Peplau's Ghost
Psychiatric-Mental Health Nurse Practitioners (PMHNP) discussing using psychotherapy within their practice. Four PMHNP program directors and a biostatistician from across the Unites States sharing their passion on how psychotherapy can help people with nearly all their emotional problems.
Peplau's Ghost
Finding The Human In Fast-Paced Psychiatry with Dr Shawn Gallagher
A busy inpatient hallway, a tight clock, and a patient who needs more than a prescription—this is where the art of psychiatric nursing matters most. We sit down with Dr. Shawn Gallagher, a dual-certified PMHNP and FNP, former ISPN president, and retired Army officer, to explore how small choices—eye contact, posture, sitting at the bedside—turn brief encounters into meaningful care. Sean shares mentorship pearls from his consultation-liaison roots, why perception of time can be altered without changing the clock, and how to set clean expectations for 15–20 minute visits that still feel human.
We dive into the “invisible ink” of psychiatry: the detective work of CL practice, the unspoken rules of formularies and cultures of prescribing, and the social determinants that drive outcomes as much as any medication. Sean explains how dual training empowers whole-person care on inpatient units, where diabetes, hypertension, and acute psychiatric needs often collide. He also opens up about imposter syndrome—how even experienced clinicians feel it—and offers practical strategies to disarm “gotcha” moments with transparency, curiosity, and a dose of humor.
The conversation closes with a thought experiment: what would Hildegard Peplau celebrate today, and where would she push us further? She might applaud broader scope and stronger science while warning that progress can dilute the therapeutic relationship. The charge is clear: use systems and technology to protect the human core, not replace it. If you’re a PMHNP, RN, student, or interdisciplinary teammate seeking practical steps to build trust under pressure, this one will sharpen your craft and renew your purpose.
If the episode resonates, follow the show, share it with a colleague, and leave a quick review—what simple habit has improved your patient rapport the most?
Let’s Connect
Dr Dan Wesemann
Email: daniel-wesemann@uiowa.edu
Website: https://nursing.uiowa.edu/academics/dnp-programs/psych-mental-health-nurse-practitioner
LinkedIn: www.linkedin.com/in/daniel-wesemann
Dr Kate Melino
Email: Katerina.Melino@ucsf.edu
Dr Sean Convoy
Email: sc585@duke.edu
Dr Kendra Delany
Email: Kendra@empowered-heart.com
Dr Melissa Chapman
Email: mchapman@pdastats.com
Yeah. Just my take on things. My answer number two. Identifying challenge in your beliefs.
SPEAKER_01:Alright, I think we're recording. Welcome back, everybody, to Pep Lao's Ghost. I am your host, Dr. Dan Wiesman, and I am thrilled to have another guest here that quite honestly been trying to kind of nail down. He's a busy guy. So it's been kind of one of those scheduling things, but I am super excited to have him here on the podcast and get to hear from his perspective about why he likes to be in Psych and psychotherapy and its use in that and such. So I'm always here. I'm joined with my friend and colleagues, uh Dr. Sean Convoy from Duke and Dr. Melissa Chapman Hayes from Minneapolis. And so I'm really thrilled here to have Dr. Sean Gallagher. Dr. Sean Gallagher is a PhD from the University of Arizona. We were just talking to him about the weather and the rain that he's getting. So if anybody's from that area, you kind of can relate. He is a dual-certified PMHMP and FNP. So he has both a family and psych background. He is what I strive to be here in the next couple months, the past president of the International Society of Psychiatric Nurses, as I am the current president of the Psych Mental Health Nurse International Society of Psychiatric Nurses. But in the current treasurer of the ISPN as well. So really excited about that too. And retired military. So hopefully maybe we'll get into that. Served, I believe, well, you can tell us. I mean, uh, I believe in the Army. Is that correct? U.S. Army officer. And so excellent uh to join you and thank you again for your service in that regard as well. So um so this is you know one of the questions I'd like to throw out. I I think, Sean, we've known each other long enough to ask this question. Uh do you remember the first time that we met?
SPEAKER_04:Uh I think it was at a um on uh a ISPN foundation um meeting, right? Uh I was I was aboard liaison, I think.
SPEAKER_01:Um yeah, that's right. I forgot about that. I I was thinking the first time we met was in uh Ronaldo Beach uh at the ISPN conference. Um I think that was in 23. And um and yeah, we were cheering on the uh Hawkeyes, the lady hawkeyes. They were um Caitlin Clark was kind of doing her thing through the uh tournament, and so we were watching there. So uh I think that was the first time we physically met. I think physically met.
SPEAKER_04:Absolutely. Yeah, I I do I remember I remember that weekend well. Yes.
SPEAKER_01:Yes, all right. Busy time. So awesome. Well, thanks, John. Well, the first question I'd like to get out is just to kind of you know hear from your story, like what first drew you to psychotherapy, you know, incorporating that in your practice again, kind of even if you want to go back to like your FMP days, you know, what draw you to you know, PMHMP role and psychotherapy? Um, was there a patient, a mentor, or or some moment that kind of really changed your perspective on that? So let it take away from there. Thanks.
SPEAKER_04:Sure, thanks. Thanks for having me. Um, I can't say that there was one specific moment. I did my advanced practice um uh psych uh gradual rotation on a um consultation liaison service at a on a at an academic medical center um in Rhode Island, and I had a fantastic um mentor. And uh one of the first things he said to me um is that you know um that we have a we have to get a lot of information from people in a very short amount of time, and the only way we can do that is to um to talk with them, uh to talk with people. And uh the bottom line is if they don't feel comfortable talking with us, then we can't help them. So it's incumbent upon us to do what we can to uh try to establish a comfortable, safe environment, uh, if you will. Um and so that was one of the uh sort of first uh um lessons or um pearls of wisdom uh uh I took away from uh Dr. Badger, uh Jim Badger, um uh in Rhode Island. And so it was really from from that point on, um, it kind of clicked, I guess, um, the importance of the art of communication. Um, and even though um I knew I wasn't going to be a bona fide psychotherapy therapist, um, but that psychotherapy um is is our origin, right? Uh speaking of Peplau, right? Um, and then even in a consultation liaison role where it's you know um ICU, ER, you're you know, busy, got everything going on, all these teams, at the end of the day, you're sitting on the side of someone and you're you've got to talk with them, um, and you know, provide that that support because in that moment, uh right, not only is there something going on from a you know mental health perspective, but in that setting, they're also um very physically ill, right? I mean, let's face it, like uh people who are uh physically well aren't kept in the hospital very long. So if you're in the hospital, you're not feeling good physically, you've got something from a mental health perspective going on. And so I think uh establishing um some sort of a rapport, um interpersonal rapport from um yeah, the minute you walk in the room and say hello, just the the whether it's the look on your face or um um you know, not looking down at at your uh at your chart, or back in those days it was the PDAs, the uh the personal uh pocket uh uh whatever they used to be called, um uh and making eye contact. Palm pilots, thank you. There we go. It was yes, it was nobody will reference that. So looking at a palm pilot, that was a thing with eyes up from the palm pilot. That was uh um and so really that from that uh point on, I I I guess I, you know, if I if I had didn't understand before that, I sort of was intentionally aware um of the importance of that uh interpersonal um connect. It's trying to establish that interpersonal connection um to start building the um a trust.
SPEAKER_01:So yeah, I if I can paraphrase that a little bit. I mean, it's you know, something that I I don't know, this week has just kind of hit me over the head a lot of times that that this is a a very relational type of uh specialty that we get into. And I think that's what you're emphasizing for sure. And so um, do you remember anything from Dr. Badger? Like any little any quick tips, like you know, anything that he kind of, you know, it's always funny how you know you get some wordings that just say it the words a certain way. I think like you were saying, you know, keep your eyes up and and other things that you know are kind of foundational, but anything else that you remember from Dr. Badger that uh that you still kind of carry around today?
SPEAKER_04:Um the the uh eye contact, maintaining eye contact, um, which I guess sounds simple, but I initially it I found it kind of challenging um because it's it's uncomfortable, right? Especially as a as a student. Um so that that the that eye contact, that you know, sort of trying to um body language, sort of, you know, sort of leaning in just enough, but not too much, but you know, showing that you're engaged. Um and and then so I'd have to say from the the a psychotherapy interpersonal perspective, um those those are some uh pearls that that stand out. Um and he certainly taught me so much more. Um, but in terms of um uh that relational perspective, yeah.
SPEAKER_00:So Sean, I'm gonna I'm gonna go back to your initial introduction and then ask you a question. So I I typically find when people are reminiscing about the past and they say, and I'm writing this down because it was a good quote, I remember that weekend well. Suggests to me that was one heck of a weekend. So sometime offline, I'm gonna have to find out that weekend with you. When you were uh talking about Dr. Badger, you kind of brought me back into my past and working with some really seasoned clinicians who taught me a lot. I uh I'm uh when you talked as when you mentioned his name, the name Michael Nolan kind of came to my head. And and Michael Nolan shared with me uh uh when I was a Navy hospital corpsman working in psychiatry back in the early 1990s, he said, Sean, the secrets of our profession are written in invisible ink on the margins of the textbooks that we read. And I always thought that to be a really profound statement. So give you know, give you an open page here to kind of speak to it. But what are what is what's the stuff written uh in invisible ink on your textbook that you teach your students?
SPEAKER_04:Wow, that that that's a profound uh uh quote um or maxim. Uh that's that's fascinating. Um, you know, that's a good question. Uh it's uh one of the something I do say often um is that I I will say, quote, this is as much an art as it is a science. Um and so I always uh always put the art first. Um and I'd have to say that it's um well it's as much seen as what's not seen. Because my my sort of uh educational roots were in consultation liaison psychiatry, um, as as we all know, that that's a lot of detective work. And so I guess from um my background and my frame of reference and where I come uh when I'm talking with um um with students, uh, because my uh background and my preferences have been uh inpatient and crisis oriented since, is that um what we're seeing, you know, when we're talking with someone in front of us is is probably um um 30 or 40 percent of what's going on. Um and so really the um social determinants, before we were calling them social determinants, um, or you know, using that term, um, spend a lot of time um you know acknowledging that um social determinants um uh and and finding out uh you know what what um where someone lives, you know, uh their their you know their access to care, um the the basics, right? Um but those are the things that aren't necessarily in the textbook, right? When you're talking about um, you know, sort of the uh rudimentary aspects of an evaluation, um you know, uh I have to say, yeah, looking looking deeper than uh than what's what we're what's uh who you're talking to. Look looking looking at the person's bigger uh uh their bigger um their big their bigger picture.
SPEAKER_00:Well said. I uh I I think one thing uh that's been reinforced to us particularly over the past couple of years is that uh and I think it was a previous surgeon general said it, um perhaps our zip code is probably more actionable than our genetic code, right? Wow. Yeah. Cool.
SPEAKER_01:Sean's blowing this podcast with quotes. Man, he's coming home. Seriously. Yeah, I love it. Yeah, invisible ink and that's it. That's the Monday Friday. Yeah.
SPEAKER_02:Um, so I one thing that we've learned on this podcast and heard over and over again is that so many PM H and Ps today feel pulled toward shorter visits, more prescriptions, and um pressure to not have as much connection as desired or would be therapeutically helpful. How have you personally navigated that tension in your own work and what keeps you grounded in the psychotherapeutic side of practice?
SPEAKER_04:So true, right? Um I uh I'm up front with um with folks when we first meet. Um again, most of most of my background is inpatient um um in crisis. So um in terms of those brief outpatient visits, I don't have as much of a frame of reference for that. I do have some. Um, but in either either setting, um, when I when we sit down and introduce myself, um I try to um to the best of my ability based on the situation, um sort of say, hey, you know, introduce myself and you know, gonna if it's all right with you, we're gonna, you know, talk, we're gonna ask you some questions. You know, we probably have about, you know, if this were an outpatient visit, you know, maybe 15, 20 minutes, um, you know, and I'll just kind of say, I said, you know, it's it's not enough time. Um, but what I want to do is uh I want us to work together so that I can offer you the most um that I can uh in that amount of time so that when you leave here, we've got a plan. Um and if we need to talk longer, um that's fine. Um but we're gonna we can have we can schedule um some additional time to do that. Um so I try to sort of uh set the expectations. Um, you know, uh sort of this is this is how it has to be for now, right? Because if for no other reason you've got a schedule to keep, um, but wanting to maintain that rapport, right? That that's right. So then also sort of I I I do say to them, you know, I we can absolutely talk more after if if you'd like. We can, you know, happy to do that. And I've always offered that. I I can't say that I recall uh you know anyone that's ever come back later in the day to do that, um, but I've always put that offer out there. Um and so I and in an inpatient setting, uh again, uh psychiatric inpatient or crisis, uh people are very, you know, um uh upset or a lot of emotion in the moment. And so in those settings, um it's important it's very important to establish a connection um for de-escalation. Um and so I think that there's uh you know uh there are moments for that interperson to establish that interpersonal connection, even when someone um um is you know uh psychotic, um that that presence um you know, really sort of um letting someone know, like, okay, we're here, we have a few minutes, like let's make the most of it. Um I'm kind of paraphrasing here. Um, but I'd have to say to to get the most out of it, I'd uh for me I I sort of establish up front what the just the realistic, just the reality of it, just the quantum physics. This is how much time we have. Um, I want to do the most that I can to help you. Um and if it's not enough right now with talking, then you can come back um and we can talk more.
SPEAKER_01:Um yeah, I think you know that may go into a lot of I think of what's you know, perceptions, right? I mean, I think um I I tell my students a lot of this that that you know, they're and I have to look up the study, I don't know it off the top of my head, but I remember there was a study once that had followed around physicians who would go in and do rounds, you know, in a hospital. And you know, they'd go in, they'd come out, they go in and come out, and and they kind of tracked how long they were actually in a room, um, which most physicians are not very long, you know, and and probably nurse practitioners are probably in that same boat, but but they they actually showed a difference as far as perception of how much time was spent with them if they sat down in the chair or you know, rolled up in one of the rollers or something like that, but just took that minute. The actual time didn't change very much. But if the patient kind of felt like you were there, and and and so that's what I guess I'm hearing from you, Sean, is that that you're you're setting up that parameter, you're setting up that you know, expectations that there's not enough time to talk about it, all the problems that are bringing you to the hospital right now. But um, but you know, we you know, I'm I'm available to you and and and that's important too. So um yeah, does that sound like kind of what you were saying, or does that relate?
SPEAKER_04:Well, well, yeah, be absolutely, because right, if if again, we're in a market uh driven um uh healthcare infrastructure. And so, yes, so our role primarily um um is medication man, you know, biophysical and uh medication management. Um, and right, as we all know, to be able to do that, you know, uh you know, um safely, uh appropriately, um people have to feel comfortable talking with us, um, even if it is in those those brief moments. Um But you're absolutely right in terms of that perception of time, um, sitting down, yeah, on the roll on the roller uh stools, yes, uh pulling up to on the side of someone's gurney.
SPEAKER_01:Um doesn't take much, but it takes a lot, right? I think I remember back to when you were saying just you know maintaining eye contact. You know, sometimes, you know, especially for our students, that's uncomfortable, right? You get you get more comfortable as you go along, but uh but taking that few moments, just and I've always kind of reminded myself that when I go into a room, you know, find the chair, try to sit down. Um, and again, that's I I know that's not gonna impact, you know, how long I'm gonna be with that person, but it does have quite a significant impact on their perception of that time. So well, my next question kind of goes back a little bit, just uh I'm I'm just gonna ask you to kind of you know do some free association here. We'll kind of get psychodynamic, but um, but just think back on your career, you know, and and maybe this is a focus on you know, you do have multiple certifications, so you you're coming from family practice and you're in psych now. And so was it sometime when you were a student or when you got into practice that that maybe kind of solidified and said, I found my home? You know, it's like you know, I hear people when I go, they go to conferences, I found my people, you know, I'm I'm with my tribe, you know, those kind of things. But but I think that's something that kind of happens over time. And so do you mind kind of sharing, you know, that that event or multiple events? I mean, sometimes it doesn't have to be just kind of one type of thing, but uh anything kind of jump out that you can think of.
SPEAKER_04:Sure. So it actually started when I did my psych. Um I was actually psych first and then family practice. And so um doing the uh my graduate rotation in that consultation liaison um setting, it felt at home, right? Even though I hadn't been there before, it just it just felt natural. Um, and so then uh from that point on, I was always um drawn to inpatient ER crisis type environments. And um probably about it was about two and a half years later. Yeah, about two and a half years later, I was um doing travel nursing. Um and I I had I had finished graduate school at that point, um, getting ready to take my exam and was working um in uh at a at an inpatient unit in Alexandria, Virginia. One of many inpatient units I'd worked on with travel nursing and whatnot. And it's back in 2002, people people are sick, right? Like people that have psychiatric conditions that are in the on a psychiatric unit. Like there's they're they're physically sick, right? Like it's it's one of those things where it's like, wow, there's two things going on at the same time here. Um and uh so again, I I was in my early 20s, so of course that's not uh new information that uh new not new clinical information, but for me, sort of kind of grow like growing and in the experience and being like, wow, like people are like this it's a lot going on here, diabetes, hypertension, um, and the sequela that go along with that. And so this was back before the DNP days, right? Um, and um and that this was actually before the psych the PMHMP role was sort of national, if you will, right? It was kind of regional at that point um in many respects, because I went to graduate school in Rhode Island and up there in the northeast, I think I think Boston College may have been one of the first programs in that region of the country to have a bona fide psych MP program that started growing in the early 2000s. But primarily then it was it was the psych MP role, you know, uh wasn't wasn't there. So it was that it was the um psych uh clinical nurse specialist with prescriptive authority um that we were that was the model I was educated in in a in sort of the academic setting and then inpatient and so doing all the psychiatric prescribing and whatnot. But the psych MP role wasn't there yet. So the only avenue for um those of us uh that were advanced practice psych that wanted to sort of you know treat the whole person, um uh and especially those that were rather you know ill, and we're talking more than just for sore throats and ear infections, was you go back and you become a family nurse practitioner. So you go back. And so I went back to uh Marymount um university in Arlington uh uh part-time for a couple years, and I got my um uh family nurse practitioner certification um there and um um that I would say that was in uh finished 2006, uh certified in 2007. And you know, was it magic after that that uh you know I was able to do so much more? No, but wow, as time went on, has that made a difference? Um having that uh expanded uh not just knowledge um but also the um the skill set, uh the privilege, the honor of being able to take care of someone uh as a whole person. Um again, especially in these uh inpatient environments where um it's not uncommon for um psych NPs um that are working in uh inpatient units to also be responsible for doing right, like regular physical HMPs, like the right, and so, but then being able to also you know help manage someone who was you know relatively stable on you know with diabetes management, hypertension, um uh, you know, cholesterol, all of the uh chronic conditions that would otherwise bring someone else in who just doesn't have that understanding of um folks that that we work with that that have those um those needs. And again, I I'm talking about uh sort of the more acute. I know that most of the our population, right? We it's most are treated in in uh family practice, primary care, but so I'm talking about sort of a more acute um and so it was it was really that that was sort of my uh sort of trajectory from psych uh to family practice, which is sort of um opposite of what we're a trend that we're that we see since, right? It's usually mostly family practice and psych.
SPEAKER_01:Um yeah, yeah, that my apologies. I my bias was showing, right? I mean, that's that's my experience as a lot of FNTs going back and getting psyched. So thank you for correcting me on that. I appreciate it. It's all good. But it's you know, and that's you know, that's that could be a whole conversation too. I mean, I I I appreciate that that's where the solidifying kind of came that you were in the right space, right place, um, and and felt qualified enough to to care for the multitude of issues. Because you're right, because I I I do a week and a month on a psych unit, and yeah, it is the most terrifying thing. And and thank God we have a hospitalist that rounds with us because um, because that person, yeah, I I frequently am texting him all the time, going, Hey, this is going on. Can you help me out? And he's so good, he's just oh yeah, I'll take care of that. And so um, but yeah, to have that capability and scope to be able to kind of care for both of those uh issues, which are so relevant, is is great. So thank you, Sean.
SPEAKER_00:Hey, Sean, I uh as you were talking, I was reflecting, and uh we we share some similar experiences. I think uh my first experience after graduate school was uh assigned uh doing consultation liaison and hospitals work in an overseas military treatment facility. And I remember those first three years doing that role, never feeling more alive as a psych NP, and never feeling more scared as a psych NP. And uh to this day, I still send uh Christmas cards to the neurologist and the internal medicine doc that I had on speed dial while I was there. Uh I uh it got me thinking about this idea of imposter syndrome. And and a pretty good chunk, I imagine, of our listenership are students uh who are kind of enrolled in Psych NP programs. I'm wondering from your vantage now, you're on the other side of your career where you've had a lot of experience amassed. Can you give them some guidance about how they can potentially navigate imposter syndrome moving forward?
SPEAKER_04:Yeah, that's good. Yeah, I mean, I I may be on the uh other side, but I'm I still experience it, right? Um, I'm not, you know, I'm I'm not sure if for me, uh I'm not I don't know if that'll ever go away entirely. Um because in any environment that that that you know for me, I can just speak for me, if I'm going into an environment that's that's new to me, well, people have been there. So they've been there long before Sean Gallagher, they'll be there long after Sean Gallagher, and so I'm there for however brief a period um that is. And so um, yeah, I I've it's not probably on a at least uh six or nine month basis, uh, wherever I am, I'm reminded sort of in my own mind, like that sort of that imposter piece. Um, I guess accepting it, you know, under understanding that that's it's okay to feel that way. Um right, but as we know, what what's when it becomes an issue is when it interferes with your ability to function as a provider. But um, but yeah, acknowledging it's okay, you know, I I kind of feel like I don't belong here. I'm not really quite sure. Um I know what I'm I'm doing. I remember um even this was in an inpatient crisis setting I was in, we were talking about something, and it was about cotiapine. And um I didn't realize that, you know, sort of on the street, so to speak, um uh Sarah were called Susie's, I guess. And in the jail in jail, and you know, correctional facilities, it's it's really, you know, it was not uncommon um for it to be misused. Well, at the time I didn't, I didn't know that, right? I mean, I hadn't I didn't have much background in correctional care or really any background. And um, I remember, you know, um I had I had ordered cotiopine for someone uh who happened to, you know, uh be going back to jail probably you know within the next you know few weeks after he was stabilized. And you know, some from a colleague had said, Oh, well, you I see you order critiopine. And I was like, Well, yeah, that's you know, uh, for a variety of reasons, explained it. And he's like, Oh, well, he's you know, he's gonna be going back to jail, and I wasn't getting it. Like, I was I was like, Okay, well, you know, this is and I did, I felt in that moment, I would have to say I felt some imposter syndrome because there were a couple other people around, and it's like I I didn't know that. And I'm like, wow, I I'm kind of wow, I'm and I said that in the moment. I was like, I said I feel really uncomfortable right now, like I almost like I don't belong in the conversation because I I had no idea about this. Um, so I'm a fan of uh transparency and uh self-depreciating humor uh in terms of when it comes to you know um things like imposter syndrome um and just sort of sort of just putting it out there, disarming, right? Disarming people, saying, okay, hey, you know what? I'm the new guy. Uh I don't know if that answers your question or not, but brilliantly so.
SPEAKER_00:And I I will just go to the audience and say, if it is an incredibly seasoned doctorally prepared psych nurse practitioner who's been the past president of the ISPN can continue to experience imposter syndrome, it's perfectly reasonable that you'd feel it in transition to practice. Give yourself some grace. Amen. Absolutely.
SPEAKER_01:I love that too. And I I think um, you know, it's because I just had this as well. I I had a colleague of mine who's uh 10 years down the road further, and I wanted to put her up for an award, and she immediately came back saying, I don't think I deserve this award. I'm like, you meet every criteria for this award. What are you talking about? And it's just like, and that's why I wrote back to her. I said, Well, I guess imposter syndrome never goes away. It's it's something we just continue to hope. And the other thing, I don't know why this kind of brings up too, but I'll just kind of share the vulnerability that I think you shared, Sean, is something that should be admired more. Um I think too much we live in a world of gotcha, you know, especially, you know, especially an inpatient, acute, you know, it's all this kind of gotcha type of thing. Um, I I think of less of less gotcha and more just kind of having an understanding and just being okay with that, that you know, maybe you don't understand everything. Maybe, you know, I don't think we ever understand everything. And so, yeah, I don't know. That just came up. I don't know if you want to speak on that, but um, yeah.
SPEAKER_04:Oh, in terms of just uh sort of the our uh sort of fallibility or in terms of uh just clarify that a little bit just to uh sorry, yeah.
SPEAKER_01:No, but I was gonna say that that gotcha kind of place that people sometimes get to where uh you know it's like aha, now I you know I got you, you're you're using your LPRASLAN too much, or you're gonna be misusing your quitiopine or these kind of things where maybe we should look at them and say, hey, you know, what's going on? Why are you misusing these medications and kind of get to that route?
SPEAKER_04:Oh, I yeah, I see what you're saying. Yes, yes. That the yeah, and as uh so what uh Sean was saying a few minutes ago, regardless of where you are in your career spectrum, someone's gonna yes, there's always gonna be sort of that ri the risk of that situation, or if I could just say the proverbial like that guy, you know, that's gonna try to you. you know, um uh you know, trip you up or or whatnot um when you're in those uh settings or situations with it and it can be intimidating, right? Especially if someone's saying something to you about medication that you've uh prescribed or didn't prescribe or whatnot, that can kind of, you know, it's like it's like quite then you're getting questioning like you know clinical judgment or whatnot. And so that's where I say I just automatically for me, my coping mechanism is sort of just transparency, self-depreciating humor. Um so if if it if they did have it a gotcha intention, um chances are and hopefully I've probably disarmed it um uh you know within the the first um few seconds but yeah speaking of of students listening if I if I could just um it's never worth a power struggle it is never worth a power struggle we're all gonna just people are gonna have disagreements and that's okay uh something I did remember from graduate school when we were talking about medications one time in clinical and it was about um uh SSRIs and uh remember I remember asking you know how do you you know how do you decide which one and and um it wasn't my preceptor it was uh uh another psychiatrist I'm forgetting who it was but he was um out of UMass general and we were talking and he's like you know he's like honestly he's like I could go through a whole like litany of pharmacokinetic and pharmacodynamic he's like at this point when you get out he's like it's dealer's choice he's like you're gonna have you're gonna become comfortable with you know your your agents that you're gonna use that are you know and and that's when I also started learning about formularies he's like it's gonna really depend on what's on formulary um and whatnot and so we be that's how we sort of um become accustomed to practicing and so when you go into a different environment yes that's where you could get the you know some of this gotcha stuff it might be a different formulary you know different culture of prescribing um so it'll never go away but just just I just I guess just smile and look away great advice um so I think I believe this is the last question since we're on a podcast that's called Pepplau's ghost let's imagine that Hildegard Peplow herself was sitting in the room with us what do you think she'd be most proud of in psychiatric nursing today and what do you think she might still be challenging us to do better I think our the progress I think that we've made in terms of you know pride um again because she was a trailblazer and so to see where we've come um from late forties early 50s right um in terms of our um our knowledge base scope of practice the impact that we've had um with with helping people um and I think uh to that end uh the other side of that coin is the concern is that has come at a bit of an expense uh if you will in terms of uh not uh the the interpersonal uh aspect or foundation um that she really that is really you know her um trademark has been somewhat diluted right I guess that's that's how I would so I I guess that that that's where I would see that sort of two sided well wow you've made a lot of progress but oh boy yeah that has come at an expense because now you you are just I think we were talking earlier just meeting with people for 15 or 20 minutes and and not getting to to know people. Yeah and then AI Dr. Convoy had mentioned about AI yeah I I think that that's something that anyone will be concerned about. But um I think that would probably also be a of particular concern to someone um uh like like Hildegard Peplow.
SPEAKER_01:Yeah. Sold our soul a little bit, right? I mean it's it's definitely has paid off and then you're right there you know it'll be a it's it's it's a fun kind of intellectual trick to think of you know how far she would see us. I mean it's like yeah somebody from the 50s throwing an iPhone in their hand then we'd just be blown away by it. But uh but yeah sometimes that distance and and things that we still strive for is is missing and and how do we how do we keep that up? So we keep that up by having this podcast. So that's uh that's the end of our episode right now. So thank you so much. Appreciate you listening please please please subscribe like put a comment in um thank you to Dr. Sean Gallagher for being here. Really appreciate his uh information his knowledge his expertise his wisdom um just being who he is so thank you so much and and wonderful and we'll we'll be back and taking a little break I think you know we're gonna be off a couple weeks but we'll be back and we'll have more new episodes coming so take care and uh we'll see you later oh sure yeah yeah yeah it's it it it's it's one of those things I think we just continue to to get better at I I don't know it's um but yeah no Sean you did great I thank you again for for all that you do and uh well you all too uh and Melissa we've haven't had a chance to meet um Sean Gallagher uh Arizona where are you out of again?
SPEAKER_03:I'm in Minneapolis Minnesota and I am not a psychic I'm not a nurse I have a psych background but I'm a psychologist okay yeah yeah okay all right Minneapolis okay so yeah you gets cold up there with Dan right uh it is Sean not so much right Sean's also in a tempered area relatively tempered yeah you're making me jealous how cold is it Melissa is it getting really cold or not too bad it has been so warm this season it's just starting to dip I think the high today is like in the 60s so it's it's great we still have green trees wild stuff wild all right well thanks again everybody appreciate it we'll see you later take care of emotional reasoning too much thought like this too much seasoning oh they feel it therefore it's true work hard until those thoughts are finally leaving so you can be you uh they feel it before it's true work hard until those thoughts are finally leaving so you can be you guide discovery identifying challenging your beliefs for beliefs for framing your mind negative thoughts release let it go cognitive distortions decrease until they see discovery identifying challenging your beliefs for framing your mind negative thoughts release let it go cognitive distortions decrease until they see
