163 - Katie Kunda Pt 2: You’ve Got to Get the Buy-In

Continue with nurse, nurse educator, and Snohomish, Washington native Honored Guest Katie Kunda as she waxes eloquent about a couple of non-traditional nursing jobs, how her pre- and post-Africa trip prepared her for nursing education, her passion for cross-cultural nursing, how she prepared for her trip to Africa, why she chose Africa, the lack of resources she and her peers had to work with, cultural differences, how training takes place there, and more!

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Transcript

0:01

Hello everybody and welcome to the B, part B flip side of the Katie Kunda experience. And there's something I wanted to touch on before we dive into that. uh part of it was because the sports fan in me just automatically, like for those that are like, my gosh, that's a shallow discussion. But like, mean, Katie, you and I were talking in the in-between and Katie's like, no, I mean, it's like, that's right. Like what were you saying when I brought that up to you? What were you telling me about the whole sports situation? fan in general. Like the good days are great and you're like, yeah, this is why I'm team Seahawks or this is why I'm team, you know, Bulldogs, right? Like, cause they win and this is great. But then the bad days really just make you want to kick a hole in the wall. Very much so. so, but before that crystallized in my mind, there was something else I wanted to touch on just from what you were saying about all of that and having the hard days and all that business. And this was something that stuck with me so much so that I just saved it in my photos on my phone and, you know, reposted it and all the things. But this comes from a website or a website, an account on Instagram. I think it's a daily log of files. And I don't know. I only saw the one post they did. I haven't checked in on them daily. I haven't checked in on them daily. But there was a word that pops up in my feed and it's suckrifice. S-U-C-K-R-I-F-I-C-E. Doing what you absolutely must do even though you really, really hate it. And I'd love to say that being a middle-aged gentleman myself that I've overcome all the need to do that, but there's just days where you have to sacrifice. And this is their further discussion on it. They're expounding of the definition, if you will. Suckrifice is a humorous modern slang word used to describe the act of doing something you absolutely hate but must do anyway because responsibility leaves you no choice. It obviously, I'm putting in the word obviously, blends the word suck and sacrifice, capturing that resigned acceptance. when a task is unpleasant, annoying or draining yet unavoidable. And that is what I love. It goes on to talk about it like, it reflects adulthood in its rawest form, choosing discipline over desire and getting things done despite the internal protest. I don't want to go to work today. Okay, I'm going to work today, but I don't want to do that thing. Well, I don't want to float. Well, I, I, I, I, I, And those shifts, I don't know about you, Katie, some of those shifts for me are the ones that I get the most from. And I'm like, oh, this is why I had to do this today, or this is why I had to be there today, right? Yeah, it gives you things to draw back on, experiences to draw back on. I think, yeah, I mean, you and I were chatting too in the in-between about regrets and things like that and not having any, because there's always a learning experience we had from them. So yeah, yeah. yes. Oh, I love it. Everybody's like, okay, Eric, you're really not following your own format. You usually start with the fluff questions. We're still going deeper on the conversation we ended on there. I just, I can't help it. It's that important, and especially in today's modern society where, man, we want easy money, right? We want to make those social media bucks. Yep, let's just, and that's great. If you can do that, more power to you. And if you get an income stream from that, great. But there's something to be said for character building when you have those moments that require sacrifice, as the case may be. But on that note, Katie, let's say today is not a sacrificial day. Let's say you're not on a podcast chatting all things nursing. Instead, you're enjoying your hobbies. What might those entail? Well, I'm an avid reader. I love books, mainly fiction. I do love a good nonfiction, I would say, for any health care nursing folks out there. The Ice Pick Surgeon by Sean Keane, I he's the author, is a great one. Talks about ethics and talks about all the things done in history in the name of science and the ethics behind it. things all way from Cleopatra to current ethical debates in the healthcare setting, so, or in the scientific setting. So that's, that's one of my favorite non-fiction, but I mainly do fiction. I do love, I do love some good fantasy. So yes to, you know, yes to fourth wing, yes to all those good fantasy, Akhatar, shout out to my Akhatar peeps out there. But yeah, so I'm an avid reader. um Pick that back up after nursing school, cause really, let's be honest, you don't do. anything but textbook reading and articles in nursing school. um And then for other hobbies, I like to snowboard in the wintertime and camping in the summer. Those are kind of my two seasonal activities. And then of course there is travel. So I love the travel. love it, I love it. Any favorite places that you've been so far? My favorite place that I've been so far, I'd have to say is Scotland. I that's my favorite. um So for, I got to go during the Fringe Festival in the summertime, which is they like shut the whole city down and everything turns into an art venue. They have everything from music to performing arts to physical like art, like paintings and sculptures and stuff like that. They've got acrobatics, all sorts of things. It's really fun. So. That was, I think I'd say that's my favorite trip, but I would say my most out there trip has been Africa. So those looking at the episode tile picture here, that picture came from her trip to Africa. And so excited to talk about that. But before that, my math brain is demanding that we touch on two more brief little bits of your career. And so you mentioned, of course, you're in the ER for four and a half years, but the math in my head said you've been a nurse a little bit longer. so the first step of that is, what other things have you done? Yeah, so there was about a year after nursing school, not quite almost, that I was applying to different residency programs and waiting to kind of get a spot to get in. And so I did odds and ends of various nursing jobs kind of to pass the time and make income. And of course I graduated, I think it was 2021. And that was kind of right as we were kind of coming, starting to come out of COVID a little bit, and they had just released the COVID vaccine. And so um a lot of healthcare organizations were partnering with the different counties to do vaccine clinics. So I did, I worked for a time as an independent contractor actually for a third party healthcare organization. So I did vaccines. Um, so one the cool things I got to do was actually go on, up and down the coast of Washington, all the way from, um, Vancouver BC, all the way down to Vancouver, Washington. Um, and visit all the ports and do, um, get on the container ships and do vaccinations on. And then, um, jump and race back to Seattle or Bellevue or somewhere out there and do a King County vaccine clinic. So that was one of things I did some time at BioLite. for plasma donation. So I did donor screenings and that was very interesting. Taught me a lot of foundational stuff actually going into nursing about um just kind of chronic diseases and chronic illness and things like that. I thank you for kind of enlightening us on that because I, you know, again, what's the bulk of everyone, you know, and a lot of nursing schools are geared towards getting students ready to go into the inpatient world and, you know, the hospitals, you go to the hospital, you graduate, you become a hospital nurse. And I mean, I knew in the very early going on that I didn't want to be a hospital nurse and then things changed, you know, the way my story went. But the point is there's so many opportunities out there, so many different things you can do, things you don't even know that exist. So thank you for kind of enlightening us on that. Like they give you the foundation that is really helpful or tidbits and pieces that are really uh helpful going into bedside nursing. So there's no such thing as a a dumb nursing job, right? Like they're all going to teach you something and give you foundational tidbits that you take into bedside. Ah, very well said, very well said. And then the other bit before we get into your passionate topic is that you also mentioned becoming an educator. Obviously that's how I met you, is it Gunziga? You mentioned the who that got you in, but the what, I want to ask more of the why. Why education? How'd that come along? Was it just strictly that conversation you had with her? Was there more to it? perfect segue and I'm so glad you asked this because I know that we are going to be talking about my Africa trip and this ties in beautifully because I, it was the preparation and that kind of all the things around the post pre and post Africa that actually got me into education. So um I told, I talked about last episode that um I have become really close with my old Dean. because she reached out after nursing school and um wanted to sit down with me and talk about, you know, the good, the bad and the ugly of nursing school. And she had found out, like I said last episode, she had found out that I was planning a nursing mission over in Africa and asked if I would be willing to come back and talk about my trip. And I said, yes, I'd love to, because that's the thing, the nursing program that I went to, they have that built in. So typically your senior year, It's not an optional thing. It's not a summer thing like some nursing programs do. It is built into the curriculum where you spend a month practicing nursing somewhere else. um You know, be that another country. Sometimes you do stay in the US, but you get to go to other more remote regions like the Appalachians or um Alaska with the Inuit villages. And so you go and practice nursing for a month. in uh a very, very different environment. I'll say that. uh Most of the time it is overseas, but with COVID I didn't get that experience. And so I wanted to kind of initiate or instigate my own cross-cultural experience. And so I ended up planning that and we can talk about that in a second, but I ended up planning that and going over there. And before I left, I asked, I said, okay, so when you have me come back and talk, about my time in Africa. What course? Because I'm fresh out of nursing school. Everything's fresh on the brain. I remember all the courses, all the classes. So I said, what class are you wanting me to come back and speak in? And so she told me. And it's one of our cross-cultural nursing courses, because there's a few. And I said, OK. And I had everything saved on my laptop from nursing school. So I pull up the syllabus, took my laptop, put the syllabus, took it all to Africa, and literally took notes. My whole time there, I did interviews with some of the doctors and program managers and stuff like that over there and asked questions based on the syllabus for the class that I was going to come back and talk in. And then I came back and put together some slides and again really highlighted what that syllabus, what those uh kind of learning objectives were for that course. And the rest is history. I loved that. And so I ended up going back and teaching. ah or guest speaking a couple more times, um like in the professional, uh intro to professional nursing course and things like that, and volunteered a little bit in the lab and just, I loved it. I loved it. So then ah I moved over here and knew that I wanted to get on at one of the local schools. So did a little bit of time at Eastern ah and then ended up settling over at Gonzaga. That is so freaking cool. Alright, well then, enough about the rest of everything else because uh your passion for this cross-cultural nursing is evident. So just, I'm in your class now. I'm chilling. I'm taking notes. And I'm in Katie Kunda's cross-cultural nursing class. yeah, alliteration's always fun. ah But no, legitimately, I'm gonna shut my mouth and just like, what do you wanna share? What do you want listener to hear? where do you want me to start? Because I mean, I can talk all the way about the preparation and talk about like, because I know there are a lot of students out there that are interested in going overseas and doing that. And I, again, went the unconventional route and did not go with the health care organization because as a new grad, you need experience to do that. kind of, I mean, I can talk about my intro on how I got there if, I don't know. Yeah. got we've got I'm looking at the clock. We've got easily another 40 minutes. You got 30 to 40 minutes to share whatever you want to share about cross-cultural nursing, whether that includes the prep work and or the I mean, let's land on how it impacted you and everything. from you, okay? We're talking about buy-in. I need some buy-in from you. You got it, 100%. So how do you prepare for something like this? em Yeah, so I looked at the, I mean, there's so many organizations out there. There's Doctors Without Borders, there's Mercy Ships, there's churches that will send groups over there and do nursing missions or healthcare missions over there, medical missions, there we go. em But I, um at the time, ended up settling with a volunteer organization. It's actually based out of the UK, Help Projects Abroad is the organization that I use. And it's strictly just volunteering. They have different pathways that you can do everything from healthcare to human rights. So a lot of like law students that are pre-law will go and take a summer and do a volunteer mission elsewhere and kind of in the human rights realm. There's environmental conservation. So there's all the different areas that you can do in. And so of course I chose healthcare. And then um they have the countries that they offer those programs in. And so from there, after you've chosen the program that you want to do or the volunteer pathway, then you choose the location that you want to go to. And so they have many, have many different locations. I ultimately decided on Africa. um and ended up doing it that route. So as a new grad, it's really hard because you're either getting on with like a medical mission that a church is organizing um or a volunteer organization. There's more than just projects abroad. There's several out there. um But yeah, you kind of have to go that route because you don't have the experience under your belt as a new grad yet. to be able to go uh with an actual medical organization. They do require that you have a certain level of experience for that, which as a fresh graduate, because I literally took, I graduated, I took the NCLEX a couple of weeks later, and then like two days after I took the NCLEX, I was on a plane to Africa. So. oh this, this, no, and I'm just gonna toot your... fingers that I actually passed because I had a job lined up when I got back and I was like if I didn't pass the NCLEX I'm screwed. But I'm gonna use this moment to toot your own horn, or to toot your own horn, I can't toot your own horn, but I'm gonna toot your horn because I mean, like that speaks to the person you are. You know what I mean? The very first thing you do after taking the NCLEX is this. And I just think that is so absolutely amazing, Katie. Well, I had no idea what I was getting myself into. I will just say that too. I have a love-hate relationship with the idea of new grads doing nursing missions or volunteer nursing overseas, especially when it comes to developing countries. And I can talk a little bit about my time there too and the challenges that came with that. But um just finishing the final thoughts on how to get there, I would say the pathway that you choose to get there um comes with pros and cons as well. um I will say that going with a volunteer organization, you typically see a younger demographic. It's less professional and more like college age kids going over there um because they're taking gap years. Or, you know, one of the volunteers that I spent some time with was a 16 year old from China and her parents wanted to uh to give her some extra experience or extra education and volunteer time. And so they funded this overseas trip for her. it's a lot of much younger demographic. And when you're in those settings, the volunteers that the locals work with, they never know what level of experience they're going to have. Most of the volunteers they get have no experience at all. It's just they're interested in health care. They're interested in law or human rights or conservation. And so they go over there to dabble in it um or to just kind of volunteer and have some experience in it. And so because of that, I also felt like there was a level of almost kind of distance and I won't say distrust necessarily, but just a level of like um, assumption that, you know, these people don't know what they're doing, which to a certain extent that is true. Um, but it is, it definitely felt like a hurdle that I needed to overcome because, yeah, it's, it was, it was definitely a hurdle I had to overcome just trying to bridge that gap and be able to, um, share experience and share knowledge with the people that I was working with, the locals that I was working with over there. So. that makes complete and total sense. I see where you're coming with that. I mean, you've done the work, you've gotten there, you're heading to Africa. Very briefly, why Africa? I don't know how many choices there were, but why did you choose Africa? That's also a good question. I wanted, so when you go to more developed countries, there's a lot more um protections in place just in terms of scope of practice um and limitations in what you can practice. And so for me, I wanted to choose a country that I would get experiences doing things that maybe I wouldn't get. again, because of the protections in place and the legal factors in place and things like that in perhaps a more developed country. And of course, when you're talking uh Africa and developing countries and developing nations, there is a lot more things like tropical diseases or things that you would not see in more developed countries because of water and um clean water and things that you wouldn't experience. Kind of tells it for a couple reasons. Nice, nice. So then you choose Africa, you go to Africa, you're taking all these notes for your class while you're in Africa, but I mean, obviously what people want to know, what is that time like? Open our eyes, bring us there with you. Let's stick to the practical standpoint besides the inspiring standpoint, which we'll kind of end on, but from a practical standpoint, what did you get to do? What did you see? What were the sights? What were the smells? What were the sounds? Well, first off, I went to Tanzania. So Arusha, Tanzania was where my kind of home base, volunteer base was, which is a, um it is, I would say a larger, I use quotations, but a larger city in Tanzania, very close to the Kenyan border. I think if my memory serves me, it's about an hour south. Wow. Okay. the Kenyan border. And so very rainforest, very tropical, very, I was actually shocked. It reminded me a lot of Western Washington weather. uh Very cool. I was shocked. I joke. When I went to Africa, I thought, oh, I'm going to Africa. It's safari. It's hot. It's deserty. And did not do the proper research on Arusha. And so I brought a bunch of summer clothes to a very chilly, uh moist climate and froze my high knee off quite a bit while I was over there because I did not have proper clothing. basically just rewore the same like few pieces of warm clothing that I had while I was there. um Yes, so do your research folks. Don't don't do what I did. No, no. um And so yes, very very tropical, very rainforest and very, very developing. don't, their healthcare system is you pay to be seen. Most of my time was in the ER. um I did a little bit of time um kind of on their pediatric unit. um I did like a week there, but most of my time was in their their er um and you you pay to be seen and if you can't pay you sit there until somebody can come and pay for you and if there's nobody to pay for you they do have kind of like their their equivalent of like social work like there's a social worker at the counter that they can go and um see if they can qualify for any help but it's very very rare that they are offered any sort of financial assistance um And so most of the time if they can't pay up 90 % of the time they're sent away and they cannot be seen. um of this EMTALA we have here, you know, in the United States, right? there is none. There is none. So I give the example. And if anyone squeamish, don't listen to this podcast or don't listen to this episode, I should say. But we had uh a gentleman that was in a motor vehicle, a motorbike accident and with a tip-tip fracture and definitely bad, a bad one. and he sat on a stretcher for eight hours. And I got in and he came in right as I was getting in there in the morning and I left in the afternoon and he was still sitting on that stretcher, just hanging out, waiting for somebody to come pay the fee for him to be seen. nobody really lays a finger on the patient until they pay up. And so it's a very different healthcare structure over there. It was very jarring. um literally having to send people home to die because that that did happen on occasion. um And so it was yeah, it was they they have very limited resources over there and they do the best they can with the resources that they have. But a lot of times that means if if somebody comes in and they're deemed, you know, too too far gone, then there's no resources that are invested in them because it would be a waste of what little resources that they do have. could save somebody else. um And so I think not to to jump right into the trauma, but there's, yeah, I, we had a uh child come in, um who was end stage AIDS. And what was in what looked to be DIC. And, and they basically called it and they said, we're, we can't there's no resources that we can do. And so again, had to channel my inner advocate of like, okay, if we're not gonna save this eight year old kid, then let's at least make them comfortable. And so really pushing for like oxygen or I mean, you know, they can't even do an IV to do pain meds, nor was this child conscious at the time. And so it was just like, how do we do what little we can and I worked a lot with the interns. They had usually like one attending for the department. So they had the one attending and then they had a bunch of interns that worked underneath them. And so the level of teaching and experience was actually for me, having received my education in the US was more akin to what their interns over there receive, their doctor interns. And so the time that I worked over there, a lot of the times I was working side by side with the doctor, the MD interns. And they're like, well, you're the one with the stethoscope, so you listen to him and you tell us when to pronounce that. And so I had to pronounce an eight-year-old kid in DIC over there. And it was heartbreaking, heartbreaking. And so it's one of those things where I caution people that are looking to do, especially new grads, because like I always say that nursing school, you're beat over the head with best practice, like literally beat over the head with best practice with a wooden stick. And so to go from that, that like polar opposites, right? You, all the things best practice in a perfect world. Here's how would we do things, right? They teach you an NCLEX. When you take the NCLEX, what questions you're looking at it in a perfect world, how would we do this? And then to go. Yep. Yep. unlimited, yeah, yeah, everything. um To the polar opposite, going to a place that does not have even remotely close to the same level of resources that we have here in the US. um And there is no such thing as best practice over there. And you drop something on the floor, wipe it on your pants, and you just keep using it. Like that is, you just go, I don't know, that's how they do it over there. uh It was, it's a shift. is, it is a mind, uh, word that I can't say on a podcast. I mean, I've got ways of bleeping things out, but I think everybody got that picture nice and clear. Wow. So, I mean, like, I don't... It sounds to me like do it. If it sounds like it's something that you don't even like, let me ask this first. You're glad you did it? You're you did it. I am glad I did it. I would say I would have done it differently next time. um I don't know that I would have jumped right in as a new grad or conversely, if I was bound and determined to do it as a new grad, I would have probably gone more with like a nursing or like a medical mission maybe that a church was uh sending out. um somewhere that I was working with other US professionals. think that being the only US trained one in a sea of non, I don't know. And I don't want to sound like egocentric or um it's just, it's very different. The level of expectations, the level of shock that you experience over there. I think it would have been a very different. environment for me had I been with other uh professionals who were trained as I was trained. Mm-hmm. And maybe had a little bit of experience in these missions, you know what I mean? Or something along those lines. Because like you said, they look at you and they're like, you're the one with the stethoscope, so tell us when we're pronouncing that. Oh my gosh. like, I jumped in and I'm like, can we get this kid oxygen? Can we get him, like, can we make him come? Because he's just like laying on this, basically this wooden table, bleeding to death. And I'm like, what can, what can we do? Like, let's, obviously we can't give him pain meds. There's no such thing really over there. I mean, there, there is, I like, there is, but again, very, very limited resources. And so they have like a little portable pump oxygen thing that they use. And I was like, whipping that out. I was like, can we at least give this kid, I don't know, like, can we wrap them in a blanket? Can we make him warm? Can we do anything to make him comfortable? And so because I was kind of like jumping in and was like, let's do what we can. And they're kind of like, okay, because when you see it that often, you become like that's your everyday to you. Yeah. And that was not my everyday to me. It was very shocking. And so they're like, well, you're taking charge on this. So I guess you call time a death. And I was like, ah what? So not something I'm trained to do. no. And I mean, it sounds to me like it definitely forces you. I mean, it takes critical thinking to a whole new level is what it sounded like to me. Well, yes, and then the cultural side of that too, there's a whole cultural component because the child that had AIDS, just so people are aware, uh I can speak for Tanzania. I won't speak for every country, but I will speak for Tanzania. There's been a big push in AIDS medications. um They can be found virtually in every village. They are very, very accessible over there. the issue or the hurdle, I should say, is the stigma that is still surrounding an AIDS diagnosis. to locals over there, to villagers over there, going and getting the drugs is basically an announcement that you have AIDS, and then you are pretty much shunned from that point on. it's a very shameful thing over there. And so, they would rather deny and say, you know, no, I don't have AIDS or no, my child doesn't have AIDS because of the shame that would come within their village or within society if they, if they did go and get those medications. With this particular case, the mother did not have AIDS. And so you can kind of fill in the blanks of how the child ended up getting, contracting um HIV AIDS. ah But there's, as I found out, there is a lot of abuse that happens um over there. uh One of the program director that I spoke to over there, I kind of asked her about it. I said, is this a normal thing? Is this unusual? This is like, I'm so confused about this. Why would they not seek help for their child? This is strange to me. And so she was kind of explaining the culture. And also there's been a really big push um over in those developing nations historically have seen a lot of female genital mutilation. And there's been a big push for governments to really try to nip that in the bud and to address that. And so the unfortunate side effect of addressing that issue with the um female child population is that some of the abuse has shifted to the male child population. so that's and as was the case with this child that I encountered. So uh it's very heartbreaking. The whole thing is very heartbreaking. uh It's the first time that you I have I have ever heard a parent or a loved one like just scream out in agony when they found out that their loved one had passed. um So that was the first time. Obviously working in the ER, I've heard it several times since, which every single time really sticks with you, but especially that first time. um So yeah, it was very, very shocking for me to experience that as a new grad coming from the environment that I had come from in school. So then let me ask you this, and I don't wanna, if there's more stories, more experiences, by all means share them. like, do you, cause to me at this moment, I'm hearing, man, I would walk away from that, I don't wanna say defeated, but you know what I mean? Like, man, those are some gut punches. it just feels so callous to even summarize it that way. But just like these brutal things that happen over there, like were there inspiring things? there, you know, did you walk away, like, How does this, how are you uplifted by this experience when you have to face these dark, traumatic things? actually say my time doing um nursing or healthcare stuff outside of the hospital is actually even more uplifting than what happened inside of the hospital. I will say one thing that was uplifting. I got to do my first IV. hey, Africa, that was my very first IV. um Yeah, it was a learning experience. They don't have the same materials. And again, COVID, so all of our IV stuff when I was in school was canceled. And they just said, well, a lot of you are going to go do senior practicum. You'll learn in senior practicum, or you'll learn as a new grad. We're not really too concerned about this. So I didn't get any IV training in school. so I went over to Africa. And my senior practicum, as a side note, was at Seattle Children's. And so they have a specific IV team that they use over there. The regular four nurses come to the IVs on the team. And so again, no, no IV experience. And yeah, went over to Africa. That was my first IV. And then the other, I will say the other fun part was because I was working with interns, um the way that they do training over there is that they do the really the four years of school. They do four years of medical school, ah but their residency that they do is all specialties in one year. Whoa. So they do OR, they do ER, they do mother-baby, they do pediatrics, they do oncology, they do ortho, all of those things. They do their residency. Basically, it's just popcorn. They just pop from one specialty to the next and fit it all really within one year, which means that a lot of those interns or residents, if you will, over there, um It's so fast paced, it's just kind of like whipping them through all the different specialties that it's hard to, I don't know, it's hard to be then really good at one thing. And so I remember distinctly when I was in doing um PEDs, inpatient with some of the um residents there or interns, we were rounding and seeing all the patients and upper respiratory diseases are like huge. It's like pretty much, I... venture to say the number one killer over there is upper respiratory diseases. ah Things like pneumonia and all the rest, but pneumonia is one we saw so much over there. ah But yes, so we were uh looking at this little, know, it's hard to say how old they were because they were so tiny and malnourished, ah but had... very, very abnormal vitals. And as a mother baby nurse, Eric, you know that vitals are going to be different for peas. And so they had like a respiratory rate of, I think like. wow for something like that. I mean, it was like very, very low, but they were like, well, technically 12 is normal. And I was like, well, 12 might be normal for an adult, but not for like a little baby. And then, yes. And so um just even like being able to kind of converse with them and, and T like give a little bit of knowledge to them too was really fun. I feel like they taught me. A lot and I got to teach them a lot and we were kind of learning together being paired up with these like medical again interns residents The the phrasing the verbiage is a little bit different over there. But yeah kind of residents if you will so that was I was uplifting and then We got to go out and do stuff in the local villages um There there is a pretty well ingrained level of distrust um for white people coming into these villages because they in their minds, and it was again right after COVID and the vaccine was starting to make its way out to the rest of the world. uh And so they thought that we were going to basically force treatments on them and force vaccinations and shots on them and they were very, very fearful. um And so getting to work to bridge that gap of easing that fear. I think that was pretty uplifting. I got to work with a lot of the village kids. We did basic teaching like hand hygiene, personal hygiene, how to take care of your bodies, what are germs, how do you get sick, uh just that very basic elementary level of health. So we got to go into some of the village schools and teach that to the little kids and they just look at you like you're like a celebrity, you know, they just They are just happy to see you. They're happy to hug you. They're happy to be there. And seeing their joy is just, I don't know, it brings a whole different piece of joy in you when you get to see their joy and being um so happy and so appreciative and so um uplifting given their living situations and their kind of circumstances. Yeah. I got goosebumps. I just, I love it. So before we close in our traditional manner, there's one more kind of, feel like it's a low hanging fruit question, but one I have to ask just the same. And that is like, for obvious reasons, like this experience that you had, that you're passionate about, has informed your care moving forward. know, then you come back to the States, you start working in an ER, you know, all the things. But I mean, does that... Does that experience still echo now X number of years out? How do you carry that with you on the daily, for lack of a better term? say that if that trip taught me anything, it's that it's very humbling. Going in with the assumption that you do not know everything um and you may think that something will help a patient, but sometimes they kind of know what's best for them. I don't know quite how else to explain it, but just kind of Again, it's just very humbling and gives me more of the mindset now of, I can go to a patient and say, you need X and Y and Z, that'll make you better. But that is not a fix, right? Like that doesn't mean that the patient is gonna be able to do that. That doesn't mean that that's gonna be what's best for the patient. I'm trying to come up with an example to kind of like, alliterate more what I'm talking about. um to maybe the nursing students who are kind of learning this, like um say for example that they need a patient needs to start taking the medication. Okay, but then how do they pick up refills? You may send them home with this medication, but that's going to be great for 30 days, right? And then what? So then looking at kind of the whole person and seeing the individuality in folks of like, you can think you know what's best and And that may be technically what's best, but that doesn't always mean that's going to be what works for the patient. And so there was a lot of that in Africa, working with different cultures in a different environment. always, I kind of think it's uh hilarious, but a little depressing hilarious. Like the India government gave this hospital in Arusha a CT machine. And they're like, this is the greatest gift ever. This is so expensive. We're going to give it to you. Well, they don't have the training to run it, nor do they have, nor do people have the money to pay to get a CT scan. And so it sits in their basement, a brand new CT machine that they received years ago sits in their basement, not used ever because they just, can't like, and so it's just, we do things with all the best intentions, but that doesn't mean that that's the best route. Like how do you, again, we talk about buy-in. How do you get buy-in from people? um you know, maybe instead of spending millions on a CT machine, you could have spent millions on training or, you know, setting up some sort of long-term process for them to be able to receive certain medications. I don't know. You know what I mean? Like there's, other options that you could have done so much more good than throwing a, you know, multimillion dollar CT machine at a hospital that's not going to be able to utilize it. So I think the same could be said in our practice with our patients in that, you you got to get the buy-in, you got to figure out a long-term plan that's going to work for the patient, not just trying to cram something down there. Mmm. I love it. And what's popping to my mind while you're saying this is that old cliche, right? The road to hell is paved with good intentions. And so another one is teach Amanda, what is it? him fish and feed him for a day or teach him how to fish. Yeah. he can feed himself. all just speak towards this, you know what I mean? And I love that it causes even me, I don't care if you're a tenured nurse, if you're just about to be a nurse, if you're brand new, wherever you are on the spectrum of nursing, nursing school or otherwise, you always come to your patient. Yeah, so we've got research, right? We've got research, evidence-based practice. And thank God for that. But just because it's the right thing to do or maybe the best thing for most people, it may not be what works best for your patient, for that hospital, for this, that, for the other. again, evidence-based practice is only as good as we make it and as much as we have funding for it. I'm not gonna go down this whole rabbit trail, but like. You know what mean? Bloodletting was the thing. You know what I mean? Let's drill a hole into somebody's skull and the evil spirits out. wait, it's not quite how that works. So we, maybe even then, things are done with the best intentions. And I feel like that's why we get a lot of pushback in modern healthcare, which I'm gonna be honest, maybe this is shocking, I don't know. I'm grateful for it. I'm grateful for the ones that are like, well, do I really need this? vitamin K shot for my baby, speaking from my limited perspective. Do I really need this procedure? Do I really need? Ask the questions. And then hopefully you and your provider, be it nurse, doctor, healthcare team, hopefully you guys are coming at it again with good intentions and like, well, here's why we do this. Here's the information that I know so far. This is up to date, current evidence based. And then if they say no, thank you. That's not gonna work for me. That's not gonna work for my family. It's not your job to strong-arm them into it. You know what I mean? I just love that this discussion, Gaty, is like, we're right until we're not. We know we're right until we learn something new. And so I, yeah. and that was kind of, again, my whole thing when I was over in Africa is like, well, I can't buy them medications because that runs out. can't, you like you can't give them certain things because at a certain point something's going to run out. And what's the thing that never runs out? Education, teaching, knowledge. And so, you know, when you're when you're having conversations with the residents, when you're taking the kids out in the villages, how to care of themselves and prevent thickness from the get go, you're giving that education and that knowledge and that's something that is infinite, right? Like that's never gonna be taken away. It's never anything, it's not something that's ever gonna run out. And so I kind of try to take the same approach with patients. It's like, you know, especially, I'll give you the example of the homeless population that we see in the ER. Like they don't have a ton of resources and so. What can we do? What kind of education can we impart on them to prevent them from ending right back up in the ER because they need another medication refill or they need something that ran out um or they are, you know? And so it's that idea of education and how um limitless or teaching patient, I'll say patient education and how beneficial that can be. and empowering. mean, that is it. I tell my students, information is power. Give your students, give your patients information. And then the flip side of that, don't stop learning. Don't close yourself off to the old, this is how we've always done it. And it was evidence-based 10, 20, 15, five years ago. And now something new is coming down the pike. Well, guess what? Do the investigating yourself. Is it better? If it is, adopt it. Do it. Do the thing. Okay. Katie, my gosh, I just love it. Thank you so much for chatting, chatting, chatting. Let's wrap this up in our traditional manner, and that is you chose three and a half words with a hyphen somewhere in there to describe nursing school. What were they and why did you pick them? first one was turbulent. And I think it goes without saying that nursing school during COVID is going to come with its bumps in the road and it certainly did. would say unchartered territory. Again, piece of that is nursing school in COVID. But then everything is always very new. Like it's nursing school is its own world and you're coming in and I don't know, it's just, there's so much out there. And so everything is new. um including me going into a field I said I would never or a specialty I said I was never going to go into so there is that. then the third one was foundational and so I think nursing school definitely set up a good foundation and I like that it kind of all wrapped up because at the end you know I'm sitting down with my old dean or my former dean and she's now igniting this passion for education and is now one of my um dearest mentors. So just that foundation that was built with nursing school, I think is invaluable. Mmm, love it. And then you have one piece of advice to give the listening audience. One thing they can walk away from after listening to both of your episodes. What is that one thing? Get a nurse tech job. I'm going to tell the audience, but I tell all my students, get a nurse tech job. Go do it. In nursing school, it's the best thing you can do for yourself. I love it. Katie, thank you so much. Thank you for taking time on your Monday morning, this beautiful Monday morning, not an anxiety-filled Monday morning, and for just dropping the wisdom, my friend. No problem, thanks for having me.