Dr. Michelle Patch, PhD in Nursing | Assistant Professor at Johns Hopkins School of Nursing

In this episode, we discuss Michelle’s fascinating journey from the US Navy, ROTC, and working in the Navy Nurse Corps to getting her master’s and eventually her doctorate in nursing from Johns Hopkins, her experiences working in different leadership roles at the Johns Hopkins Hospital and School of Nursing, and her take on the importance of finding both humor and a support system of colleagues to manage the challenges of working in healthcare.

Hosted by Brooklyn Arroyo

To connect with Michelle and to learn more about her story, visit her page on the PHutures #100AlumniVoices Project website.

Transcript

Brooklyn Arroyo

I'm co-host Brooklyn Arroyo and this is 100 Alumni Voices Podcast, stories that inspire, where we explore the personal and professional journeys of a diverse group of 100 doctoral alumni from Johns Hopkins University. Today we're joined by Michelle Patch, PhD, in Nursing. And how are you on this fine Friday?

Michelle Patch

I am well. Thank you so much for for taking time to chat with me today, Brooklyn.

Brooklyn Arroyo

Yes, of course. So as we're recording this, I think that it's both a beautiful day and I'm feeling optimistic because I'm really excited to work with you. So, tell me a little bit about what led you into studying nursing and and what did that look like for you?

Michelle Patch

Oh gosh, it's kind of a long, winding tale, so I'm going to try to explain this in a linear fashion, but please know I might go off the path just a little bit.

Brooklyn Arroyo

That's what this is about.

Michelle Patch

Awesome. So, I have been a nurse now for 23 years, and when I was in high school, I really wasn't sure what I wanted to do. I had grown up in a medical family but I just, you know, there were just so many different paths and and my family actually went through a divorce. And so, there were also some financial limitations. So, I my grades were good enough and I was able to get a scholarship to the local Community College. This was out in Arizona. And I like to say like this is like kind of the theme at times is failing to succeed is my thing because a lot of times we feel really comfortable with telling people about what we did that was successful and was easy, right? And then we're maybe a little more reluctant to talk about our failures, but I think those are just so, so important and instructive in how we got where we we got, right. So, here I am now I'm in Community College. I really don't know what I want to do and and it just kind of felt like an extension of high school to me. So, first semester I'm put on academic probation for not maintaining my GPA and 2nd semester I lose my scholarship because I didn't maintain the number of credits. So, here I am, I'm working a couple of small jobs. And really not sure what's going to happen, but I know I don't want to stay where I am, and I thought, well, maybe, you know nursing would be good, you know, it's flexible, et cetera, et cetera. But but how am I going to get there? So, I did enroll in a phlebotomy course, but bills were piling up and things weren't fabulous. And so, I decided I was going to join the Navy. And that sounds really cliche, but it is true. And so, I went in and I wanted to be a hospital corpsman. But they didn't have any of that. And this was in the mid-90s, so it was the end of their recruitment cycle. And Bill Clinton had lifted the ban on women serving on combatant ships. So now all of these jobs that used to be only for men had opened for women. And one of those was a job called a fire controlman and these are individuals who maintain and operate large weapon systems. And my little feminist jumped up and said I can do that. I can totally do that. So so here I am now I go to boot camp, I go through an initial school to learn basic electronics and engineering. I go to a specialization school where I worked on this very large Gatling gun close in weapons system. But I never really lost that desire to want to be in healthcare and to help people from that perspective. And I didn't know about ROTC. I know that sounds odd, but I didn't and I had. So, I'm on the the PRAC deck or the practice deck, right? And we have a mockup of the system and I'm I'm in school. And one of the instructors came up and said what are you doing here? And I thought he meant like what are you doing here female? Like you shouldn't even be here. And he's like, no, no, you're really smart. Why are you here? Why aren't you you know in college? I’m like what? So, he actually, gave me kind of that that spark again to say, maybe I should look at this and he introduced me to some individuals and and I talked about ROTC and I applied. And I convinced somebody that maybe I would make a good nurse. So, the US Navy actually paid for me to go to school. I went to Marquette University in Milwaukee, WI for four years and then I came back in and I was a commissioned officer in the Navy Nurse Corps. I served at Naval Medical Center Portsmouth, which is in southern Virginia, Portsmouth, VA, and I started off as a pediatric nurse and I was on a 28-bed ward with patients who were three days to 21-22 years old. Everything that wasn't ICU. And I got a really great grounding in med surge for kids. And then, because the military also wants you to be a little bit of a Jack of all trades, right? If you think about it from a strategic perspective, you want to be able to put people be able to move people around depending on what the mission is and what the issue is. So, an opportunity came up on psychiatry, inpatient psychiatry. And so, I moved there. After a year on PEDS and I worked acute care and addiction medicine and some transition care work. Now when I first got to Portsmouth, I told you it might be a little circuitous here. When I first get to Portsmouth, very shortly thereafter a couple months after the USS Coal bombing happened in Yemen. And that sort of foreshadowed many of the things that were going to continue to happen in my career. So, we did see some of the patients from that explosion as well as once I moved into psychiatry, some of the aftermath of of that whole experience. So now again, I've been working on psychiatry. I'm there on September 11th, 2001. Got my patients, everybody's doing their thing, getting ready for groups. And when the corpsman comes running in and says, oh my gosh guys. A plane just flew into one of the Twin Towers in New York. We're like you, you gotta be insane. What are you talking about? We ran in the back and turned on the TV and we were seeing the footage of the second plane going in to the building. So now here we are. We're trying to manage our own fears. I had gotten married to someone I met back in my initial schooling in the Navy. He was Coast Guard and he was deployed at the time, so I didn't really actually operationally know exactly where he was and I wasn't able to communicate with him. So, we all had our own fears about our families, but we also had an entire ward of patients that we were responsible for and to explain to them what happened when we weren't really sure. Cell towers went down. We did know what was going on. It was a lot of kerfuffle. Originally, I was supposed to go down to Guantanamo Bay and work psychiatry with some of the prisoners that were being held there. That I ended up not going down for. I got switched to a different command. Then I was supposed to go on the USSQR Sarge to go and support the fleet and that also didn't happen. And then I had my first kiddo with my husband, and he ended up getting shore duty and I was stationed at the hospital and we had been, like geographically separated for about 6 years at this point. We were always like somewhere different. So, we had a whole year. We were together. We had a kiddo. Everything was great. And then they came and said, oh, by the way, yeah, we got another mission. We got to send you. 2004 we're going to send you to Kuwait and you're going to be there for six months. So, I said goodbye to my husband. I said goodbye to my 13-month-old daughter. Very, very painful. And I got on the plane and went over there to Kuwait. And while I was there, I worked Med surge at the Kuwaiti Armed Forces Hospital for about a month and then I was asked to go and work at a clinic in an austere camp, which is now a huge camp era F John out there and and care for individuals for their mental health need. As you can imagine, it was a pretty stressful environment and so working with people and and helping them to to get through some of these really difficult and and significant issues. So came home. Transferred from Portsmouth to one of the child commands, so to speak, so it was one of the clinics that serviced the whole Navy the Norfolk Navy Shipyard and I managed an ambulatory clinic. So, I mean I was hopping around all over this place to psychiatry. Oh, and I missed. I also helped out with the psychology clinic. I was their first manager and I went there, there, there. Up tempo was really high. My husband and I and then we were shortly thereafter expecting our second kiddo. And and so we had to make some hard decisions, right, because we're both active duty. We didn't have family, we didn't have folks that you know, could help us out with the kids. So, I said, well, I'm a nurse. I have a nursing degree. He was also weapons systems. Like yours is not going to transfer as easy to the civilian side as mine probably will. So, I said, OK, I'll get out. But here's the deal. I want to go back. Because I really, really enjoy forensic care of patients. I want to, I want to do this. And they have this great program at Hopkins, which is just a state away and and somehow, and I'll spare you all those details. But I applied. I came, I interviewed, I got accepted. And my husband was able to get orders up here to the Coast Guard yard. And we moved our little tiny family up here and I started classes in 2006. Got done in 07 and I said OK I need a j-o-b. I have bills coming in. And I found out about this really cool new opportunity that was happening in our emergency department here at Johns Hopkins Hospital on the East Baltimore campus, and they were hiring for a brand-new role, which was a safety officer. And like what the heck is that? Well, you know, this is a person that they wanted to come in and help them identify patient safety issues, but not just identify them, right? Cause a lot of times you know what those are, but how do we put processes structures in place to prevent them? And to help support the staff who are working extraordinarily hard and trying to provide that great care? And I thought, I could do that too. OK, I can do this. I've never worked in an emergency department before, but sure, why not? They took a chance on me. And I ended up being there for 10 years. 

Brooklyn Arroyo

Wow

Michelle Patch

It was fabulous. Awesome, awesome team of people. Got to know Hopkins really well. And somewhere in there, though, again like this, little little voice jumped up and said, yeah, you know, but don't you want your doctorate? You know you want your doctorate. I had to convince my husband that, like, that was a good thing. Cause after the masters, he was like, oh, no. And so finally, like stars aligned. And I said, alright, well, and and I apologize, I'm kind of dating myself now. But I'm like I'm 40. If I don't go back to school, then I'm afraid it's not going to happen. So, I applied. My GRE scores in math were sadly kind of abysmal. My, my, my writing's great. You know, the math part was kind of a problem. So, I was very worried about whether or not they would also take a chance on me. And they did. And I had the absolute pleasure of being advised and mentored by Doctor Jacqueline Campbell, who is a rock star, and her work is in survivors of intimate partner violence in particular, and how do we give them the tools to be able to assess the risk of their particular situation? Give them the tools to be able to be as healthy as possible? And how do we prevent injury and morbidity and mortality? And that has been her whole focus. And she is an absolute, absolute wonderful person, scientist, outside the box thinker. And so, for me, this rule—I follow the rules—Doctor Campbell was really able to help me to kind of jump out of that box a little bit as a nurse and as a, you know, as a scholar. What does that look like? And so, my dissertation under her was looking at, I wanted to partner my patient safety stuff with my forensic and my violence stuff. Like so how do I do that? So, I said, well, let's look at emergency department visits by women after they have sustained intimate partner violence and my interest area was actually strangulation as a mechanism of that. And what do we do really well? And what is it that maybe we could improve upon? And I used a diagnostic model, national academies of medicine, and I interviewed women, and I did a large data set analysis. So, it's this big mix method study and it was messy at times, but I was able to learn how to write a proposal, how to get through IRB, how to really ensure the safety of the situation for the participants who are so kindly like volunteering. I learned how to code and to be able to analyze national level data sets. I'm not saying I'm an expert, but I, you know, I did get that experience. It was very humbling for those who do it all the time. And I defended my dissertation in 2019. Yay! But I wasn't going to be an academic. And cut me off if there's some if you want to jump in here at any time. I'm almost done though. So, 2019 I graduate. But I want to be operations right. I've been operations. I've been on the, you know, the, the supporting team and leadership for a long time. And I got an e-mail saying, hey, by the way, you know, the clinical nurse specialist program could use some faculty. I'm wondering if you're interested. And this is the same CNS program that I graduated from when I came up to do that forensic program that masters when we first moved here. And they needed somebody to serve as the track coordinator for that, and again, my little dander jumped up and said I can. Yeah, yeah, yeah, I wanna, I wanna help. I wanna help this this program that gave me so much and and be able to support it. So, I jumped over. And I came back across the street from the hospital and I started as an assistant professor here at the School of Nursing and leading the CNS program in January of 2020. And pause for effect. OK, January 2020. March we're told, well, actually, I mean, we knew things were going on in January, but March was when, oh my gosh, everybody out of the office. Don't come back. We're going to have to learn this Zoom thing and figure out how to do this and how to support our students and how to keep moving forward, even when and understandably many of the places for their clinical placements were closing to students and they were just saying, you know, we can't. We can't do it. So, we had to get creative outside the box. Thank god for Doctor Campbell and others like like her who are willing to be flexible and pivot and think on you know how how can we really do this in the best way possible that's safe? That doesn't end up where we are maybe using up supplies, right? That the team really needs like, OK, because we have students on and they all need face masks that those are fewer masks that we could have for the staff that really need them. So, all of those considerations. I get a call from the incident commander at the time for the health systems unified response to COVID and said would you be able and willing to come over and help us with some of the work that we're doing here. And I talked to the Dean here and she was, of course, very supportive. And so, I went over there and I helped and served as their operations chief. And and did did and then maybe three days a week. So, there was another operation chief, but you know we kind of shift who was doing what role and that was the responsibility was to communicate and help facilitate work at all of the hospitals within the Hopkins system as well as the services such as like lab and Pharmacy and all of those other other really, you know, critical roles and to try and get all of that together and then be responsible to the incident commander and be able to move information and personnel and all that kind of stuff. So that also allowed me the chance to work with some of the same people that I worked with back in the emergency department, but in different roles and to see the organization at a different level and to be able to do some really great work on how do we take these supplies and allocate them safely, equitably? And how do we get this stuff to, you know, to who needs it at the time that they need it and keep things moving as we were starting to get more and more and more COVID patients. So pretty stressful. But then that kind of tapered off, but then we got vaccine. So, then I got another e-mail. I shouldn't open my emails is what this says. I open the e-mail and it says hey, and this is from our Executive Vice Dean, who said we would really appreciate your leadership. We want to develop a vaccine volunteer program through the School of Nursing to be able to coordinate the efforts of all of the wonderful people here who want to help and volunteer but they're not quite sure how to do that. So, myself and a coordinator that was working with me we put all the infrastructure together and collaborated and coordinated with the leaders from Unified Command and the hospital and etcetera, etcetera, and all of these local areas and we were able to get vaccine out to the community, particularly senior housing areas and and get our students some really great experiences at the same time. And so now here I am, still sitting here. Now I'm back in the office. It's lovely. I have my view. I can see Bayview from here and. And continuing just to do the good work and I'm not, you know, you just never know what's coming down the Pike and what the next thing is, but I feel like sometimes as you look back on all of it, it starts to make sense how you got where you are. Those degrees, and particularly the PhD helped position me to be able to respond to the need and help in the most effective way, I guess and and it's OK to fail. Because it will just make you stronger. It is really an opportunity to humble us as well and to remember, you know, so when I have students, who're like, I can't do this. I'm like, oh, well, yeah, you can. Trust me. You can. And I can say that authentically because I too have been on the other side of that.

Brooklyn Arroyo

Definitely. And I think that your entire journey really does allude to the fact that, like what you're speaking on, that it's OK to acknowledge that it's not a linear path of just success and then accolades and you get this and this and this and it's very much, you know, gradual progression after failure and sometimes it's continuous failure. You fail and you fail and you fail. But I think like to mention like even in your journey you briefly bought brought up the different bumps in the road that you faced and then, oh, somebody must have noticed me. And so, I went back into nursing and I got this scholarship and this and this. And I think that it is important to mention that, you know, we need to acknowledge sometimes those things aren't accidents that we are impressive and we are getting the attention and you know, so congratulations to you and I think that you have an amazing story about just progress and perseverance. And something that is really interesting to me is the field of psychiatry and forensics as well. I I hope to specialize within that area completely and so.

Michelle Patch

Oh, that's wonderful.

Brooklyn Arroyo

Yeah, and so, I think that your journey both on a personal and professional level is is, is really powerful to me. And so, I think that I'd like to ask sort of what was it like for you? And I know that you had a lot of experiences that helped you prepare for this sort of high intensity and serious work and place of study and what was it like for you working with some of the the patients, the women that you were talking to and and how did you go about remembering that you had a family at home, but also working with such a serious subject area and such a serious work environment and and how did you go about balancing that?

Michelle Patch

Oh yeah, no, that is an absolutely wonderful question and complicated question I think. I I worry sometimes that we talk about work life balance or school life balance and I think that's a bit of a misnomer because I don't know that we're ever truly balanced, right? You know, we're usually, you know, leaning to one side or to the other side and and wanting people to know that that that is that's OK. That balance that we're trying to get to is sort of a trajectory of balance, not necessarily, not necessarily day-to-day and that you also have not failed if you're leaning with the other. So I can't say that I did it perfectly at all, but I will say I had a couple of things going for me. Number one, a pretty wicked sense of humor. If you haven't picked up on that already and I I really do believe that within certain, like contexts, right humor is an extremely powerful tool to help you get through really, really difficult situations and has to be used sparingly and you know, and just in in the right way. But that has brought me a lot of support of sorts and and and and just being able to laugh a little bit about things along the way. Working with patients who, I mean they they never wanted to be where they were that day, right? Nobody ever says I want to. Well, maybe someone I don't know, but not very few people are going to say I want to be in the ED today. I want to break my arm. Or I want to do XYZ and I want to go and see all those great people there who are you know, doing the good work. So, it was very, very again I use the word humbling. I mean, it really is to be trusted with people’s stories and people's experiences and and they it is not for the faint of heart. But I also had a really tight group of my family and friends. And friends who do similar work to me, who also can understand some of what I've you know what I've experienced because they've experienced similar things. And so, we're able to connect and and talk through and laugh and cry together and you know, get get through and and try the best that we can to to recognize and appreciate and respect what that is, but that we really have to keep moving forward if we're going to be continuing to be helpful in this world which you know, again, kind of cheesy, but it, but it it's true. You know, this is all we know that we have and we really need to be the best that we can to use our skills to use our gifts. As you said, the scholarships, the you know, somebody recognizing you, somebody lifting you up, well you owe that back. And pulling the next person up on your shoulders and the next one. And so, it's OK to to pause, to reflect, to think about things. But you can't stay there.

Brooklyn Arroyo

I think that you speak on something that is also really important specifically, in any field, but I feel like especially in healthcare of being able to have a diverse plethora of experiences, really that support you as an individual, and I think that that's what helps people understand that your patient is also an entirety of a person with a plethora of their own experiences. And I think that it's really important for for nursing, for psychiatry, for any realm of healthcare, really because, things can sometimes feel lack luster on the patient’s side, you know, sometimes there's experiences, oh, my doctor doesn't view me as a whole person. Brushed aside, this and that sort of thing. So, I do think that that's just a really important thing to highlight, of viewing people, respecting their individuality, but also, we all have a millions of experiences that make us who we are. So, I think that I found that your story is really inspiring and I would like to know sort of the grand finale of each one of our interviews is what inspires you right now?

Michelle Patch

What inspires me right now? So, last week I had the sad privilege to go to a remembrance funeral for one of our phenomenal faculty members, Doctor Benny Gaston Johansson and listening to the stories from her family, the stories from and Doctor Campbell spoke, and it was almost like a kind of like a final lesson of sorts, just sitting there and listening to the extraordinary life that she led, the extraordinary good that she did for this world. And the the amazing experiences that she had and how she used those to help these you know, her kids, her colleagues, her, you know, just international work. And I think that really has inspired me again to take stock of, you know, what is what’s your North Star. Remember, it's not about you. Dr. Campbell likes to say, you know, because I don't really like giving presentations. I got to be honest. But she says you just have to get out there because it's not about you. It's not about your story. It's about getting the information out there, getting the science out there and connecting with audiences right to help them to see what needs to be done and to then give them, you know, the support that they need to do it. So, I think Doctor Johansen's memory is inspiring me at this moment, along with just all of the fabulous people that I've come to know over the years and am excited to still meet and just even meeting you and chatting with you today, Brooklyn, has been so much fun and inspiring in itself.

Brooklyn Arroyo

Thank you. Thank you. I I think that building our networks, growing as people, that is probably the most inspiring thing that we can ever experience. So, thank you again and I had to have really appreciated being able to speak with you and and experience your insights. And I think the audience members will also appreciate that. So just the PHutures podcast applauds you and thank you for coming today.

Michelle Patch

Thank you again so much for the opportunity to chat today. It's been lovely.