What if the path to a fulfilling nursing career led you into uncharted territories? This episode, our seasoned guest - a nurse with a robust experience of over 20 years, shares her journey across diverse areas of nursing, from medical-surgical to labor and delivery and case management. She candidly discusses her trials with transitioning injured workers back to the workforce, her admiration for utilization review, and her unquenchable thirst for knowledge through higher education.
Hold on to your seats as we shatter stereotypes around non-traditional nursing careers and highlight the indispensable role of nursing skills in different areas like medical sales. The conversation takes a deep dive into case management and utilization review complexities, emphasizing the importance of interdisciplinary teamwork and the critical role of self-care in a nurse's life. You'll find her insights immensely valuable whether you're an aspiring nurse, an experienced one, or someone curious about the world of health care.
Finally, we navigate the exciting future of nursing and healthcare, exploring home dialysis, and telemedicine. Our guest leaves no stone unturned, sharing intricate details of her experience in medical sales and the nuances of case management. She emboldens nurses to venture into non-traditional roles and engage in enlightening conversations with industry professionals. Don't miss out on this episode that not only broadens your horizon on the vast opportunities in nursing but also reiterates the timeless role of nurses in patient care.
What if the path to a fulfilling nursing career led you into uncharted territories? This episode, our seasoned guest - a nurse with a robust experience of over 20 years, shares her journey across diverse areas of nursing, from medical-surgical to labor and delivery and case management. She candidly discusses her trials with transitioning injured workers back to the workforce, her admiration for utilization review, and her unquenchable thirst for knowledge through higher education.
Hold on to your seats as we shatter stereotypes around non-traditional nursing careers and highlight the indispensable role of nursing skills in different areas like medical sales. The conversation takes a deep dive into case management and utilization review complexities, emphasizing the importance of interdisciplinary teamwork and the critical role of self-care in a nurse's life. You'll find her insights immensely valuable whether you're an aspiring nurse, an experienced one, or someone curious about the world of health care.
Finally, we navigate the exciting future of nursing and healthcare, exploring home dialysis, and telemedicine. Our guest leaves no stone unturned, sharing intricate details of her experience in medical sales and the nuances of case management. She emboldens nurses to venture into non-traditional roles and engage in enlightening conversations with industry professionals. Don't miss out on this episode that not only broadens your horizon on the vast opportunities in nursing but also reiterates the timeless role of nurses in patient care.
Absolutely, absolutely. I'm glad you could make it. Yeah, absolutely, thank you. Thank you for being a guest on my show, and this is a topic that I have been wanting to discuss but didn't know who to talk to about it. You know, nurses, we always bat things off each other, and that's a good thing, but what I do do as well, I always open up with a prayer, okay, and then I'm going to let you introduce yourself, sure, and we'll get started with that. So we're going to go ahead and get started. Heavenly Father, lord God, we just thank you for an opportunity to thank and to praise your name. Lord God, we thank you for being a keeper. Lord, bless everyone that comes through this shell. Lord, god, bless their household. Meet us all at the point of our need for these and other things. Bless your son Jesus' name, amen, amen, amen.
Speaker 2:Thank you, Ms Keralit, for having me.
Speaker 1:Oh, you're more than welcome. You're more than welcome. Now go ahead and introduce yourself. Go ahead, Tell us about yourself.
Speaker 2:Sure, sure. So I am a registered nurse and I have been a nurse for over 20 years and I've done a little of everything, and we are going to dive into some of the little of everything that I have done throughout my career. I thought that I would, you know, stay at bedside and do bedside nursing you know, this is before I touched any patients at all and have that lovely experience. So I thought that I would be in it for the long haul. I saw my mother do it, I saw my sister do it, I saw, you know, other family members do it. So I just thought in, friends of family do it. So I just thought that that's where I would be for the long haul. And it didn't quite hit me the way it worked or worked out the way for me that it did for them. And certainly we're going to, you know, talk about that a bit more throughout this conversation here.
Speaker 2:Sure, but I started off as a med-surgeon nurse, that's, a medical-surgical nurse, and I worked for Mount Sinai Hospital in New York that's where I'm originally from and I started off there on a GI GU air, nose and throat floor. I mean, they just wanted to lump everything all in together and it was, to say the least, it was heavy, but not heavy. The GU patients weren't, you know, they, those weren't that heavy, but the GI patients definitely were, because you had those patients that had colostomies and everything going on with them, bowel related. So the bladder piece wasn't so bad. Didn't see a whole lot of those patients, it really was more GI the air, nose and throat.
Speaker 2:There was a specialist that was doing head and neck surgeries, like real head and neck surgeries. So it was a lot of trachs and we had a step down unit that they created. So there was a lot of tracheostomies and lots of nice heavy duty nursing going on there. You know sort of ICU, but not really fully that level, not a whole lot of drips that they were on or, but there was some cardiac monitoring. So that's where I started off. I stayed there for a couple of years and then decided, met some travelers and decided that that's where I wanted to, that I wanted to travel, yeah, yeah. And then I ended up in Atlanta, georgia, and worked, did some travel, nursing there on a telemetry unit. That was pretty heavy because you know telemetry, if you know anything about some of the units, telemetry is kind of where they dump everybody.
Speaker 2:They do and so you had some of everybody on that floor and that was a little challenging. I cropped a long hospital in. It's no longer cropped along now they have changed the name, I think Emery took it over but met some really, really, really good people in Atlanta and then I decided that I did. I didn't want to do med surge anymore and I wanted to become a labor and delivery nurse and add high aspirations of becoming a nurse midwife. And there was a wonderful hospital, northside Hospital, in Atlanta that were doing training of nurses, established nurses who wanted to try labor and delivery and so I applied to the program and they accepted me and and then they trained me to become an L and D nurse and I loved it for a good little while and again thought I would retire doing that.
Speaker 2:But it got heavy. That hospital was very busy at the time. We were doing something between 15 and 18,000 deliveries for the year. So they were busy, busy, busy, busy, busy hospital with labor and delivery. And then I just said no, I can't do this anymore, I need to get a nine to five. And I thought that that was my passion and I wanted to get this nine to five job where I was doing case management and I started off in disability management for a company in Atlanta and did that for a little while and then moved into another case management role After leaving them.
Speaker 2:That was a little a little different, the disability management.
Speaker 2:And then we were very, very heavy on injured workers.
Speaker 2:Heavy, that's what we did with the injured workers and trying to help them return to work, which is which it can be kind of difficult following them through, you know, their steps of disability, and then you know, ultimately the companies and organizations wanted them to come back to work and sometimes that just that's just not that feasible.
Speaker 2:So following that, yeah, so following them through that continuum, that's how I got my feet wet in in case management. And then I moved on to medical case management with a company, an insurance company, that was based out of Denver, colorado, and I started working with them doing utilization review, and that was my first taste of utilization review and I loved it. I was there, yeah, I was with them for a good little while and I just continued on that path but worked, you know, with various health care companies and then insurance companies, I should say, and then, ultimately, you know, working with hospitals, directly with a hospital system, and so that's where I am currently dabbling in some other things here and there to keep, you know, money going yeah yeah, the name of the game, that's name again.
Speaker 1:Well, I'm going to stop you right there, where you can get a sip of water, and I'm going to play something that I hope you enjoy, and then we'll come back on the other side.
Speaker 5:Young people is nothing wrong with dancing for Jesus, but we can't forget where we come from. So, if you don't mind, let's have a little church right now. Something about that name. Thank you, jesus. Listen. Something about the name Jesus. Something about the name Jesus. Hallelujah, yes, sir, it is the sweetest name, sweetest, sweetest, sweetest name I know and I love, oh, I love the name Jesus. Oh, I love the name Jesus. Oh, I love the name Jesus. Come on and lift your hands and say it. It is the sweetest name. Thank you, jesus. I know, listen to this right here.
Speaker 5:Some people say I'm crazy, but I can't explain. No, no, the power that I feel when I call your name, when I call your name, said it's just like fire, oh, oh, shut up in my bones, oh, oh, oh, oh. The Holy Ghost is moving here. Yes, it is, and it just won't make me lonely. I'll do something. Yeah, yeah, yeah. Something about the name Jesus. Something about the name Jesus. Oh, I realize it is the sweetest name. I know I gotta be honest with you. I love, oh, I love the name Jesus. I love, I love the name Jesus. Oh, I love the name Jesus. It's the sweetest name. Oh, yeah, it is the sweetest name? Yes, it is. Let's set a sweet at the end. Oh, oh, oh, from the honey come out. I can feel the Holy Ghost moving. Yeah, yeah, it won't leave me alone. No, no, no, no, no, no, no At the name of Jesus. Oh, oh, oh, ever in me has got to buy, got to buy, so you don't have to wait till the fire comes, you can go shout praise to God now. Oh, oh, yeah, yeah, something about the name Jesus. Oh, oh, oh, something about the name Jesus. It is the sweetest name. Oh, yeah, I know I love the name. Oh, I love the name Jesus. I love the name Jesus. I love the name Jesus. Oh, oh, oh, oh, it's the sweetest name. Yeah, oh, oh, oh, yeah, I know, mhmm, I know his name. I know Sweetest name. I know Sweetest name of all Best thing that's ever happened to me. I know Sweetest name of all Something about the space, something about the space, something about the space. I know Sweetest name of all Something about the space. I know Sweetest name of all yeah, yeah, yeah, yeah, yeah, yeah, yeah. Sweetest name of all Holy Innocence, holy Innocence.
Speaker 5:What's this all? Is this world a puzzle? There is healing. There is healing, salvation in the living being. Yeah, yeah, yeah, yeah, yeah. Holy Innocence, holy Innocence, holy Innocence. What's that for name of Jesus? Yeah, yeah, yeah, yeah, yeah. I know I love his wonderful name. He is so wonderful. You see, he's been so good to me, he's been down to me, yeah, and I even know how to speak to myself. Bring it up. Can I tell you about that name? You tell him about that name. There's power in that name. Your sins Can't. Nobody do what he does. No, no, no. I love the name. Jesus, jesus, jesus.
Speaker 1:Okay, denise, how did you like that one?
Speaker 2:Hold on. That is one of my favorite Kirk Franklin songs that I am ever trying to get into praise mode, that's the one that I would put on.
Speaker 1:Great, great, great. Now let me ask you this Were there any specific skills or resources that helped you navigate your various career choices?
Speaker 2:And that is a good question. I felt like I didn't have anyone to tap into. I was really doing it, winging it.
Speaker 2:I was winging it all on my own from the very beginning, which is kind of sad, but I did not have a point person that I could ask about this stuff. I think I just did my own research and I just applied to various. God is good, because now that I'm thinking about this, how did these opportunities drop into my life, in my life? And they literally did. I mean I had to do some lead work, but no one said call this person or go to this company. It wasn't any of that. I just applied with the disability management company that I worked for. I just applied and they interviewed me, called me, interviewed me which, of course, I was shocked over interviewed me and then offered me the position because I didn't have any experience. But no, I did not have. I cannot list to you any one person or individuals or resources that I had at my fingertips. This was all I just had to buckle down and just do my own research.
Speaker 1:Okay, well, that being said, so there were no true mentors or role models. It's just like you said, just kind of fell in your lap and you know, I think that's why I wanted to have this conversation, so that other nurses coming into the profession would know how to navigate through, not necessarily the system, but we need bedside nurses. Well, I was going to need bedside nurses, but when it comes to time, one young lady that I worked with was in a car accident so she no longer could be at the bedside. Now she was physically able to come to work, but she couldn't do anymore, you know, pushing a pull, and even though she was charge nurse, you know, charge nurse is just a title but you still have to do the work and assist your staff in doing so but she was on restrictions no more pushing or pulling because she might injure her arm and then need surgery.
Speaker 1:So who needs that? So that's when she decided nobody's helping me find the position. I said they're not, honey, you got to get out there and find one for yourself. And so, yeah, that's why I think I wanted to have this conversation, just to open up to nurses that there are other paths that we can all take, because I myself am a nurse. So what are some misconceptions or stereotypes that you've encountered about your non-traditional career?
Speaker 2:Well, I mean, that's all I thought. You know, I thought that nurses were supposed to be at the bedside and that's it. So that was a big misconception, huge. We didn't even have. I think they were just starting to have classes and training on other areas in nursing outside of med surge or psych or mother baby, pediatrics, cardiology but all of that really was still geared towards you being at the bedside. Oncology All of that was still geared towards you being at the bedside. I remember having a colleague when I was in college and we were finishing up. He actually got a job working in case management and I was like, well, what is that? And none of that information was ever shared with us at all. So so thinking that you can, you know, you're just equipped to be at the bedside is definitely one of the areas. You know that I felt that's a misconception.
Speaker 1:And I agree with you. I totally agree with you on that. I'm also thinking what do the instructors really know outside of the bedside? Because that's what they're preparing you for, it's the bedside. I wonder if they're even aware of other positions out there. Or is that the philosophy of the education and training that is being done? Because you can't have step two without step one, that is for sure, right? You can't go into something else without that. Yeah, that's, that's your foundation.
Speaker 2:You know I would yeah, I would not be able to review a case if I didn't know, you know, what labs to look out for or what functional abilities you know to look out for with certain diseases. So you, so you need that base, you absolutely need the base. But anything outside of that, doing anything outside of that, as far as a job for nursing, wasn't even looked at, unless not even talk about working remotely, because that still is an area that a lot of people are like well, what do you do and how do you do that If you're not actually physically touching a patient? So you definitely need that as the base so that you can be really proficient in some of the other roles, that non-traditional roles that you can have. And to your point of the instructors, I don't think a lot of them because, let's be real, a lot of them are probably still doing bedside.
Speaker 1:Yeah, they're doing bedside, but you know they are going back to acquire their masters and their PhDs or DMPs and things of that nature and you know there's a lot. I was in LPN for five years and I really enjoyed it and I think that was one of the bases that kickstarted me, that skills are very, very important. You have to have skills. You have to know how to talk to your patient, how to treat your patient, and it started coming together so well. If I like this LPN thing, I think I'm going to go back to school and get my RN and that's exactly what I did. So now, reading through, that's a transferable skill.
Speaker 1:I, like you, started out at the bedside, learned a lot. But hey, I started out on telemedicine unit. I call it a step down unit. I called it I don't know what the hospital termed it. It's been because we did get it all. You know, you got the hip repairs, you got the abdominal surgery and we would laugh and say all that nurse was up there taking that pulse and saying, yes, lily Riggle, I think they need to be transferred and we would laugh because we had it all. But at the same time, it was a great learning experience, because it had just been MedServe's cardiac. That's all I would have known. I wouldn't have known how to basically successfully transfer a patient that had just had the surgery, or you got what I'm saying, no, exactly, you are absolutely correct.
Speaker 1:Yeah. So I just tell people, don't sleep on MedServe. That's where you learn your organizational skills and you learn how to prioritize. You sure do? You learn how to prioritize and you better.
Speaker 2:Right, and that has been consistent and stayed with me even now, even though I'm not actually physically touching a patient. You know, on our line of work you still have to prioritize because everything is coming at you all at once. Everything looks like it needs to be touched right now, but it really doesn't. You are correct?
Speaker 1:Yeah, you are correct and case management. Well, when I first went into the cath lab, sure I had this background. I had an ICU background at the time and so yeah, I could go into that. But you definitely need that background because things and when you're in a specialty unit, things can turn on a dial.
Speaker 1:And you need to be there to pick that up, either on pre-assessment or post-assessment or inter-procedural, and we had an excellent staff of individuals who knew what to do, when to do, how to do. You know, shock and menstruation, that's just that I was the RN. Well, I couldn't be everywhere at one time, but if they needed me, bam, I'm there. But now, since the 10th day, I've already had it under control, but they had already been doing it for so many years. So you can learn from your experiences and then from someone else's at the same time.
Speaker 1:And so we come down from case management, from prioritizing how to get the patient out of the hospital, so to speak, because that is the goal the patient has to go home at some point in time, eventually. So when you were in case management, what were your struggles and what brought you basically comfort for lack of a better term when it came to taking care of your patients and preparing them, because we know the goal is to start discharge planning on the day of admission. So tell me a little bit about your case management experience.
Speaker 2:So that you know, in and of itself, right is a challenge. That's planning, and that's probably the biggest piece of concern right now and or problems right now in the hospitals is getting the patients discharged appropriately. And I would definitely have to say that that was probably my biggest challenge, you know, while working as a case manager, not so much for the insurance side, but there are still some nuances with that as well, because you know you're looking at making sure that the payments are appropriate from their standpoint and just paying for the hospital stay to begin with. So I would say, certainly, certainly, discharge planning has been, you know, really, really, really difficult in the things that I have done, in the work that I have seen. And how do you, you know, how do you navigate around some of that? You have to be, you know, really savvy.
Speaker 2:But I also think you have to work, as you know, as an interdisciplinary team and I think you know that that really is key to getting a patient out appropriately and everybody has to be communicating right constantly, absolutely, you know the nurse can't know that, okay, maybe the patient is ready today. And then not the social work you know the social work or not know of the MD not know, a PT not know, you know. So you know from from their standpoint, the nursing standpoint. What milestones have they met? And then, who did you communicate that with? So I certainly think that the whole team needs to be involved in order for that work in part to really move appropriately. But it definitely has been a challenge and continues to be a challenge.
Speaker 1:You can. Well, let's stop right there and play this song, and then we'll dive a little deeper into case management and utilization review.
Speaker 4:Here we go you are, there's an answer if you reach into your soul and the sorrow that you know will melt away.
Speaker 4:And then a hero comes along with the strength to carry on and you cast your fears aside and you know you can't survive.
Speaker 4:So, when you feel like hope is gone, look inside you and be strong and you'll finally see the truth that a hero lies in you. It's a long road and you face the world alone, the one which is out ahead for you to hold. You can find love. You will search within yourself and the empty nation there will disappear. And then a hero comes along with the strength to carry on and you cast your fears aside and you know you can't survive. So, when you feel like hope is gone, look inside you and be strong and you'll finally see the truth that a hero lies in you. Long road means a lot to follow, but don't let anyone tear them away. Hold on. There will be tomorrow. In time you'll find the way and a hero comes along with the strength to carry on and you cast your fears aside and you know you can't survive. So, when you feel like hope is gone, look inside you and be strong and you'll finally see the truth that a hero lies in you, that a hero lies in you, that a hero lies in you.
Speaker 2:You know you appropriately picked these songs right. I thought that was great. You know I invited other nurses, so if there are other nurses on.
Speaker 1:I just think the song is so appropriate. Well, I feel as though we are heroes, because I often tell new nurses you're the advocate for the patient, You're the go-between for the patient and the physician. Your assessment, your findings, you have to present them to the doc. If you don't present them correctly, then what happens? Who's affected by it the most? It's not going to be you, it's the patient. So we have to always keep that in mind.
Speaker 1:Now, when I did case management, my biggest struggle was naturally, as you say, the discharge planner, and I would have sometimes a discharge planner assigned, but they didn't want to work collaboratively with me. This is fine, but I won and they had to. I'm doing my part. You got to do your, but I could do some of it. But when you have a complex case that takes you away from everything, you have to stick with a complex case, and one doctor accused me of cherry picking the patients. I was like what do you mean? Because they don't want to take them. I said no, that's dependent on their insurance and he could not understand that. That was totally out of my hand. I said now you can appeal with the physician. That's on you. At this point in time, you and the facility, I can't do anymore.
Speaker 1:And he was a great physician, Don't get me wrong. He really, really cared for his patients, but that's like there are some things that are truly out my hand. I work for the hospital, not the insurance. I give the information. They can come and review the chart, but it's up to them and that's when the appeal process comes in. So you do have to kind of wrestle and you have to be sure enough about your skill set to stand and say no, yes, not. You know this is where we are and this is what I am. You know, to make the have the best outcome for the patient, Would you agree?
Speaker 2:Yeah, no, I, I, I, I and again. It all comes back to that base, Right, you know, making sure that you have a really good strong base.
Speaker 2:And so, you know, I, I thought at one point that I would end up teaching, and that's why I went back to school to get my master's degree, and in health education, and so I thought I would teach nurses.
Speaker 2:And then I've done a lot of training in between, here and there, and but, you know, one of the things that I certainly, you know, would employ on them is to, you know, they're really good base of knowledge and information on board, you know, especially going out into these various other areas within nursing, as long as you have, you know, that strong base, which is which is what's so good about this profession, is that you can, you know, have the opportunity to do a plethora of things, and it's so, it's so rewarding to to be able to do that. And so, again, you know, coming back to that base and having that good, strong base, you know you can stand on, you can stand on that when you, you know, have to collaborate. I agree with you. I agree, you know, some of the others on on the team Mm, hmm, because you have that background, you have the history.
Speaker 1:You know, you have that knowledge base and people have a tendency to listen to you more when you can basically tell them why you feel this way about a situation. Sure, and you can explain that they have a tendency to listen to you just a little bit More. Now, getting to our love, which we found each other during performing utilization review, and tell everyone about that experience How'd you get there and what keeps you there. So, utilization so you can you know, you can you know you can you know you can you know you can, you know you can you know you can you know you can you know you can do that so utilization review really is?
Speaker 2:oh my goodness it's. It encompasses everything that I basically learned I feel like as a nurse and I don't have to touch a patient, so that's what keeps me there. There is I'm not a big communicator, so or I shouldn't say communicator, but I'm not a big person that interacts a whole lot or likes to interact a whole lot. I know some of the folks who know me on this line might be like what is she talking about?
Speaker 1:I'm just ready to say you are an excellent communicator.
Speaker 2:Now, come on, it's not something that I really like to do, so I like to be behind the scenes. I'm the person that's holding the camera. Truth be told, right, I don't really want to be in front of the camera. I'd like to be behind the camera or behind the mic. That's me. I'm the person that's holding the camera. I'm the person that's holding the camera. The patient review allows me to do that. It allows me to take all of the skillset and knowledge that I have learned and experiences that I have had, and it allows me to take care of a patient.
Speaker 2:And.
Speaker 1:I love it, I love it, I love it I love it.
Speaker 2:I love it and I will probably retire doing utilization review, but I really, really, really do like the concept of utilization review. I like the practice of utilization review and you know, when you, when you get with an organization and get it, you know, like the girls that get it, get it. So when you get an organization that gets it, it's, it's, it's a great place to be in. And I think that's a great place to be in. I'd like to think that I helped. You know some other people move along in that continuum Just by you know, knowing who I am and and hearing you know some of my experiences, and so that's that's me, and utilization review and and that's, and you know, case management and utilization review go hand in hand and I think that we can't really fully perform those two jobs at the same time if you really want to be effective.
Speaker 2:That's just my thought process, but but I do feel like they they do go hand in hand and and you for me, you know I don't have to touch a patient, to be instrumental in someone's life.
Speaker 1:I agree with you. I definitely agree with you on that. Take a second. Is there anyone in the audience that may have some questions or comments? If you do, there's a circle, there's a second circle down and you can just select that circle and I can bring you up for any question and I would appreciate some. I'm sure Denise would. Well, we're going to go to another song and then we're going to be closing out in just a little bit, but I have enjoyed this. I don't know if I needed to get it off my chest or what. Well, I hope you know.
Speaker 2:I hope you and I talk almost every day, so I hope you were able to, you know, take some some, some more bits of information.
Speaker 1:No, we still have more to talk about. Oh, yeah, yeah, yeah, yeah, absolutely, but you know, so far.
Speaker 2:You know the the goal here is to try to. I think one of the key pieces or key takeaways from me is, you know, the fact that I did not realize that no one really helped me along this path, and that is that's a little disturbing to me. So if you in this platform can, certainly. You know, I have a friend, I don't know she's on. I wish she was, but I don't, I can't tell. But I have another nurse friend and her daughter just became a nurse and she says she's looking for her next gig.
Speaker 2:Oh my goodness, I wish that I could get her on to listen, you know, to listen into the, to the call, because maybe that might help her in her next step. Now, she, she does need to have her time right, like we talked about. Absolutely, she does need to have her time on the floor and gather all of that good, all of that good information and good experience. I think that you get from there. And then another good friend of mine who's still doing some bedside. She's doing a lot of teaching but she's doing a lot of. She still does a lot of bedside and she, she's.
Speaker 2:She's another good person that you know. I bounce a lot of things off and she's so smart. She just got her her NP in psych and I'm so excited for her. But you know, you know, and she is a great person to get in contact with as far as like mentoring and and uh and bouncing some ideas off of um, because she definitely has her um foot to the. You know the pulse of things going on um bedside, uh, and so she can, you know, direct your past and all of those things. But it's it's, it's good for you know, individuals. My takeaway again is that I I just can't believe that, like I was doing all of this legwork, all of my own.
Speaker 1:Well, you know. But when you don't know, yes, you don't know. Um. Yeah, when I graduated with um, my associate degree in nursing, one of my fellow students went directly into medical sales and we were all looking at each other um like how did she land that job that? What did she know? What you know, what you?
Speaker 3:know the key words, yeah, true.
Speaker 1:And so I saw her several years later, um, after I had, uh, got my, my bachelors and all of this, and she came to the bedside and she was so fixated and I get it because she was nervous because she had not been at the bedside since we graduated with our associate degree, and she said I think I did this a little backwards and I was what do you mean she's? I think I should have been at the bedside first before I went into sales, because once I got in the cell I couldn't get out. I said well, there will be some people we wondered how you got in the cell. Uh, not, not tell her, you know, and I don't, I can't tell you that you did it back with you Because an opportunity presented itself to you. You took the opportunity. I said did you like sale? She said I loved it.
Speaker 1:I said okay, now you're coming back to get back your side of nursing that you missed. I can't say that you did right or wrong. I think you followed your heart and that's good as well. I said but what advice would you give someone, a new nurse, if you had to give them some advice? And she said I would tell them to come and get some nursing skills first, because sales, yeah, because sales. You don't do a patient. You don't know about GI issues, you don't know how to put it in in G2, you know one should probably go in, but you don't get that hands on touchy-filly of a patient and being able to look at their life, like you say it, to see what's going on with them. She missed all of that, but I still cannot tell her that she may obey a decision by taking a sales position.
Speaker 2:Yeah, and I don't think you can. I can't tell her that I don't think I can deny them. I absolutely don't think you can. I don't, I don't think you can. It's just, you know, again, for me it was these opportunities. I went out looking for them, but these opportunities ended up in my lap and I am most grateful for them because, again, it just fit in so much better with how I operate and how I function as a person and that makes that you know, the job even that much more enjoyable, because at one point, me doing bedside, I was just like I don't think I can continue doing this.
Speaker 1:Well, you need to. It is wrong. It is wrong Physically. If you do it correctly, it's wrong it is wrong.
Speaker 2:You need to help emotionally, physically, yeah but it does take a toll.
Speaker 1:Yeah, it does take a toll. You have to be the chaplain, you have to be the counselor, you have to be the nurse and you really do. And sometimes you have to be the referee. And any nurse out there whose bedside, whether you're ICU meds or whatever you know, you have to be a referee because the family is going to come to you wanting legal advice, family advice. What the hell this way? They didn't prepare me for any of this in school.
Speaker 3:You know, I'm so afraid after this.
Speaker 1:They didn't prepare me for any of this in school, but guess what? You know, you come in with some good common sense and some common courtesy and everyone basically survives that day. Okay, everyone basically survived. So let me ask you this one Now how do you stay current and up to date in your field? Are there any particular resources or professional development opportunities that you would recommend?
Speaker 2:So I don't know if I can name them, but definitely definitely you know reading right and because you know our states that we live in require us to have at least 30 continuing education units, those things help to keep me abreast, and just talking to other individuals in our field help to keep us abreast of, you know, and that's anywhere from the physicians to, you know, anyone else. If it's physical therapists, I love talking with them, seeing what they're doing on their end, and so just I just think you know, having those conversations, keep an open line with some of the other individuals in healthcare, and also, you know, keeping up with your continuing education, and that you know that runs the gamut. You can do it from anywhere. Each state has and I would say each state has a board, I guess, that they use, of where you can get your continuing education from. We all have received those books. Don't throw them out. They're really, you know it had some really good information in there, and so those are some of the ways that I try to keep current.
Speaker 1:Okay, Now you did touch on this next question what advice would you give someone considering a non-traditional path, non-traditional nursing career path?
Speaker 2:So it's you know, research and find out what you want to do, something else that you would like to do in nursing. That doesn't necessarily mean you having to touch a patient. Research what those topics are, have conversations with various individuals within healthcare. Oh, my goodness, the amount, the amount. Oh my goodness, my head is exploding with me just thinking of no seriously avenues that I wish I could take. The ideas pop into my head and, and you know, it really doesn't take that much for you to to move into another direction. It's just that you just have to be given the opportunity and then, just, you know, look for it.
Speaker 2:So those are some of the things that I would say you know, research what you like, look into things that you like and are passionate about, and, you know, start to have some conversations, reach out to some individuals, start to have some conversations, and I think that that's, you know, that's key and that's how you kind of get, you know, you can get your foot in the door. I am, you know, I'm a resource. If, if, if, individuals need to get my information, we can get that to them. I love to talk, so I will, you know, give you a whole earful on my path and and and certainly the paths that you can take to get where you are, and I'm really passionate about that as well too. I, I I thought that you know I could do I can clearly do some nursing recruitment, because there are so many areas that I feel like you know the nurses we nurses can touch and be pivotal in.
Speaker 1:That's great. And you know, I know you've done some mentoring, I've done some mentoring and you know, do you find yourself sometimes holding back a little bit because the person you're mentoring is just too fresh and you don't want to put too heavy of a burden on them.
Speaker 3:You have to know you don't want to.
Speaker 1:Yeah, you definitely have to know them, but I enjoy mentoring. I'm with you. I don't mind sharing information At all.
Speaker 2:At all.
Speaker 1:Oh, my goodness.
Speaker 1:At all, because how do they know? How would they? And people still I have been in nursing over 35 years and people still how do you do it? And then they'll ask you a question well, I just don't feel so good. So, what do you think? What do you need to go to the doctor and then, when you start telling them, they give you a scenario. And when you start telling them what we do, when they say what do you do? Give me a day, give me, give me a day in your life. And you start telling them, they were like how do you do all of that? It just has to be done, it just has to be done. And they have no, they still don't have an idea, I think, of what we do as nurses. Does that make sense?
Speaker 2:Oh no it makes no sense, it makes absolute sense, and it's crazy, it's funny.
Speaker 1:But it's crazy, it's funny, it's good, it is.
Speaker 2:Because again, we span the gamut here. We can really do. We're not so specific, but we're not that specific that we can't work anywhere and in any country. So it's an amazing field to be in. I didn't always think so and I can get on my soapbox about how I think we are being this out. We are predominantly female dominated.
Speaker 2:I wish I had some males on this call, but female dominated and the salary is what it is. But we can go anywhere. I've never been with, I have never been without a job, never in my over 20 years, and if I want, if I was out of a job, it's because I wanted to be out of a job for that moment.
Speaker 1:So I agree with you, but I have been out of a job several times. Sure, I'm not saying it didn't happen, though, but I want them to know. Sometimes these non-traditional nursing jobs lead you into companies. Yeah, I mean, you know brick and mortar building is as good as they are and they don't have a problem with laying you off or a clothing company down, not at all Shutting it down, closing doors. And so you know and people be. How did you get laid off? You are a nerd. I said we're human too.
Speaker 5:Yeah.
Speaker 2:We work for our company, but the bounce cap is real Okay the bounce cap, it is real.
Speaker 1:Yeah, I don't have to be out of work long, that's for sure.
Speaker 3:No, no, no no.
Speaker 1:It may not be what you want to do, but it is going to be done and you are correct with that, because I have gone back into the hospital and they were like, why don't you come back?
Speaker 2:full time. I'm like I don't hear the spirit calling me for them.
Speaker 1:I am putting out resumes, honey, as we speak, is what I said to myself. Because once you come, go into a non traditional nursing role, especially something that you have a passion for, is not because I am afraid to take your patient, because, like I said, my bounce back is back into the hospital and don't make it after two days. I'm not back on my game. I am there, you know I am there, and that's why it's best to have a good foundation.
Speaker 2:Yes, because you never know when you have the best week. We would always have this saying that you never know when you have the best. That's the scope of it.
Speaker 1:It's so true, that is so so true, you know. So it's a flexible. It's a flexible career. I have encouraged. I have encouraged nurses who are single and who don't have kids and who have had several years of experience. It's especially, I see, you experience. I say it may be time for you to go travel. And they're like why did you say that? I said because you know this right. But the areas of the country there are things you can learn.
Speaker 1:Oh, yeah, oh yeah, I said you'll come back. A smarter her nurse, and she has called me and she's not the only one but this one particular nurse I can think of she. She takes me. I got a balloon pump. What do I do? I was, ooh, baby, been a long time. But when they you know.
Speaker 1:So I just text her everything she needs to do, but make sure everything is tight. Don't, don't, don't put the death grip on it, but make sure that everything is tight. We don't need them. Make sure you have a pulse in that leg, make sure you have it. That is going back to the basics, okay, and, like you said, you have to have that good foundation after and make sure everybody put it in a secure plug. You know you don't want it in a secure plug. It's not secure, you know.
Speaker 1:But um and uh, the next morning I called her. Well, I called on one of my friends that is a cardio vascular intensive care nurse and I was telling her and she did the she, she gave me the same spiel and I typed her everything, text her everything. She said. And the next morning I think I was as nervous as she was I had to do. She said. We both said, hey, that's the truth, it is the truth. And I was like, yeah, you know, cause. But I was just so thankful that she thought enough to call me first because she knows I have done a good little bit when it comes to intensive care, nursing, you know, basically, um, my biggest cardiac is my largest background, that is for sure.
Speaker 2:Um, yeah, I will reach out to you if I have a cardiac patient. They're like what is this about? What are they talking about, Please?
Speaker 1:help me, please help me. Yeah, absolutely. So you have to have a support system as well. Yeah, we nurses who have to have a support system, and we find that in one another. Um, and because you can't hold this into yourself and still effectively treat patients.
Speaker 2:No, no, no, no, no no no, you have to share, you have to share, yeah and uh, I am a share, I am too.
Speaker 1:I'm going to give it up to you. I want you to have it. I want you to know what?
Speaker 2:Yeah, I want you to move with that and then bring other people on my circle. My nursing circle is tight and we move. The one person that I worked with ain't too far behind from um, from where I used to be with them, so I do try to bring folk along with me. That's great. I do try to bring folk along with me and they know they absolutely know.
Speaker 1:They know who they are. They know who they are. Yes, ma'am, but out of the majority of the things that I have done, I see you and utilization review have been my. I fell in love with utilization review. I fell in love with it after doing disease management Okay, um, and I was like, okay, I see where it worked. The reason I fell in love with it not because it was a job in the office, but I saw the quality of that patient Right. So I saw, I saw that when you teach patients correctly why they need to take this, why they need to exercise, why they need to cut down on the salt, I saw them do better. They were able, whereas they were bed bound or home bound, they were able to go to church and had not been to church in like over a year or two years and they were so cleansed with the response of what they did and what they learned. So that was so rewarding for me.
Speaker 2:Now, saying all that, what has been probably more, on one of the most rewarding aspects of all the things that you have done so so it's just that at the end of the day, there's a patient here at the end of this, and so I think for me that that's most rewarding, but you, but also, what's most rewarding is the relationships that I have garnered from nursing, and really I don't have a large circle of people around me. Those that are are know me and are close to me. I roll with them. Even though I may not talk to a lot of them every day, there's still people. If they call me and tell me that they need something, I'll figure something out or I'll give them some information. If they need an opportunity, I can, I can figure some things out. So those two, those two things the, the, the satisfaction, the patient satisfaction and knowing that you helped a patient through a tough time. And then the, the, the colleagues that I have throughout my nursing career really have been too instrumental and the most rewarding for me.
Speaker 1:Well, that sounds great. That sounds great. Any any other parting comments before I play this last song for you.
Speaker 2:No, I just you know again, if I can, if I can help anyone, just you know, get my information, reach out and you know we are here to do a job and we need to do that to the best of our ability and and help one another.
Speaker 2:I don't want it. I don't want this path to be as difficult as it was for me. But, you know, maybe that was just my path to, you know to to walk, but it still should not be as difficult. So if I can help someone, you know, reach their goals or change, you know change direction, paths, I'm here to do that.
Speaker 1:And that that's great. Do you ever find yourself a nurse and when you shouldn't be nursing, you're looking at an individual and you assess them just by looking at them? Do you find yourself doing that All the time?
Speaker 2:Okay, I thought it was just me and now you know everything is really not in person because of COVID right. So you were listening a lot more to people and you know you can tell when some things are going on.
Speaker 1:So as long as it's not just me, let's play this song and we'll come back, okay, okay.
Speaker 4:Here, okay, but ain't no power stronger than the one that came and laid down this light? And I got mountains to climb, but the enemy can't stop me, cause there's a calling on my life. So when I'm crying, don't last too long, cause he gon' step in and make it alright. So only do it. You said you would Wait your battles for your big one wonder how you sleep at night. Only do it. Yes, it will anybody tell you something different. You know that's a lie. You gon' look back and be so amazed how it turned out. It's only his grace. Only do it. He said he would. So I trust him at all times. I'm about to lose it again. I'm about to let him know where I come. Don't take me there again. I just call on Jesus, my friend, get me back in line one more time, cause he's always listening. Ain't nobody perfect? Everybody's hurtin' Need you whisper? No, save me from my weaknesses, cause you're always on time. Come and get your breakthrough, cause I'm gon' get mine. Only do it. You said you would Wait your battles for your big one wonder how you sleep at night? Only do it. Yes, it will anybody tell you something different. You know that's a lie. You gon' look back and be so amazed how it turned out. It's only his grace. Only do it. He said he would, so I trust him at all times. You see what the intermediate plan for my downfall Turned out to be the greatest victory of my life, cause when it comes at your fast and hard, there's only ones that could come and make it right. So ain't no need for stressing and crying, cause he gon' show up just like he did the last time, in the last time, in the last time. I know, I know. I know. Only do it.
Speaker 4:He said he would Wait your battles for your big one. Wonder how you sleep at night. Only do it. Yes, it will anybody tell you something different. You know that's a lie. You gon' look back and be so amazed how it turned out. It's only his grace. Only do it. He said he would, so I trust him at all times. Only do it. He said he would, so I trust him at all times. Only do it. I feel it. So I trust him at all times. I know he will, so I trust him at all times, all times, all times.
Speaker 1:Hey Denny, what you think about that one, denny? Oh lord, have I lost you. Oh lord he needs to say Okay, can you hear us, sandra? I'm mute, sandra.
Speaker 3:Yeah, I am muted. Sorry about that. I think Trinny's dropped. I think you dropped her.
Speaker 1:Oh, okay, no, I saw her still there. Hold on, let me bring her back. Okay, there she is, okay.
Speaker 3:Sandra, what question do we have?
Speaker 1:No, you're fine. Okay, denny. Denny's, you mute for one second. Just go ahead and go on mute, because Sandra has a question for you.
Speaker 3:Well, actually I have two questions. One is absolutely I mean one is not tied to this conversation that I'm listening to today. It has to do with the fact that she says she was in the background singing and she was playing the music and I wanted to know why she wasn't singing for me and I'm a patient- I did not want to be out even further.
Speaker 1:Honey, Look at my brain I sound good.
Speaker 3:No, but really what I wanted to say was thank you so much for the work that you do and what most people don't realize, and my name is Sandra and I am the founder of Choms' Medi-Health Foundation.
Speaker 3:We are a nonprofit that is focused on patient education, empowerment and engagement, and what so often happens is that a lot of patients don't understand the role of a nurse isn't just to be at the doctor's office, although the nurse a lot of times goes well past being at the doctor's office whether it's utilization, whether it's case management, whether it's a number of things that the nurses that are not hands on do, they still, for the most part, care pretty much. They should be caring anyway about the patients, and if you get on and you respect that one that you have that's working with you, in turn they'll respect you and you'll get so much better care, because nurses on the floor are already under so much pressure to perform at a certain level and to see a certain amount of patients that if they could just get one person to be kind and gentle, they'll actually respond in the light tone.
Speaker 3:But since you're not on the floor dealing with the patients, both you and Carolyn. I had to go off to you because it wasn't as if you didn't do it.
Speaker 3:It wasn't as if you won't step up and you won't help a patient. So, from the patient side, I want to say thank you to both of you, ladies, as I sit here and listen to you and listen to the passion that you have from within to touch a patient, no matter whether it's hands on or whether it's through the means of reviewing a chart and viewing and seeing what's going on, catching something, if something doesn't seem right, and bring it to the attention of someone that can fix it. Thank you, thank you, thank you. Oh, that was well said. Have some patience. Thank you, but I believe, ms Carolyn, before Denise leaves, I think she needs to hit us up with a tuner too. Oh, no, ma'am.
Speaker 2:No, ma'am, if you want to end this on a great note, let's not do that, but I have enjoyed the selections that my teammate here has played for us. So my heart is full and, carolyn, you know.
Speaker 1:Yes, yes, yes, yes, you know, honey, you know, you know.
Speaker 2:Those others that are on the call. Hopefully they know one of us right.
Speaker 1:Absolutely, absolutely. I'm looking in the chat and that is true.
Speaker 2:I'm going to have to drop off. She said that she was going until like about 815. I actually didn't think that, but you know when we get started what happens.
Speaker 1:Yeah, it's hard to stop. It's hard to stop. Who is GSG? Who is GSG? They're trying to call in.
Speaker 3:Oh I do, do you know them.
Speaker 1:Okay, okay, no, but if they do, we'll definitely let them call in. But you know, nursing is one of those fields and I guess everyone may say the same thing about a doctor. They say the same thing about their career path. You know, is ever involving. And one thing for sure with nursing I've seen technology where they were in the hospital for 10 days for surgery to being in the hospital for three days for that same surgery. So you know, technology has moved and it keeps evolving. And so I tell people, don't sleep on technology. You know, it's not that anybody Excuse me, it's not that anybody's kicking your loved one out of the facility. It's just better for them not to be there and to be in their own environment so they can move around more and get better quicker. That's really what it's about.
Speaker 2:Yeah.
Speaker 1:That's it. That is yeah, okay, so any parting words to me.
Speaker 2:Just that this conversation is so stimulating and you know I appreciate the work that we do. And again, if anyone wants you know some additional information or some additional resources, they can reach out.
Speaker 1:I do appreciate you. I appreciate everyone who tuned in tonight. Nursing is a good profession to be in. There are a lot of things you can do with it. We've named a few. Even when you're in the hospital you can. A lot of people all they know is emergency room surgery I see you in the medical floors. They don't know about nuclear medicine, they don't know about the cap lab, they don't know about endoscopy, they don't know about PAKU. They don't know about the other components of nursing. And there's a lot you can do with teaching inside the hospital. You know you can be a nurse educated. There's so much more and especially according to how large your facility is, it's not just one and done, it is never one and done. What do you think, denise?
Speaker 2:No, no, no, you are correct. If you feel like you're stuck, you know, reach out to your educators, the career development department, your leaders. I think that those are some good places to get started, to have that conversation. You know, if you're looking at movement or just learning something new, as long as the organizations hold on to you, they're going to be willing to. That's what I have seen. They are going to be willing to work with you as long as they can keep you somewhere in some capacity.
Speaker 3:Ladies, I do have another question and I'm hoping that one of you, or both of you, can answer this. As a care, as a care patient care moves away from the hospital into in-home hospitalization, what would be the role of the nurse once that is officially underway?
Speaker 2:And are you talking about like hospice care or no, all the hospital care.
Speaker 3:there's a movement now to move patients away from the hospitals and do in-home treatment instead of doing hospital treatment, so all their care would be actually done in the house versus it being done in the facility.
Speaker 2:Well, correct me if I'm wrong, carolyn, but I know that you can't do everything at home. I agree, and so that might be where they're trying to, and I know it's cost and burden and they're not getting reimbursed the same way, so don't take up the beds, and so I know that's a phenomenon I actually heard a physician talk about that today and so not all care can be done at home. But, yes, there are certainly a lot more due to technology, again, like Karen Carolyn said, that they are able to move from the hospital to another level of care, but maybe not. They have to be really stable or fairly stable and family, and there has to be a support system in their next level of care, whether it's home or you know, as we see in where we work, the shelter, or you know all these various places, group home, but all care cannot be done at the house.
Speaker 1:Okay, I do know of one recently dialysis. One of my patients spoke to me regarding his home dialysis and he said I do it overnight and I'm free. No more going back into the clinics or the dialysis units are three days a week. He's, in fact, he's not going to do it. He's, I'm not going to do it. Yeah, that's phenomenal, but is that one of the ones you're thinking about, sandra?
Speaker 3:No, actually as good the dialysis is done at home. But if I'm not mistaken because I know someone that actually does that it's on dialysis. And I also know my niece was her mother was thinking about because she's on dialysis having her do at home dialysis. But there was so much that went into doing that at home so she was like I'm just going to take her out. But I'm actually speaking about every issue, every aspect of the hospital stay. They're trying to do away with hospitals period, the reimbursement, the inpatient. They're trying to do away with it. I mean, it's very similar to what they're doing with AI, where they're trying to run everything through this new thingal or it's not really new but through this system where we don't need people, we could just do everything at home. So they're booking that, setting up computers and robots and all that stuff to treat patients at home versus treating them in a hospital, and it's not just for dialysis but it's for all levels of care.
Speaker 1:Yeah, I'm kind of with the niece. That would be very, very frightening to me for some reason that I have seen. Now, that's just me personally, but the dialysis has freed so many people up to be free during the day, to have it during the night and just for compliance right, and just for compliance alone.
Speaker 1:Compliance and to have that support system, because it's an intensive, it's going to be a class, and they go to class for several days, for several weeks, for several hours per day in order to learn what they need to learn. And now they think that it's no way you can shortcut that one. No, no, that's just my take on that. But, sandra, I haven't heard and now I'm afraid to research it.
Speaker 2:Because that's how it's going to fight me. It is that you could think that you can take AI to the ooh. Well, good luck is all I can say.
Speaker 1:Yeah, yeah, they need to work out all the kinks on that.
Speaker 2:Oh, all the kinks, and I'm sure it's probably going to be a physician and or nurse healthcare team around and have to be available in case you know, because the machine is as good as the machine is right or the people inputting in the information. That's why computers have issues. You know, as it is, it's as good as the person who's inputting that information. So I don't you know, solely relying on that, I'm sure it's going to have to take some additional testing and training. Look, it's a wrap.
Speaker 1:Well, I saw this for lack of a better term neuro tele or tele neuro, where neurologists you dial them up on the computer, basically it has a nice camera on it and she did her assessment. She came on the screen and did her assessment right then, right there. So I can see where some things can be done. But there are some things at this point in time, especially coming from an ICU background, some things I can't see at this point in time. Agreed, but that doesn't mean that nobody's not doing it.
Speaker 2:Okay, because you know, or starting to think about it, because again, costs and money. I'm continuously hearing this message over the past couple of days, past couple of weeks, that the burden on the hospitals is quite large at financial and they're not getting reimbursed as well as they used to. So the costs of care are going up but they're not getting that money, they're not seeing that return on investment. So it's something.
Speaker 1:Yeah, so, sandra, we'll be on the lookout for that. Sure, I truly will.
Speaker 3:Carolyn, you know I don't have a problem doing the what's the name and sending it to you so you could look at it.
Speaker 1:True, Very true, but that's good. That's good, but we'll be on the lookout for that. I haven't heard anyone that's in the hospital now mentioned that to me, not that I am their source, but still you hear things and I haven't heard that. So but the dialysis I have and it's been a slow progression, but I see it picking up now for people to do it at home overnight where they're free during the day time, and but still you have to be very, very careful with that because of that risk of infection there's a risk about a lot of things.
Speaker 2:A lot of those places code.
Speaker 4:Yeah.
Speaker 2:So yeah, but, Carolyn, I'm not trying to cut the short, here we're good, we're good, we're good, we're good. Thank you for coming. I know, I know they circling the wagon. Yeah, they are, they are.
Speaker 1:Thank you so much. Thank you everyone who tuned in. Thank you, sandra, for your wonderful questions and comments, and I have enjoyed it. You all have a wonderful night. Everybody sleep tight. All right, let's get a foot. We got to work in the morning.
Speaker 2:We got to work in the morning, all right, thank you, thank you.
Speaker 1:Thank you All right, bye-bye.
Speaker 4:You said, be also dramatic. I guess Even you, one boy forgetting you just make me feel so good. I took it easy. You grabbed it.