National Nurses Week 2026 - The Power of Nurses™

In our May episode of the Beyond Nurse Residency Podcast, we celebrate National Nurses Week (May 6–12) and the impact nurses make all month long. This year is especially meaningful as the American Nurses Association marks its 130th anniversary, highlighting the theme, The Power of Nurses™.

Hear real stories from three nurses at different stages of their careers through the Iowa Online Nurse Residency Program. From building confidence in the first year to leading with resilience and reflecting on a decade of growth, these voices showcase the importance of support, teamwork, and lifelong learning.

Listen and celebrate the lasting impact of nurses on patients, communities, and each other.

GUESTS:

Noelle Fjeld, RN
Med/Surg Nurse, Spencer Hospital, Spencer, Iowa

Noelle Fjeld is a medical-surgical nurse at Spencer Hospital and a graduate of the Iowa Online Nurse Residency Program. She entered nursing as a second career after working as a travel agent and spending 15 years as a preschool teacher. Now 18 months into practice, Noelle is passionate about patient connection, teamwork, and continuous learning as she grows in her role.

Michelle Gelner, BSN, RN
Director of Cardiac Rehabilitation, Cass County Health, Atlantic, Iowa

Michelle Gelner is a registered nurse, military veteran, and graduate of the Iowa Online Nurse Residency Program with seven years of experience across clinical and leadership roles. She holds a degree in psychology from Luther College and served in the U.S. Army for eight years before entering nursing. Michelle began her career during the COVID-19 pandemic and has worked in OB, medical-surgical nursing, emergency care, and house supervision. She now serves as Director of Cardiac Rehabilitation at Cass County Health, where she focuses on resilience, communication, and patient advocacy.

Kasey Greteman, RN, BSN
Program Coordinator, QIDP

Kasey Greteman is a registered nurse, an Iowa Online Nurse Residency Program alum, and an experienced healthcare leader with more than a decade in nursing. Her background includes med/surg, emergency care, house supervision, and infection prevention. Kasey brings a strong focus on advocacy, evidence-based practice, and continuous improvement to her current role as program coordinator.

Supporting nurses is our priority. Visit https://nursing.uiowa.edu/ionrp  to explore our resources for new graduate nurses and beyond. 

Transcript

Noelle Learns Compassion Through Hospice

Host Nicole Weathers 0:01

Welcome to this special episode of the Beyond Nurse Residency Podcast, where we're celebrating Nurses Week. Nurses Week is one of my favorite times of the year because it gives us a chance to slow down a bit and really reflect on the impact nurses have. On patients, on teams, on organizations, and our communities. Today's episode is all about that. The real lived power of nursing and what happens when nurses are supported as they grow in their careers. You're going to hear from three nurses today whose paths look pretty different, but whose stories connect in really meaningful ways. I'm excited to share them with you. Let's jump in. First, you'll hear from Noelle. Noelle's story is a great reminder that nursing is a space to grow, ask questions, and to imagine what could be better. Her experience really highlights what can happen when nurses are given the time, support, and encouragement to step into their roles with confidence. Noelle is a second career nurse who decided during that pandemic to go back to school and become a nurse. She's currently 18 months into her career as a medical surgical nurse at Spencer Hospital in Spencer, Iowa, and is absolutely loving it. Let's start there and hear from Noelle. To begin with, I think I'd love to just get a sense of sort of your journey. So far, I know before we started recording, you said that you've been a nurse for a little over a year, about a year and a half. And so as you sort of think back to the first or the last 18 months, I guess, what's a moment from your first year that really kind of began to shape who you are as a nurse today?

Noelle Fjeld 1:45

When I think about that, I think about when I was following, when I had my preceptor next to me, one of the patients she gave me, one of my first patients was a hospice patient. Um, and I went into the room, I was nervous, and I it was obvious she was very fragile. And I took her vitals, I did a full assessment, and my preceptor was behind me the whole time. She could tell I was shaking. And she had said to me, you know, you know your skills, you got this, you're doing great. And I think that encouraging her to help me get through that. And then I had to reposition her. And there's no way I was going to do that by myself with the pain that she was in and the shape she was in. So I asked my preceptor to help me. She was great about helping me. And in that experience, I realized that nursing is really about teamwork and it's about more than just the skills, it's about human connection, connecting with that patient that you're working with. Um, it's about compassion. And I would say that would probably that's probably the moment that really stands out.

Host Nicole Weathers 2:54

And I think as a new nurse, you know, when you come in to that first year, most are very worried or nervous or focused about those hands-on clinical skills, right? Like doing the assessment and taking the vitals and some of those things. And so I think it's really interesting that moment that that sort of speaks to you is this part about that human connection and compassion uh and how that really does sort of influence the nurse that you have become, but also really sort of shaped probably that that first year and kind of how you look at that first year now moving forward.

Residency Community Builds Confidence

Noelle Fjeld 3:33

For sure.

Host Nicole Weathers 3:34

So each month we talk to experts about transition to practice and all the things related to new graduate nurses making that jump from academia into you know a clinical environment. But you were one that was living this each and every day. So when you think about your experience from this last 12 to 18 months, what's one thing that really worked well to support you in that journey?

Noelle Fjeld 4:03

Okay, I would say um nurse residency and communication. So, nurse residency, when I was looking for a job, I saw nurse residency at different facilities. And that very much sparked my interest because being a brand new nurse, I was looking for the support that I really felt like I needed. And that looked like the additional support, you know, that would really help me out. Meeting once a month was a great experience. You know, I got to meet with all the other new nurses. I would see the other new nurses, you know, on my shifts, but we're so busy. We're just passing by. And, you know, but this gave us time to sit down and really had great discussions about things that I realized I wasn't alone. I they had the same concerns that I had. Those discussions, it just helped build my confidence that yes, I got this. And there are other people who are also questioning these, some of these things. And it gave me resilience. I got to be tougher, you know, with myself, of course. And it was something that I looked forward to. The education was great. We have a great nurse educator who still comes and connects with me from time to time. So I would say the nurse residency was one. And then the other one was um communication at our facility is really superb. So our nurse nursing supervisors are great. They always let us know that the door is open. Just give them a call or a text. And I utilize them often and they've always been there for me. Our charge nurses are great. They're right down the hall from me. They're right on my phone, they're right there when I need them. And my pod partners and the other nurses on our shift, we have each other's back. So every time I start a shift, I know that I have the support that I need. And so I can enter a shift feeling good and not being nervous.

Host Nicole Weathers 5:59

I mean, nurse residency was a big piece of it, uh, you know, so we're glad to hear that. But this idea, too, of the communication and support, and and you kind of started talking about sort of that leadership communication and support in addition to the other members of your team. So maybe you could tell us a little bit more about that. So you said the door is kind of always open. You felt like they communicated really well. What else from kind of that leadership perspective was especially helpful through that first year?

Noelle Fjeld 6:30

One thing stands out in particular is we had a really busy, busy day, which many nurses can relate to. And I was on, we have a third floor and a second floor, and I was on the second floor with one other nurse, and she was very busy, and the CNAs were on the third floor, very busy. I called my nurse supervisor and I said, I need your help right now. And I don't think 30 seconds passed, she was right by my side. She got me exactly where I needed to be. And I'll always remember that. And I will always be thankful for that moment when, you know, everybody was just so busy and she came through for me. That's great.

Host Nicole Weathers 7:14

I mean, I think definitely feeling supported by communication, but also that, you know, physical presence. So actually showing up for you in that time of need. I mean, you talked about things that helped support you through that first year. Do you see opportunity about how we support nurses during that first year? Are there opportunities for us to support you and other new nurses even better?

Noelle Fjeld 7:41

I like I said, the nursing residency program was really wonderful for me. And the communication in our facility is great. So I I've seen other hospitals and they don't have the nurse residency. I would just like to, I'd like to hope that more hospitals um participate in that program.

Host Nicole Weathers 8:04

Yeah. Do you feel like nurse residency should be a standard for any new nurse following graduation?

Noelle Fjeld 8:11

Nurse residency or something similar, yes. Because it's just there's such a huge jump between being in school and getting your nursing degree and then putting it into practice. There's such there's such a big learning curve there that if you could get together with a nurse educator and other new nurses, which is what nurse residency is, that really helps a new nurse, you know, build her confidence, express her concerns, get the support she needs. So yeah, I I would very much hope that every hospital would eventually get nurse residency or something similar. Yes.

Host Nicole Weathers 8:54

That's great. So for our listeners who maybe aren't completely familiar with our residency program, as part of completion of the program, they do engage in what we call a professional experience, which can be a change project as one of the options. Um, this allows them to sort of put all of the competencies that they've learned throughout the program into practice to actually make a meaningful contribution, um, sort of at the unit or organization level. So maybe you could tell us a little bit about what you chose for your professional experience and how that really helped you in the first year of practice.

Noelle Fjeld 9:33

Well, the first year of practice, I noticed that my most stressful time was during the start of my shift and the end of my shift because so often I would get admits from different departments, and it would be a challenge juggling, um assessing my new patients, taking care of their needs, and getting this new admin in. I think it is still, we're just starting it right now. Um but having that half an hour, 40 minutes before and after you get report to really focus on your patients on hand and give them the care they need, I think is very important. Um, when you get those admits right at change shift, you know, the new admit isn't really getting the time that they require from you, and your other patients aren't really getting that time that's required for you. So giving the new nurse and her her patient load the time needed to get everything started make keeps every all the patients safer and gives them the care that they need.

Host Nicole Weathers 10:54

Yeah, no, I love that. I think that's and and it's so great, I think, for new nurses coming in to be given this opportunity because you do come in with a fresh set of eyes. You you see things differently. You're more likely to question, like, why do we do it this way, right? Whereas maybe those nurses who have been there for a long time have just kind of have in their head, like, it's just the way it is, right? And so having that opportunity to um be given the space to identify a challenge or identify an area for improvement, and then be sort of guided through, and what can we actually do about this? Um, I think is a great opportunity. It sounds like that was really impactful for you as well. So, how do you think that's sort of shaped your thinking about sort of the role of the nurse in your organization?

Noelle Fjeld 11:47

It it makes me realize that we do have a voice and we can make a difference. I've got resources that I can go to if I see something's not working, and we've got a very supportive staff, they're very willing to listen and help me come up with the right ideas. I I just think that you know, it made me realize that we can make a difference as a nurse. You can make a difference.

Host Nicole Weathers 12:13

And do you think coming into nursing, like as you were finishing up school, did you really see that role? Or were you more focused on maybe some of the other aspects of nursing?

Noelle Fjeld 12:27

You know, making a change like that was not something at all that I had in mind as nursing. I just really love helping people. And I just wanted to help people. I didn't realize that I could make a difference and make things better. I that was not on my radar at all. And that's kind of what nursing residency did. It made me realize that I could make the facility better.

Power Of Nursing Through Better Staffing

Host Nicole Weathers 12:49

Yeah. And I mean, I think that's really the goal, right? Is to expose you to um the very sort of foundational elements of like, how can I make things better for my patients, for my organization, for my fellow coworkers. Um, you know, I think sometimes when we talk to new nurses, um, you know, again, I'm I got into nursing to care for patients. Yes, absolutely. However, you will be the first one to recognize when things aren't working for the patient, right? Or when like this, this type of, you know, project that you talked about, I mean, it really does impact patient care at the end of the day. So, yes, it's a change to our workflow, but the outcomes of that change to workflow are not only going to help you as a nurse be less stressed and overwhelmed at the start of end of your shift, but also it's gonna make sure our patients get the best care possible from our nursing staff. Okay, so this is our nurses week episode. Um, and we want to celebrate the power of nursing, right? So the power of nursing is the theme to nurses week that's put out by the American Nurses Association each year. Just curious, where have you seen the power of nursing in action during this last year?

Noelle Fjeld 14:09

For me, I it was it was the change project that brought the power of nursing to my and to me. You know, we were not on, we just started acuity-based staffing. So before we did not have that. That was one of our change projects from our from our groups. Um, and it's going wonderfully. I can tell that my load is more balanced. You know, I don't have the um two Hoyer lifts or two CBIs. I don't have that, you know, it's it's much more of a manageable load. And that was from two nurses who decided that acuity-based staffing is something that our hospital needs and it has and has made it better. Yeah, I would say just the ability to make that change is where I see the power of nursing.

Host Nicole Weathers 15:00

I love that. And I think, you know, when we when we think too about sort of the residency program and the the first year and some of the things that we ask new nurses to do, it can seem pretty daunting, right? I mean, it can seem like a lot to be to tackle something like that in your first year. But I really do think when it's done well and an organization creates the space and the time for nurses to work on these types of things, that that really is the power of nursing, right? The power to make change, to make things better, to improve things for our patients. Yes. We also love hearing how residents apply what they learn in real clinical situations. So can you tell me about a moment when something you learned from the nurse residency program showed up in practice?

Noelle Fjeld 15:50

I would say the routines is what really I see on a regular basis at every shift I have, you know, the routine of doing a full assessment of vitals, um assessing the lung sounds, the digestive sounds, their cognitive function, their neurological function, looking at their baseline, um, looking where we want them to be, and then assessing, you know, like you said, I'm the first one to recognize when something is wrong, you know, and just using that as a foundation. And that was the routines. And I really think that one probably has stuck with me the most.

Host Nicole Weathers 16:34

So early on in the residency program, we talk about kind of two different topics, right? So developing those solid habits and routines, so getting organized for your shift, figuring out what your cadence for activities are based on whatever unit or specialty you're in. And then we also talk about that recognition of changing patient conditions. So when things aren't routine, what do we do and how do we respond? So to close out, I'd love to look ahead a bit and hear what's energizing you about the future. What are you looking forward to as you continue to grow as a nurse?

Noelle Fjeld 17:10

I would like to get my bachelor's degree. So right now I have my ADN. I'd like to get my BSN. And I don't know what I want to do, if I want to do anything else. Honestly, I I love being a med surge nurse. Um, I've seen other things around our facility. I've talked to other nurses from other facilities doing different things. And I just I feel like I'm using the skills that I've learned. I feel like I'm growing. I I've got a great um staff around me. I'm feeling good. So for right now, I'm gonna stay being a med surge nurse.

Host Nicole Weathers 17:47

Well, and that is very important. You know, I think sometimes we do a disservice in our nursing profession. Yes, we want to encourage lifelong learning and continuous growth and development, but you can also stay where you're at and still do that, right? So you can seek to get that bachelor's degree and still put all of those skills to really great use being a med surge nurse. And we need really good med surge nurses. So I think it's fabulous to hear that that's where you're happy and that is where you want to stay.

Noelle Fjeld 18:20

Thank you, Nicole.

Host Nicole Weathers 18:21

All right, Noelle. Well, this has been a great conversation. I really appreciate you taking the time to come and share. Um, so we're really excited to continue to work with Spencer Hospital and watch them uh develop their new graduate nurses, and I would love for you to stay in touch and keep us updated on where your nursing career goes. That'd be great, Nicole.

Noelle Fjeld 18:46

Thank you so much for having me.

Michelle Connects Resilience To Nursing

Host Nicole Weathers 18:50

Next up, you'll meet Michelle. Michelle is a five-year nursing veteran, and like many nurses, she entered the profession during a really intense time, right in the height of the pandemic. She's also a military veteran, and her background in service and leadership played a big role in how she found her way into nursing. Today, Michelle is the director of a cardiac rehab at Cass County Health in Atlantic, Iowa, a critical access hospital. Her story brings a really important perspective on what it looks like to take on new challenges early in your career. Let's dig in. All right, welcome, Michelle. Thanks so much for joining us here today. If I remember correctly, there was a portion of this program where you did a project. I kind of remember that project stemming from some of your military background. Would you mind talking a little bit about that?

Michelle 19:44

Um, so I did my project on resiliency. Um, it is a big component anywhere in life, but in the military, it's a big component because you are constantly adapting, you're constantly changing. Um, if you are off in combat, you have to be resilient in any type of situation, any scenario that is put in front of you. And sometimes it's challenging for people to be resilient, especially when they just keep getting knocked down or a hurdle keeps coming up or something's not going right. And which, you know, we saw that in COVID with people getting frustrated in the nursing field or leaving the nursing field. Um, and it wasn't just us, patients were getting frustrated, and everybody was frustrated. So it was kind of nice to see, you know, I learned about real resiliency in the military that, you know, it's the same application to the nursing field.

Host Nicole Weathers 20:38

So do you feel like it was a little bit of kind of the timing of you know your entry into nursing, kind of what you were seeing with our response to the the COVID pandemic that sort of led you to pick that as a topic for your residency project?

Michelle 20:55

I would say it it gave me the idea for it just because just some of the conversations you heard with um staff or you know, with people being frustrated, not being able to do what they normally did in the medical field, or listening to a patient being frustrated with what you know they used to be able to do when they went to the provider, or a woman that, you know, they used to be able to have all this support while they were going to have a baby. And now sometimes they weren't even allowed to have that spouse in there, or it just was that one person. So it just is nice, it was a nice way to take background from one area and combined it with a new field I was getting in that just being frustrated from being a new nurse and not knowing what I didn't know. Um, just, you know, you can always find the brighter side in something. You just have to sometimes look for it a little harder.

Host Nicole Weathers 21:48

All right. So since I've already got you thinking about that first year of nursing, um, you know, as you kind of look back at that transition from nursing school into the first year of practice, Is there a moment from that time that you feel really shaped the nurse you've become today?

Michelle 22:06

I am one that is always wanting to learn. I love, even if I think I know something, there is some way that I can always improve or enhance either for myself or a patient or a fellow coworker. I still feel like a new nurse sometimes.

Asking Questions And Owning Errors

Host Nicole Weathers 22:23

Well, I think you need to give yourself a little bit more credit than that. Um, but I think what you're saying, and maybe correct me if I'm wrong, but you know, every time, I mean, I think a lot of times we look at this first year of nursing and it's like, okay, once we just get through this, then we'll be good to go. But what we learn a lot of times is that every time we make sort of a transition into a new role or a transition, you know, into a different specialty, that some of those feelings we had as a new nurse come right back, right? Or we kind of have to go through that experience again. Um, so maybe tell us a little bit about your career, because I don't even think we got into this and into the introduction, but tell us a little bit about your career trajectory. So where did you start? What have you done and where are you now?

Michelle 23:12

So I started out, I was hired for OB, but we don't have a single unit for OB. So you started out in MedSearch. And when I first started, they would require you to get basically oriented to MedSearch, and then you would go do your OB, which initially I was, I'll be honest, I was upset about. Um, I didn't think that's what I how I wanted to progress, but honestly, it was the best thing that could have happened because you learn, I mean, you can read a book and you can see, you know, what it's supposed to be, but until you actually see it in person and do it, you get to learn the basics and what is good for a patient and what's not. Um, so then I went into OB. And then after that, I helped in a house supervisor role, um, filling in part-time, and then I went to the ER, and then I switched to now a leadership side in and I'm in cardiac and pulmonary rehab. Excellent.

Host Nicole Weathers 24:07

And so when you look back now at that sort of career trajectory, what what are some of those things that sort of got you through that first year that you're still using today?

Michelle 24:20

I will, regardless, and I always will start this phrase out, regardless of who I'm talking to, I will always apologize. You know, I got a dumb question for you, but I'm still gonna ask you. And most times you get everyone's like, oh, there's no dumb questions, but sometimes you're thinking, okay, this is a dumb question. But um, just always willing to ask if you don't know, not, you know, assuming, never assume I did learn that the hard way when I first started down in the ER, I assumed, and it just created a med error that I had to own up to. And I mean, it was stupid, but I learned from it. And I never make that mistake again. But just always be willing to ask the questions, you know, if you think you're doing something one way, is there a way I could do it better? Is someone doing it better than me? Can I apply it to myself to help better my skills, better that experience for a patient? And just always go back to being resilient.

Host Nicole Weathers 25:17

Well, I mean, you talked about the fact that you're, you know, a continuous learner. You've been through a lot of transitions with this, with kind of where your career has gone so far. And you learned in the in in your early years, you know, the importance of always, you know, asking questions and not assuming. So I think that's really good. So we talk each month with experts about transition to practice of new graduate nurses. And while it's, you know, been about five years or so since you lived it, um, you have a little bit different perspective now that we've got a little distance between now and then. So when you look back at that first year of nursing, what's one thing that you feel like worked really well in supporting you as a new nurse?

Michelle 26:06

What was helpful? Asking questions and being willing to go and look it up, not just ask the question, but going to look for it or try to solve my own solution or solve my own problem. And then if I couldn't figure it out, then go ask. But honestly, just yeah, asking the questions, even if I know the answer, asking anything that could be related to, you know, the patient or whatever situation you're put in.

Host Nicole Weathers 26:35

So do you think having those mentors or somebody to go to was, you know, a key piece of of that support during the first year that helped you with that ability to always feel comfortable asking those questions?

Michelle 26:49

Yes, it was. I so when I started out, um, I was assigned to one person during the day, and then I had one person at night. And you could tell that they liked what they were doing. Um, they both had their own different personalities, but they enjoyed teaching, they would challenge you, they would, you know, give you feedback if you need it, they would correct you if you needed it, and but still supportive.

Host Nicole Weathers 27:15

So definitely I think having those supportive people, those people that you can go to that you feel comfortable, maybe you've got that you've developed that relationship, whether they were assigned to you or not, having somebody that you work with that you can go to, I think is a really important piece of providing good support for new graduate nurses during that first year. So on the flip side then, what's something you wish would have been in place or you know, maybe it would have supported you a little bit better.

When Pandemic Work Feels Isolating

Michelle 27:50

Well, like you said, I was starting out kind of in the COVID era or a couple years of it. I think just with every being everyone being so focused that this was, you know, a new challenge we were facing in nursing, you know, we weren't necessarily prepared for it or what we thought we were doing for it, you know, it wasn't necessarily working. I had my two people I could go to, but once you were done with orientation, I felt like I didn't necessarily have the people to go to, if that makes sense, because you know, we had this pandemic everybody was focusing on, and there was a lot of isolation and not a lot of people were. I mean, you were a new nurse, but you know, you were expected, you know, to catch on. We're in a pandemic, we need all hands on deck. Um, and that especially when you're starting at nighttime, sometimes you just don't have those resources and you're like, well, we're gonna learn, or we got to get through the night somehow. So we're gonna learn. But I think it just kind of felt more of an isolation.

Host Nicole Weathers 28:49

Well, and I think that, you know, as you said, during the pandemic, that is what people were focused on. And they they maybe lost sight a little bit about you as an individual and the fact that not only was this pandemic new for you, just like it was new for them, everything in nursing was new for you. Um, and so I can definitely see we're having some of that ongoing support or those ongoing check-ins, you know, throughout the first year from a mentor or leader of some sort could have been very helpful. I know that's one thing that we talk a lot about with um the organizations that we work with in this residency program is yes, what we're doing, what we are doing online with these individuals are important. The topics that we're talking about with them are important. But what's even more important is that somebody at your organization is continuing to check in with these individuals and helping them put all the puzzle pieces together of what we're talking about and how this fits in their specific organization.

Michelle 29:51

Especially like if they ever come across like their first first code, first death, first anything, it I don't think they I mean, just from my experience, if it doesn't affect you as you thought it would. And if you don't have anyone to go, you know, if no one comes up to you or you don't feel like you have that person, you know, to go debrief with or, you know, just blurt everything out that you're thinking about and that you feel safe, you know, blurting everything out to, I think it can either make or break you. And I we've had I saw one, honestly, I think she just didn't have the support and she left. I mean, she's still in nursing, but she unfortunately left our hospital. I think that could make a big difference for especially neural nurses. Yeah, you're not alone. You know, we've been there before. You know, let's try this.

Host Nicole Weathers 30:40

So, since this is our nurses week episode, we want to celebrate The Power of Nurses™. So that is the theme that the American Nurses Association put out there for um nurses week is sort of celebrating The Power of Nurses™. So I'm curious, where have you seen the power of nursing in action? Either early in your career or maybe even more recently?

Michelle 31:04

I would say advocating for your patient. It is the greatest feeling if you talk to a patient and they are just feeling stuck or unheard, or, you know, they're alone if they're facing a challenging thing. Um, even if it's just sitting there and talking to someone for 10 minutes, or, you know, helping them get a gas card because, you know, they have limited funds and they need to get to an appointment, or setting them up for, you know, most hospitals probably have ride shares or something like that. But just taking that five to 10 minutes to sit with that patient, sit with your patient and get to know one thing about them or help them in something can make a big change in their day. And it may be small or it may be big, but just seeing how it can truly affect their life on the other side is probably like the biggest thing that I love seeing.

Host Nicole Weathers 31:58

I think not only does it make a big difference for the patient, but I think it really impacts the nurse that takes those extra minutes, who takes that time to really, like you said, sit down, learn something about the patient, and find a solution for how you can help.

Michelle 32:16

Even if you're never going to see them again, that extra connection that it'll leave a mark either on you or who you come across.

Host Nicole Weathers 32:24

So we always love hearing about how residency learning shows up in real practice. And I know it's been a bit since you've been in the program, but can you think about or share a moment when something you learned in the nurse residency program continued to influence how you think or practice, or now in this sort of leadership role, how you lead?

Michelle 32:47

Well, I think, I mean, the biggest thing, I mean, and it was in nursing school, but in even in Red Sea, like being able to communicate and be effective at what you're communicating, because if there is any chance of miscommunication or you're not willing to change how you're communicating, it it's not only it can potentially hurt you, but it can also potentially hurt a nurse. And it just can create a toxic work environment, and nobody wants that.

Host Nicole Weathers 33:18

So, I mean, in the program we talk a lot about communication. That's a big kind of focus early on, anyway. Um, whether we're talking about, you know, shift handoff, calling physicians, sort of that conflict resolution um piece of it as well, you know, delegating, um, all of those things re uh really require good solid communication skills. And I think communication is something that, you know, regardless of how long we've been doing this or, you know, where we're working, it's a continuous work in progress, right? Um, every situation is going to be a little bit different. Every, you know, person you interact with is going to, you know, have their own story and react and interact and in unique ways. And I think that is, you know, a challenging thing. Um, regardless of where your nursing career goes, I think it's always something that we can continue to work on. But a lot of the basic things that maybe we learn about in nursing school or talk about in residency uh continue to show up uh in your in your career, in your professional work life uh for years to come.

Michelle 34:36

I agree with you 100%. And you can always find something in your communication that you can work on. Mine is delegating. I'm probably the worst delegator because I just want to get it done. And it is something I'm continuously working on and trying to improve and getting better at slowly.

Host Nicole Weathers 34:52

So we talked a little bit already about your um residency project, what we called the professional experience. And I know that, you know, a lot of our projects during the time of COVID weren't able to fully get implemented because obviously there were much bigger things sort of going on. Um, but you nonetheless, you learned the process of, you know, making an improvement at your organization. You walked through the steps. Is that something that has continued to show up in your career over the last five years? Um, or, you know, what does that look like for you right now?

Michelle 35:30

Um I would say it definitely has applied um when I came to a new department. They had always been doing stuff just because that was the way it had been done. And we recently just went to a conference and found ways that we can change and improve our process to make it one, eliminate steps because they're redundant, but um just make the process a little smoother and cleaner. And so it's, I would say it's happening more and more every day.

Host Nicole Weathers 35:58

So getting a little bit of exposure to it maybe in residency, while at the time, usually most of the residents that I talk to are like, I don't know why we have to do this, right? This is just one more thing. But it's good to know that you have seen this show up as your career has um progressed. And hopefully you're a little less timid maybe about engaging in that kind of work because you have the opportunity to see it once before.

Michelle 36:24

I feel it, it it does. And I was one of those students like, why are we doing this? Like, what am I gonna do for me? Um, but it does if you can look back on things you learned um and apply them, you know, even if you can if you still have your tools that you can go back to, it might help you through a process change or implementing something new that you have that tool there if you need, you know, idea or help on how to do that, or what step am I missing?

Host Nicole Weathers 36:50

All right. So to close, I always like to look ahead. What's energizing you right now about your nursing career? What is something maybe you're looking forward to as you continue to grow?

Michelle 37:00

To continue to learn and improve things in my department, still looking at potentially going back to school again because I like learning. Um but just, you know, also being able to, we started a nurse uh like a nursing program here at the hospital, but being able to help the newer nurses come in because I mean, we need to keep improving and being able to replace our older generation that is retiring and build the workforce and build strong nurses.

Host Nicole Weathers 37:32

Well, Michelle, it's been so great to catch up with you today and hear more about where your career has gone, reflect with you back on that tumultuous time of entering uh the nursing profession at the time of the pandemic. And I'm excited to see how you continue to grow uh and where your career takes you into the future. Well, thank you.

Michelle 37:56

It was my privilege to be here with you.

Casey Gains Confidence From Recognition

Host Nicole Weathers 38:01

Our final guest today is Kasey. Kasey was part of one of our very early cohorts of the Iowa Online Nurse Residency Program back in 2015. And she is now 10 years into her nursing career. Her journey really shows what can happen over time when nurses are supported early and encouraged to grow. Since completing the program, Kasey has built an incredibly diverse career. She's worked as a medical surgical nurse in the emergency department, as a house supervisor in infection prevention. And along the way, she's developed a lot of great experience in hospital operations, regulatory, and leadership. Kasey's story brings a longer view what nursing growth can really look like over a decade and how our leadership skills evolve and how we can continue to shape systems beyond our first year. So let's hear from Kasey. So I'm gonna make you stretch here a little bit, and I want you to think back to your journey into nursing and looking at your sort of transition from school into that first year. And I want you to think about maybe a moment that stands out for you that really shaped sort of the nurse that you've become today.

Kasey Greteman 39:18

I would say my biggest moment that shaped me was right around the time that we're we finished our residency program. I was actually nominated for a Daisy Award and received the Daisy Award. Um so I was still a I was still a baby nurse. I was still learning it all. I hadn't gotten a lot of ER experience yet. I was still just working on med surge and it was, I just wanted to get through my shift. I was constantly still questioning myself. I wanted to make sure I was charting right, getting everything done right, make sure that it was enough, you know, like was I enough? Was I doing enough? And then I went to the ceremony and they read the nomination letter, and it just kind of was like the story behind it. The reason that I was nominated, it gave me a lot more confidence because it made me realize that I actually was making a difference and I actually was doing everything that I should be doing to take care of these patients. So I think that's probably like I said, it was right at the time we were finishing the residency program. So I still had all the knowledge right there in the front of my brain, and I was just utilizing everything that I had learned in the program, and I won the award that year. So, and the I think the part that stands out the most to me is the person who nominated me was for taking care of her father, but she was a nurse who had been a nurse for 20 plus years at the facility I was working at. So for her to acknowledge the baby nurse doing a good job was a big deal for me.

Host Nicole Weathers 40:53

That is such a great story, and I think such an important reminder, too, of how this idea of recognition and reward, if you will, how much that really does impact a nurse, whether they're new or not, and things like their competence, things like reminding them why they got into this work in the first place, and really probably that desire to continue to really move forward and move that career forward.

Kasey Greteman 41:22

It wasn't not only just recognition from a family, but it was recognition from a colleague that helped a lot too. But you don't know who nominates you. I figured out because of the story. So I think that was kind of the cool piece for me is just to know who it was.

Host Nicole Weathers 41:37

Like you said, you know, what a great way to be recognized by, you know, a nurse who's been doing this for a really, really long time. Um, and then you being just brand new, finishing up your first year. I know that when you get into nursing as a new nurse, you look at all these nurses that have been doing this forever and you think, wow, like how do they know everything that they know? Or how did they get so good at the things that they've gotten good at? Um, and so I think that just makes that story really special.

Kasey Greteman 42:08

I think it was even better because my boss knew I was winning it and she made my parents show up and I had no idea they were coming. And it was just a good experience. It kind of really solidified the fact that this was the right path and the right career for me. All right.

Host Nicole Weathers 42:22

So, you know, we talk each month on this podcast with experts about transition to practice, but you've lived it and now you've got even some distance between when you were a new nurse and now. And so looking back, what's one thing that you feel like works really well in supporting you? And then on the flip side, is there anything you wish maybe would have been in place or, you know, might support nurses even better now?

Coworkers And Mental Health Support

Kasey Greteman 42:49

I'm going to say the number one thing that I think helped me the most in the start of my career was my coworkers. We had quite a bit of us that were brand new baby nurses. None of us still work for the same facility, but we still get together several times a year. Those people are the people you lead on. Those are the people who understand what you're going through. Those are the ones who are in the trenches with you. They're the ones who are up at four o'clock in the morning just trying to get us through a shift with you. Um, they're the ones who understand when you have a really hard night that you might just need to walk away for five minutes. They are your team. They are your rocks. I think a lot of baby nurses go into it thinking that they need to be able to do all this on their own and they need to, you know, not ask for help. But I think truthfully that group of girls that I worked for years and years with, we got each other through hell and back. So I think that's one of the things that that's that's what helped me the most. And I think that is often overlooked. Your coworkers are your lifeline sometimes.

Host Nicole Weathers 44:04

We talk a lot about sort of, you know, the support and the relationships that we have with other people. Like there's a lot we can do in terms of getting you education and building your confidency and your confidence. But those relationships that you have, I think even early on, more than even later on, are so important for getting you to want to show up to work every day, right? Wanting to maybe um, I think, engage in your organization to do a little bit more. I mean, having a friend at work that you can confide in or go to when you've had a tough day, like nothing can can replicate that, nothing can sort of fill that void, in my opinion, anyway. What do you think?

Kasey Greteman 44:53

I think it makes all the difference in the world knowing you have people there that have your back and that will help you. Um, going into it thinking you're a one-man show is gonna make nursing hard for you. I really believe it.

Host Nicole Weathers 45:08

So, is there anything you wish maybe would have been in place or sort of looking now, if you work with new nurses, things that you think might help support nurses as they make that transition?

Kasey Greteman 45:20

I think COVID really, really changed a lot of mental thoughts towards nursing. I think we need to um have better and more structured support around the emotional and the mental side of nursing, around the burnout. I think we've done good with improvements. Um, do I think that we're where we need to be? No. I think having more of a structured, supportive role, having a mentor for a longer period of time, I just truthfully, I think that that emotional and mental aspect is what I wish existed a little bit more in nursing.

Host Nicole Weathers 45:59

And it's interesting that you bring that up because as I was kind of, you know, thinking about having you come on as a guest and sort of some of the things that have changed in our program since you were in it 10 years ago. Um, you know, this is one of the things too that we recognized around that COVID time, actually, and even kind of starting a little bit before, was that, you know, yes, like the competencies, how to do our job, all of that, super important, right? But then as you said, it's all the other stuff too. Like how do we cope with and deal with sometimes the realities of nursing? And there are a lot of intrapersonal skills that we don't learn about. Nobody intentionally teaches us those things, right?

Kasey Greteman 46:45

It's just nobody teaches you what it feels like to be in the emergency room with a car accident in a family, and three of the four of them don't make it. Nobody teaches you how to deal with loss like that. Nobody, I mean, yeah, you're supposed to do your, you know, after action reports. It doesn't leave you because you leave work at the end of your shift. Like you're still gonna carry that with you. Like 10 years in, I've got stuff that I'm still carrying with me that I I can't believe that I have seen and I have done in the medical field, all in general, not just nursing, providers. I mean, housekeeping cleans up some of this stuff. Like it's everyone that there is a huge emotional and mental toll on humans in the medical field.

Advocacy Skills Mature With Trust

Host Nicole Weathers 47:36

Well, I think one of the things too that probably goes unrecognized, um, especially as you're talking about working in a small hospital, working in a critical access facility, is a lot of times you know these people too, right? Like maybe you have that personal awareness of them, personal relationship with them, and they're the ones that are being brought into your ER. And that's a whole different level. You know, that, like I said, that was one of the things, or that was one of the things that we recognized that we needed to add into this program. So now just the FYI for you every month. Okay, so since this is our nurses week episode, we want to celebrate The Power of Nurses™. Where have you seen the power of nursing in action, either early in your career or even more recently?

Kasey Greteman 48:45

I think throughout my entire career, the biggest power of nursing that I've ever seen is the advocacy. If you have a good relationship with providers, if you have a good relationship with the families, if you have a good relationship with the patients, the clients, the residents, whatever area you're working in, and you know that something is not right, and you can advocate for that patient, and you get that provider to be like, oh yeah, you know, you you probably you might be on to something here. Like it's even in the ER, like a lot of the docs are pretty cool with, you know, hey, I think it might be this, or what do you think? And I just think advocating is one of the biggest power moves that nurses have. The best we can do for our patients, no matter the case, whether it's they need to transition to hospice or they are looking septic after an operation or they need some physical therapy or thickened liquids, whatever. Advocating for that patient, I think, is a huge flex for nurses, is that advocacy part.

Host Nicole Weathers 49:53

How do you think your view of advocacy as a nurse has maybe evolved throughout your career? If you think back to when you were brand new.

Kasey Greteman 50:02

Baby nurse was very cautious about how I would bring up things. Um, seasoned experienced nurse is a little bit more, I'm seeing this. This is what I'm seeing, this is what I think. You know, can we do this? Can we get that? I'll ask more specific. Baby nurse didn't really want to speak up because baby nurse was afraid of getting yelled at or told she didn't know what she was doing.

Host Nicole Weathers 50:26

So I I remember, I mean, and and maybe it was your group, maybe it was another group, but I do remember, you know, one of the topics that we talk about every time in this residency program is around, you know, clear communication with providers. We talk a lot about SBAR and we talk about that recommendation piece, right? And that's really what I think the very initial steps of advocacy really are around that recommendation piece. I know every new nurse that I've ever talked to is like, well, I'm not gonna tell them what I think, right? Or I'm not gonna tell them what I think they need to do, or I'm not gonna ask for a specific order. Do you remember some of that as a new nurse?

Kasey Greteman 51:07

Oh, yeah, absolutely. Because you could be like, hey, um, their respirs are like 40 and they sound really rattly, but you would not ask for a breathing treatment. But then, you know, seasoned nurse is like, they've got something going on with their lungs. Can I get a duo neb and boom, you know? And I think a lot of it has to do with the provider relationships that you have too. Like once a provider gets to know a nurse and can trust a nurse, I think they're a little more like, yeah, they do know what they're doing, they do understand it. They're not asking for the moon, they're not asking for MRIs and CTs and narcotics or whatever it might be, but she's seen their struggling breathing. Let's get them that breathing treatment. Communicating with them, but the relationships you have with them is huge. I still, from baby nurse, I had a couple of the same doctors, five, it was the same two doctors that split five days out of the week. And they got to the point where they, you know, they trusted us and they believed that we were seeing what we were seeing. And I think that's a huge part of nursing too. And advocacy is the trust.

Host Nicole Weathers 52:12

Yes. And I think for you know, new nurses, um, or for those who work with new nurses, just reminding them too that that takes time, you know. It does.

Kasey Greteman 52:22

It's not an overnight thing, like it takes months. Some doctors, it takes years, and sometimes you have to learn the approach. Sometimes you got to make them think it's their idea, it's not yours.

Evidence Based Tools That Improve Safety

Host Nicole Weathers 52:34

So we love hearing about how residency learnings sort of show up in real practice. And I know that it's been, you know, 10 years since you were in the program, but you know, can you share any moments maybe when you something you've learned in that first year or in the residency program continued to sort of influence how you think, practice, or even now in your in your role sort of lead?

Kasey Greteman 53:01

I think one of the biggest things that still, I mean, even from your ADN classes um and the residency program, use evidence-based practice. Don't just Google and find a random site. Use the evidence-based practice, see the big picture. Don't circle in, don't look for the zebra, you know, but just see the big picture and use the evidence-based practice to see what this is.

Host Nicole Weathers 53:30

We continue to have what we now have termed sort of our professional experience, but is what we called the residency project when you were in the program. Do you remember what your project kind of focused on or what you worked on for that?

Kasey Greteman 53:45

So we were a really teeny tiny critical access hospital, and you have certain medications that are a high-risk med that you hardly ever use. So, our residency project, we me and one of the other residents, Becca, put together a binder of all the quote unquote high-risk meds. Um, the correct, you know, how to pull them, how to give them, how to waste them, you know, potential side effects because it's a lot easier in the moment to pull that binder with stuff. And of course, we only did the ones that we we stock that we don't use. I couldn't even tell you what they were off the top of my head anymore. But I think there was a good 30 or 40 meds in the binder that we had a step-by-step sheet that this is how you draw it up, this is how and where you administer it, this is how long you take to administer it. So I think it was more of a quality project than a practice project. But yeah, that was that was my residency project a long time ago.

Host Nicole Weathers 54:46

And as you were describing it, I'm like, I remember that the second you said the high alert meds. I was like, oh, I do. I remember working on that with you. Um, and yeah, so was that something that you know continued to exist beyond the residency program? For all I know, it's still there. It was still there when I left. And um, so when you think about kind of your experience with, I mean, it's the first year of nursing. We're asking you to do this project. Walk me through a little bit what you were thinking then versus maybe how you feel about it now.

Kasey Greteman 55:22

Oh, Nicole, you were evil for making us do work on top of work. But yeah, I just I feel like we were all just kind of like, this is stupid. This isn't, you know, why are we doing this? But as we got into it and as we were doing it, I think it clicked to us that this is really beneficial to not only us as new nurses, but even this nurse that's been here for 10 years has never once given this medication. I mean, I think you gotta look at the big, like I said, you look at the big picture, you find the evidence-based practice and you look at the big picture because that's what's gonna. I mean, did it suck to do all the extra work? Yeah, but yeah, I feel like it was totally worth it in the end.

Host Nicole Weathers 56:04

And did you like, as you continued your career, did you use any of those skills ever again?

Kasey Greteman 56:10

Yeah, like especially as an infection control nurse, la creating all the policies, procedures, teaching. I mean, you know, there's been a lot of funky things coming out over the last few years. I've had to educate staff on monkeypox and the new world screw worm and measles is coming back, so it's one of those things that you just you gotta figure it's things that you don't see that are now here, and you gotta educate staff and patience and know who to call and what to do. So lots of cheat sheets for that kind of stuff was made.

Host Nicole Weathers 56:47

Yeah. So I mean, even though, you know, as a new nurse, sometimes we don't always see, you know, why are they asking us to engage in this type of work as a new nurse? Um, it sounds like these are skills that you've been able to take with you.

Kasey Greteman 57:01

10 years out, I don't think that there's anything from the program that I haven't used somehow in my practice. As much as you don't want to do it because you're like, I just got done with school and here I am doing school again. It is a hundred percent worth it to do that program. I think it gives you more confidence. It makes you feel like you know a little bit more, that you understand a little bit more. I think the residency was worth it for all of us.

Lifelong Learning And Nurses Week Farewell

Host Nicole Weathers 57:29

Well, that is so great to hear you say that, you know. I mean, just like you kind of alluded to at the beginning of this conversation, you know, it's always good to have reinforcement or recognition that what you're doing is actually making a difference. So I appreciate you sharing that today with me and for the rest of our listeners. So to close, I would like to kind of look ahead a little bit. So I'm curious, what's energizing you right now about your nursing career? And what are you looking forward to as you continue to grow?

Kasey Greteman 58:03

Um, I am loving my current environment. I think I was really nervous about coming over to a facility with all the, you know, the adults with the intellectual and physical disabilities, but you just love them and you just want to help them and you just want to see them living their best life. So I think knowing that I can utilize my nursing role in other ways other than just the bedside. I'm just excited to keep growing in this role, um, work towards some leadership, combine my clinical knowledge with my leadership, my advocacy. Uh yeah. I just want to continue finding ways to improve it. I think nursing is a wonderful career and a great path, but it's also a continuous learning. You are never done. You will never know it all. You will never be fully educated. Just continue to grow and learn and advance, is what I want to do.

Host Nicole Weathers 59:03

Well, I don't think I could have said it better myself. I think, Kasey, this sounds like a perfect fit for you, a perfect role. Um, as you said, it's bringing your clinical background, your leadership background, and you know, this important topic of advocacy that you find so powerful in our nursing profession. And it's wrapping it all up into a nice little bow. And it does, it really does. And giving it to you as a career path. So that's just really exciting um to hear. And I look forward to continuing to watch you grow and develop and see where your nursing career continues to take you. So appreciate you sharing your story with our listeners. Thank you. I'm so happy to get the invite to do this. Happy to do it. I hope you enjoyed hearing from Noelle, Michelle, and Kasey as much as I did. Together, their stories really show the power of supporting nurses early in their career. Thank you for spending part of your Nurses Week with us on this very special spotlight episode of the Beyond Nurse Residency podcast. As we celebrate Nurses Week, I hope you'll take a moment to recognize a nurse who's made a difference for you and reflect on how you make a difference every single day. Thanks for listening.