer where it's mostly recognized"},{"startTime":561.6,"endTime":566.08,"body":"for our white counterparts versus black people. "},{"startTime":561.6,"endTime":566.08,"body":"So, it's different. So, being able to pick up on"},{"startTime":566.08,"endTime":571.6,"body":"those things. So that's kind of the the foundation "},{"startTime":566.08,"endTime":571.6,"body":"of it. But oftentimes even though we've made a lot"},{"startTime":571.6,"endTime":577.68,"body":"of advancements not only in our medical practices "},{"startTime":571.6,"endTime":577.68,"body":"and technology and we've advanced in culture"},{"startTime":577.68,"endTime":583.04,"body":"period as a race you often still see this. So "},{"startTime":577.68,"endTime":583.04,"body":"again even when it comes to education where we"},{"startTime":583.04,"endTime":589.52,"body":"think, okay, I'm educated, I might be exempt from "},{"startTime":583.04,"endTime":589.52,"body":"this even then we're often dismissed. So even our"},{"startTime":589.52,"endTime":594.08,"body":"education can't even save us. So, you know, "},{"startTime":589.52,"endTime":594.08,"body":"some of the those are some of the, you know,"},{"startTime":594.08,"endTime":601.52,"body":"core reasons why this is happening. Definitely, "},{"startTime":594.08,"endTime":601.52,"body":"Dr. Marie Wilson, I have to agree with you about"},{"startTime":601.52,"endTime":607.84,"body":"that and the historical data shows it. I just want "},{"startTime":601.52,"endTime":607.84,"body":"to tap in if we ever read Linda Villarosa and also"},{"startTime":607.84,"endTime":613.28,"body":"the story where they talk about the two twins "},{"startTime":607.84,"endTime":613.28,"body":"who were 13 years old and sterilized. It's been"},{"startTime":613.28,"endTime":618.64,"body":"historically inundated in us to be tested upon as "},{"startTime":613.28,"endTime":618.64,"body":"black women. And even till this day, when there's"},{"startTime":618.64,"endTime":623.6,"body":"a new trial for birth control, a new trial of "},{"startTime":618.64,"endTime":623.6,"body":"a patch for menopause, look at the population"},{"startTime":623.6,"endTime":629.92,"body":"that is tested upon. It is black women that are "},{"startTime":623.6,"endTime":629.92,"body":"subjected to it. Right? So even historically,"},{"startTime":629.92,"endTime":634.72,"body":"we need to change that moving forward. So black "},{"startTime":629.92,"endTime":634.72,"body":"women do not feel safe to go into these spaces"},{"startTime":634.72,"endTime":640.08,"body":"to seek care because we're we're fearful and "},{"startTime":634.72,"endTime":640.08,"body":"mistrustful of it being delivered. One of the"},{"startTime":640.08,"endTime":644.64,"body":"things I wanted to also highlight too about the "},{"startTime":640.08,"endTime":644.64,"body":"disparities is just awareness for the population"},{"startTime":644.64,"endTime":650.4,"body":"by ethnicity and race. there is significant "},{"startTime":644.64,"endTime":650.4,"body":"differences. The leading cause for caucasian women"},{"startTime":650.4,"endTime":656.0,"body":"according to the New York City maternal mortality "},{"startTime":650.4,"endTime":656.0,"body":"was mental health. So we had a fruition of mental"},{"startTime":656.0,"endTime":663.12,"body":"health programs development of ACT teams within "},{"startTime":656.0,"endTime":663.12,"body":"these hospital systems but the leading cause of"},{"startTime":663.12,"endTime":669.52,"body":"deaths were by African-American women due to "},{"startTime":663.12,"endTime":669.52,"body":"ectopic pregnancies right or cardiovascular"},{"startTime":669.52,"endTime":674.48,"body":"health. Another significant identifier that we "},{"startTime":669.52,"endTime":674.48,"body":"found on the New York City maternal mortality"},{"startTime":674.48,"endTime":680.64,"body":"was black women were dying from BMIs greater than "},{"startTime":674.48,"endTime":680.64,"body":"40 and attributed to cardiovascular health. But do"},{"startTime":680.64,"endTime":685.68,"body":"you ride the subways and see advertisement for, "},{"startTime":680.64,"endTime":685.68,"body":"hey, we need better cardiovascular health? When"},{"startTime":685.68,"endTime":690.16,"body":"did you last get your blood pressure check? So, we "},{"startTime":685.68,"endTime":690.16,"body":"need to have campaigns that are directly targeted"},{"startTime":690.16,"endTime":695.6,"body":"for our race and in our communities that have "},{"startTime":690.16,"endTime":695.6,"body":"access. Maybe we need to go into the hairdressers,"},{"startTime":695.6,"endTime":700.64,"body":"the barber shops, the nail salons where we can "},{"startTime":695.6,"endTime":700.64,"body":"reach our people and get out there and get this"},{"startTime":700.64,"endTime":706.4,"body":"information. We need to also advocate when we're "},{"startTime":700.64,"endTime":706.4,"body":"in this space. I want to share a story that I"},{"startTime":706.4,"endTime":713.2,"body":"was doing simulation with and actually my student "},{"startTime":706.4,"endTime":713.2,"body":"shared it with about her birth experience and she"},{"startTime":713.2,"endTime":718.8,"body":"said she didn't go back and she wanted to say I "},{"startTime":713.2,"endTime":718.8,"body":"was on my second child and I went in when I was 33"},{"startTime":718.8,"endTime":725.84,"body":"weeks bleeding and my name is Tata Fante you know "},{"startTime":718.8,"endTime":725.84,"body":"and she gave it like that - giving an example, not"},{"startTime":725.84,"endTime":734.08,"body":"the real name. But her name was different, unique, "},{"startTime":725.84,"endTime":734.08,"body":"right. And they made fun of this name, right. So"},{"startTime":734.08,"endTime":738.56,"body":"she didn't feel safe. You're there seeking care "},{"startTime":734.08,"endTime":738.56,"body":"and she could hear by the nursing station them"},{"startTime":738.56,"endTime":743.68,"body":"repeating this name. And then they're laughing. "},{"startTime":738.56,"endTime":743.68,"body":"What kind of name is that? Who would say that?"},{"startTime":743.68,"endTime":749.04,"body":"We serve different races populations. We need to "},{"startTime":743.68,"endTime":749.04,"body":"be diverse. Right? So that was very concerning."},{"startTime":749.04,"endTime":754.72,"body":"And she said, I wouldn't go back there. So I "},{"startTime":749.04,"endTime":754.72,"body":"didn't go until I had time to deliver my baby."},{"startTime":754.72,"endTime":759.52,"body":"And that's hurtful, right? These are disparities. "},{"startTime":754.72,"endTime":759.52,"body":"But she's seeking care in her own community, but"},{"startTime":759.52,"endTime":764.32,"body":"we're not advocating for the proper care or giving "},{"startTime":759.52,"endTime":764.32,"body":"empathetic care and respectful care. So that's a"},{"startTime":764.32,"endTime":770.24,"body":"big part of those disparities. Thank you. I think "},{"startTime":764.32,"endTime":770.24,"body":"there's so many factors, but what I'm getting"},{"startTime":770.24,"endTime":775.44,"body":"from the conversation is, you know, implicit bias "},{"startTime":770.24,"endTime":775.44,"body":"plays a role in the care and getting subpar care,"},{"startTime":775.44,"endTime":781.52,"body":"not getting treated. What I found is people not "},{"startTime":775.44,"endTime":781.52,"body":"being heard, coming in stating that they're having"},{"startTime":781.52,"endTime":786.08,"body":"this symptom and it's really not taken seriously "},{"startTime":781.52,"endTime":786.08,"body":"and they're sent home and then you find out,"},{"startTime":786.08,"endTime":789.6,"body":"you know, with these horrible stories we've been "},{"startTime":786.08,"endTime":789.6,"body":"hearing on the news that they wind up coming back"},{"startTime":789.6,"endTime":795.12,"body":"deathly ill, dying or not even making it back to "},{"startTime":789.6,"endTime":795.12,"body":"the hospital. but yet they went in two, three,"},{"startTime":795.12,"endTime":801.68,"body":"four times complaining of, you know, a headache "},{"startTime":795.12,"endTime":801.68,"body":"or having a difficulty, a difficult time breathing"},{"startTime":801.68,"endTime":807.6,"body":"or heavy bleeding and just not being heard. So, "},{"startTime":801.68,"endTime":807.6,"body":"I thank you for sharing again your stories. So,"},{"startTime":807.6,"endTime":812.8,"body":"let's turn it a little bit more into what can we "},{"startTime":807.6,"endTime":812.8,"body":"do about it? And Kandis, you gave some examples,"},{"startTime":812.8,"endTime":819.12,"body":"but when it comes to nursing education, how do "},{"startTime":812.8,"endTime":819.12,"body":"we best prepare our new graduates? How do we let"},{"startTime":819.12,"endTime":823.84,"body":"them know that this is going on? Because one of "},{"startTime":819.12,"endTime":823.84,"body":"and Kandis, you mentioned this. I think a lot of"},{"startTime":823.84,"endTime":828.56,"body":"people think that, you know, postpartum hemorrhage "},{"startTime":823.84,"endTime":828.56,"body":"is the number one cause of death for women and"},{"startTime":828.56,"endTime":832.72,"body":"it really I was very surprised to find mental "},{"startTime":828.56,"endTime":832.72,"body":"health, whether that's substance use disorder"},{"startTime":832.72,"endTime":838.96,"body":"or suicide is actually ranked even higher when "},{"startTime":832.72,"endTime":838.96,"body":"we think look at it from a national perspective."},{"startTime":838.96,"endTime":843.6,"body":"So what can we do in nursing education "},{"startTime":838.96,"endTime":843.6,"body":"to kind of open our our learners eyes,"},{"startTime":843.6,"endTime":848.96,"body":"these future nurses to this disparity and how "},{"startTime":843.6,"endTime":848.96,"body":"we can do things differently so that we can"},{"startTime":849.68,"endTime":855.28,"body":"hopefully contribute to a reduction in the black "},{"startTime":849.68,"endTime":855.28,"body":"maternal death rate. I believe Dr. Bryant that we"},{"startTime":855.28,"endTime":860.24,"body":"can incorporate a nursing education scenarios that "},{"startTime":855.28,"endTime":860.24,"body":"highlight these critical differences in our health"},{"startTime":860.24,"endTime":865.76,"body":"disparities but while now defuting the stigmas, "},{"startTime":860.24,"endTime":865.76,"body":"right? We don't have to make it that the black"},{"startTime":865.76,"endTime":871.12,"body":"woman comes in and she always has preeclampsia but "},{"startTime":865.76,"endTime":871.12,"body":"maybe she had a history of chronic hypertension"},{"startTime":871.12,"endTime":876.0,"body":"prior that evolved. Sometimes we tend to make "},{"startTime":871.12,"endTime":876.0,"body":"it very stereotyped. So we really need to be"},{"startTime":876.0,"endTime":881.44,"body":"dismissive of that as nurse educators. I find "},{"startTime":876.0,"endTime":881.44,"body":"even in the books we used to have textbooks that"},{"startTime":881.44,"endTime":886.48,"body":"say we feel less pain. So we need to educate the "},{"startTime":881.44,"endTime":886.48,"body":"students that that these things are not true. Your"},{"startTime":886.48,"endTime":891.28,"body":"assessment may look different for your different "},{"startTime":886.48,"endTime":891.28,"body":"races and your populations of patients. But they"},{"startTime":891.28,"endTime":895.76,"body":"need to also be aware that there is a starking "},{"startTime":891.28,"endTime":895.76,"body":"difference in the maternal health disparities."},{"startTime":895.76,"endTime":901.28,"body":"I open my class up with Kira Johnson's video by "},{"startTime":895.76,"endTime":901.28,"body":"her husband to highlight of what happened. She"},{"startTime":901.28,"endTime":908.08,"body":"was a educated black woman in a very popular "},{"startTime":901.28,"endTime":908.08,"body":"hospital but still died and it failed due to"},{"startTime":908.08,"endTime":913.84,"body":"assessment delay in intervention. Even when they "},{"startTime":908.08,"endTime":913.84,"body":"were advocating for her to get this CT scan, it"},{"startTime":913.84,"endTime":918.88,"body":"was still a delay because she was not prioritized. "},{"startTime":913.84,"endTime":918.88,"body":"So I think we need to bring as nurse educators in"},{"startTime":918.88,"endTime":925.2,"body":"the scenario one having like manikins that look "},{"startTime":918.88,"endTime":925.2,"body":"like the students that we are being training right"},{"startTime":925.2,"endTime":930.56,"body":"we just now started incorporating over the last "},{"startTime":925.2,"endTime":930.56,"body":"5 years brown and black manikins. All we used to"},{"startTime":930.56,"endTime":935.68,"body":"train upon were task trainers. I remember myself "},{"startTime":930.56,"endTime":935.68,"body":"being an educator, as a simulationist, and I had a"},{"startTime":935.68,"endTime":940.16,"body":"beige pelvis. So it was really it didn't "},{"startTime":935.68,"endTime":940.16,"body":"fit the scenario. So it's important that"},{"startTime":940.16,"endTime":945.36,"body":"we have access to all different modalities we "},{"startTime":940.16,"endTime":945.36,"body":"have the capability now using vSim simulation"},{"startTime":946.0,"endTime":950.8,"body":"manikins, task trainers to make sure we have "},{"startTime":946.0,"endTime":950.8,"body":"manikins and tools and resources that look like"},{"startTime":950.8,"endTime":956.32,"body":"us for the students that we train. I think I want "},{"startTime":950.8,"endTime":956.32,"body":"to encourage institutions also, especially in New"},{"startTime":956.32,"endTime":962.24,"body":"York, to have a truly diverse population of nurse "},{"startTime":956.32,"endTime":962.24,"body":"educators. I sit here with two masters of nursing"},{"startTime":962.24,"endTime":968.64,"body":"education, a masters as an FNP and my DNP. And I'm "},{"startTime":962.24,"endTime":968.64,"body":"almost hurtful to say I did not have a professor"},{"startTime":968.64,"endTime":974.0,"body":"that looked like me, right? So, a lot of the "},{"startTime":968.64,"endTime":974.0,"body":"cases, but I had immense support. I do not deny"},{"startTime":974.0,"endTime":979.52,"body":"that through my education. But it's just important "},{"startTime":974.0,"endTime":979.52,"body":"that we now incorporate that we have a rightful,"},{"startTime":979.52,"endTime":985.12,"body":"respectful, racially concordinate nursing faculty "},{"startTime":979.52,"endTime":985.12,"body":"to serve these populations of a students out there"},{"startTime":985.12,"endTime":989.76,"body":"so that we can just have more relatability. "},{"startTime":985.12,"endTime":989.76,"body":"There's an article out there unfortunately"},{"startTime":989.76,"endTime":994.64,"body":"that shows that we are very low in percentage as "},{"startTime":989.76,"endTime":994.64,"body":"nursing faculty. So we need government programs"},{"startTime":994.64,"endTime":1002.48,"body":"to heighten that. Definitely. I agree with you "},{"startTime":994.64,"endTime":1002.48,"body":"100% Dr. McLean. Thank you for really spelling"},{"startTime":1002.48,"endTime":1009.6,"body":"that out for everyone. On the clinical side, I can "},{"startTime":1002.48,"endTime":1009.6,"body":"say that especially being a nurse leader on labor"},{"startTime":1009.6,"endTime":1014.96,"body":"and delivery postpartum, especially postpartum "},{"startTime":1009.6,"endTime":1014.96,"body":"where we think people are out of the clear where"},{"startTime":1014.96,"endTime":1019.84,"body":"emergencies do happen like hemorrhage. I'm also "},{"startTime":1014.96,"endTime":1019.84,"body":"proud to say, and I didn't say this earlier,"},{"startTime":1019.84,"endTime":1025.04,"body":"I'm also a consultant for a National League "},{"startTime":1019.84,"endTime":1025.04,"body":"for Nursing simulation where we're creating"},{"startTime":1025.04,"endTime":1031.28,"body":"simulations for nursing students and I'm "},{"startTime":1025.04,"endTime":1031.28,"body":"focusing on hemorrhage. The hemorrhage,"},{"startTime":1031.28,"endTime":1038.48,"body":"preeclampsia, some of the common crises that "},{"startTime":1031.28,"endTime":1038.48,"body":"may occur that they're able to kind of curve"},{"startTime":1038.48,"endTime":1043.44,"body":"that knowledge gap especially during the Covid "},{"startTime":1038.48,"endTime":1043.44,"body":"pandemic where a lot of nurses weren't afforded"},{"startTime":1043.44,"endTime":1048.0,"body":"to go to the hospitals to do their clinicals as "},{"startTime":1043.44,"endTime":1048.0,"body":"they as part of their curriculum. So there is"},{"startTime":1048.0,"endTime":1052.0,"body":"that knowledge gap even with the new nurses that "},{"startTime":1048.0,"endTime":1052.0,"body":"are coming out there or if you are transitioning"},{"startTime":1052.0,"endTime":1057.68,"body":"from specialty. Oftentimes when there are "},{"startTime":1052.0,"endTime":1057.68,"body":"emergencies you find the labor and delivery"},{"startTime":1057.68,"endTime":1062.48,"body":"nurses are running up to postpartum and they "},{"startTime":1057.68,"endTime":1062.48,"body":"sometimes consider postpartum as low acuity,"},{"startTime":1062.48,"endTime":1067.28,"body":"which is not the case. However there is a "},{"startTime":1062.48,"endTime":1067.28,"body":"knowledge gap there. So being able to recognize"},{"startTime":1067.28,"endTime":1073.2,"body":"early signs. It's important to do simulations "},{"startTime":1067.28,"endTime":1073.2,"body":"regularly with our nurse educators, with our"},{"startTime":1073.2,"endTime":1078.88,"body":"providers, and to provide real drills. Just as "},{"startTime":1073.2,"endTime":1078.88,"body":"if we do a fire drill or a active shooter drill,"},{"startTime":1078.88,"endTime":1086.4,"body":"we need to do postpartum drills. Different topics "},{"startTime":1078.88,"endTime":1086.4,"body":"such as hemorrhage, sepsis, preeclampsia, and even"},{"startTime":1086.4,"endTime":1092.4,"body":"amniotic. Thank you. Thank you for that. Amniotic "},{"startTime":1086.4,"endTime":1092.4,"body":"embolus which is very rare but I've seen that once"},{"startTime":1092.4,"endTime":1098.16,"body":"in my 18 years career and it's very rare and I've "},{"startTime":1092.4,"endTime":1098.16,"body":"seen it once and it's and those are things we're"},{"startTime":1098.16,"endTime":1104.32,"body":"not really well trained on. So it's important that "},{"startTime":1098.16,"endTime":1104.32,"body":"we do this regularly and also we have to you know"},{"startTime":1104.32,"endTime":1110.32,"body":"utilize MUSE we have to also utilize the SBAR and "},{"startTime":1104.32,"endTime":1110.32,"body":"we're making sure that nurses are able to escalate"},{"startTime":1110.32,"endTime":1117.68,"body":"remember SBAR really SBAR really protects us as "},{"startTime":1110.32,"endTime":1117.68,"body":"far as when like al alerting us when to escalate,"},{"startTime":1117.68,"endTime":1123.68,"body":"but also uses has also allowed nurses to know when "},{"startTime":1117.68,"endTime":1123.68,"body":"what they recognize at early intervention. So when"},{"startTime":1123.68,"endTime":1128.8,"body":"we see vitals, what do we do? We just document it "},{"startTime":1123.68,"endTime":1128.8,"body":"or are we escalating? Are they feeling empowered"},{"startTime":1128.8,"endTime":1133.92,"body":"to escalate this? Because this can be life "},{"startTime":1128.8,"endTime":1133.92,"body":"or death for a lot of people. So having those"},{"startTime":1133.92,"endTime":1141.2,"body":"regular drills and also establishing cohesive "},{"startTime":1133.92,"endTime":1141.2,"body":"teamwork between labor and delivery between even"},{"startTime":1141.2,"endTime":1147.84,"body":"the antenatal space as well because those those "},{"startTime":1141.2,"endTime":1147.84,"body":"nurses are spending most of the time with those"},{"startTime":1147.84,"endTime":1152.56,"body":"patients versus labor and delivery postpartum. "},{"startTime":1147.84,"endTime":1152.56,"body":"It's acute. It's two to three days and it's like,"},{"startTime":1152.56,"endTime":1157.44,"body":"see you, have a good life. So we've developed "},{"startTime":1152.56,"endTime":1157.44,"body":"a rapport with people in the in the ambulatory"},{"startTime":1157.44,"endTime":1162.56,"body":"care setting. It's important that they all are "},{"startTime":1157.44,"endTime":1162.56,"body":"connected and saying, hey, is there a connection"},{"startTime":1162.56,"endTime":1167.6,"body":"and a bridge and communication like, hey, this is "},{"startTime":1162.56,"endTime":1167.6,"body":"a patient. She's due to deliver on this at this"},{"startTime":1167.6,"endTime":1171.76,"body":"date they're coming this day. This is what we "},{"startTime":1167.6,"endTime":1171.76,"body":"need to be alert of. There's that communication"},{"startTime":1171.76,"endTime":1178.72,"body":"gap there so I think that with drills with "},{"startTime":1171.76,"endTime":1178.72,"body":"escalation they that knowledge gap will be"},{"startTime":1178.72,"endTime":1184.96,"body":"reduced significantly. Great. You both had really, "},{"startTime":1178.72,"endTime":1184.96,"body":"really great suggestions for our nurse educators"},{"startTime":1184.96,"endTime":1190.24,"body":"out there. But my next question is so where do "},{"startTime":1184.96,"endTime":1190.24,"body":"they get the resources? Let's say that they want"},{"startTime":1190.24,"endTime":1195.36,"body":"to implement simulation and practice some of these "},{"startTime":1190.24,"endTime":1195.36,"body":"scenarios that you discussed. Do you have any"},{"startTime":1195.92,"endTime":1202.0,"body":"sites, any advice or recommendations for where "},{"startTime":1195.92,"endTime":1202.0,"body":"they can get research resources if they want to"},{"startTime":1202.0,"endTime":1208.72,"body":"implement more of these examples you've discussed "},{"startTime":1202.0,"endTime":1208.72,"body":"into their programs? So definitely I would love"},{"startTime":1208.72,"endTime":1212.88,"body":"to just recommend and not because it's the "},{"startTime":1208.72,"endTime":1212.88,"body":"organization I've been with since I was 19 years"},{"startTime":1212.88,"endTime":1218.0,"body":"old when I became a nurse but AWHONN - Association "},{"startTime":1212.88,"endTime":1218.0,"body":"of Women's Health and Neonatal Nursing. We have"},{"startTime":1218.0,"endTime":1224.0,"body":"a full DEI page. It's a big mission. The "},{"startTime":1218.0,"endTime":1224.0,"body":"AWHONN OPS, Obstetric Patient Safety course,"},{"startTime":1224.0,"endTime":1229.44,"body":"has multiple scenarios and escape rooms that I "},{"startTime":1224.0,"endTime":1229.44,"body":"strategically worked with with educators across"},{"startTime":1229.44,"endTime":1233.68,"body":"the United States. And one of the things that "},{"startTime":1229.44,"endTime":1233.68,"body":"drive my passion to really represent with them"},{"startTime":1233.68,"endTime":1239.68,"body":"is we have black women in rural Indiana, right, "},{"startTime":1233.68,"endTime":1239.68,"body":"that are facing different disparities than what"},{"startTime":1239.68,"endTime":1245.2,"body":"we face in New York State. I had the privilege of "},{"startTime":1239.68,"endTime":1245.2,"body":"going out there and almost being petrified because"},{"startTime":1245.2,"endTime":1251.2,"body":"I traveled 90 miles on a transport carrier because "},{"startTime":1245.2,"endTime":1251.2,"body":"we were 90 miles from a hospital. And I said,"},{"startTime":1251.2,"endTime":1256.0,"body":"\"Are we going to birth in this ambulance?\" That is "},{"startTime":1251.2,"endTime":1256.0,"body":"a totally different scenario than what we face out"},{"startTime":1256.0,"endTime":1262.0,"body":"here in New York State where almost every 15 miles "},{"startTime":1256.0,"endTime":1262.0,"body":"we have a hospital, right? So you know it was very"},{"startTime":1262.0,"endTime":1268.72,"body":"good to see this in AWHONN them going out there to "},{"startTime":1262.0,"endTime":1268.72,"body":"make this course that can be internationally and"},{"startTime":1268.72,"endTime":1274.4,"body":"in the United States integrated about DEI. So it "},{"startTime":1268.72,"endTime":1274.4,"body":"has scenarios about preeclampsia, amniotic fluid"},{"startTime":1274.4,"endTime":1280.24,"body":"embolism, but also with the background of, hey, "},{"startTime":1274.4,"endTime":1280.24,"body":"we know there's disparities. There's a special"},{"startTime":1280.24,"endTime":1286.16,"body":"component in it about mental health, especially "},{"startTime":1280.24,"endTime":1286.16,"body":"about black women, but we added actually added a"},{"startTime":1286.16,"endTime":1292.48,"body":"twist from feedback about Asian ethnicity because "},{"startTime":1286.16,"endTime":1292.48,"body":"it's highlighted that also too that help mental"},{"startTime":1292.48,"endTime":1298.96,"body":"health was not accepted in this culture. A lot "},{"startTime":1292.48,"endTime":1298.96,"body":"of times as a Caribbean person, we weren't able"},{"startTime":1298.96,"endTime":1304.0,"body":"to say, \"Hey, we have a mental health problem.\" "},{"startTime":1298.96,"endTime":1304.0,"body":"If you take antipsychotics, you're frowned upon"},{"startTime":1304.0,"endTime":1308.64,"body":"by your family. So there's a component within "},{"startTime":1304.0,"endTime":1308.64,"body":"the course about that and especially different"},{"startTime":1308.64,"endTime":1313.36,"body":"cultures and how that's actually interpreted "},{"startTime":1308.64,"endTime":1313.36,"body":"amongst your family. I think this is important"},{"startTime":1313.36,"endTime":1318.08,"body":"conversations that we need to have because yes, "},{"startTime":1313.36,"endTime":1318.08,"body":"as clinicians, we feel safe to talk about mental"},{"startTime":1318.08,"endTime":1323.84,"body":"health disparities, but it's still a very hard "},{"startTime":1318.08,"endTime":1323.84,"body":"thing for families and culturally very biased."},{"startTime":1325.04,"endTime":1330.96,"body":"Thank you, Marie. Do you have any resources "},{"startTime":1325.04,"endTime":1330.96,"body":"for our listeners? Yes. Dr. McLean said it"},{"startTime":1330.96,"endTime":1336.88,"body":"great. I think AWHONN has a great it's really "},{"startTime":1330.96,"endTime":1336.88,"body":"centered focused around nurses as well to for"},{"startTime":1336.88,"endTime":1343.04,"body":"their education. I think that's great. Definitely "},{"startTime":1336.88,"endTime":1343.04,"body":"even in the National League of Nursing. Also NPWH,"},{"startTime":1343.04,"endTime":1347.2,"body":"which is an organization for women's health "},{"startTime":1343.04,"endTime":1347.2,"body":"nurse practitioners. They have a robust amount"},{"startTime":1347.2,"endTime":1352.72,"body":"of information and simulations at conferences so "},{"startTime":1347.2,"endTime":1352.72,"body":"they can be trained and also to sit in conferences"},{"startTime":1352.72,"endTime":1358.32,"body":"to keep abreast to what's current because as you "},{"startTime":1352.72,"endTime":1358.32,"body":"know healthcare is evolving every single day. But"},{"startTime":1358.32,"endTime":1364.48,"body":"again if again when you look at the clinical "},{"startTime":1358.32,"endTime":1364.48,"body":"side it's important to feel empowered to share"},{"startTime":1364.48,"endTime":1369.28,"body":"things. I know myself like we have a huddle "},{"startTime":1364.48,"endTime":1369.28,"body":"morning huddle every morning and I empower all"},{"startTime":1369.28,"endTime":1374.48,"body":"nurses to take a take an opportunity to bring up "},{"startTime":1369.28,"endTime":1374.48,"body":"articles of what's going on that they don't know"},{"startTime":1374.48,"endTime":1379.44,"body":"about because you know we get so laser focused on "},{"startTime":1374.48,"endTime":1379.44,"body":"our task our assignment but what else is going on"},{"startTime":1379.44,"endTime":1384.24,"body":"we constantly need to be educating ourselves and "},{"startTime":1379.44,"endTime":1384.24,"body":"taking that initiative and not be forced to oh I"},{"startTime":1384.24,"endTime":1389.2,"body":"have to do my mandatory training versus you know "},{"startTime":1384.24,"endTime":1389.2,"body":"doing it for ourselves because you bring that to"},{"startTime":1389.2,"endTime":1394.16,"body":"the forefront that they weren't aware of you "},{"startTime":1389.2,"endTime":1394.16,"body":"know speaking in terms bringing knowledge that"},{"startTime":1394.16,"endTime":1399.44,"body":"is evident based that's best practice to keep "},{"startTime":1394.16,"endTime":1399.44,"body":"that breast and then also getting involved in"},{"startTime":1399.44,"endTime":1404.56,"body":"things like professional governance in your "},{"startTime":1399.44,"endTime":1404.56,"body":"hospital, where we are literally governing as"},{"startTime":1404.56,"endTime":1411.36,"body":"nurses what we do our practice. And we can change "},{"startTime":1404.56,"endTime":1411.36,"body":"policies. Se go to Albany and to Washington DC"},{"startTime":1411.36,"endTime":1416.96,"body":"to speak with lawmakers. We have so much power "},{"startTime":1411.36,"endTime":1416.96,"body":"that we don't know. So it's beyond the bedside,"},{"startTime":1416.96,"endTime":1422.48,"body":"it's beyond the hospitals, beyond the clinic. "},{"startTime":1416.96,"endTime":1422.48,"body":"It's literally changing policy, changing laws in"},{"startTime":1422.48,"endTime":1427.92,"body":"place to advocate for us what it looks for us. And "},{"startTime":1422.48,"endTime":1427.92,"body":"speaking not only from my own personal experience"},{"startTime":1427.92,"endTime":1434.48,"body":"but also what we've experienced as professionals "},{"startTime":1427.92,"endTime":1434.48,"body":"and how we really have more power than just a"},{"startTime":1434.48,"endTime":1441.68,"body":"nurse or bedside nurse. So it's really important "},{"startTime":1434.48,"endTime":1441.68,"body":"so much things that you can do to really bring"},{"startTime":1441.68,"endTime":1446.96,"body":"forth change in the communities that we serve. "},{"startTime":1441.68,"endTime":1446.96,"body":"And having people that look like us can speak"},{"startTime":1446.96,"endTime":1454.16,"body":"and advocate for us. Oh boy, I can't believe we "},{"startTime":1446.96,"endTime":1454.16,"body":"have run out of time. I want to thank you and what"},{"startTime":1454.16,"endTime":1458.4,"body":"a way to end, you know, to talk about advocacy "},{"startTime":1454.16,"endTime":1458.4,"body":"because if you want to make the biggest change,"},{"startTime":1458.4,"endTime":1462.72,"body":"it's really, like you said, talking to "},{"startTime":1458.4,"endTime":1462.72,"body":"our politicians and making those changes"},{"startTime":1462.72,"endTime":1469.12,"body":"when it comes to laws and where funding goes "},{"startTime":1462.72,"endTime":1469.12,"body":"and money is spent to help reduce this black"},{"startTime":1469.12,"endTime":1473.92,"body":"maternal mortality rate. So, I want to take the "},{"startTime":1469.12,"endTime":1473.92,"body":"time out right now to say thank you to both of"},{"startTime":1473.92,"endTime":1479.2,"body":"you. You shared a wealth of knowledge for our "},{"startTime":1473.92,"endTime":1479.2,"body":"listeners and so many different strategies and"},{"startTime":1479.2,"endTime":1485.92,"body":"even starting small you know even you know "},{"startTime":1479.2,"endTime":1485.92,"body":"I'm we're pro-simulation so even simulation"},{"startTime":1485.92,"endTime":1490.96,"body":"incorporating that into your nursing program "},{"startTime":1485.92,"endTime":1490.96,"body":"can make a significant change. So again thank"},{"startTime":1490.96,"endTime":1495.76,"body":"you for sharing your insight and we appreciate "},{"startTime":1490.96,"endTime":1495.76,"body":"your support and we look forward to all of you"},{"startTime":1495.76,"endTime":1502.96,"body":"joining us on our next episode. Thank you so much "},{"startTime":1495.76,"endTime":1502.96,"body":"Kandis and Marie. Thank you so much. Thank you."}]}