172 - Kendall Martin Pt 2: Being Hungry and Willing to Learn Goes a Long Way

Continue with nurse and Eureka, Nevada native Honored Guest Kendall Martin as he chats about his path from nursing school to the CICU, working as a nurse born with club feet, the benefits of faith and family, his advice for talking with family members of a patient in the CICU, ethics committees, the importance of team, his advice to someone starting in an ICU, the importance of being willing to go the extra mile, the challenge of applying to CRNA school, his extracurricular nursing activities, and more!

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Transcript

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Alright everybody, thanks for making the jump to part two of the Kendall Martin experience. I was excited to make this a two parter because in this one we're going to focus on his pathway to critical care. What? Didn't we touch on that in the first episode? Yes, yes we did. But this is where we really get into the nitty gritty about it. But before we do, as we like to do with the second episode, a little soft lob question to warm us both up after we had a momentary break there, and that is this. Mr. Kendall Martin, what hobbies... uh Keep you going. What do like to do when you're not doing all things critical? So I grew up obviously in a very small town where there wasn't a whole lot to do except do things outside. So spent a lot of time ah outside riding four wheeler, uh camping, hunting was a big part of my life as well. And also that went hand in hand with working in a butcher shop. I... I really enjoy camping, hunting, fishing, and I've also gained a new hobby after moving up here, which was snowboarding. ah Am I good at it? No, but I can make it down the mountain without falling, but that's about it. I just got to go elk hunting with my brother-in-law in Nevada here this past October. For anybody that's... uh into hunting, Nevada is just a really hard state to draw an elk tag in. It has really good elk hunting, but he was able to get a really nice elk that scored like, yeah, roughly 378. And it was just good to spend time with family and yeah, it was just an awesome experience. I'm not a hunter myself, and couldn't ever be. That being said, why is it difficult to pull an elk tag in Nevada? Is it like a lottery system? It is a lottery system. So the way the system works is you apply and then every year uh you get an extra point in the lottery. Basically is the way it works. And it takes on average seven to 10 years to draw a then after you draw a uh tag, you have to wait seven years before you can apply again. And so to get, it's about, you can get about two to three tags in a lifetime in Nevada. And that's for a resident. As a non-resident, it's like next to impossible. Wow! I mean, and I appreciate that, you know what mean? Obviously we're trying to, you know, I'm assuming this is all in place so that we aren't over poaching elk and all the things, but hot dang, you gotta be committed. You gotta be committed. Yeah, I love it. Speaking of committed, uh we just talked about Kendall's career progression, kind of early days in the EMS, why he wanted to become a nurse, how he became a nurse, kind of that bit, and some brief practical tips on how to study in nursing school on those days where you need to survive. and then trying to thrive. And I feel like this second part is more of kind of your thriving story to me. And so at first, right after graduating nursing school, there's this whole thing about getting your first nursing job. And there's something you wanted to talk about that. So what did you want to say about that? Yeah, so after I graduated nursing school, I knew that I needed to move somewhere where I could get into the level of ICU that I wanted to get into. So I moved to Spokane basically knowing nobody. I had got in touch with um a friend that mutual friend or a friend that goes to a church that I know up in Bonners Ferry, Idaho and then he got me in touch with someone that works at Sacred Heart and Goes to the church that I currently go to now and so that was the connection that brought me to brought me to Spokane and I Knew applying to the hospital there. They didn't know me. I didn't know I didn't really know them and so I was really wanting to get into the ER ah right out of nursing school. But they were taking a limited number of people and they were taking mostly people that had done their clinicals there or practicum students. obviously I had none of those connections. So I applied to a few different units and knowing nothing about the hospital, I seen there was a position for a float pool. And so I applied to float pool just to kind of get my foot in the door. And one of the draws for a float pool at the time was that they were doing, boarder patients in the ER. So they had like four rooms right beside the ER and patients that were admitted, the ER would send them over to those four rooms and then essentially kind of get a jumpstart on the admission process, getting them admitted before they went to the floor and taking care of that. So I took the job. But MedSurg nursing was not my cup of tea or what I at all wanted to do. No offense to anybody that does it. But I just knew it wasn't for me. I really struggled with it initially, but I just found uh that just because that's where you start doesn't mean that's where you have to stay. And so I worked really hard at that. And the nice thing about uh working with Borders is I was right down by the ER and so I got to know the ER staff and got to know them really well and some of the management there. And I ended up applying to the ER about seven months after I was in the float pool and started working in the ER. And that... was kind of my progression then to get my foot in the ICU. And I worked in the ER for about a year before uh applying to the cardiac ICU where I am now for the last three years. That's awesome. I did want to, the one thing I wanted to throw out there, you know, he's talking about just not knowing anything about the hospital, applying to Float Pool, coming from a smaller town. thanks. And it is like the hospital we're in, 600 plus some odd beds. 600 and I don't remember what we're at. You'd have to look it up online, but it's over 600 beds. So to be in the Float Pool in a 600 bed hospital, you know, there's a lot of territory there you could possibly cover. So I love though that that's the point you're drawing out from this. Just the fact that Your first job may not be your dream job. It may not be the thing you want. But to you, it sounds like this was the foot in the door. You did the time that you needed to do and this kind of opened the door to possibly getting into critical care. Would that be accurate? Yeah, no, absolutely. yeah, the ICU at that time wouldn't take me yet either. They were wanting people more from the sixth floor or the eighth floor. And they also were taking people from the ER. didn't, at the time, didn't really want to work on either of those floors. And the ER was more where I felt at home. So that's where I went prior to transitioning to the ICU. So now the question that's on those listeners who are as crazy as you know fun no offense implied But who love the critical world who love the ER who love going to the ICUs and again, man I want someone like you taking care of me if I have to be in there and Hopefully that's no time soon, but I'm so glad you guys do that. So those that are like, okay enough Eric I want to know what is it like working in critical care? So I know that you want to talk about some of the challenges that there are working in critical care, but before we talk about those challenges, I want to, you kind of opened a door to some challenges you faced in your personal life. And so just very briefly, what have you had to deal with and how have you worked through them? Yeah, so I was uh born with club feet and essentially. if you don't know what club feet is, both your feet are turned in and kind of malformed essentially. And I've had three surgeries on my feet, starting when I was four years old, nine years old, and then 13 years old. And my one foot just kind of had a mind of its own and grew a different way than it was supposed to, even after my surgeries. But I specifically remember uh when I was nine years old, and this kind of goes into anesthesia as well, but I remember the anesthesia provider taking care of me and I was inducted with... uh with gas and I remember them asking me what gas flavor I wanted and I picked grape and I remember very vividly after they put it on my face I was like this tastes nothing or smells nothing like grape this is done right terrible and I put up a little bit of a struggle and ended up passing out and I don't remember Obviously the first thing I remember after that was the nurse taking care of me ah as I woke up. And I just remember how calm and caring the anesthesia provider was for me before I drifted off into unconsciousness. And then also the nurse that took care of me right when I woke up. And those are two things that stood out with me. But growing up, I have pretty limited ankle mobility. Working in a butcher shop, being on my feet all day, my feet would just really hurt by the end of the day. So I had talked with dad eventually and I was like, hey, I can't continue this anymore. And that's what led me into EMS and then what led me into nursing. But yeah, it's just kind of one of those things. It is what it is and you just deal with it and yeah. Wow, I mean you're talking three surgeries, you know what mean? I just, my mind can't wrap itself around that. You talked about having faith earlier, I'm assuming. Has faith always played a part in your life? Did that help you get through those trying times as a young child and child? Or were there other things at play? Just support from family, what got you through those? Yeah, would say faith played a large part in that and also my family. I have very supportive family and yeah, those two things is what got me through. And at the end of the day, it's just kind of accepting that's the way I was made and just kind of working through it and yeah, just being thankful for what I do have. I just, I love that. I love that about you and it's like getting me choked up because, you know, of course there's the old tale. Old Testament, you've got Job. And this isn't a Bible lesson, everybody. We're not going all pastoral on you here. And yet, there's still that old children's pastor in me. But I think I believe it was Job who had told God, Chris Godin died, or no, it wasn't Job. It was his wife or one of his friends. Said something about curse God and die like this all these bad things keep happening and yet you still look to him and I love that you just say you know what at some point I you phrased it as I accepted this is the way I was made and I don't I if those words could land any firmer for anyone out there like I I can't express how many heartaches in the world heartaches in people's would simply be, I don't want to say go away or fixed or resolved, but at least embraced more easily. If we just said, okay, you know, cause there's, know so many people, you know, I was born with diabetes, I was born with cystic fibrosis, all these patients that I've taken care of that have these genetic diseases for which we don't necessarily have a quote unquote cure, cancer, you know, hematology, oncology, all these things. And there are these moments where it's like, why me? Why my family? Why myself? Why do I have to struggle through this? And it's one of those age-old questions that can't be answered, right? If there's so much evil and sadness in the world, how can a God exist? How can a good God exist? All the things. And yet, here's the answer to me, is you gotta get to a place where maybe you just say, this is the way it was made. I don't know why this is happening. Sometimes we don't have the answer why, I believe it's very profound what you say in that this is the way I was made, it is what it is, and I'm gonna embrace it and, know, going and doing the thing and you recognize the limitations that that produced for you working in the butcher shop, you have a conversation with your dad, okay, I can't do this. But now, I guess let me ask you this, for those that are like, can barely stand all day and I've got nothing going on, how do you stand all day? You know what I mean? Working in an ICU, going busy here and there, how does that work for you with those feet? Yeah, honestly, it hasn't been terrible. I was a little nervous about it going into nursing school. ah And I went and saw a foot and ankle specialist right before I went into nursing school to try and get some orthotics, better orthotics and things like that. And so that has helped quite a bit. The other thing too is I do work 12 hour shifts uh if I'm not working overtime. I work three days a week and then I can usually recover enough that it doesn't bother me and I can get back to what I was doing. Versus when I was working in the butcher shop, especially when we were busy in the fall, it was everyday like nonstop and it was standing in one place on concrete floors. more so in the ICU now versus the ER, but ICU I have, it gets busy at times, but I can often sit down and sit at the computer and kind of give my feet a break. And so that helps quite a bit. But not to say that. my feet don't really hurt by the end of the shift. There are times where I come home and they are really sore. Thank you for being open about the challenges that you have had to face with having club feet. I can't even imagine, and I appreciate you sharing that, because I can guarantee you people are listening, and there are some people out there that are gonna go, I have this that I thought might be a challenge in nursing. I have this physical situation. And in fact, I have an opportunity to sit down with someone who is going to share that very thing about themselves, and they are the next recording session that I have in a couple weeks. But that's a story for another time, Kendall. This leads into what we've been waiting for. you know, talk about the challenges you faced in your personal life and how you have navigated those. I imagine a lot of that carries over into the challenges that you face in a very critical area of nursing. So I know this is something you're passionate about. Talk to us. Open up about what are some of the challenges, what they don't teach you in nursing school, and how you would suggest transitioning and all the things you want to share about. So yeah, after working in the ER for about a year, I transitioned to the cardiac ICU specifically. And some of the challenges that I was immediately kind of confronted with that they don't really talk to you about in nursing school, or I don't know how you prepare for them is talking with family members whose family member, who's your patient. is more than likely going to have a bad outcome. And just kind of setting those expectations and trying to be realistic with them. can be really challenging and just being there and walking with them as they navigate what their family member would want and if they're going to go comfort care or if they're going to continue. with treatment and just walking there and being with them is something that I don't know if it can ever really be taught and it's just something that's learned and yeah, it's one of the more challenging aspects. And it brings up something to me. There's a saying by Mark Twain that I love and you you talk about you just have to be there. Good decisions come from experience. Experience comes from making bad decisions. And I in that like that rings so true to me. And when you're talking about, you know, how do you prepare someone in nursing school for that scenario? You know what I mean? uh And so I what if someone's listening going, OK, so Kendall, you're telling me I just have to live it. Like, what have you learned along the way that might help progress someone down that road of being able to navigate those rough waters maybe a little smoother? So one of the things out for me, I always try to remember is it's not about you. It's about the patient and about their family. What someone's quality of life might look to them might be very different than the quality of life that you would want. I specifically remember one time that I had a patient, their family member, came in and was a little frustrated with the way things were going and they felt like they weren't being heard by the ICU team and that this was not what their family member would want. just being sympathetic and listening to them and then advocating for them on behalf of the ICU team is something that I've found extremely rewarding and also difficult at the same time. And in that instance, I was able to talk with the provider and the ICU team and the patient's family member felt like they were able to be heard. And we ended up going comfort care with that patient. And I just walked with that family member through the whole, the whole scenario, the whole situation. And yeah, It was challenging and rewarding at the same time. I can only imagine. I'm assuming that there are resources you've had to get involved, um namely the one that pops into my mind are ethics committees. Have you ever had to work with them? Um, I specifically haven't had to request, uh, ethics for any of my patients, but that is something that we do, uh, have involved a fair amount with some of our patients, especially when we're kind of hitting the end of the road and there's no, no good outcome. And also, unfortunately, sometimes we get patients where there, there is no family. They have nobody to make decisions for them and they're ah unable to make those decisions for themselves. so then ethics ends up getting involved and yeah. And it's tough. feel like and so I bring that up. mean, I've had some personal experience with them or at least, you know, not myself as a nurse, but myself as a father, our son being in the Peds ICU and a lot of very challenging decisions. And I've talked about it before in the podcast. This isn't the episode for that. But the idea is that I distinctly remember that team going, you know, we've we've even reached out to the ethics committee about what, know, this, that and the other and these decisions that you have to make. that are, I mean, unimaginable decisions. And they're like, they are for what it's worth, not seeking validation, not anything like that, but for what it's worth. The ethics committee, this is, there's no difficulty in their eyes. This is the right decision, X, Y, Z, whatever the case may be. And I'd love it if life were black and white. I'd love it if every medical case were black and white. But uh I imagine, Kendall, you see many, many, many shades of gray, and it's navigating the specific Oddball situations in the moment, yeah? Yeah, no, absolutely. And I imagine that you are able to also rely on your team in that regards. I do you guys function pretty well as a team? do who can you go to when you're like, what do I do here? Yeah, no, we have, we have a great team in the ICU between the ICU intensivists and the chaplains that are readily available, which is a huge asset that we have. This is the only hospital that I've worked at, ah but I've been told other hospitals don't have chaplains like we do here. And the amount of, uh, what they're able to work through with family members and what I'm able to pass along to them to come see family and they take a huge burden off of us as nurses quite frequently. So that's a huge asset. Look into your resources, whether you have that level of chaplaincy, whether you have ethics committees, whatever the case may be, lean into those that can shore up the weaknesses or maybe provide some direction toward the answers that you seek. uh For those that want to get into critical care and are listening to the path you've taken and all of that, what advice would you have for them, for someone who's like, I start in an ICU, whether it's CICU or an ICU or something along those lines, what would you say to them? willing to, I don't know if I quite say start over, but be humble and be willing to learn. And for me, I think start over is a good word. I come from the ER, there was a lot I didn't know, but there was also a lot I didn't know. And just being open with about what you don't know. and being willing to learn. one thing I like to say is when, especially like when you're starting out off and you're being precepted, there might be some things that you do know, but your preceptor might have a different experience or a different uh idea or a way of looking at things. And if they bring something up and you go and you make the comment, I already know that it shuts down conversation. And so that's something for me personally that I've tried really hard to work on is even if I think I do know it, don't say I know it. Be willing to hear their perspective and hear them out because more than likely they have something new that they can teach me. I love how you say that because I mean even something as simple as spiking an IV bag I remember one time someone was spiking an IV bag totally different than how I was taught totally different than how I was like I was about to say something like my gosh, and then I was like oh, that's actually that's brilliant I like that I think I might adopt that and so you you may think you know it But guess what even if you do and if you know exactly how they're gonna do it like you said you may still learn something new and At the worst it does shut down that two-way conversation So Kendall, you know what I mean, you're talking about it from the receiving end of being precepted, but what I know about you is that now you are on the other side of that discussion and you enjoy teaching and precepting new nurses. So, I mean, What makes a good new grad? You know what mean? What makes a good, you're kind of already touching on it, but what advice do you have for people? What helps them stand out as someone who's coming in new to an area and being precepted by someone like you? We're your student. Teach us. So one thing that makes it super, I shouldn't say easy, but nice and easier to precept a new student, whether they're a new grad or new to the ICU from a different floor is someone who is hungry and excited to learn and is willing to go the extra mile to to learn something new, even on their off days, which I know we like to have our off days and do our own thing. But if there's something that you don't know or don't understand, be willing to look it up and learn it. for me, kind of, I guess going back to me personally, but one thing I often found is when there was something that I was super uncomfortable with in the ICU, the best way to be comfortable with that is, to learn more about it and to be familiar with it. And so I would go home uh later and look up that disease process or if it was something with a device that I was using that I was unfamiliar with, I would look that up and do my best to learn about it and be familiar with that. So that way when that situation came up, I would be more comfortable in that situation. But yeah, just being hungry and willing to learn goes a long way. very much so, and I feel like, and this is no offense to certain people out there who maybe don't do that, and I can tell you right now, being as many years as I'm in it, there are times that I need to learn about something, whether it's so I can teach my students or whatever, but other times I'm like, just, I don't have the extra time or energy to put into it. So I'm not offending, I'm not trying to offend anybody out there who might be of that persuasion, but I feel like what you're describing there, that hunger. Sometimes you cannot stop that passion. That passion will make you like this right now. You and I are sitting here talking about nursing outside of our careers, outside of our shifts because we both want a better future nurses. We both want to add to the conversation that is feeding our young. And that separates the good nurses from the great nurses. And again, not trying to classify, not trying to put people on tiers. I just feel like when you are ready to when you are hungry enough to go that extra mile to like you said, you go home and you're like, ah I wasn't comfortable with this device. I wasn't comfortable with whatever this was. I need to learn more. The learning never stops. And that's the key, right? Like always learn. Don't say I've arrived, I've achieved. We're done, right? Yeah, absolutely. Yeah. yeah. So speaking of not being done learning, you're, and we've kind of hit it at the beginning of your first episode, but uh rumor has it you're not done learning. You've been applying to CRNA school. This is a desire of yours. And yet you've listed it under your challenges section. Why? Yeah, so my pathway has been a little kind of up and down and I knew it would be be challenging getting into school and school is fairly competitive. Often you have 400 plus applicants for 25 to 30 seats and fortunately I've been able to get interviews. I interviewed at four schools last year. Three were nose and then my fourth one I got waitlisted at. so I kind of realized through my first couple interviews what I needed to work on in the interviewing process and that my interview skills weren't at the where they needed to be. And so that's something that I've really been working on the last last year or so. And and I've been getting better at. And so just not giving up and continue to work on that process. And I currently have uh three more interviews next month. So we'll see how that goes, but yeah. Best of luck to you on those interviews as well. But it sounds like it's a process that A, can lead to a sense of defeat if allowed to. How have you prevented that from happening? Just always coming back to the why, remembering why I wanna go back to school and the passion that I have for learning and continuing my education and also coming back to why I wanna be a CRNA and the picture that I have for myself 10 years from now. It drives you. It drives you. I love this. This is the second time you've talked about the whys. You talked about it originally in the context of to understand and to have a knowledge of what's going on biophysiologically and in a human body to understand the why and then maybe you can put the puzzle together to figure out what's happening in your patient. And now from a totally heart perspective, don't forget your why because the why is what's going to keep you going in those moments where you are tempted to just survive and not thrive, right? Yeah, no, absolutely. So before we close in our traditional manner, there was one other thing that I know of that you definitely wanted to talk about. um And you talk about, you know, in nursing, doing what excites you, seeking out those things. And there's other opportunities that you have outside of just bedside nursing and all of that. So kind of open the window to that. What do you do, Mr. Kendall Martin, outside of all of these incredible things that you already do? So as much as I enjoy working in the cardiac ICU, I find myself sometimes getting a little bored with that and wanting to do other things. And since I had worked ER before, before going to the ICU, I still pick up in the ER. I enjoy the chaos of it. And I'm often reminded of also why I like the cardiac ICU better than the ER, but I still nevertheless enjoy working in the ER. The other thing. Um, outside of nursing is I've gotten involved with our inland Northwest ACN chapter, which is American association of critical nurse care nurses. And each region has their local chapter and our chapters like covers Spokane, Coeur d'Alene, Northern Idaho, um, and kind of reaches into Oregon and Montana a little bit as well. And I serve on the board as treasure. And so. that help manage our finances. And we're also planning a critical care symposium, which we're holding, don't have the exact dates, March three or March four and five, I want to say. was a Wednesday and a Thursday is when we're having our symposium, but just helping manage that and get speakers lined up is something that's also been extremely rewarding. And then the other thing outside of that is our specifically to our hospital, we have a special pathogens unit or it's called the SPE unit. And there's only one per region. I think there's only like 11 total in the U S and our region covers all of Washington, Idaho, Oregon, not quite Oregon, all of Oregon, but, and then Alaska. And so if someone with a novel disease or like, let's just say Ebola, for example, comes in our region, they would get sent to our hospital. And so we're trained specifically to help uh manage those patients as well as being an appropriate PPE and things like that. So that adds uh a different avenue that makes life interesting. And then also I stay active in EMS. I'm on the, local fire department. I volunteer on the ambulance there ah just to kind of keep. those skills alive and keep kind of what got me into medicine close to home and remind me of why I do what I do. Dude, you inspire me. I'm just sitting here listening to you and I'm like, my gosh. And I just love it. I love that you, and I chuckled when, I'm just dialing it back to where you said, know, sometimes working at the ICU, I get bored of that. And I just, you know, those two words, first of all, I never heard together at the same time. But also then my mind is like, but it's true. You know what I mean? Like doing, I've told people I have worked in two of the best fields ever. Peds heme/onc and Mother Baby. And ah I love both of those worlds. And yet, if you do it full time, all the time, even a little less than full time, you gotta add some variety eventually, because I love it, I'm passionate about it, but you're just like, oh, I gotta go in for another shift. ah Like this week, I worked four shifts. But my first three were at my bedside job, and then I taught today. And the teaching for me is what adds that variety. You know what mean? I get to do that. This podcast, this little pet project that started a year and a half ago, I looked forward to it. told my wife, said Thursday is going to be in some ways busier than Monday, Tuesday, Wednesday. But it's a different kind of busy and it's a fun kind of busy. And so to me, maybe is that kind of what you're describing there is just adding these extra flavors into what it is that you do and are passionate about. yeah, no, absolutely. And the variety is what for me, what keeps the spark alive and like working EMS, getting called somewhere, nothing, absolutely nothing about the patient arriving, having to do my own assessment and come up with my own own treatment plan and where I'm going to take that patient just adds a whole nother variety. And yeah, I just, um, I just really enjoy doing different things and, and in medicine and keeping that variety. So let's dial back all the way to the three words you chose to describe nursing school. What were they and why did you pick them? So I picked rewarding because at the end of the day, Um, when you end up graduating, it's extremely rewarding to see the amount of work that you've put into nursing school come to fruition and, and to be able to look back on that. And then I picked resilient because it takes lot of resiliency through nursing school. There might be times you don't pass a class, um, or you didn't get the grade that you wanted and you kind of have to pick yourself back up. and not let that get you down, but look forward and keep continuing. And then I picked transformative because nursing school would change your life. It'll change how you look on life and it will forever change how you see healthcare. Amen, hallelujah to that. And so, if you had one thing, after both of your episodes, you want someone to walk away just keeping one thing tucked away in their heart of hearts, even if you've already talked about it, what is that one thing? Never give up and be comfortable with being uncomfortable. I almost feel like that's the title of one of your episodes uh No Kendall, I cannot thank you enough man. It has been an honor to get to know you I again I find my name on the board to float to the CICU I wasn't excited about it into the first time I've been down there in a very long time and I'm gonna tell you guys right now I don't care if you've been I don't care how long you've been a nurse I don't care if you're brand new or if you've been doing it for 19 years like me You see your name on the board and you're like, oh, this is the one place that I want to go You know what mean? Oh, okay, one of a few. You know, I'm just like, but then the difference is, earlier in my career, that would have probably changed my attitude, and I probably would have gone in there with a bad attitude. Now that I'm a little bit more tenured, I can at least go, okay, shove those feelings down inside, and let's just go serve whoever I get to serve that day. And then, typically, it's those shifts, like that one, that are the things you get the most out of. I came out of there, you know I mean? The patients we've got to take care of, an incredible, incredible patient. know what mean? It brings a lot of things to the surface for me. But then I get to meet someone like Kendall. And I promise you, if it's not for that, I don't know where I meet you at, Kendall. I'm not outdoors. We're almost exact opposites in almost every single way. And yet I love that we are kindred spirits. And I cannot thank you for pouring into the next generation. Awesome, thank you. Thank you for having me.