Nurse Essentials: A podcast focused on caring for you
Nurse Essentials: A podcast focused on caring for you
Diversity, Equity and Inclusion in Healthcare and Nursing
In the most recent episode of Nursing Essentials, Myra King, DNP, APRN-CNS, ACNS-BC, CCRN-CSC, delves into the importance of the DEI movement. “As long as we have healthcare disparities – as long as we are struggling to move the needle at it relates to healthcare disparities – then we have to keep having these conversations,” says King, APRN manager and a clinical nurse specialist in the Heart, Vascular and Thoracic Institute at Cleveland Clinic.
Myra King (00:05):
We hear the terms diversity, equity, inclusion, and increasingly, belonging, throughout our conversations and our travels. But do we really understand what those terms mean and how important they are to the nursing care we provide? I'm joined today by my friend and colleague, Dr. Myra King. Dr. King is a clinical nurse specialist. Her practice specialty is intensive care in our Heart, Vascular, and Thoracic Institute, and she serves as a manager of our clinical nurse specialist team. She has some wonderful insights on how we can move from concept to practice.
(00:40):
Hi, and welcome to Nurse Essentials, a Cleveland Clinic podcast where we discuss all things nursing from patient care to advancing your career to navigating tough, on-the-job issues. We're so glad you're here. I'm your host, Carol Pehotsky, Associate Chief Nursing Officer of Surgical Services Nursing.
(01:01):
Welcome back everyone. Today's topic is diversity, equity, inclusion, and belonging. You know, often I refer to myself as an older nurse, or perhaps (laughs) somebody who's, who's been in this profession a minute or two. And even looking back on the topics we talked about in nursing school, or even my, my entree into the profession, there's a lot of conversation in our classes and in the education modules, we had to take around cultural competence, but that's really as deep as it got.
(01:32):
And what a wonderful thing it is that 20 years later, we're getting deeper and we're really talking as a profession as well as nurses delivering care to patients, well beyond cultural competence to really talk about how do we look like the patients we serve and give the patients and the caregivers we serve a voice. So, with that, it's my great pleasure to welcome my friend and colleague, Dr. Myra King today. Dr. King, Myra, if I may-
Carol Pehotsky (01:58):
Absolutely. (laughs)
Myra King (01:59):
(laughs) ... is a practicing clinical nurse specialist here at Cleveland Clinic in the ICUs and the Heart, Thoracic and Vascular Institute, as well as, uh, a manager of our clinical nurse specialist team. Myra, welcome.
Carol Pehotsky (02:09):
Thank you for having me. I'm so excited. I'm, I'm delighted to be here.
Myra King (02:12):
Excellent. You know, we go way back.
Carol Pehotsky (02:14):
Yes, we do.
Myra King (02:14):
I would like to say.
Carol Pehotsky (02:15):
Yes.
Myra King (02:15):
And it's been such a pleasure. I have learned from you throughout our, our friendship and our, and our colleague experience together. And so, I'm so excited that our audience gets to learn from you as well. You have a fantastic story about how you got into nursing and your nursing journey. So, I hope you'll start us off with a few tastes of your journey so far. And what makes you excited to be a nurse still?
Carol Pehotsky (02:36):
Absolutely. You know, I was reflecting on that question. I was thinking about kind of where I started in nursing.
Myra King (02:37):
Mm-hmm.
Carol Pehotsky (02:41):
And it really goes back to when I was in high school.
Myra King (02:43):
(laughs)
Carol Pehotsky (02:44):
And I decided to get some community volunteer hours as a high schooler, and-
Myra King (02:44):
All right.
Carol Pehotsky (02:49):
... I became, I don't know if you remember, Candy Stripers.
Myra King (02:49):
Oh, yeah. (laughs)
Carol Pehotsky (02:49):
(laughs) Which that's what we used to be called.
Myra King (02:49):
Yep.
Carol Pehotsky (02:51):
Candy Stripers, which were volunteers in the hospital environment. So, we would go into patients’ rooms, and we would help deliver trays and we would deliver ma- newspapers and I loved that. I loved the ability to serve patients. I loved the-
Myra King (02:51):
Sure.
Carol Pehotsky (03:07):
... ability to feel like I was helping them and that I was building a relationship with them. And that was my first exposure-
Myra King (03:13):
Yeah.
Carol Pehotsky (03:13):
... to the hospital environment. I began to look at nurses and look at what they-
Myra King (03:18):
Mm-hmm.
Carol Pehotsky (03:18):
... did to help to build relationships with patients. And I was like, "I think that's what I want to do."
Myra King (03:19):
All right.
Carol Pehotsky (03:24):
So, I would say that I didn't find nursing, but that nursing found me.
Myra King (03:24):
Okay.
Carol Pehotsky (03:28):
And so, I started off in the cardiovascular intensive care unit here at Cleveland Clinic, and I think-
Myra King (03:34):
Oh, that was your first role?
Carol Pehotsky (03:35):
That was my first role.
Myra King (03:35):
Oh, okay. Wow.
Carol Pehotsky (03:37):
Yeah. I was a new graduate.
Myra King (03:37):
Yeah.
Carol Pehotsky (03:38):
That was 26 years ago.
Myra King (03:39):
(laughs)
Carol Pehotsky (03:39):
Oh, my goodness. I can't believe how, how quickly that time has gone.
Myra King (03:43):
Sure.
Carol Pehotsky (03:43):
Um, and I fell in love with the patient population and decided to, up until now, really devote my career-
Myra King (03:43):
Yeah.
Carol Pehotsky (03:49):
... to that patient population. It was about seven years into my career when I started to realize this love that I have for supporting our nurses, being a preceptor at the bedside...
Myra King (04:02):
Mm-hmm. Sure.
Carol Pehotsky (04:02):
... educating them. And so, I decided to move into a role as a nurse educator.
Myra King (04:08):
Yeah.
Carol Pehotsky (04:08):
At the time we were called clinical instructors.
Myra King (04:10):
Yes. (laughs)
Carol Pehotsky (04:11):
(laughs) Now they're nursing professional development specialists.
Myra King (04:14):
Mm-hmm.
Carol Pehotsky (04:14):
And I absolutely also love that role. I was able to support nurses at the bedside-
Myra King (04:15):
Mm-hmm.
Carol Pehotsky (04:19):
... and educate them as they care for patients. And then I did that for a couple of years and realized that in addition to teaching...
Myra King (04:27):
Mm-hmm.
Carol Pehotsky (04:27):
... I also love to promote best practices at the bedside.
Myra King (04:31):
Yeah.
Carol Pehotsky (04:32):
I love to ensure that we were advancing nursing practice.
Myra King (04:35):
Mm-hmm.
Carol Pehotsky (04:35):
I realized that almost everything that I loved about nursing was, was embodied in the clinical nurse specialist role.
Myra King (04:36):
Ah.
Carol Pehotsky (04:42):
And so, I was very fortunate to be able to go back and become a clinical nurse specialist.
Myra King (04:47):
Mm-hmm.
Carol Pehotsky (04:47):
Which is one of the four advanced practice nurse roles.
Myra King (04:50):
Yes.
Carol Pehotsky (04:51):
I've been doing that ever since; it's been about 15 years.
Myra King (04:51):
Wow.
Carol Pehotsky (04:54):
And then, you know, it, it has been an amazing, amazing journey. And as you stated about, gosh, 10 years ago, I moved into a leadership role.
Myra King (05:02):
Has it been that long? (laughs)
Carol Pehotsky (05:04):
It really has. So, I have this distinct honor-
Myra King (05:06):
Yes.
Carol Pehotsky (05:07):
... of, of leading and serving a brilliant group of advanced practice nurses.
Myra King (05:10):
Yes.
Carol Pehotsky (05:11):
And so, it's been a great journey.
Myra King (05:12):
Yeah.
Carol Pehotsky (05:12):
Like, I have just been so privileged and so blessed and it fuels me every day. So, yeah, I get to live out my why every day, which is just wonderful.
Myra King (05:20):
Oh, my gosh. All right, everybody, pause, rewind, write that down...
Carol Pehotsky (05:24):
(laughs)
Myra King (05:25):
(laughs) ... and now we'll go forward. So, getting into the topic of the day, going to start with the word diversity.
Carol Pehotsky (05:31):
Mm-hmm.
Myra King (05:32):
Right. It's a word that we hear a lot of, whether that's in our social media life or our walking around life or our health care life. But what does it mean to you in health care?
Carol Pehotsky (05:42):
You know, when I think about the word diversity, I think about celebrating and respecting the differences that we all have.
Myra King (05:49):
Okay.
Carol Pehotsky (05:49):
Right? And I think about realizing that it's important to have representation.
Myra King (05:54):
Mm-hmm.
Carol Pehotsky (05:54):
So, representation from people with different demographics, different backgrounds, whether it's race, religion, ethnicity, sexual orientation...
Myra King (06:02):
Mm-hmm.
Carol Pehotsky (06:02):
... age, you know, abilities, all of the differences and making sure that we are representatives of the society of the patients in which we serve. And I think that, you know, sometimes people think about diversity, and they think about inclusion and, and they feel as though those words are interchangeable. So even though it's important...
Myra King (06:03):
Mm-hmm.
Carol Pehotsky (06:22):
... that we ensure that we have a diverse team...
Myra King (06:22):
Okay.
Carol Pehotsky (06:26):
... that we diversify the nursing workforce, for example.
Myra King (06:30):
Mm-hmm.
Carol Pehotsky (06:30):
It's also important that we take it a step further and that people feel included.
Myra King (06:36):
Ah.
Carol Pehotsky (06:36):
So, inclusion is-
Myra King (06:36):
Sure. (laughs)
Carol Pehotsky (06:39):
... really taking that step further and saying, "Listen, we're going to create this environment where people feel valued, where they feel as though they're respected. Their input matters." And I love this quote by a DEI consultant, her name is Verna Myers. And she said that diversity is inviting people to the party, whereas inclusion is inviting them to dance, so-
Myra King (06:39):
Okay, there you go. Yeah.
Carol Pehotsky (07:04):
... we're going to invite you to the table, but you're at the table now, we're going to invite you to share your input and we're going to respect and listen to that input. So yes, diversity is important, but we really need to make sure that we also are including people and that we're treating them equitably.
Myra King (07:18):
Right. Sure. It's not just a seat at a table. It's saying, and we'd like to hear from you while you're sitting with us.
Carol Pehotsky (07:23):
Absolutely.
Myra King (07:23):
Okay.
Carol Pehotsky (07:24):
So, listening to their input, and then really listening. Not listening to respond.
Myra King (07:29):
(laughs) Yeah.
Carol Pehotsky (07:29):
But listening to truly understand and incorporate their ideas into our plans, into our projects. We know that that will improve outcomes.
Myra King (07:38):
Absolutely. So, you've touched on a lot of this already, but just to really hone it in for our audience, clearly diversity and inclusion play a really important role in a healthy work environment in health care teams of nurses and physicians working together. So, what are some of the first steps that as a nurse I should be thinking about or taking? So, I'm not necessarily a leader, but I'm a nurse, I want to make sure that the unit I'm working in is inclusive, is diverse. What are some things that I can do as a bedside nurse?
Carol Pehotsky (08:09):
I think that's a really important question because I don't think that we oftentimes think about how important it is that we create welcoming atmospheres-
Myra King (08:16):
Sure. Mm-hmm.
Carol Pehotsky (08:17):
... for the nurses that are entering our units, right?
Myra King (08:17):
Mm-hmm.
Carol Pehotsky (08:19):
And so, it's getting to know our co-workers.
Myra King (08:19):
Mm-hmm.
Carol Pehotsky (08:22):
It's getting to know them beyond the gate. care that they give at the bedside.
Myra King (08:26):
Sure.
Carol Pehotsky (08:26):
But really, who are they as people? What is their heritage, right?
Myra King (08:26):
Okay.
Carol Pehotsky (08:31):
What are their values? What's important to them? What's their family like? And inviting them into conversations that we have.
Myra King (08:37):
Mm-hmm.
Carol Pehotsky (08:38):
I think, unfortunately, nurses are known to, a- and I'm, I, I know that we're trying to get away from this, but-
Myra King (08:38):
(laughs)
Carol Pehotsky (08:45):
... you know, we eat our young, right? So, we ca-
Myra King (08:45):
Yeah.
Carol Pehotsky (08:47):
(laughs) And that goes for all nurses, right? That we, you have to somehow come into our unit and prove yourself.
Myra King (08:52):
Yeah.
Carol Pehotsky (08:52):
And that's really not. Guess what, they've gone to nursing school. They've passed...
Myra King (08:55):
Right.
Carol Pehotsky (08:56):
... the NCLEX, if that's the testing-
Myra King (08:57):
All the hoops have been jumped through. Yep.
Carol Pehotsky (08:59):
Exactly.
Myra King (08:59):
Yep.
Carol Pehotsky (09:00):
So now we need to hold their hand and-
Myra King (09:00):
Mm-hmm.
Carol Pehotsky (09:03):
... to take them along this journey of becoming a nurse.
Myra King (09:06):
Mm-hmm.
Carol Pehotsky (09:06):
It may not mean that this is the unit for them. Perhaps they might be better suited in another clinical environment.
Myra King (09:11):
Sure.
Carol Pehotsky (09:11):
But at the end of the day, they are a nurse, and we want them to feel valued.
Myra King (09:11):
Mm-hmm.
Carol Pehotsky (09:15):
We want them to feel respected. We want them to feel as though they matter. So as a bedside nurse, really making sure that I'm including my coworkers, building relationships with my coworkers, and that I don't gossip and talk about them and have a toxic relationship-
Myra King (09:31):
Sure.
Carol Pehotsky (09:31):
... toxic environment-
Myra King (09:32):
Yeah, yeah.
Carol Pehotsky (09:32):
... which sometimes can be the case.
Myra King (09:34):
It seems so simple, and yet...
Carol Pehotsky (09:35):
Yes. (laughs)
Myra King (09:36):
... we still have work to do in that area. (laughs)
Carol Pehotsky (09:37):
We still have work to do in that area.
Myra King (09:38):
And as I'm thinking, receiving that, not listening to respond. (laughs)
Carol Pehotsky (09:39):
(laughs)
Myra King (09:43):
But, you know, you think about the experiences that a lot of nurses unfortunately have had coming into the profession. So, it's not just, I'm not going to be mean to you.
Carol Pehotsky (09:43):
Mm-hmm.
Myra King (09:52):
It really is saying, I want you to feel like you are your whole self here.
Carol Pehotsky (09:52):
Mm-hmm.
Myra King (09:56):
So, so how is, as a preceptor, can we do that? Right? The new graduate nurse might be scared anyway.
Carol Pehotsky (10:02):
Mm-hmm. Right.
Myra King (10:02):
May not feel comfortable offering much about myself. So now I'm a preceptor.
Carol Pehotsky (10:06):
Right.
Myra King (10:06):
How do I really create that inclusive environment and say, "I want to hear from you?"
Carol Pehotsky (10:10):
Well, I think it's asking the questions.
Myra King (10:12):
Mm-hmm.
Carol Pehotsky (10:12):
Asking those probing questions like, "How are you showing up today? What questions do you have for me? I'm here to support you along this journey." And making yourself available to them, not judging them, right?
Myra King (10:13):
Yeah.
Carol Pehotsky (10:23):
But really making them yourself available to them. We need to make sure that our nurses feel like we care about them.
Myra King (10:23):
Mm-hmm.
Carol Pehotsky (10:30):
We talk all about, and it's so important that we treat our patients like we want to be treated.
Myra King (10:37):
Absolutely. Yeah.
Carol Pehotsky (10:37):
That we treat them equitably and we provide them with the resources that they need. We also need to translate that to how we treat each other-
Myra King (10:37):
Mm-hmm.
Carol Pehotsky (10:45):
... as nurses, whether it's a new nurse, whether it's a coworker that we've been working with for years.
Myra King (10:46):
Mm-hmm.
Carol Pehotsky (10:49):
That we make them feel that we treat them fairly.
Myra King (10:49):
Mm-hmm.
Carol Pehotsky (10:53):
And that we make them feel that they are a valuable member of the team, right?
Myra King (10:54):
Sure.
Carol Pehotsky (10:57):
That's how you build community. And we talk about community nursing-
Myra King (10:57):
Yeah.
Carol Pehotsky (11:00):
... with our unit, that we are all connected. And when you hurt, I hurt. When you succeed, we all succeed.
Myra King (11:07):
Yeah.
Carol Pehotsky (11:08):
Right? And that's absolutely what is needed in the, in the units in which we work.
Myra King (11:09):
Mm-hmm.
Carol Pehotsky (11:13):
And we can do that by ensuring that all of our nurses and all of our caregivers, right-
Myra King (11:18):
Mm-hmm. Yeah.
Carol Pehotsky (11:18):
... that is a part of our nursing team...
Myra King (11:20):
Absolutely.
Carol Pehotsky (11:20):
... feel equally valued and that they're, that they're seen, that they're heard and that we're open to supporting them in any way that we can.
Myra King (11:21):
Mm-hmm.
Carol Pehotsky (11:28):
So that, that's really, really important, right?
Myra King (11:28):
Yeah.
Carol Pehotsky (11:31):
And then we check our own implicit biases.
Myra King (11:33):
Well... (laughs)
Carol Pehotsky (11:34):
Right?
Myra King (11:34):
Yeah. All right. So [inaudible 00:11:37].
Carol Pehotsky (11:36):
We all have them.
Myra King (11:37):
Yeah. Mm-hmm.
Carol Pehotsky (11:37):
Okay. We all have these, these biases about people based on how they look or where they come from, or maybe religious affiliation that they may have that we know that-
Myra King (11:45):
Sure. Something going on in myself that has nothing to do with them. Yeah, absolutely.
Carol Pehotsky (11:48):
So, something could... That's like, "Maybe this is based on my experiences that I've had in the past."
Myra King (11:52):
Mm-hmm. Right.
Carol Pehotsky (11:52):
So, we bring that into our work environments, we bring that to the table, and we have to be cognizant of that so that we make sure that those implicit biases, those beliefs are not impacting negatively the way in which we are interacting with other nurses-
Myra King (11:52):
Sure.
Carol Pehotsky (12:09):
... and other members of the health care team.
Myra King (12:11):
Yeah.
Carol Pehotsky (12:11):
It can happen. And so-
Myra King (12:13):
Sure.
Carol Pehotsky (12:14):
... we need to check it at the door and be aware of it.
Myra King (12:16):
And, and I think everybody thinks, "I don't have any biases."
Carol Pehotsky (12:16):
(laughs)
Myra King (12:19):
Or "I don't show it." But it's absolutely visible.
Carol Pehotsky (12:23):
Absolutely. Yeah.
Myra King (12:24):
I was reading something that said there's something like over 130 different types of biases.
Carol Pehotsky (12:24):
Mm-hmm.
Myra King (12:29):
So, so listeners. (laughs)
Carol Pehotsky (12:31):
Yes. (laughs)
Myra King (12:32):
You can spend some time investigating that or just acknowledge that we all do have those biases. So, so what, what internal work should we be doing to identify what they are?
Carol Pehotsky (12:40):
Absolutely. And then not only identifying them, but also identifying how they may be impacting-
Myra King (12:46):
Right.
Carol Pehotsky (12:46):
... how we're treating our patients...
Myra King (12:46):
Yes.
Carol Pehotsky (12:48):
... or how we're treating our coworkers. What is my response based on those biases? And so, recognizing them and then associating that with our behaviors, our language and our interactions is important.
Myra King (13:01):
Yeah. You know, s- some of nursing is very much a, um, I see something, I have to rea- react to it, but a large part of what we do, there's that moment to apply that filter... (laughs)
Carol Pehotsky (13:01):
Yes.
Myra King (13:10):
... and to think about, "Okay, how is this going to be received?"
Carol Pehotsky (13:14):
Mm-hmm.
Myra King (13:15):
Am I making the people around me, the caregivers around me, feel like they have a voice?
Carol Pehotsky (13:21):
Right. Absolutely. And I think too, it's important that our caregivers know that they have a voice in things that matter to how they practice. So that goes-
Myra King (13:21):
Yeah.
Carol Pehotsky (13:30):
... back to share governance and-
Myra King (13:31):
Mm-hmm.
Carol Pehotsky (13:32):
... and practice councils and being able to speak up at meetings. Like, we want to hear your input because what-
Myra King (13:32):
Right.
Carol Pehotsky (13:38):
... you have to say is important to how we are going to implement practices-
Myra King (13:43):
Yeah.
Carol Pehotsky (13:43):
... our units and policies. And when people know that they are seen and then they are heard, they actually kind of are encouraged to speak up more.
Myra King (13:51):
Absolutely. Yeah.
Carol Pehotsky (13:52):
They actually say, "Hey, I, I, I guess I can."
Myra King (13:52):
Yeah.
Carol Pehotsky (13:55):
"I, I think I'm kind of important."
Myra King (13:56):
Mm-hmm.
Carol Pehotsky (13:57):
And then I have experienced that in my own career.
Myra King (13:57):
Yeah.
Carol Pehotsky (13:59):
Where I am in the many rooms where I'm the only or one of the only people that look like me.
Myra King (13:59):
Yeah.
Carol Pehotsky (14:05):
And it took a long time for me to get the courage to speak up.
Myra King (14:05):
True. Yeah.
Carol Pehotsky (14:11):
To find my voice and to understand that what I had to say and what I had to contribute was important.
Myra King (14:11):
Mm-hmm.
Carol Pehotsky (14:19):
That I contribute a perspective-
Myra King (14:22):
Mm-hmm.
Carol Pehotsky (14:22):
... that's unique and different than what others can contribute.
Myra King (14:22):
Absolutely. Yeah.
Carol Pehotsky (14:27):
So I can't deprive others from what I have to contribute because I don't feel like I, I don't have that courage or I don't feel like I'm going to be heard.
Myra King (14:35):
Wow.
Carol Pehotsky (14:35):
So being able to find your voice-
Myra King (14:37):
Yeah.
Carol Pehotsky (14:37):
... when you're in the, in those situations is so important. But we also have to create the environment that is conducive-
Myra King (14:44):
Right.
Carol Pehotsky (14:44):
... to people speaking up and feeling comfortable in those situations. So, I'm grateful that I found my voice. I still struggle with this sometimes, right? But it is a lifelong process.
Myra King (14:54):
Yeah. So, ladies and gentlemen who are listening, I think Myra is underselling herself a little bit.
Carol Pehotsky (14:54):
(laughs)
Myra King (14:58):
If you were to think of, I mean, thinking about all the nurses you've educated and all the policies and the practices that you personally have elevated...
Carol Pehotsky (15:06):
Mm-hmm.
Myra King (15:06):
... we, we absolutely benefit from hearing your voice.
Carol Pehotsky (15:07):
Thank you.
Myra King (15:09):
So, you mentioned that that's been a journey for you. Any, any highlights along the way or, or pearls of wisdom you would say to other nurses or health care providers of any type that are in that space where they-
Carol Pehotsky (15:23):
Mm-hmm.
Myra King (15:23):
... there aren't people who look like them at the table and, and they're trying to figure out, "How can I be brave. What are the next steps?" Any, any nuggets to share?
Carol Pehotsky (15:31):
Yeah, I think the first thing you have to do is just take that step of realizing like, "First, I'm going to come to the table."
Myra King (15:31):
Mm-hmm.
Carol Pehotsky (15:38):
I am not going to sit on the sidelines and be silent, right?
Myra King (15:42):
Right.
Carol Pehotsky (15:42):
That I'm going to actually come to the table. That's the first step. And then while I am there, I am going to speak up about things that matter. I'm not going to be silent and I'm not going to worry about judgments or what other people think of me.
Myra King (15:56):
Mm-hmm.
Carol Pehotsky (15:56):
But really that's their business, right? What other people think of you is their business, not mine. (laughs)
Myra King (16:00):
That's right. I've said that to my teenager several times. (laughs)
Carol Pehotsky (16:01):
It's a great philosophy.
Myra King (16:01):
It's great.
Carol Pehotsky (16:04):
Truly, that has been transformative-
Myra King (16:06):
Yes.
Carol Pehotsky (16:07):
... for me.
Myra King (16:07):
Yeah.
Carol Pehotsky (16:07):
Because I've grown up really caring about what other people-
Myra King (16:09):
Sure.
Carol Pehotsky (16:09):
... think about me. And that can stall your progress so much. But when you say, you know, I, I cannot, that's them.
Myra King (16:17):
Mm-hmm.
Carol Pehotsky (16:17):
Um, if there are aspects of me that I need to address, okay, fine. But really-
Myra King (16:21):
That's based on your own self-reflection, not... Yeah.
Carol Pehotsky (16:24):
That's based on your own exa- my own self res- reflection.
Myra King (16:24):
Mm-hmm.
Carol Pehotsky (16:25):
But really, I'm going to have confidence and I'm going to have the courage to speak up. And, and understand the value that you bring to the team that ultimately will improve outcomes.
Myra King (16:26):
Yes.
Carol Pehotsky (16:36):
And it could improve the lives of other people. So, when you see that, and you see that-
Myra King (16:37):
Mm-hmm.
Carol Pehotsky (16:41):
... value in yourself-
Myra King (16:42):
Yes.
Carol Pehotsky (16:43):
... right? Like y- it starts with you seeing that in yourself. Others will also see it. So, I really-
Myra King (16:43):
Because people are always watching. (laughs)
Carol Pehotsky (16:48):
Yes, people are always watching and they're always listening.
Myra King (16:52):
Yes.
Carol Pehotsky (16:52):
Right.
Myra King (16:52):
And you've set such a great example for so many-
Carol Pehotsky (16:55):
Oh, thank you. (laughs)
Myra King (16:56):
... PCNAs, clinical nurse, techs, nurses. I mean, the list is endless.
Carol Pehotsky (17:00):
Thank you.
Myra King (17:00):
So, we've, we've spent most of this time so far talking largely about the health care provider.
Carol Pehotsky (17:07):
Mm-hmm.
Myra King (17:07):
Now, let's flip it to patients.
Carol Pehotsky (17:07):
Mm-hmm.
Myra King (17:08):
So, while we want to make sure the care that we deliver is also including the patient's voice.
Carol Pehotsky (17:09):
Mm-hmm.
Myra King (17:14):
Making sure that we're sensitive to each individual's needs, how does having a more diverse, inclusive workforce help patients? And how does all this translate into confidence and trust with our patients?
Carol Pehotsky (17:27):
Diversifying the nursing workforce is really crucial...
Myra King (17:30):
Mm-hmm.
Carol Pehotsky (17:30):
... to addressing health inequities. Even the future of nursing report that was published, you know, in 2021, I believe it was, really speaks to that.
Myra King (17:31):
Yeah.
Carol Pehotsky (17:40):
Because when patients come into our health care facilities and they walk into our hospitals, they walk into our ambulatory settings, and they see people-
Myra King (17:47):
Sure.
Carol Pehotsky (17:48):
... that look like them-
Myra King (17:49):
Yeah.
Carol Pehotsky (17:49):
... that have similar traits...
Myra King (17:51):
Mm-hmm.
Carol Pehotsky (17:51):
... then they start to feel as though, "Listen, I can trust."
Myra King (17:55):
Mm-hmm.
Carol Pehotsky (17:55):
And this has been shown in research. Research shows-
Myra King (17:58):
Over and over. (laughs)
Carol Pehotsky (17:58):
Over and over that improves patient satisfaction and improves communication between patients. It improves building relationships.
Myra King (17:59):
Mm-hmm.
Carol Pehotsky (18:08):
And we know that mistrust of the medical community has been a pervasive problem for decades, right?
Myra King (18:08):
Mm-hmm.
Carol Pehotsky (18:14):
And due to a variety of reasons.
Myra King (18:16):
Right.
Carol Pehotsky (18:16):
Whether it's racism and healthcare that was present as, just as it was in society.
Myra King (18:21):
Mm-hmm.
Carol Pehotsky (18:21):
So how do we kind of rebuild that trust, right? It didn't happen overnight. So, it's not, as we reverse the mistrust that exists-
Myra King (18:30):
Mm-hmm.
Carol Pehotsky (18:31):
... it's not, it's not going to happen overnight.
Myra King (18:31):
Right.
Carol Pehotsky (18:32):
So, it's going to be a process, but it really does start with, Listen, let's make sure that our workforce represents the patients that we-
Myra King (18:32):
Mm-hmm.
Carol Pehotsky (18:40):
... care for, right? And then as we do that and we have health care workers that represent our patient populations, they can also help us uncover the needs of those patients that we may not otherwise see.
Myra King (18:53):
Sure, or they might not tell us.
Carol Pehotsky (18:54):
Right or they may not tell us.
Myra King (18:54):
Mm-hmm.
Carol Pehotsky (18:55):
Or they may not trust to tell us.
Myra King (18:56):
Right, right.
Carol Pehotsky (18:57):
So, whether it's race and ethnicity or LGBTQ community, really being able to have those healthcare workers is crucial, right? So, we can address the health disparities that we know continue to be pervasive in our country.
Myra King (19:09):
And really, the receiver of that information could be really anyone in the healthcare continuum if they've s- created that trust with the patient.
Carol Pehotsky (19:15):
Absolutely, yeah.
Myra King (19:15):
Everyone from somebody who welcomes you at the door...
Carol Pehotsky (19:16):
Sure.
Myra King (19:18):
... to the physician who's the last person who sees them, maybe.
Carol Pehotsky (19:21):
Absolutely. Anyone can create that trust, right?
Myra King (19:22):
Mm-hmm.
Carol Pehotsky (19:24):
It doesn't matter how you look, but it definitely is building the trust is about building relationships.
Myra King (19:30):
Yeah.
Carol Pehotsky (19:31):
It's about listening. It's about being open. It's about showing respect and showing that the input of others matters.
Myra King (19:31):
Mm-hmm.
Carol Pehotsky (19:39):
So, if it's patients, like, "I want to incorporate your values, your beliefs, what's important to you into your plan of care." That's person centered care.
Myra King (19:39):
Right.
Carol Pehotsky (19:50):
That's showing cultural humility. And you mentioned, you mentioned cultural-
Myra King (19:50):
Yes.
Carol Pehotsky (19:54):
You mentioned cultural competence.
Myra King (19:55):
(laughs) Yes.
Carol Pehotsky (19:55):
Which cultural competence is really important.
Myra King (19:57):
Sure.
Carol Pehotsky (19:57):
We get to kind of learn about the different-
Myra King (19:59):
Mm-hmm.
Carol Pehotsky (19:59):
... cultures and we are committed to that. But cultural humility takes it a little bit further.
Myra King (20:05):
Yeah. Sure.
Carol Pehotsky (20:05):
Because it says, "Listen, I'm going to be open to continuing to learn. So, this is a lifelong process."
Myra King (20:11):
Mm-hmm.
Carol Pehotsky (20:11):
I'm never going to be truly competent about anybody else's culture, right?
Myra King (20:11):
Right.
Carol Pehotsky (20:16):
Or their experiences, but I'm going to be open to learning.
Myra King (20:19):
Mm-hmm.
Carol Pehotsky (20:19):
And I'm going to be willing to put my ego aside. So, what I feel is important. I'm going to be able to put that aside. I'm not going to feel like I am better or superior...
Myra King (20:29):
Right.
Carol Pehotsky (20:30):
... than someone else. So cultural humility is really where we are-
Myra King (20:33):
Mm-hmm.
Carol Pehotsky (20:33):
... we're aiming as healthcare workers to address healthcare disparities. So, it's, it truly, truly is important.
Myra King (20:42):
Yeah, wow. So, we talked about biases and the fact that really all of us...
Carol Pehotsky (20:42):
Mm-hmm.
Myra King (20:47):
... the condition of being human comes with having biases. Let's say I'm a nurse, I walk onto the floor, we're all getting started for the day, and perhaps I, I observe, hopefully not, but perhaps I observe either a coworker that's really showing intolerant behavior, or it's a patient...
Carol Pehotsky (21:05):
Mm-hmm.
Myra King (21:06):
... what can I do? I mean, lots of things we could do, right, in that situation. But we want to keep that relationship with the patient.
Carol Pehotsky (21:06):
Right.
Myra King (21:11):
Right? Patient is showing intolerance.
Carol Pehotsky (21:12):
Mm-hmm.
Myra King (21:13):
We still need to deliver care to them. (laughs)
Carol Pehotsky (21:14):
(laughs)
Myra King (21:16):
We need to set some boundaries. What are some suggestions you might have in that scenario?
Carol Pehotsky (21:20):
You know, I always start with being self-reflective...
Myra King (21:23):
Mm-hmm.
Carol Pehotsky (21:23):
... first, right? So, we walk into the situation and before we walk into the situation, we pause-
Myra King (21:23):
Mm-hmm.
Carol Pehotsky (21:28):
... and really consider, "How am I showing up in this situation? Do I have biases?" Am I interpreting-
Myra King (21:35):
Okay.
Carol Pehotsky (21:36):
... uh, or, or judging-
Myra King (21:37):
Yeah.
Carol Pehotsky (21:37):
... this patient based on the way the patient looks-
Myra King (21:40):
Mm-hmm.
Carol Pehotsky (21:40):
... or their socioeconomic status or things that I know about them? And really taking the moment to pause and be self-reflective in that situation just to ensure that you are aware how you're showing up.
Myra King (21:51):
Okay. Yeah.
Carol Pehotsky (21:52):
So, it starts with being self-aware.
Myra King (21:54):
(laughs) Not making a part of the problem.
Carol Pehotsky (21:55):
Not making, not becoming a part of the problem. Um, and then it moves to, okay, now that I'm, I'm ready to-
Myra King (21:56):
Mm-hmm.
Carol Pehotsky (22:01):
... address this, I have to speak up. I have to address the behaviors.
Myra King (22:02):
Mm-hmm.
Carol Pehotsky (22:06):
We're not addressing the person necessarily, but we-
Myra King (22:06):
Ah.
Carol Pehotsky (22:09):
... are addressing the behaviors.
Myra King (22:10):
Yes.
Carol Pehotsky (22:11):
We address the person then they can become defensive. So, you are acting in a way that is impeding our ability to provide the quality care that we hope to provide for you.
Myra King (22:11):
Right.
Carol Pehotsky (22:21):
Can you, can you talk to me a little bit about more where you're coming from, right?
Myra King (22:21):
Mm-hmm.
Carol Pehotsky (22:25):
What's making you, um, react this way because I want to understand?
Myra King (22:29):
Okay.
Carol Pehotsky (22:29):
So now you are raising the awareness to that individual about their behaviors. And maybe they aren't 100% aware. Maybe there's something-
Myra King (22:37):
Yeah.
Carol Pehotsky (22:37):
... underlying it-
Myra King (22:38):
Mm-hmm.
Carol Pehotsky (22:38):
... that we need to be aware of.
Myra King (22:39):
Mm-hmm.
Carol Pehotsky (22:40):
So, trying to dig deep into why are they upset? Maybe their concerns are legitimate, and we need-
Myra King (22:40):
Right.
Carol Pehotsky (22:45):
... to address those concerns.
Myra King (22:47):
Mm-hmm.
Carol Pehotsky (22:47):
So again, starting with self-awareness and then moving into addressing the concerns. I think it opens the door to improve communication.
Myra King (22:55):
Yeah.
Carol Pehotsky (22:56):
And so there are many strategies out there that we can implement-
Myra King (23:00):
Mm-hmm.
Carol Pehotsky (23:00):
... in trying to better communicate in those situations and de-escalate the situation.
Myra King (23:00):
Right.
Carol Pehotsky (23:05):
So, one of my favorites is the use of the CUS acronym. (laughs)
Myra King (23:08):
I know we use that; we use that all the time. (laughs)
Carol Pehotsky (23:10):
Yep, yep. There are many others that are out there, but what I really love it because it's simple-
Myra King (23:14):
Yep.
Carol Pehotsky (23:15):
... and it basically says, "Listen, I'm concerned-"
Myra King (23:17):
Mm-hmm.
Carol Pehotsky (23:18):
"... about what's happening right now. And again, exploring, can you tell me more-"
Myra King (23:18):
Right.
Carol Pehotsky (23:21):
"... about what's happening and where you are?"
Myra King (23:22):
Mm-hmm.
Carol Pehotsky (23:24):
And so C is concern. And then U is, "I'm really feeling uncomfortable."
Myra King (23:28):
Right. Owning the feeling. Yeah. Mm-hmm.
Carol Pehotsky (23:30):
I'm really feeling uncomfortable in this. Owning the feeling, naming the feeling. I'm really feeling uncomfortable and this is really impeding the ability to have a safe environment.
Myra King (23:30):
Mm-hmm.
Carol Pehotsky (23:37):
So that is a great way to kind of open up a discussion about getting at what is the underlying concern, right? And so, I think those are, are great strategies to start with.
Myra King (23:49):
Mm-hmm.
Carol Pehotsky (23:50):
Trying to understand what's underlying the situation. And while obviously we get to a point where we might need to solicit the help of others-
Myra King (23:58):
Yeah.
Carol Pehotsky (23:58):
... and bring others into the situation to get their perspectives and to help handle the situation. So, I always would encourage nurses that when they find themselves in this situation, specifically with patients, right?
Myra King (23:58):
Mm-hmm.
Carol Pehotsky (24:09):
That they really say, okay, if they feel as though they are in an unsafe situation-
Myra King (24:09):
Yeah, absolutely.
Carol Pehotsky (24:13):
... we need to hurry up and we need to get help.
Myra King (24:14):
Mm-hmm.
Carol Pehotsky (24:15):
We need to, you know, go through, go that route of getting help. You never want to stay in an unsafe situation. But it also could be, you know, mean I'm going to reach out to the ombudsman so that they can help me navigate the situation.
Myra King (24:16):
Right.
Carol Pehotsky (24:28):
... and to create some guidelines...
Myra King (24:30):
Mm-hmm.
Carol Pehotsky (24:30):
... and some boundaries around behaviors-
Myra King (24:33):
Right.
Carol Pehotsky (24:33):
... we have in that discussion.
Myra King (24:34):
Yeah.
Carol Pehotsky (24:35):
That's equally important when we are talking about behaviors that might show up in the workplace from coworkers.
Myra King (24:40):
Yeah.
Carol Pehotsky (24:40):
Like, maybe they're saying inappropriate-
Myra King (24:43):
Mm-hmm.
Carol Pehotsky (24:43):
... uh, things.
Myra King (24:43):
Mm-hmm.
Carol Pehotsky (24:43):
Maybe they have jokes that are inappropriate. Uh, you have to speak up in that moment.
Myra King (24:44):
Mm-hmm.
Carol Pehotsky (24:49):
You have to address it. You have to raise awareness.
Myra King (24:52):
Mm-hmm.
Carol Pehotsky (24:52):
That, like, this is not okay.
Myra King (24:53):
Right.
Carol Pehotsky (24:54):
When you fail to speak up, you know, what you what you permit you promote and then, again, you have to solicit the help. We have plentiful help, whether it's your nurse manager, your A&M.
Myra King (25:04):
Mm-hmm.
Carol Pehotsky (25:04):
If, if it's, uh, an employee, maybe human resources. (laughs)
Myra King (25:08):
Absolutely. Yeah.
Carol Pehotsky (25:09):
We all have these policies, escalation policies, but prior to that-
Myra King (25:09):
Yeah.
Carol Pehotsky (25:13):
... is trying to deescalate the situation but trying to understand it.
Myra King (25:16):
Yeah. Excellent. Okay. So, we've talked about the intolerant patient. We've talked about seeing some of this behavior in our coworkers. Sometimes it's, it's perhaps a little less in your face.
Carol Pehotsky (25:28):
Mm-hmm.
Myra King (25:28):
Right? It might be the heavy sigh when where's conversations about DEIB.
Carol Pehotsky (25:34):
Mm-hmm.
Myra King (25:35):
Somebody says, "How long do we have to keep talking about this?" So, we're on the receiving end of maybe something like that. How should we respond to that?
Carol Pehotsky (25:42):
That's a really good question. I actually had someone recently say something along the lines of-
Myra King (25:43):
Oh, gosh.
Carol Pehotsky (25:47):
... like, "Really, is this still important? Is this still pertinent? How long do we have to talk about it? We've been talking about it for, for decades." And my response was, "I know it's exhausting. I know it's a lot of work. I, I know that it can even seem repetitive at times, but I also can relate to and imagine that those who are on the receiving end of health inequities are also tired."
Myra King (26:13):
Yeah.
Carol Pehotsky (26:13):
They're also just still struggling to stay above, above water. And so as long as we have healthcare disparities...
Myra King (26:22):
Mm-hmm.
Carol Pehotsky (26:23):
... a l- as long as we are struggling to move the needle-
Myra King (26:25):
Mm-hmm.
Carol Pehotsky (26:26):
... as it relates to healthcare disparities, then we have to keep having these conversations.
Myra King (26:31):
Yeah. The problems not solved.
Carol Pehotsky (26:31):
And we... The problems not solved.
Myra King (26:31):
Yeah.
Carol Pehotsky (26:32):
Right? And we have to create educational opportunities, awareness, and then action planning around this topic to be able to move the needle in healthcare inequities. I reflect on a quote by Martin Luther King that really resonates with me about creating this beloved community, right?
Myra King (26:32):
Ooh, I like that.
Carol Pehotsky (26:50):
Which is our North star.
Myra King (26:51):
Yeah.
Carol Pehotsky (26:51):
That we are moving towards a journey of creating a beloved community. And so, when we think about what that means...
Myra King (26:59):
Mm-hmm.
Carol Pehotsky (26:59):
... is that we are fostering a sense of belonging. That we are valuing and respecting and showing dignity and treating people fairly. And so, if in order to get to that North Star of a beloved community, whether we're talking about the communities in which we live, whether we're talking about the community of the nursing community-
Myra King (27:00):
Yeah.
Carol Pehotsky (27:20):
... the nursing profession-
Myra King (27:20):
Yeah.
Carol Pehotsky (27:21):
... the communities on our units, then we have to keep having the conversation and we have to keep leaning into this space...
Myra King (27:27):
Mm-hmm.
Carol Pehotsky (27:28):
... until we have made meaningful progress.
Myra King (27:31):
It's a conversation, but it's also an action plan.
Carol Pehotsky (27:33):
Absolutely.
Myra King (27:33):
Yeah. Okay.
Carol Pehotsky (27:34):
Yeah. Yeah.
Myra King (27:34):
That's great.
Carol Pehotsky (27:34):
Actions behind our words.
Myra King (27:35):
Yeah.
Carol Pehotsky (27:36):
So, it's so important. But I do have faith.
Myra King (27:39):
Yeah. Okay.
Carol Pehotsky (27:39):
That we will get to, right...
Myra King (27:40):
Okay.
Carol Pehotsky (27:41):
... this beloved community that we hope to get to if we hold hands and we do it together.
Myra King (27:46):
One of the ways you have given back to us, our profession and to our patients is really getting involved in, in policy and, and really speaking up at an advocacy level.
Carol Pehotsky (27:57):
Mm-hmm.
Myra King (27:57):
And before, before the mics turned on, we talked a little bit about what the American Nurses Association is doing in this space. So, can you educate us a little bit more on policy and advocacy around the nursing profession with diversity, equity, inclusion?
Carol Pehotsky (28:10):
Sure. I think nurses oftentimes are reluctant to lean into the space of politics and advocating for policy.
Myra King (28:17):
Sure.
Carol Pehotsky (28:17):
But I think it's so important-
Myra King (28:18):
Mm-hmm.
Carol Pehotsky (28:19):
... that we realize that we have an impact outside the walls of our, our hospital, right?
Myra King (28:19):
Mm-hmm.
Carol Pehotsky (28:23):
That we can reach out into our communities, and we can have an impact. So, as it relates to policy...
Myra King (28:29):
Mm-hmm.
Carol Pehotsky (28:30):
... it's being able to advocate for those policies that promote health equity.
Myra King (28:35):
Mm-hmm.
Carol Pehotsky (28:35):
And that could be things like, you know, I'm going to advocate for policies around air pollution, which disproportionately...
Myra King (28:42):
Mm-hmm.
Carol Pehotsky (28:43):
... impacts marginalized communities.
Myra King (28:43):
Mm-hmm.
Carol Pehotsky (28:45):
I'm going to advocate for policies around housing and around transportation and all of those things that we know impact social determinants of health.
Myra King (28:45):
Absolutely. Yeah.
Carol Pehotsky (28:53):
So are plentiful of policies-
Myra King (28:53):
Mm-hmm.
Carol Pehotsky (28:55):
... that are out there. Sometimes it's just, I'm going to vote for, right?
Myra King (28:56):
Yeah.
Carol Pehotsky (28:59):
I'm going to be an active voter.
Myra King (29:00):
Yeah, absolutely.
Carol Pehotsky (29:00):
Or I'm going to advocate-
Myra King (29:02):
Mm-hmm.
Carol Pehotsky (29:02):
... on behalf and, and rally on issues that we know impact health equity. So, we are calling nurses to lean into that space-
Myra King (29:02):
Yeah.
Carol Pehotsky (29:10):
... of policy. Another big policy that's out there is improving access to care.
Myra King (29:10):
Mm-hmm.
Carol Pehotsky (29:15):
So, you know, expansion of Medicaid and Medicare, but also the removal of barriers for APRNs-
Myra King (29:21):
Oh.
Carol Pehotsky (29:21):
... for advanced practitioners-
Myra King (29:21):
Yeah.
Carol Pehotsky (29:22):
... to practice at-
Myra King (29:24):
Mm-hmm.
Carol Pehotsky (29:24):
... their full scope. Um, so full practice authority where they can improve access to care.
Myra King (29:28):
Yeah, absolutely.
Carol Pehotsky (29:29):
Particularly in rural areas...
Myra King (29:30):
Mm-hmm.
Carol Pehotsky (29:31):
... or underrepresented communities. So those are all policies that are important to improving health inequity.
Myra King (29:37):
Mm-hmm.
Carol Pehotsky (29:38):
But also, as you mentioned, being involved in professional organizations that also have those charges.
Myra King (29:44):
Yeah.
Carol Pehotsky (29:44):
They can be an excellent vehicle-
Myra King (29:46):
Mm-hmm.
Carol Pehotsky (29:46):
... to promoting health equity because I'm going to support those-
Myra King (29:46):
Mm-hmm.
Carol Pehotsky (29:50):
... organizations, I'm going to become a member of them. And specifically, I was recently introduced to the National Commission to Address Racism in Nursing.
Myra King (29:51):
Okay.
Carol Pehotsky (30:00):
And this is, was led by the American Nurses Association-
Myra King (30:00):
Mm-hmm.
Carol Pehotsky (30:03):
... the National Black Nurses Association, the National Coalition of Ethnic Minority Nurses Association, and the National Association of Hispanic Nurses. And they really have this charge of-
Myra King (30:14):
Yeah.
Carol Pehotsky (30:15):
... bringing awareness to racism-
Myra King (30:15):
Mm-hmm.
Carol Pehotsky (30:16):
... and, and nursing and how that has impacted-
Myra King (30:19):
Oh, my gosh.
Carol Pehotsky (30:19):
... health inequities-
Myra King (30:20):
Yeah.
Carol Pehotsky (30:20):
... in our communities-
Myra King (30:20):
Mm-hmm.
Carol Pehotsky (30:21):
... and health disparities.
Carol Pehotsky (30:22):
And so, they have an excellent educational series...
Myra King (30:26):
Okay.
Carol Pehotsky (30:26):
... that I was able to attend. And it was amazing to listen to these experts in the field of-
Myra King (30:26):
Mm-hmm.
Carol Pehotsky (30:32):
... DEIB now, diversity, equity, inclusion and belonging, and really give some pragmatic ways in which I can address and reduce health inequities and realize implicit biases that can impact the care that we give to patients. So those organizations have just, j- it was just a phenomenal-
Myra King (30:52):
Yeah.
Carol Pehotsky (30:52):
... phenomenal work. And there are many organizations-
Myra King (30:52):
(laughs)
Carol Pehotsky (30:54):
... that are out there...
Myra King (30:55):
Right.
Carol Pehotsky (30:55):
... that I don-
Myra King (30:56):
[inaudible 00:30:56].
Carol Pehotsky (30:57):
Right. There are many organizations. There are many opportunities.
Myra King (30:59):
Yeah, no kidding.
Carol Pehotsky (31:00):
You just have to find the organization that fits what is important to you and then support that organization. And then of course, obviously being involved in the community.
Myra King (31:00):
Mm-hmm.
Carol Pehotsky (31:07):
Whether it's volunteering, whether it's being involved in the volunteering at food pantries or community fairs or giving educational or seminars to the public and to improve preventive screening. So, all of those are ways in which we can be advocates for our patients outside the walls of our healthcare organizations.
Myra King (31:27):
Well, we've just scratched the surface. (laughs)
Carol Pehotsky (31:29):
Absolutely.
Myra King (31:29):
And I feel like we could keep talking-
Carol Pehotsky (31:30):
Yes. (laughs)
Myra King (31:31):
... for several episodes.
Carol Pehotsky (31:33):
Yes.
Myra King (31:33):
I'll, I'll wrap up this topic with one last question though.
Carol Pehotsky (31:35):
Mm-hmm.
Myra King (31:36):
So, we've mentioned that we haven't dug into it, you know, diversity, equity, inclusion and belonging.
Carol Pehotsky (31:36):
Yes.
Myra King (31:41):
So, what does the B, what does the belonging add to the conversation and how can we measure it and enhance it?
Carol Pehotsky (31:49):
So, the belonging is a concept that has recently been added-
Myra King (31:53):
Mm-hmm.
Carol Pehotsky (31:53):
... to the diversity, equity, inclusion movement.
Myra King (31:55):
Mm-hmm.
Carol Pehotsky (31:55):
And it is an important aspect-
Myra King (31:58):
Mm-hmm.
Carol Pehotsky (31:58):
... of this whole discussion. So earlier I talked about the difference between diversity and equity, right?
Myra King (31:58):
Mm-hmm.
Carol Pehotsky (32:04):
So, diversity is making sure we have representation.
Myra King (32:06):
Yep.
Carol Pehotsky (32:06):
Inclusion is making sure that people, that we create these environments where people are valued.
Myra King (32:07):
Mm-hmm.
Carol Pehotsky (32:12):
And that we solicit their input.
Myra King (32:12):
Mm-hmm.
Carol Pehotsky (32:14):
And the sense of belonging is the effect of those two. It's really okay, now I'm going to go to the person and say, "We tried to create this environment..."
Myra King (32:25):
Ah.
Carol Pehotsky (32:25):
"... but is that really how you're feeling?"
Myra King (32:26):
(laughs) Sure. Yeah.
Carol Pehotsky (32:27):
You know, "How are you-"
Myra King (32:27):
Okay.
Carol Pehotsky (32:29):
"How are we doing in this space?"
Myra King (32:30):
Mm-hmm.
Carol Pehotsky (32:30):
Are we making you feel like you are valued, that you belong to this community of nursing? How well are we doing? What are opportunities?
Myra King (32:38):
Okay.
Carol Pehotsky (32:38):
So, we can do a lot-
Myra King (32:40):
Yeah.
Carol Pehotsky (32:40):
... to create environments.
Myra King (32:40):
(laughs)
Carol Pehotsky (32:41):
But if we aren't effective-
Myra King (32:43):
Right.
Carol Pehotsky (32:43):
... and successful...
Myra King (32:44):
I don't like dancing.
Carol Pehotsky (32:45):
... in making people-
Myra King (32:45):
Then inviting me to dance is not great.
Carol Pehotsky (32:48):
... feel that. Right, so I'm not gonna... (laughs)
Myra King (32:48):
(laughs)
Carol Pehotsky (32:48):
Exactly. Then it's like, okay, so now I have to really make sure that I check in with you and say, "Do you-"
Myra King (32:48):
Ah. Okay.
Carol Pehotsky (32:53):
"... feel like you belong? And if not, what can we do to make sure that we improve or upon our interventions that we're doing to create a sense of belonging?" So that sense of belonging is when you feel like you are connected...
Myra King (33:07):
Mm-hmm.
Carol Pehotsky (33:08):
... to a community.
Myra King (33:09):
Okay.
Carol Pehotsky (33:09):
So, we think about on a nursing unit...
Myra King (33:09):
Mm-hmm.
Carol Pehotsky (33:12):
... that you are truly a member of that team, that you are an equally valued-
Myra King (33:17):
Mm-hmm.
Carol Pehotsky (33:18):
... and respected-
Myra King (33:18):
Yes.
Carol Pehotsky (33:18):
... member of the team. That you are part of this, that community. And so, belonging is rooted in love, is rooted in kindness.
Myra King (33:27):
I love that.
Carol Pehotsky (33:27):
It's rooted in compassion, and so it, it, that, which are fundamental, right?
Myra King (33:32):
Absolutely.
Carol Pehotsky (33:32):
Are fundamental to our needs. It's actually part of the Maslow's (laughs) hierarchy of needs.
Myra King (33:36):
Absolutely.
Carol Pehotsky (33:37):
Right?
Myra King (33:37):
Yeah.
Carol Pehotsky (33:37):
Love and belonging.
Myra King (33:38):
Right.
Carol Pehotsky (33:38):
So, it truly is something that we all need. It measures, it's that barometer.
Myra King (33:43):
Mm-hmm.
Carol Pehotsky (33:43):
So, when we think about our employee surveys...
Myra King (33:45):
Yeah.
Carol Pehotsky (33:45):
... engagement surveys, we ask those questions.
Myra King (33:48):
Mm-hmm. Yep. (laughs)
Carol Pehotsky (33:48):
We're truly asking. So how well are we doing, right?
Myra King (33:51):
Right.
Carol Pehotsky (33:51):
How do you feel like your voice is heard? Do you feel like you, you, your opinions matter? All those questions come up on surveys.
Myra King (33:51):
Right. Yeah.
Carol Pehotsky (33:58):
So, we look at that and we measure it. And then we come up with action plans when we see that there are opportunities. And we also know that we can measure by retention, right?
Myra King (33:58):
Yeah. Mm-hmm.
Carol Pehotsky (34:05):
Like, people, the sense of belonging inherent is, like, "I belong-"
Myra King (34:09):
Yeah.
Carol Pehotsky (34:09):
"... here and I'd rather be here than anywhere else."
Myra King (34:12):
They vote with their feet, yeah.
Carol Pehotsky (34:13):
So, I'm going to, I'm going to stay where I am...
Myra King (34:14):
Mm-hmm.
Carol Pehotsky (34:14):
... because I'm a part of this team.
Myra King (34:14):
Mm-hmm.
Carol Pehotsky (34:16):
So, we can look at surveys, we can look at retention.
Myra King (34:19):
Mm-hmm.
Carol Pehotsky (34:20):
All of those things, and it ultimately will improve patient outcomes. So, we look at-
Myra King (34:20):
Yeah.
Carol Pehotsky (34:24):
... our outcomes as well.
Myra King (34:25):
It's just, it's just asking that next question that says, "I've done these things, how, how are you receiving them? What can we do better?"
Carol Pehotsky (34:31):
Absolutely.
Myra King (34:32):
I love it.
Carol Pehotsky (34:32):
I love it.
Myra King (34:32):
Fantastic.
Carol Pehotsky (34:34):
(laughs)
Myra King (34:34):
Well, (laughs)
Carol Pehotsky (34:34):
It's a lot.
Myra King (34:36):
This is the end of part one. No, I'm... (laughs)
Carol Pehotsky (34:38):
Right. (laughs)
Myra King (34:38):
This has been fantastic, Myra. I can't thank you enough for joining us today. Before we call it a day, we're going to flip to our speed round...
Carol Pehotsky (34:45):
Yes.
Myra King (34:45):
... where our audience gets to learn a little bit more about you as the full, well-rounded human being you are, in addition to being an amazing nurse.
Carol Pehotsky (34:52):
Yes. (laughs)
Myra King (34:52):
So, with that said, what's something you do for you to recharge?
Carol Pehotsky (34:57):
So, my husband and I really love to see sunsets.
Myra King (35:02):
Oh, okay.
Carol Pehotsky (35:03):
So, we make it a priority as much as we can to go and see the sunset and to go for walks in the park and to spend that quality-
Myra King (35:10):
Nice.
Carol Pehotsky (35:10):
... time. So really being outdoors-
Myra King (35:13):
Okay.
Carol Pehotsky (35:13):
... is, is, is something that I do frequently. Sunsets and sunrises, that's our thing. But really making the time to spend with family and with loved ones also is important to me. So, yeah, those are things that I do to unwind.
Myra King (35:25):
Oh, it's wonderful.
Carol Pehotsky (35:26):
Yes.
Myra King (35:26):
Sunsets more than sunrises for myself.
Carol Pehotsky (35:28):
(laughs)
Myra King (35:28):
But yes, I respect that. (laughs)
Carol Pehotsky (35:29):
Me too, actually.
Myra King (35:32):
And what's something about you that surprises people?
Carol Pehotsky (35:36):
You know, I think it's a, I always mentioned about when I was in high school...
Myra King (35:36):
Mm-hmm.
Carol Pehotsky (35:40):
... how I had this propensity to be a rapper.
Myra King (35:44):
(laughs) Really?
Carol Pehotsky (35:44):
So, I love to rap. (laughs) Right. I'm not that good at it as I used to be, but I, I actually was a part of one of our high schools, uh, assemblies where-
Myra King (35:44):
Really?
Carol Pehotsky (35:53):
... I rapped in front of the whole school.
Myra King (35:54):
Oh, that's awesome.
Carol Pehotsky (35:57):
And, you know, I kind of wrote these raps and I was kind of like, you know, Mrs. Rock box, if you will.
Myra King (36:01):
Cool.
Carol Pehotsky (36:01):
So, I was really...
Myra King (36:01):
(laughs)
Carol Pehotsky (36:02):
(laughs) People are surprised at that, that, that is something that had a propensity for. But I absolutely loved it. I kindly still actually do love rap. So yeah, I think that that's something that people will find surprising about me.
Myra King (36:12):
So, part two will be done in full, rapid beat box. Got it. (laughs)
Carol Pehotsky (36:16):
(laughs) Exactly. Exactly.
Myra King (36:17):
All right. Well, thank you so much for joining me today. Our audience has gotten so much out of this conversation with you.
Carol Pehotsky (36:22):
Thank you for having me.
Myra King (36:27):
As always, thanks so much for joining us for today's discussion. Don't miss out. Subscribe to hear new episodes wherever you get your podcasts. And remember, we want to hear from you. Do you have ideas for future podcasts or want to share your stories? Email us at nurseessentials@ccf.org. To learn more about nursing at Cleveland Clinic, please check us out at clevelandclinic.org/nursing. Until next time, take care of yourselves and take care of each other. The information in this podcast is for educational and entertainment purposes only and does not constitute medical or legal advice. Consult your local state boards of nursing for any specific practice questions.