83: Shawna McMillan Pt 2: We all Have Biases; Investigate, Don't Ignore

Continue with nurse, nurse educator, and Sacramento, California native Honored Guest Shawna McMillan as she discusses working in reproductive health and family planning, caring for the LGBTQ community, helping others make decisions for themselves without judgment, investigating and not ignoring biases (the unrealistic expectation of leaving biases at the door), her love of teaching, paying attention to the person before paying attention to the task, the importance of soft skills, doing away with the hierarchy of nursing, the importance of curiosity, remembering you’re never alone, absorbing knowledge of others, and more!

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Transcript

0:01

And here we are on the proverbial flip side of this amazing honored guest, Shawna McMillan. Shawna, hello. How have you been since I last spoke with you? No. yours as well. It's just been too long. We can't wait these three minutes anymore to catch up. Let's just pick up exactly where we left off. So you just finished talking about anyone who missed her first episode. Man, I'm not even going to. recommend you Star Wars it and prequel it and all that. Go back, listen to the first one, then come back here because we're springboarding right off of what we talked about. We just ended talking about her career in Peds Oncology, obviously a subject near and dear to my own heart. But now the question, Shawna that you even wanted me to ask you, which was if you were not practicing in Peds Oncology, where would you be practicing and why? go back to working in reproductive health and family planning. I thoroughly enjoyed working in that field for many different reasons. I felt it was such an honor to be trusted with some of the stories that were shared with me and being able to help people make decisions that were so critical in their life. The decision to have children, if, when, how, not to mention just, you know, boiling down to, you know, sexual health, you know, that's sexual health is, I mean, we are humans, that is very much a part of it, but yet it's very stigmatized. I think adolescents in particular are given so much misinformation, false information, or no information at all, are oftentimes led to kind of figure things out on their own, which... can lead to lot of blunders, some of which are pretty benign, some that can have more devastating consequences. Also currently in our kind of political climate, we're seeing the devastation of what is happening when women don't have access to making their own reproductive health choices. So if I was not in peds oncology, I would definitely be back into the world of women's health. And I hope to eventually make my way back there. I also just am a big fan of community health in general, working just kind of with low income communities, underserved communities, in any way to kind of really get people the health care that they need. think what draws me, mean, many, many, many things draws me to reproductive health and family planning. But I think it's also because it's an area that gets so stigmatized and I feel very comfortable working in the world of I don't know, controversy, I guess I should say. I am very comfortable in being able to be that voice and to provide that space. And I feel that just as it's an honor to care for kiddos in the world of pediatrics, it's also an honor to be able to help people navigate through some of these very challenging. healthcare decisions that they have to make, especially when it's so convoluted with politics and religion and so many other layered things that it's, it should just be about the healthcare. But unfortunately it's not. It's so layered with so many other things that I like being able to be the person in that space to kind of pull back some of those layers or just make the path a little bit clearer. and a little less muddy. So it would definitely be women's health, reproductive health, family planning, all of that kind of world. Yeah, I love that. I absolutely love that. You talk about the underserved, you talk about politics, you talk about all that, and as a disclaimer here for everyone who's listening... As I've said in previous episodes, you know, we've had someone on who's a Christian or, you know, whatever the case may be. So, you know, the goal of this podcast is obviously not to discuss the deeper issues of religion, politics, etc. That's not what we're here for. But when they intersect, obviously the whole crux of this podcast is having honored guests on and who you are and who that person is. And no one on this podcast will ever be, you know what I mean, silenced on one subject or the other. because of whatever's going on in the climate today. And that is a guarantee I'll take to my grave, regardless of whether there's, you know what I mean, a few dozen episodes of this or it grows legs and lasts for a long time. But the idea is that before I've said, hey, so and so is a Christian, don't shut them out already because you have a preconceived notion of who that person is. And so now asking you, Shawna, being in the Bay Area, whether or not it's a fair, you know, I mean, being from or having been in the Bay Area, whether or not it's a fair assessment, you know, those of us up north or elsewhere, you know what I mean? Like there's, kind of think of this large LGBTQ community, know, trans individuals when you're talking about women's health, you know, see that as well, just even, you know, up here in Podunk, Spokane. I say Podunk, it's one of the three largest cities in the state, but it's still very like, you know what mean? Washington's very unique. For those that are not here, the left side of the state, very liberal and generally central and right side of the state, very conservative. But it's not like it's 50 -50. It's very populous on the west side. So overall, know, democratic governor, all the things. for quite some history there and much to the chagrin of conservative population. And so, you you see it played out on the daily. You talk about these, you know, political decisions that are being made and I, you know, we're super close to the Idaho border. Idaho, very much a red state, Republican state. And so when Roe v. Wade and all that happened, you see how the different states, you know, okay, well now it's up to the states to decide, which in my entire life, like that was not a thing. So like trying to navigate these waters is totally brand new. And so you've got Blue State, Washington, for the most part, you've got Red State, Idaho, and partially Eastern Washington. And so, I mean, we've personally seen there were a whole OB department in a hospital in Northern Idaho that shut down because the providers are, they don't want to provide there. They're afraid of what it can mean for their license. You you're talking about potential jail time. if things happen that weren't even necessarily, someone's come in and asked for, say, an abortion, but maybe there's something that happened that couldn't be prevented, and now these providers are worried that their licenses are in jeopardy. And, ugh, just the women's health, anyway. So, I digress, I'm going down the hole, maybe none of this makes the episode, maybe it does, who cares? Point of the matter is, you're down in the Bay Area, so if you don't mind talking towards this subject, do you see... either population, Peds Oncology or Women's Health when you've worked that previously. Have you seen like a large contingent of say specifically trans community, LGBTQ, and how does that affect how you care for them if at all? So I loved working in the Bay Area because there were so many spaces. In fact, there was a wonderful clinic called Lyon-Martin which I believe is still in existence that worked predominantly with the trans population, which I think is so cool. We had clinics that were specifically devoted to LGBTQ populations. And where I worked at the Women's Community Clinical, where I started, I should say, as a volunteer, we were open to anyone who identified as a woman. And we had folks on staff who were along that spectrum in any way, in various forms, identified in various ways. And it was awesome. And I I really loved being in an environment where everyone was kind of accepting and you treat the patient based on what their concerns are, right? It's all about meeting your patient where they're at and what it is they're coming in for and what it is they're asking, right? So, I would say that for me, I don't know how to say this. It's not that it's not, it doesn't matter to me. It matters to me how somebody identifies and what is important to them. but it doesn't matter to me in the way that I provide healthcare. I provide healthcare in the way that they want healthcare to be provided. And that doesn't just go for the world of reproductive health or family planning. That also applies to my world in pediatric oncology, right? It's across the board. My nursing practice is to provide the care that people are needing and looking for. And what kind of information can I present to help them make the choices that they need to make that that best work for them. And again, that's not just women's health specific, that's not just peds onc specific, that is just my healthcare kind of philosophy is how can we help people get the information they need to make the best decisions for themselves? And that's what for me it's all about. And it's not up to me to decide what I agree with, disagree with, and full disclosure, I'm full support of you know, my LGBT trans community, I am all on board. And I think that we, you we have a lot of room to grow. I'm very lucky here in California, but even then I've seen, you know, we have a lot of room to grow here in Sacramento. It's not the same bubble that we were in the Bay Area, and even the Bay Area has room to grow. We all have room to grow, all of us. And all it means for me is that we need to remain open, remain curious, and Remember why we got into this profession and that's to help others. It's it's not to be it's not my place to judge it's not my place to You know make my beliefs anyone else's beliefs my my goal is merely to help you make whatever decision is you need to make Make for yourself that works best for you and your life and your family I will say in the world of peds oncology you know, right now I have a handful of patients, adolescent patients who identify as trans. And I think that, you know, that information is important because it does, knowing certain things does affect certain medical things, right? So for example, you know, in the world of our adolescent oncology patients, we can do a better job of talking to sex and sexuality and reproductive health and pregnancy prevention, right? We often think, we're just focused on the world of oncology. And we ignore the fact that they're 17 years old or 18 years old and they have a significant other, right? It gets even muddier if they maybe identify as trans or maybe identify as, you know, somewhere, you know, not on the binary, right? Somewhere in the middle, whatever the case may be, they don't identify as one or the other. And those conversations become even more absent, right? we get even more, know, so many providers in the world, the pizza, you know, we don't talk about sexuality here. This is oncology. And it's like, well, there's still, you know, teens and young adults. We still need to be having these conversations. And it gets even, again, muddier if, you know, it's not a kiddo who identifies as male or female, or maybe identifies as trans or somewhere in the middle, those conversations become even more absent. And I think we need to do a better job of having those conversations. with our teens and young adults, regardless of how they identify and regardless of what specialty that they are in at the moment, right? And so it just goes beyond all of those things. And we tend to compartmentalize in the world of healthcare and humans aren't compartmentalized. And so it's important that we acknowledge all factors of somebody's life in order to provide the best healthcare that we can possibly provide. I just my brain is like as you're talking about these things There's two things that I have to get out there one of which is the term holistic care Which we often think about you know well don't just forget about the physical you know don't just focus on the physical Focus on the spiritual focus on that you know everything the emotional the mental health all of that that that is where yeah That's where people go to with holistic care, but the way you're describing it you just changed a paradigm in my mind that that holistic care also includes, hey, if you're in a certain specialty, don't be so narrowed on that specialty. Here we only talk about cancer. No, the holistic care means you've got a teenager who has hormones, who has reproductive organs, and who has these reproductive cells that then you're talking about. hopefully departments are, at the very least, I recall ours being very good about, okay, we need to have frank discussions about. egg, you know what mean, preserving eggs, preserving sperm donations prior to chemotherapies that may demolish the ability to have genetically born children down the road. And so the holistic care is, whether you're a med -surg and you've got someone who's there for respiratory stuff, obviously you're thinking about these other things. And I just love that it's a beautiful way that you've represented that. And for me, the other thing that popped into my brain, which is just like, sometimes and almost to a fault, I will boil things down to the simplest ideas because A, I feel like that's easier to teach other people and B, sometimes it's just easier for little old me to understand. And so when you boil that down to its essence, what you're saying is, are you, Jane Doe, John Doe nurse, nursing student, willing to go into your patient's room and subconsciously or not subconsciously be willing to say, you know what? You're getting less care from me today because you're not like me. Because you don't believe what I believe in. That just, so one of the things that I often, know, when I work with students, I'm just about to embark on my 25th group of students, which is very exciting. So I not only teach peds, but I also teach community health, and this will be a community health group. But regardless of the students that I teach, that this concept of leaving your biases at the door. Now, I say that that's not possible. You are a human, and you're gonna have biases. What I encourage you to do, is to investigate why you have those biases. Look at why you have those biases and how they might affect your behavior. I want you to be self -reflective of those. I don't want you to ignore them. I don't want you to act like they're not there because they are there and they will come through. So what I'd rather you do is when you're having those feelings, when you're having that snap judgment, I want you to pause and think about where that snap judgment came from and how can you challenge that snap judgment. So for example, in the world of pediatrics, occasionally, family members aren't present at bedside. And I can't tell you the amount of students I've heard be like, well, their parent isn't here. And have an immediately negative assumption. And I go, pause, let's take a time out and think about why that parent might not be here. That parent could be a single parent. That parent could have other kids that they have to get to and from school, to and other practices. That parent might be the only person who is working for that entire family. That parent might have exhausted all their, you know, their leave in order to be here. If they have a kiddo with a chronic illness who's frequently hospitalized, they may not have the time to step away from their job. Like there's so many reasons as to why a parent can't be here 24/7. So it's like, let's not judge that parent. Let's support that parent. Let's figure out what we can do to help that parent. Part of that could be just making sure we're taking really, really good care of their kid and not just in the medical world, but their social needs as well. I've been, most of my colleagues, I think in the world of pediatrics, I might be biased, but the nurses are just fantastic. It's just a different group of people. And we've been at nurses station with the kids at the nurses station with us or what have you. So I always just, for me, with the biases, you're gonna have them. We all grew up differently. We all have a different background. We all have different associations. We all have different things that trigger certain memories or experiences. And I don't want anyone to ignore those. That's what makes us who we are. But if it's one that causes a negative or one that might impact your behavior negatively, I want you to pause and think about why it's doing that and how can you challenge that assumption. because I think leaving biases at the door is an unrealistic expectation, right? And that was what I was often told in nursing school. But I think when we do that, we don't challenge ourselves to get over that bias. We don't challenge ourselves to better ourselves so that we can better provide patient care. And so, you I think that you're gonna have biases that's, we are human, but my goal anyways, as both a human as an educator is to How can we walk through that bias? How can we dismantle that bias? How can we pull it apart and kind of maybe look at it a little bit differently so that we can provide better care? that's, mean, leaving biases at the door for me is just not realistic. And I think it ignores and potentially perpetuates kind of the negative healthcare outcomes that could happen because of those biases. So well said. You know, yeah, listener, of course, Shawna and I have it together. Of course, I've always cared for my patients with 100 % holistic true intent. Legitimately, there was a family, sorry, I do speak fluent sarcasm if you haven't picked up on the podcast by now or if this is your first episode. So know that that was 100 % sarcastic. I had a family I remember one time, beautiful in peds onc Beautiful, beautiful toddler, beautiful, like not a great prognosis and but just still totally with it and all the things and this patient's parents, you know, I would find them consistently behind the curtain that exists to separate their sleeping little area from the patient's area and like during the day or you know what I mean during the evening when I first come on, so it's night shift nurse at the time. And I mean, man, I was quick to just be like, this is awful. This child needs their parents. you don't know how much time you have left. I mean, all these thoughts and you just never know, not excusing anyone's behavior, anything in that regard. even like just saying this the way I'm saying it. You know what I mean? Like, I'm already checking people's biases, but the truth of matter is you don't know what they went. You don't know what they've gone through in their life and grief is a it's a beast. It is a beast and so They're already grieving the loss of their child Before that child is gone So do they is this a self -protective measure? Are they you know what I mean trying not to attach anymore and you know I mean is that I and all that it's life is not black and white It's never black and white and we know this but yet We still live in the fallacy of trying to make this, like you said, compartmentalize it, compartmentalize grief, compartmentalize life and death, and these guys are horrible, they're not taking care of their child, and they're not spending their last remaining time with them. You can go to simple postpartum. I tell my moms, almost 100 % of my moms, I tell them, guess what? You're gonna get judged no matter how you feed your baby, whether it's breastfeeding, bottle feeding, formula feeding, pumping. you are going to be judged. Congratulations. Welcome to the world of parenthood. And people are even nowadays more free with their opinions than they always have been. So do what's right for you and your baby. That's the bottom line. You know what I mean? Like I just, it just drives me nuts. Drives me nuts. I thank you. Is there anything else you want to add on that before I flip the script here on you? No, let's flip it. keep, I mean, I can talk about this until I'm blue in the face. So we gotta keep on chugging along. Otherwise we're just, never gonna make it through. Chug it along. I love it. with that, let's talk about you as Shawna the Nurse Educator. So what is it that you teach? Why do you teach it? So I teach pediatrics and most recently the past two years or so I've picked up community health. I teach pediatrics, I'm a Peds nurse. I love everything about it. I love teaching. I absolutely love teaching. In fact, right now I full -time nurse, part -time teach. My ultimate goal is to flip the script and full -time teach and part -time nurse is my long -term goal. But I love, I teach the pediatric rotation and the past couple of years I picked up a community health rotation because I love community health. And community health was one of the departments in which you did have a master. So I mentioned earlier that the school I was teaching for wanted all adjunct faculty have their masters and then halfway through my program they gave an exception to those who teach peds or maternity. But I was already halfway through and I was like, well, I'm going to keep chugging along. Well, that opened the door for me to be able to teach community, which I love. Again, my first undergraduate is in health education with a focus in public health. So I thoroughly love teaching. It is by far one of my favorite things ever. You know, I don't have to do this financially. If I wanted to do something financially, I'd prep up a per diem job at another hospital and do a per diem somewhere else. I don't do it for the money grinded side money is always welcomed. But I do it for the love of teaching. I think there's so many things that I had great instructors in nursing school. had not so great instructors in nursing school. I think because I've been teaching almost, I mean, not even two years out of nursing school, feel like I never left nursing school. So some of it, so much of it is still fresh in my mind. But. I think the thing that I love most about teaching and the thing that I tried to teach the most is the soft skills. And so a lot of my students come in and they're all nervous. I haven't started an IV. I've never done an NG. I've never done a Foley. Very skill, skill, skills. And don't get me wrong. I think skills are incredibly important. Learn as many of them. Learn as many of them as you can. That being said, I don't really care if you ever get good at starting an IV. You probably won't be good at any skill when you're in nursing school. you're just not going to get good at any of it until you're actually in your area of nursing. Right. So for example, all I've ever done as a, as a registered nurse is peds oncology, giving chemo and blood and central lines and all of that. I never did any of that as a student. Right. And that's all I do now. all the things I learned in maternity, I don't ever do now. Right. It's like, always tell my students like, you're gonna need, you're gonna learn the skills that you need for whatever unit you end up on. So. you know, don't worry if you've never started a Foley in nursing school. You may be on a unit in which you never start a Foley or, you know, don't worry if you don't get that grade at inserting NG tubes. You may never have to do one wherever you end up. Like it's okay. But what I want them to learn is those soft skills. Like I said, the checking of the biases, the really the figuring out how to talk to families, how to work with families. One of the things my students often, in the world of pediatrics, they struggle with is your families are your best experts. Don't act like you need to walk into the room and know everything. And that could be said for all areas of nursing. If I walk into a room, especially kiddos with any sort of complex medical history or chronic illness, their families are the pros. Those kids oftentimes are the pros, not me. I walk in and say, okay, how do you guys normally do this? How can I fit into that puzzle? What can I do? So that's what I want my students to learn. I also want them to learn the nuances. I was with a student once and we were taking care of this older kiddo. was very, yeah, he had very severe Down's syndrome, not very high functioning. He was alone and they actually had him restrained, soft restraints because he would otherwise pull out all his tubes, lines, And... He was also nonverbal and we go in and we do the assessment. And throughout the assessment, kept having to remind student, no fault to the student. This is very common for students to be get task focused and not person focused. And so I always have to slow down, still a person in front of you. And then before we left, I was like, how about we offer him something to drink? She never even, that didn't even dawn on her. like, look, know, he can't do it himself and he's nonverbal. He can't even ask for it. And the minute she gave me something to drink, you can tell it was like the best thing that ever happened to him. And I'm like, see, these are the things that we have to pay attention to. We have to pay attention to the person before we pay attention to the task, right? One of my trick kind of questions I asked before, and I don't like to do like trick questions or anything like that, but like when I say, okay, what's the first thing we're gonna do when we walk in a room? Students will give me hand hygiene, introduce myself, check emergency equipment. I'm like, ba ba ba. Back up, like look at your patient. How is your patient doing? What is going on? Are they okay? Are they safe? are they in a good, like, because that is gonna completely change the directory of whatever your primary goal was, right? Like, look at your patient, that's your first goal, right? And so I think, you know, just teaching students those kind of softer skills, you know, how to engage with other nurses, how to engage with the clinical team, you know, how to really, really, really advocate for your patient. I mean, straight up, I've had conversations, you know, I remember working inpatient. and surgery would wanna go in and do a dressing change. I'd be like, hold up, I just put that kid to sleep. You are not going in that room. You are gonna have to come back at a different time. Or if you come back and wanna do a dressing change, you need to call me 30 minutes beforehand so I can get pain meds on board. And feeling really comfortable with advocating for your patient, regardless of whose toes you might quote unquote step on, right? I think when I step into a shift, that's my patient. I am responsible from the start and stop time of my shift of this patient. And that doesn't mean I don't collaborate with anybody else. That doesn't mean, but what my goal is, is I'm the quarterback and I need to make sure that whoever steps in that room is doing so appropriately. And so I try to teach my students those soft skills of working with families, also paying attention to the other people in the room. In my world of pediatrics, paying attention to the siblings. The siblings often get so left out when there's a kiddo with any sort of illness, especially a chronic illness. Yep. I do make a strong point to engage with the siblings that are also in the room, right? You're kind of working the whole room. Also how to read the room. I'm a pretty animated, silly, kind of over the top person, which works well in pediatrics, but you also read the room when it's a bit more somber, right? I don't always go in with this cartoon character personality of mine, you know, and knowing how to read the room and when to take it down, or sometimes when to lighten the mood, right? Like I got more. silly 10 year old jokes than you can, you you imagine, right? And really being able to make, you know, yourself vulnerable and silly and what have you. So I'm trying to teach these nuances to my students is yes, tasks are important, but anybody can learn the task. It's the new, such the nuances of nursing, being able to be there during the high, being able to be there during the low, being able to read those moments, being able to, you know, the right questions, right? People won't often tell you full story. It's all about knowing how to ask the right questions. Also, knowing about how to read the room, read their body language, and that goes with family, that goes with patient. So for me, my philosophy in teaching is primarily soft skills. How can I teach you as many soft skills as possible? Because I think that's what we don't learn in nursing school. We learn all the tasks, tasks, tasks. And don't get me wrong, those are so important. I'm not downplaying those in any way.-hmm. But soft skills are so important. And then the other element that I always want my students to know is there is no one area of nursing that's better than the other. There's this idea that ICU is better than ED, which is better than med surgery, which better than outpatient, which is, it's all hard. You just have to pick the level of hard that works best for you, right? So it's like, you know, home health, they go into a stranger's home and by themselves with whatever equipment they have in their bag, and they have to be able to do that to me sounds crazy, right?-hmm we can't fault know, I can't fault's the wrong word. We can't categorize the difficulty level of nursing. It's all hard, right? And like put a nice few nurse and a med surgeon, they're like, what am I doing? There's like four patients, they're all walkie talkies. They all need things, they're running around, like, right? And so it's so different. Or like I've worked with, you know, I've had coworkers who've gone into. other areas because you know they no longer want to do what we're doing or I've met nurses and that's I should go back to that that is the beauty of nursing too is the fact that all levels of nursing or all areas of nursing are hard. There's no one area that's harder than the other. We find what works best for us in our period of life and when that no longer works nursing is so wonderful that we can make those changes and so I always tell my students like If you ever find yourself getting burnt or disgruntled or starting to affect the way that you care for patients, take a step back, reevaluate and potentially move into a different area of nursing because that may not not work for you anymore. So example, I've worked with peds oncology nurses and once they have kids, they decided I can't do this anymore. And that's fine. Like there's nothing wrong with that. You work with what's best for whatever fits in your life. It doesn't make you any better or any worse of a nurse, right? It has to transition for whatever works for you. And so there's no hierarchy of nursing. I think that that we need to do away with that myth. It is all challenging. And the beauty of nursing is we get to change if we need to throughout our career. Amen. Hallelujah. That hierarchy of nursing is exactly what part of this Feeding Our Young podcast is about combating. Right? Like it's not just nurses eating their new young new nurses. It's you see it all the time. You know what I mean? And it's in real life. How do you like, you you can always make yourself better by comparing down, but you can also always make yourself feel worse by comparing up. And there's sometimes there are actual hierarchies. And in this case, there are not. This is not a thing that exists or should exist for the exact reasons you just said. I can't even like, there are some people that have absolutely told me, you went from peds onc to Postpartum. You know, it's so much easier there. I'm like, spend a day in my shoes and tell me. Like when I first started summarizing for people, well, how do you compare the two? Like, what is that like? And I'm like, it's very easy for me to describe for you. You're just as busy. You are just, and maybe it's a tasky busy, it's a more tasky, and maybe the acuity is not always as there as it is in Peds Oncology, for sure. But it's still busy, and you're still running your rear off, and you're still X, Y, Z. And so there's this misperception that maybe you go from some area to, well, postpartum. And whether it might be even labor and delivery to postpartum. And then, well, when postpartum burns you out because it is so busy, then you go on to greener pastures like in case management and this, that, and the other. And that's what I'm saying! they have to do, they're working with insurance, they're working with outpatient services, like are you kidding me? They're quarterbacking so many things to say that's not hard. I work with coordinators and the amount of balls they are juggling on any given day is just, it's, and ultimately this whole idea of hierarchy nursing is nonsense. It's the patient who's in front of you. They need healthcare and they need the same level of attention and skill that any other area of nursing, you're not any, you're not deserving of any less nursing care because you're quote unquote, not as acute as somebody else. Like you still, you know, every patient who walks into the world of healthcare, whether it's outpatient, inpatient, whatever department they're in, they're still there because they need some sort of healthcare. And it's our job to provide that in the best possible way. So to say that there's, you know, one is better than the other is absolutely nonsense because that's like saying that some patients are more deserving than others of healthcare. I don't buy that. I don't agree with that. That's not my philosophy. Every human is a deserving of the utmost quality healthcare. And it doesn't matter whether it's because you need emergency care or ICU care or postpartum care or oncology care or home health care, whatever the case may be. Again, if you say there's a hierarchy in nursing, that's like saying there's a hierarchy in patient needs. And I'm not talking about emergency triage, that's a different story. Yes, there is a difference between someone who can't breathe versus someone who needs stitches, but that's a different story. I'm not saying that. I'm just saying all of those patients, I don't want my ED nurses to come after me. That's not what I'm referring to. We do know that certain issues require our immediate attention. But that doesn't mean that any patient deserves any less care based on whatever they're presenting to us with. any less quality of care. Yes, you might need more attention in the moment because you're trying to die, but otherwise, quality of care. I don't care if you're trying to die or you're on the opposite end of the spectrum bringing life into the world or you're just there to get a stub toe look at. The quality of care needs to be there. And to those nursing students who are hearing Shawna's discussion, which again, man, just bringing it. your discussion about those soft skills and that sort of thing. There are some of you that are listening to that and you're going, yes! And it's inspiring you and you are ready to just conquer the world. And there I guarantee, because I've got students in mind that I've cared for before and helped along the way that are hearing your discussion about soft skills and going, you mean I've got to worry about all of that too on top of everything else? And to you, just, yeah, we just want to encourage you. And I preach the same thing to my students about like, you will learn the skills you need to, yes, you need to, like you said, we're not discounting skills, and you need to pass XYZ skill exams, and you need to do all the things, and you don't cross the sterile field. Don't give somebody an infection. Don't do this, don't do that. Those are all important things. But you're gonna learn those particular skills that you need to learn for the niche you're gonna jump into. Hopefully on that job and you're going to get to learn those and perfect those skills more when you enter that field It's the other stuff that can't get neglected because like you said you will walk into a room and you're it's the it's that skill mentality the task mentality and I was there in the first, know, honestly a couple of few years of my career yeah, it's what you focus on and don't beat yourself up for that because You also want to make sure the vanco gets in on time before the gent has to get in, before you have to give blood and platelets. And let me tell you, you've only got sometimes a couple lines to make that happen and that's rough. So yes, focus on what you got to do to organize all that, but don't lose the person in the process. So thank you for saying that. Before we wrap this up in the traditional way we wrap it up, which will include that one thing you want nursing students to take away. excluding the one thing you want them to take away. Is there anything else you want to mention as far as like what you teach your students, the important things that you that are near and dear to your heart? I mean, I mean, you have already shared so much. I'm like, we could end right here without saying anything else. And this is gold. But is there anything else I want to give you the opportunity? I don't want to shut you down as far as like anything else you want to make sure it gets communicated. think the last couple of things I just want to say about my philosophy and teaching and the kinds of things that I want students to walk away with is first and foremost, be curious. Be curious. Always look to understand the why behind the what. If you don't know like why something is happening, figure it out. One of the things that I really appreciate about my trajectory in nursing and so I oftentimes when I teach pediatrics, teach on like a general mixed floor. So there are some oncology patients, but there's a lot of other stuff. Now I've only ever done a Peds oncology. So when students come to me with questions, sometimes I'm like, I don't know, let's look it up. Because I think nursing school does two things very wrong. They teach you that you need to know everything and that you are alone in doing it. And those two things couldn't be further from the truth. I say the smartest nurses are the ones who know where to go for the answer, right? So as a Peds onc nurse who walks into a med search floor with these students, I'm like, well, look, I've not encountered that before, but let's look it up together. And this is how I would figure it out as a nurse, a registered nurse who's not experienced with this sport. Let's walk through this. I love those moments. And it also gets to show students that I feel like nursing, you need to be very humble and you can't have any ego. Be ready to learn, be ready to ask for help and don't stick to this is what I've always done. So this is how it could only be done. No, we have to be humble. We can't have any ego in the game. And if you don't know something, Figure it out, whether that means looking at your policies and procedures, whether that means asking your nurse educator, asking a more experienced nurse on the unit, asking a family member. Tell me more about this chronic illness that I have never heard of, right? And so, you know, the thing is, is nursing school, you don't have to know everything. You just have to know how to find the answers you're looking for. There's no reason for you. The resources are at our fingertips, whether it be online, whether it be with our colleagues. So... You know, and then not to mention you're never alone. Phone a friend. That's why I always tell my students, if I ask them a question and put them on the spot and they don't have an answer, I look at them. If there's another student around, I say, phone a friend. Ask your coworker. Ask your classmate right here. Like this is how you would do it in the real world. You would ask if you didn't know how to do something. As a new nurse, I can't tell you the amount of times I walked in a room and something didn't sit right with me or I heard something or saw something. I'm like, I don't know about this, but I'm going to go find someone who might. And then I get more experienced. You saying what I'm seeing, I'm getting a feeling and I don't really know what this feeling means or I'm hearing something. I don't know if I'm hearing it right or seeing it right. And it was so great having a more experienced nurse speak. no, you're right. This is like, and they would oftentimes be able to call what I was sensing or be able to kind of point me in the right direction. no, we need a call provider. We need to get X, Y, and Z on the board. But you're not alone. You don't have to know everything, but you do have to stay curious in order to find those answers. Know your resources and stay curious and be humble. Like just Always, you know, this is not about who is the best at this. This is not a competition. The goal is to get patients the best care they possibly need. So if, you know, if you don't have the answer to a question, you don't have the skill to do what is that that's needed, then you find someone who has that knowledge and who has the skill to do that, to help teach you that. doesn't mean you pawn it off on them. That means you absorb that knowledge, right? So for example, something as silly as, I do, I've learned to do ultrasound IV starts. I do a lot of ultrasound IV starts on the kiddos who come into my unit. Every now and again, there'll be a kiddo that I'm like, I am not successful at this and we'll have to call the action team. But you better believe when I call that action team to come in and do that line, I'm standing right over their shoulder and I'm like, what are you saying that I didn't see? What technique are you utilizing that I didn't utilize? So it's me now trying to learn from that resource the best that I possibly can. And that's just one tiny example. So just stay curious, like, Be humble, don't have any ego, be curious, and the goal should be to provide the best patient care no matter what it is you're doing, no matter what unit, no matter what department you're on. Patient care is of the utmost importance. I'm speechless. I just, you guys, tell me you've got a pen and paper. I'm bringing, I'm showing my age. Tell me you got a pen and paper. At the very least, you've got your MacBook, you got your laptop, you're writing notes. And if not, go back and listen to this again. Because I'm like sitting here, I wanna take notes myself. The literal wisdom that you are bringing, Shawna, I just, can't thank you enough for that. 100%, because there are so many, sometimes we get, an episode will be the heart. You know, we get into heart matters and we have a good cry. We have a good like all the things. Some episodes it is just nugget after freaking practical nugget. And that's what this episode is. So go back nursing student. If you haven't already recognized the opportunity that has come before you. And like even just for me as a nursing instructor, I'm like, OK, yeah, I'm. kind of been doing this, I love the way like, da da da da da da da. We're always learning from each other, never stop being curious. I just, thank you. I hate to end it. We're gonna end it, we're ending it. So, Shawna, the three words you used to describe nursing school, come back around to them to remind us what they were. They were talked about way back in episode one. What were they and why'd you pick them? The first one I chose was fast and that's because I was in an accelerated program. It was 12 months long. think, you know, by the time where I figured out where the blankets were on a unit, I was now on a different unit. It was very, very fast. and I think nursing school in general, whether it's a one year or two year or whatever the program may be, it's just fast. Like you know, whenever graduates nursing school feeling like they know what they're doing and that's okay. You're not supposed to know nursing students. You're not supposed to know. You're not going to walk out of nursing school being ready to be a full fledged brand new nurse ready to go on your own. There's nurses like Eric and I and many others that are out there who are ready to take you under our wing. Find us on your unit, whatever unit you end up on. We will be your safe space. We'll walk you through. We exist out there in the world. So there's a lot of us who do love our new nurses. And then the second word I chose was exciting. boy, it was exciting. The amount of knowledge and learning was just bonkers. And it wasn't just like the actual information. that I was learning that was like just mind blowing in itself, but just learning a lot about myself, learning a lot about patients and their life and kind of all of the nuances that got them to be in the position they were in. Again, I had to question some of my own thoughts and feelings about situations, that whole idea of questioning your own bias. I do it on the regular. Why do certain things make me feel a certain way? It was just, it was very exciting both in my... personal learning, whether it be in my personal growth or even my kind of academic growth. But it was also just exciting to then be able to be a person who could be of utmost service to somebody else. Being able to be in a position where I could provide as much care as us nurses do was really exciting and overwhelming. Overwhelming in all the things that I had to learn overwhelming and the responsibility that nurses have overwhelming in my student loan debt, overwhelming in the emotions that I would feel, the falling in love, the heartbreak, the everything in between, right? The emotions were so overwhelming. My love for my classmates, I had such a tight group in my nursing program. I couldn't have got through it without them. I'm still really close with a good number of them. it's just, feelings, be open to feelings. Just crack that chest wide open. The more you do, the better it is. You're gonna get your heart broken and that's okay, but you're also gonna fall in love. It's just wonderful the amount that you will learn. The whole experience has just been overwhelming. And I don't say that as in a negative. It's just overwhelming everything. Overwhelming good. There's been overwhelming sadness. There's been overwhelming learning. There's been overwhelming disappointment. It's just been so wonderful. I can't imagine another profession. I just, really can't. How many times have we heard that on this podcast? From me, from others, from everything else. There's no better profession. And for those of you, again, bringing that back around, maybe just listening to the last hour and a half has been overwhelming. I don't know. You either have been inspired or you've been inspired and overwhelmed or you've just been straight up overwhelmed. Our apology, yeah, yeah, because we live in that state and we live in that state, especially in nursing school. You're not. Fault for feeling that way and also know that hopefully you figured out by now That's not our intent not Shawna's not mine to overwhelm you with this and if you are great take it Unpack it at your speed go back relisten to it take the notes you wrote or gonna write you know what I mean and just Pour over them reflect over them. You know in the vast amounts of free time that you have but Yes know, one of us, someone who, me and Eric, all the educators in the world, all the nurses on the unit who love their new nurses, who remember exactly what it's like to feel overwhelmed. And that's not to say as experienced nurses that we don't feel overwhelmed. We're just more experienced on how to navigate those feelings of being overwhelmed. So get used to feeling overwhelmed. What's going to change is that you're going to learn how to deal with those feelings of being overwhelmed much better and more efficiently. You're gonna find your person and you're gonna lean into them. We talk about that often. Okay, Shawna, if it hasn't already been covered, man, so many practical things. What's the one thing you want nursing student to walk away from your episodes with? that you made the right decision by going into nursing. You made the right decision. I know there are so many memes out there all over the Instagrams and what have you that say, know, did I choose the right profession? Yes, you did. Yes, you did. And if you are questioning that, then maybe you need to be on a different unit, maybe in a different department. Maybe you need to be inpatient, outpatient, whatever the case may be. But if you had a calling towards nursing, then you made the right decision. Just maybe you need to be at a different hospital, maybe you need to be in a different environment, but you made the right choice. Nursing is absolutely wonderful and it can be everything you want it to be in every sense of the shape, form and fashion. Just find your spot. And sometimes it takes a little bit of time, but once you find your place, I promise you, you made the right decision. And your one piece of advice for fellow instructors, lecturers, teachers, professors. Remember what it was like. Don't forget what it was like to be a student. Don't forget what it was like to be a student. Focus on the things that really matter. I tell my students all the time, yes, our care plans and whatnot are important, but I would much rather you be in a room with your patients than at a computer working a care plan. If you tell me, the nurse that I paired you with is off doing patient care, but you're at a computer trying to get your care plan done, I would rather you be in a room. And so for those instructors, like, really remember what is actually important and it's not the care plan. I'll tell you that much. That's not the most important part. Yes, it's a very, very good learning tool, but it is not the most important learning tool. In fact, it's out of that inpatient care, patient care takes. just nursing instructors don't lose sight of what is important and don't lose sight of what it was like to be a nursing student and don't. don't lose sight of why we are nurses and let's teach why we became nurses and the beauty of nursing. And yeah, just remember what was like to be a student and focus on the skills that are going to help them thrive, not some of the nuances that we all have to do as part of academia. But yeah, let's remember what it was like to be a student. There's nothing left to say. There's nothing left to say. Shawna, and yet there's so much more we could say, but thank you so, much for giving up your time this beautiful afternoon, especially California. That's gotta be beautiful weather down there. It's not too shabby up here either, but thank you. I hope you have an amazing rest of your day. Thank you for having me. This has been so much fun. Just know student nurses, we love you. We're out here for you. We're rooting for you. And yeah, good luck in all you do nursing students. We're rooting for you. And thank you so much, Eric, for having me. This has been so much fun. My delight, my pleasure. Go Night Owls Night owls, woohoo!