Taking Bricks Out of the Backpack

Dr. Heather Gilmartin shares her evolution from nursing to leadership coaching. She talks about how a highly challenging moment in her professional life led to her desire to pursue guidance from a coach, and she describes the transformative moment in which her coach was silent, present, and without judgment. She makes linkages between coaching and the nursing profession, between the state of relational flow and sacred moments. Dr. Gilmartin highlights her personal mindfulness practice, elements from sports psychology she uses in her coaching strategies, and the ways her patient care could have been different by using a coaching lens. We touch on the significance of building trust, emotional intelligence, and attunement in coaching relationships. As an added bonus, Dr. Gilmartin helps to uncover a bit of my own psychology – how I can’t make a decision about dinner, how too many options paralyzes me with indecision, and how familial influences impacted my ability to recognize and access my own emotions.

Sacred Moments Initiative
2800 Plymouth Road
North Campus Research Complex
Building 16, Room 430W
Ann Arbor, MI 48109-2800
734-936-5216

Transcript

Prelude

Heather Gilmartin (00:00)

I broke down, right? I cried and I became angry and all of these things that I had kept inside, bottled up, that I finally let go. And it was sacred because she didn't judge, she didn't correct, she didn't bring advice, she just was present. And she bore witness to my revelations. It changed everything.

Show Introduction

Nate Houchens (00:40)

Hi and welcome to Boundless Moments, the storytelling podcast that brings sacred moments to life through the voices of those who lived them. I'm Nathan Houchens. Support for Boundless Moments comes from the Sacred Moments Initiative. 

At Boundless Moments, we are careful to ensure that all stories comply with healthcare privacy laws. Details may have been changed to ensure patient confidentiality.

All views expressed are those of the person speaking and not their employer.

Some stories featured on Boundless Moments may contain themes or content that could be upsetting for some listeners. We encourage you to use discretion and take care of yourself while listening.

Introduction: Heather Gilmartin

Nate Houchens (01:23)

Dr. Heather Gilmartin is a nurse practitioner and research health scientist at the Denver/Seattle Center of Innovation for Veteran-Centered and Value-Driven Care, located within the Rocky Mountain Regional Veterans Health Administration Medical Center. She is the Associate Director of the Denver Center of Innovation and co-Director of the Denver VA Advanced Research Fellowship for Health Services Research. She serves as a Clinical Associate Professor at the Colorado School of Public Health, Department of Health Systems, Management & Policy, and is the Associate Director of the Colorado Clinical and Translational Sciences Dissemination & Implementation Research Core. Dr. Gilmartin is an Associate Certified Coach with the International Coaching Federation, providing executive leadership coaching to VA clinical leaders through the VA Leadership Coaching Cadre.

Her research is dedicated to understanding and optimizing healthcare culture to enhance workforce stability, efficiency, and the delivery of high-quality, innovative patient care. Her work promotes organizational learning through the implementation of supportive learning environments and high-reliability practices, including team training, leadership coaching, and relational coordination.

Introduction: “Taking Bricks Out of the Backpack”

Nate Houchens

(02:33)

Dr. Gilmartin shares her evolution from nursing to leadership coaching. She talks about how a highly challenging moment in her professional life led to her desire to pursue guidance from a coach, and she describes the transformative moment in which her coach was silent, present, and without judgment. She makes linkages between coaching and the nursing profession, between the state of relational flow and sacred moments. Dr. Gilmartin highlights her personal mindfulness practice, elements from sports psychology she uses in her coaching strategies, and the ways her patient care could have been different by using a coaching lens. We touch on the significance of building trust, emotional intelligence, and attunement in coaching relationships.

As an added bonus, this is my most personal episode to date… Dr. Gilmartin helps to uncover a bit of my own psychology – how I can’t make a decision about dinner, how too many options paralyzes me with indecision, and how familial influences impacted my ability to recognize and access my own emotions.

The Story: “Taking Bricks Out of the Backpack”

Heather Gilmartin (03:59)

I'm gonna share a sacred moment that emerged during my journey through leadership coaching. I'll tell the story how I was at a pivotal crossroads in my professional life and I just had a lot of chaos in my head and I needed someone to help me work through it. And I remembered that I had had coaching as an athlete in college and maybe that was an option. 

So I'll begin at my story. So I'm a nurse by training and nursing is a profession that we hold space for people. We aren't there to cure, but we're there to care. We will hold a hand and sometimes just witness because we aren't sure what else can happen because sometimes we can't do anything for them. And that sitting and bearing witness has always been a really powerful tool for me in my professional and personal life. I don't have the solutions to much. And I always lean back on that. 

So when I myself was in professional chaos, I was in a career development program at the Veterans Health Administration on the research track. And so I had opportunities. I had research I wanted to pursue, but did I want to take on a teaching aspect to my career? Did I want to take on a leadership aspect to my career? Did I want to stay in the Veterans Health Administration? Did I want to take my work out into the consulting world? Those are all options on my table. And in addition, I was a mother of two high school boys, happily married. And it was this concept of, can I have it all? Career and a family and the health and the joy of life. 

And the moment that drove me towards leadership coaching was when I was not having it all. I had hit a real low point. I had really high burnout, could not make a decision to save my life. And my family told me I need to pull my cookies together. 

My experience with coaching had been only at an athletic level. I was a collegiate swimmer and sailor and coaches helped me just do one little thing different. And it sort of always put me so much farther ahead than if I had tried to do the work without someone's set of eyes and ears. And I thought, well, athletic coaching is pretty great. What about leadership coaching? 

I reached out to a leadership coach. had a background in psychology, but I wasn't looking for therapy. I was looking for someone to just be present and witness me as I processed my ideas. And it took a bit, one or two sessions to develop trust. And I think trust is at the core of most sacred moments, to be honest. Because you have to let your guard down to get to the good stuff. 

I sat with her for two two-hour sessions, right. And she would ask me just really general questions and I would talk and I would talk and I knew I had my armor up. Right. Because I had built protective mechanisms to keep certain things away. Things that had come from my professional past or my personal past that I was like, don't want to go there. That's a little touchy and I’m fine over there. Just can we stay in this lane? 

But she kept trying to peel back little pieces of that armor. And at first I wasn't ready and so she didn't push and then in the third session she just kept pushing. I want you to sit with this. I said something. I realized that I did not believe that I had earned my success. I didn't think I was smart enough and lots of other sort of imposter syndrome concepts. And instead of her doing what most people do, which is correct me. No, no, no, you're fine. You absolutely earned it. Of course you did! Look at all the degrees you have. She just sat there and was silent and silence is tough. And I think the silence was what led me to think of this as a sacred moment for… it just opened up my armor. I just experienced and I felt and sadly for her, I broke down, right? I cried and I became angry and all of these things that I had kept inside bottled up that I finally let go.

And it was sacred because she didn't judge. She didn't correct. She didn't bring advice. She just was present. And she bore witness to my revelations. It changed everything. 

It seemed so silly. It was like a five minute tantrum, right, on my own, where I was just letting it all go out. And then I started crying and I blew my nose. And she asked me, so what was that? Tell me what that was.

And that was the sacred moment. That I was given the opportunity to dwell, right? To face my fears, dive deep into my mind and my emotions. And I felt completely safe… and I felt completely heard. That was incredible.

And from my side, at first I thought, what was the magic that she just did? Uh, but in reality, it was a lot of what I learned in my nursing profession, which was sometimes our patients didn't want, to be honest, to be told what to do. And they didn't want us to put them on a track. They just wanted a space for us to acknowledge them, the challenges that they had to get where they are today and be present, witness, and then still love them. Because it really does come down to love. 

So that was a moment, and it was lovely. And what it did was I then spent the rest of that day thinking deeply, where was all that stuff coming from? Why had I suppressed it? And it really came back to things that I hadn't thought about in years that I had been carrying as multiple bricks in my backpack. And I decided to let them go. I took those bricks out of my backpack, and I felt lighter. I just then moved forward. I was able to say, this is why I think I hadn't earned it. And now I believe I have earned it. And so now I will go and apply for a leadership position because I think I'm actually ready for it. Where before I had talked myself into not being ready and I wasn't going to ever talk myself out of that until that incredible, beautiful moment. 

And due to that transformation, I started talking to people that I worked with about coaching. And I realized I wanted to become a coach. I wanted to train as a coach because I no longer was at the bedside. I no longer was working with patients and getting that lovely spiritual experience where I sat with patients, right, and both in the best moments of their lives and the worst moments in their lives, it filled my cup. And I was missing that as a researcher. And I thought maybe coaching would fill that. 

And so here I am now two years later. I have completed a leadership coaching program through the National Center for Organization Development in the VA. And I've been coaching almost 30 different leaders in the VA, 150 hours. And I will tell you that it does fill my cup. So as a professional in the caring field, coaching is caring. You're trying to help people improve their personal and professional performance. 

And I have experienced sacred moments with my clients. And what is fascinating about it is this concept that I was not aware of initially called relational flow. And it's a dynamic when a coach and a client, they enter a zone where they are fully challenged at a high level of skill and awareness. That was such an interesting term because, you know, sacred moments are sort of the same, right? Like where you get into a phase where it's just like time sort of stands still and you're fully, fully there and you're experiencing each other's both emotions and you know, the world around you.

What's interesting is I never realized I was trained for that as a nurse until I was just trained for it as a coach. There's a skill to it. When this happens, right, when you have a sacred moment with a patient, like back in the day for me, there was a trust that happened that then when they would ask for something, my advice, they would actually listen, right? When a patient would tell me something, I trusted them. It would change the way we worked. 

And in coaching, it's the same way, right? I am there to hold space for my client and, many times it can feel effortless. Like, wow, that just happened. Amazing! But other times, especially if I'm not fully, I’m listening, but I'm listening so hard to try and make sure that they know that I'm present. So they're working hard trying to reveal their stuff and break down their armor. And I'm sitting there trying to focus really hard. It means that I'm not there yet. I was a nurse for 20 years. And my first couple of years in nursing, there was not a lot of sacred moments. It was a lot of panic. But then you get into the groove and you get confident and you can find that space. And I'm seeing that with coaching, right? So I've been doing it for a while now. And you know, within a couple of sessions, we get to a place where we have trust. My client and I can get into a relational flow, which is where the big transformations happen. 

So it's interesting. I've been a nurse almost for 30 years now and my training around, you know, holding space for healing, for advocacy, right, for bearing witness, I still carry with me. It is the foundation of everything I do, and it informs my coaching practice. And so I hold space, right, for my clients, not just for physical healing, because sometimes there's that, there's their suffering from pain and things, but more often than not, it's to help them be courageous as they're trying to discover who they are, where they want to go, and what they want to be. 

So I'll end the story with, it's been an honor. I decided I wanted to be a nurse when I was like 17 years old. And I still think it was the best decision I've ever made. Coaching has come later in life. And I think it will provide me with the same personal and professional satisfaction over the years to come. 

And it's because of that idea of the sacred moment and the relational flow. Because it has to be reciprocal. I can't just give and no one gives back. It's a real incredible thing when we give to each other. And that fills my soul. And that helps me with my burnout, which is a crisis in healthcare right now. My breakdown was not a high point in my life, but it led to me finding my path again.

Interview

Nate Houchens (15:00)

I'm here with Dr. Heather Gilmartin, who just shared that really wonderful story of her evolution into becoming a coach after being coached herself. 

And I was struck by some of the mirroring of how we as healthcare professionals show up for our patients and hold space for our patients and how coaches can do the same for those that they coach. Thank you for sharing that, Dr. Gilmartin.

Heather Gilmartin (15:24)

Thank you, it was enjoyable.

Nate Houchens (15:26)

I wonder if you have a little bit of time, if you could take us back to that crossroads moment in your professional life and just share a little bit more about what was happening and the sort of balance that you were trying to achieve, family and career and health, and sort of how that led you to think about coaching differently.

Heather Gilmartin (15:47)

I mean, I'm not unique, right? Everyone has a world of things going on in their lives in addition to their work. I guess I had the luck of having so many choices. You almost get drowned in it. There was a study out there once about having like too many toothpaste options out there. Like if they could just give us three, we actually would be happier than having 20. And that was where I was. I had a lot of career opportunities that I wanted to take advantage of, but I knew if I did, that would diminish my time with my family, my friends, and my health. 

And so I had a mentor, and my mentor would tell me what to do. And I don't like being told what to do. It's just not my personality. And someone said I should go see therapist. I thought, I just need some guidance. It's my problem, maybe I have the solution to fix it. And so that's when coaching came in. Because I remember, as a college athlete, my coach has never said, you stink. They said, you're good. You want to get a little bit better? And I would say, yeah, yeah. What do need to do? 

So that's where coaching fell. It was just one other lane of this incredible highway of professionals who are there to support you. I could have probably gone to a religious person as well, right? A guru or whatever, mindfulness, to priests. They might've been an option. That's not really in my toolbox. So I chose coaching.

It seemed low risk and something I could end at any session. That was the beauty of it, right? I wasn't making a long-term commitment to somebody. It was like after one session, if it wasn't what I liked and I didn't like the person, I'm out. I like those low risk kind of things.

Nate Houchens (17:29)

I’m with you on the analysis paralysis when you have a thousand different choices. It's a Houchens family trait to not be able to choose what's for dinner. I mean, we are we are known for that in my family. And so too many choices really does become paralyzing. 

It also resonated with me when you talked about how coaches really focus on what you're doing well and how you can do it even better. And I feel so often that in health care, we are very much a field that is focused on deficiency first. Asking what's wrong rather than how are things going well in your life, for example. And we know this with health care trainees as well. They're really just waiting for that modifying feedback rather than the reinforcing feedback.

So, yeah, I think coaches can play such an immense role even just to highlight what someone is doing incredibly well. 

You mentioned your experience as a college athlete. So you've had your own coaches before all of this. How did those early coaching relationships shape your understanding of what it means to be truly seen and heard?

Heather Gilmartin (18:42)

I had the great fortune of being part of a sailing team in college, which seems so strange, right? But that is a thing. And we had a coach that instead of focusing on the team and the wins, we got to win nationals, their approach was to make each of us a better sailor and a better person. I went to a Jesuit university, so that very much was the focus on the person.

And actually, ironically, when I watched Ted Lasso recently, it was a very Ted Lasso philosophy. It wasn't about winning for winning sake. It was about, make sure you grow upon the journey. And so the individual one on one was something I hadn't been part of. Right. In high school, I played lots of sports. And again, I was on, I sailed. And that was a lot of, make sure your team wins the high school national championships. It's all about the team. 

But in college, it’s about the person. That was a growth moment. And I don't know why that is. Maybe that's changed. I think we know a lot more about the sports psychology. But when I realized that the tension on me would make me better, but then that would help the team be better. 

Ironically, that actually is what my whole research is about. You know, we always say there's no I in team. In healthcare, we have our hierarchy, right? Physicians are in charge and everyone else works. But when the whole team is working together and each individual is able to perform at the top of their license and, and show up their best selves, I mean. It's the best place to work ever. And that's what I try and do in my research. Though I'm saying this out loud realizing that maybe this has come from, wow, a long time ago. That's pretty fun.

I've also had some bad coaches in sports who belittle you and make you feel like you are so broken and the only way you're going to get better is to sacrifice and to experience pain and suffering. I don't respond well to that. Some people must because it is a more traditional approach. I prefer the, you're good, let's get you going. 

And then the pause, right? So I was actually, I'm on a master swim team here in my hometown and my coach, I was talking to this morning, right? Master swimming is adult swim team. It's hilarious. If you ever want to do it, it's phenomenal. And I have a coach on the deck who will read you first thing in the morning and say, ooh, you might need a little more of a rest day than maybe a push day. I might get a lot more good girls. I mean, I'm in my 50s and to have a coach tell me, good girl, that was great, is probably the finest moment of my days. When do you get someone to tell you good girl? That coach, my coach sees me as a human and a complex human and then sees me in the pool as someone who just wants to get a little bit faster every day. So it all feeds into each other. 

And so in my leadership coaching, I try and bring that in, right? You're showing up as a nurse manager in a cardiac cath lab and you come to coaching because you have a problem. I say to them, you're not broken. You're just trying to do things different or better. And it's, you know the problem. So let's, let's help you find your solution. And they often are like, no, no, no, I want you to tell me what to do. And like, mmm, we'll see how that goes. How about you tell me. Inevitably it comes to them. And then they get a little bit faster and then they come back and they go, what next? I had a small win, right? BJ Fogg would say you have a tiny habit and then you want to do the next one and the next one… 

It's all coming together. Look what you're doing, you're like my own personal coach right now… Nathan.

Nate Houchens (22:11)

Oh! This is an honor for me. I think what I'm tapping into is really doing my best to do what it sounds like effective coaches have done for you, which is being attuned. How attuned must you be with another person to be able to have that insight of maybe this is more of a rest day for you? I'm reading the energy here and I'm just picking up on these vibes. Maybe this kind of workout would be better for you today. What an incredibly rewarding ability to know another person to that level.

Heather Gilmartin (22:48)

Mmhmm, yeah, you honor the person and you honor yourself. It's lovely.

Nate Houchens (22:53)

And it leads to all of the things that you described in your story about being coached, about that safety and the trust to be able to let your armor down and to get to the good stuff.

Heather Gilmartin (23:05)

Mmhmm, people walk around with a lot of armor and lots of bricks in their backpacks. And the only ones who can take those off is them.

Nate Houchens (23:27)

Yeah, and so tell me more about this concept that you described called relational flow. And I think we're sort of alluding to it a little bit. And you spoke about it in your story with relational flow in coaching, can you maybe describe a moment when you and a client sort of entered that space together? What did it feel like in your mind and in your body?

Heather Gilmartin (23:51)

Yeah. So one particular time was someone who I had been mentoring for a period of time. And again, this person wasn't really interested in being told what to do. In the relationship, I asked their permission, how about we try a coaching approach instead? Because coaching does require that acknowledgement, I would like to coach you, so that they know that they're not being grilled. And so this person said, yeah, let's give it a go. You know, I been mentoring them for a while. And so I started the coaching. Like, what do you want to talk about? What do you want to achieve in our time together? And what would success look like? Which is an evidence based approach to coaching that I was taught. And even just the moment when they when I asked them, what is the outcome you want to achieve… It was like time slowed because their problem was something that they hadn't figured out what the outcome was they wanted. I guess no one had ever asked them. I hadn't asked them as their mentor. So bad on me.

And that just, I saw her sort of like struggling, like you could see smoke coming out of the ears, like it was just this, and the body language changed from like closed off to open, to tired, like all within a matter of seconds. Then she shared, you know, this is my outcome. So by the end of this time, hour together, I want to achieve this. I asked one more question, right? So what do you want to do? And that was all it took.

So for me, it was sacred because I think I asked the right question to get to the right place and she felt safe enough to dig in. It just flowed. Like all of a sudden, I looked at the clock and I was like, oh my gosh, we're over time because it went by so beautifully. Time stood still.

At the end, we reflected back. Like, did we get where we wanted to go here? And she said, you know, I’m farther than I thought, I'm ready to keep going. And I never asked her at the time because I didn't appreciate the idea of relational flow or a sacred moment, but it felt that way to me and it filled me up for days to come. I just was like, that was the greatest thing. I bore witness to that.

Nate Houchens (25:52)

Mmhmm, incredible to be able to see someone that you care about grapple in such a sort of profound and pretty personal way, to be able to both witness that and guide and observe that journey of self discovery all in the span of a very short amount of time. Sounds really impactful.

Heather Gilmartin (26:14)

In the coaching literature, the idea of relational flow requires some skills, right? Like, so I wasn't just sitting there letting her talk. I, you know, I would ask probing questions. I would, I would reflect. I would say, this is what I hear you saying. Did I get it right? And no, that's not what I said. Or, oh yeah. Or I would use a metaphor, right? Like, it sounds like you're at a crossroads. So there is a skill to it. And as I said in my story, like that, that was probably after doing 60 hours of coaching in addition to my 150 hours of training time. I was never going to get that on a first go. It took a while. 

In my understanding as, as coaches move forward in their proficiency, it comes quicker, right? The more master coaches can get you there really quickly. I mean, in nursing, right? We know that there's that, you know, novice to expert. And in the work on sacred moments, it's not the intern who comes in potentially and has a sacred moment. It's probably the attending, right, who can set it up really quickly. So I think there's, there's skill, there's competencies. I think, I think religious people train too to get there.

Nate Houchens (27:22)

Yeah, you alluded to some of them, but what are those sort of pieces that you use to become a coach that fosters these kinds of moments? You've mentioned a few. I don't mean to repeat myself, but I'd love to hear your thoughts about what is it that we can do as coaches to set ourselves up for these kinds of moments?

Heather Gilmartin (27:40)

I think I've been doing this work in preparation for this phase of my career for a long time. So I've had a mindfulness practice for almost 30 years. And that came from something that I actually published with some of our colleagues at University of Michigan. When I was a nurse practitioner, I was really struggling with burnout and paying attention in a really intense clinic. And so I started using hand washing as a time to practice a moment of mindfulness.

That drove me into a proper mindfulness practice, right? So I learned how to meditate, I went on retreats, I do a lot of self reading on wisdom philosophy. So that is just part of my life now because my burnout as a healthcare provider early in my career was gonna stop my career. And so I chose to take this path. Now that's really commonplace. 

But that mindfulness allows me to drop into a coaching moment really quickly. I can be fully present. Because of my ability, I've sort of worked my mind to be able to focus. My training on the stages of change, right? So where are they? Are they in the pre-contemplative stage, contemplative stage? That's a cue really quickly within a coaching program. So if they're just wanting to chat, that's fine. But by the end of our session, I need them to at least have gotten all their ideas out and a plan. But then I want to move them along the stages of change as quickly as possible. 

Sometimes it feels a little bit like motivational interviewing, right? You're just trying to keep them moving because coaching is a forward action oriented, you know, where therapy is more like reflection on the past and processing. I think you're a better healthcare provider and a more in tuned coach if you have tuned up your emotional intelligence, right? To read cues, to sense body language, eye rolls, everything. Because you can call people out on that. And they don't know they're doing it. And it's phenomenal when you're like, whoa, that was amazing. Why do you keep looking off in the corner and you're sort of spacing out? What is that? That sometimes a lot of people express themselves emotionally. 

And then the term that I was trained on is relational competence. Can you do this? There are many who are not skilled at relational aspects of life. And what's fun actually in the coaching world is I can see you know, physicians, for instance, that I coach who very much like the linear, the fact based, they just want to tell me that. And then I'll say, well, how did you feel? Doesn't really matter. So let me tell you more. Okay, so you didn't really connect with that side of things. So you felt nothing? Well, of course, I feel something. Can you put a name to it? How do you name your emotion, right? And they don't want to that's their armor, right? We as healthcare providers put up our own boundaries, so we don't take the work home with us.

I, you know, to be able to say, I hear you, if you don't want to talk about that, that's totally cool. But one day we might want to, so let me know when you're ready. You know, that's that confidence in learning how to do relationships. So I think those would be the four key things.

Nate Houchens (30:37)

Yeah, thank you for sharing that. I'm reminded of… maybe it's armor for myself. I'm speaking for myself now, but as a physician, a lot of what you say resonates. And when I have my own conversations with a therapist or anyone else, you know, sometimes they'll ask kind of how things feel and, you know, what's your emotional response to this set of circumstances? How does it feel in your body? And I always have to really pause and think about it and my response is almost always pretty cognitive, at least on first blush, right? Well, this is what I thought at the time. You know, these were the circumstances. And that's been so ingrained in me for so long that it takes more to be able to harness what emotions are there and not just sort of the superficial ones, but the ones that are really deep down. 

So, yeah, I think in some cases it's armor, in some cases it's just a lack of experience and sitting with and being with yourself.

Heather Gilmartin (31:44)

Where does that… you said ingraining, like it was ingrained in you.

Nate Houchens (31:48)

Yeah, not to get too intense in the sort of psychotherapeutic space, but I think it came a lot from family for me. We spent a lot of time in the cognitive space and I think there was a lot of discomfort around sharing emotional responses and sharing and being vulnerable. Because I think many in my family were at a point where they didn't feel like they had the luxury to do so. And so, it was just something that you didn't really talk about or think about.

Heather Gilmartin (32:19)

Yeah, well, thank you for that.

Nate Houchens (32:21)

Yeah, yeah, no problem. I can't wait to share this with my own family.

Heather Gilmartin (32:28)

I will say that the piece around coaching, which I was taught about early on, is you do ask for permission. Like, can I coach you on things? Because when I was training and I have two teenage boys and I would be like, oh, I'm going to try this out on them. And they would be and I'd be like, so tell me more. Why do you think… I'm so curious? And I'd be like, are you coaching me? No. 

Nate Houchens (32:48)

They got wise to it.

Heather Gilmartin (32:55)

And I would say, what would you like? Would you like to be coached? Would you like to be hugged? Would you like to be told what to do? And for a period of time, they'd be like, yeah, I wouldn’t mind a little coaching. I was mmmmm. Sometimes there's just like, I just need a hug. That's my favorite. I don't get that very often.

Nate Houchens (33:05)

Yeah, yeah. I think that's so great because so many times people gravitate toward how can I fix this? How can I reassure this person? Because that will make them feel better. And yet for so many of us, that's not at all what we're seeking. We're simply seeking the hug or the coach or what have you.

Heather Gilmartin (33:24)

Yeah, absolutely.

Nate Houchens (33:46)

Asking permission is something that I have done a lot with patients. I mentioned it before, but it sounds so much like being a coach is similar to your role as a nurse as well. I'm curious how you see them as similar or how are they different?

Heather Gilmartin (34:05)

Mmhmm, I remember when I started out as a nurse, right? I felt so empowered. I knew so much, right? Stop eating sugar, right? I didn't, as a nurse practitioner, I specialize in diabetes. And I just remember this. I was doing an internship at the Bronx, in the Bronx, and I was working with a clientele who I didn't know their lives. A lot of them were from, you know, the Middle East or Puerto Rico. And I would sit down with them and be like the smartest person in the room. You know what the problem is? You're eating too much sugar and fat. So let's talk about that. Let's look at your diet, right? And I look back on it and I'm horrified. I was so insulting. But I was full of knowledge and I wanted to educate them, right? Cause in healthcare, we mostly think that it's a lack of education that is holding people back from their ideal self and health. 

And as soon as I moved into a more confident space, I would ask more questions of them. Tell me, right? For example, I had no idea that rice and beans, if you're from Puerto Rico is made with lard. Rice and beans in my house was made with low fat, low salt. Great. Not in theirs. And so I'm telling them that they have to change the way their great grandmother has taught them how to cook rice and beans. I think the answer is no. Right. 

I also asked a gentleman, like, why don't you walk to get the paper instead of having it delivered to your doorstep? I didn't know that he was in a gang ridden area and it wasn't safe to walk. Right. So I was, I was making assumptions. And so as a new nurse and new nurse practitioner, I wish I had been a coach and ask them, what do you want to talk about today? What do you hope to achieve by the end of our session? And then ask them to reflect on things that are holding them back, things that they've done in the past that has helped them be successful in other ways that they can apply to this situation. 

And then they actually would come up with their own ideas. I maybe would encourage them and then hold them accountable and off they would go. But I didn't do that. Silly me. 

So I think we have a lot to learn. And I know nurse, you know, we have health coaches now. That is an industry we're seeing more where non-trained healthcare professionals are coming into clinical settings, meaning non-professionally trained, to supplement what physicians and nurses, social workers, and pharmacists are telling patients. Maybe they're translating it better and they're using a coaching approach, because that's not in our schooling.

Nate Houchens (36:21)

I agree with you. I sure hope that that's on the horizon and being taught as a competency. And I'm reminded just how uncomfortable it makes so many people feel to abdicate that kind of control, to let someone else be the captain of the ship, since you mentioned sailing before. I had to go there. Couldn't help it. Couldn't help it. But to let someone else kind of steer, right? To let someone else identify what they see as barriers to their health or to their enjoyment to let them take the reins. That is tough for so many people who are used to being in control.

Heather Gilmartin (36:59)

Yeah. I mean, smoking cessation was the first time I really thought about this thing. You can't just tell people to stop smoking. It doesn't work. But you know, if you give them space to figure out why is it they smoke, what are the, you know, the things and many people get there or if they've stopped smoking and now they want to do something else, they can use that behavior that they were successful with across life. And that's super empowering. When you realize a lot of people don't think they've been good at anything. And then you, you know, and then they realized actually I was good at that. Maybe I could do that here. And that's the aha moment, right? That's when you see them and they go, huh, and the hard part for all of us, right? As a nurse, I'd be like, great. So tell me what you're doing. I'm going to write that down, put it in the note six times and, you know, make sure that, that we documented the check. We did it right. We did our job, our job. I think the relational piece is to let them just sit.

Nate Houchens (37:57)

And we as an industry, as a field, have to get better at recognizing and celebrating that kind of work, as opposed to just checking the box and saying, hey, look, mission accomplished.

Heather Gilmartin (38:10)

The challenge is our system is not built for that, right? Our system is built for checking the box so that we can bill correctly. And then if there is a medical error, they can go back and be like, she didn't do it. She didn't check the box. So now you're responsible. Root cause analysis. And then also we have a new policy and a new federal regulation that says that we all have to do this, right? We know, though, the best of us, right? We've had those providers. We've seen those providers in action who do prioritize this. And it never is checked off on a box, but those are the ones who everyone wants to see. 

So unfortunately our system is designed for exactly what it gets. I mean, you think back to the days when your doctor would come visit you at home, right? You had a nurse at your bedside when you were giving birth at home. Those were the days. Doesn't mean we can't go back, but might take some major changes.

Nate Houchens (39:03)

To say the least, yeah.

Heather Gilmartin (39:05)

I whisper it like, major changes.

Nate Houchens (39:08)

That's right. That's right. Switching gears ever so slightly, I think health care is after just getting off service, taking care of patients in the hospital, so many different emotionally demanding environments that we find ourselves in. And just in your story and in coaching, sounds like it's similar as well. There can be a lot of need for being attuned to emotions and responding to them in real time. How do you sustain your presence, your being present and your sense of purpose in these emotionally demanding environments like healthcare and coaching?

Heather Gilmartin (39:49)

Oof, that's a tough question. I mean, I'll be honest, I left the bedside because I was struggling with that. And ultimately, I went on to do a PhD to answer that question, right? Because I feel that the way to help individuals be present and find the joy in their work and do the best work that they are possibly able to do is partially responsible, the team and the culture impacts that. 

So you could come in every day and be like, today's a good day. It's gonna happen. I'm so excited. And whoa, I've got a lot of patients to see and, this is a pretty tough day. But you look around and you go, my team's on task today. And in our huddle, we started off with a good part of the day. So we all got a little positive energy flowing. We determined who's everyone's roles and responsibilities are. Things are nice and clear. And you hit a low point, but you come back to your good moment and you all have lunch together, right? And so you get to like have this relational moment, you feed off each other. And then the end of the day, like before everyone signs out, everyone has a quick huddle to debrief. So you can process what went well, what didn't go well, so you don't take it home with you. 

That is what my research has shown helps create individual resilience and decreases burnout, decreases turnover, are these environments that support the individual practitioner. So this is a long way to say like, I have no clue how to do it because I couldn't do it. So those who can't do, they teach or they research it.

Nate Houchens (41:31)

As someone who really like identifies as both an educator and researcher, man, that hits home. That just hits. It's so true. You know, I mentioned I was just on service and every day I would have these. I wrote a little sticky note to myself, deep breaths on rounds, and I didn't do it when I sort of washed my hands, although I should have. I didn't do it in the elevator like I have done in the past. And every day I walk in and say this is going to be a really uplifting, positive experience. And within, I don't know, 20 seconds, probably, things were just off the rails. Right. And then I just felt like then I had so little impact. And maybe what I'm hearing from you is if I had spent more time in fostering those relational moments and those moments where I can just have lunch with my team, perhaps it wouldn't feel quite as chaotic. Perhaps. Maybe something to explore.

Heather Gilmartin (42:28)

Because otherwise it's just you, right? And it's all on you. And that's really hard. But aren't, you know, they say it takes a village. Before COVID, you know, people were very much talking about you need to be more mindful, take care of yourself. And then it was supercharged. Right. OK. In the midst of COVID, we also want all of you to do these online mindfulness classes and make sure you get enough sleep and take your vitamins. And it was so tone deaf.

And so all the wellness programs in healthcare were focused on the individual. You need to be better because if you're not resilient, you failed. Luckily, we had some really smart scientists and the Surgeon General amplified this with his work on workplace burnout that showed it cannot be a me problem. It's a we problem. And when we focus on we solutions, it's not just on you.

It takes time though. People don't have time. I don't want to get to know my coworkers. Ugh, they're going to tell me things I don't want to know. Right? I don't want to have to spend a minute asking how their day was in a huddle. I just want to get to business. I want work. But the science of every industry has showed us that it behooves you to build relationships with the people around you and to create systems that support you being mindful, you breathing. You finding joy in work, things like that. 

And so that's what I'm trying to do. My coaching is individual, right? But I coach individuals within the Veterans Health Administration, within the organization. I'm sort of coming at it from both angles. I want to help the individual, but then I also provide them with tools to help change the system. So that's the research program aspect. Because you could be the best, most incredible high performer and show up every day. And in about six weeks, the system will take you down.

Nate Houchens (44:30)

I wonder what advice you would offer to someone who feels called to coaching, particularly in service oriented professions like nursing or like healthcare.

Heather Gilmartin (44:44)

For someone who is looking into coaching, and it's an industry now, right? It's an unregulated industry. So for myself, I went through the National Center for Organization Development, which is a certified program by the International Coaching Federation. So it uses various models and frameworks to teach us how to ask the right questions. It's guided by the ethical code of the International Coaching Federation. Because we're healthcare providers, we’re scientists. We're gonna do what the science tells us to do.

If you are called to coaching, I encourage you to go there. There are coaching classes you can find on TikTok. You know, they're all over the place, whatever you choose to do. If you're going to service the healthcare industry and patients, I would encourage you to find those that are scientifically based. And then you have to do a lot of work on yourself. Cause if you're coming in to be the smartest person in the room, probably the wrong choice. You know, Michael Phelps, greatest swimmer of all time. Nobody knows the name of his coach.

Nate Houchens (45:42)

Yeah, we don't do it for the recognition or the prestige necessarily.

Heather Gilmartin (45:46)

And you can make a living. A lot of people apparently make an incredible living. But healthcare providers, that's different than executives, right? Like there are people out there charging a thousand dollars an hour for leadership coaching to executives, to the tech industry, you name it. Awesome. Go for it. 

I chose a long time ago to be a nurse. I have an incredible wage. I earn a great living. I have a lot of flexibility and it fills me up. And I feel like I'm making the world better. So as a coach to other healthcare providers and patients one day potentially, I go with that. I'm not looking to be famous. I'm not going to be on TikTok. I'm not looking to make millions. But if I can make those who care for others' lives better, then that's worth it.

Nate Houchens (46:27)

While doing the same for yourself.

Heather Gilmartin (46:29)

Yeah, it's a bit selfish. I do get something out of it, don't get me wrong.

Nate Houchens (46:32)

The best endeavors, I think, have that dual edge to them. 

Is there anything else that you'd like to share with the audience of Boundless Moments before we part?

Heather Gilmartin (46:43)

I would like to thank you and your team for bringing this forward because I think we are at a time when we should look for the sacred and we should think that there are no boundaries to what we can do. Because I think, where are we now? June 2025 feels pretty confining and the spiritual and sacred is not out there as much. And in healthcare, I think if we tap into that, it will remind us the good work we do on a daily basis. Yes, our healthcare system is broken, but look for the greatness, be delighted in the small moments and you'll get through it. These are not the worst of times. These are just times, and we can control some things.

Nate Houchens (47:26)

I'm really hoping that sacred moments can be the sort of beacon that so many people are thinking about. And, you know, our research has shown over and over again that particularly people in healthcare, maybe they don't know it as such. Maybe they don't know the term sacred moments. But when we describe it and when we describe how time seems to expand or even stand still, when we describe that there's this deep interconnectedness, people know right away and they start nodding and they start seeing they start reliving it in their own minds. 

And so my hope is that even just by sharing some of these stories that people can recognize their power and hopefully share their own stories with us and with each other.

Heather Gilmartin (48:22)

Yeah. I mean, to go back to what you said, you don't use emotions. You don't tap into those as much. You have to name them, right? So you have to name what I experienced with my first amazing coach as a sacred moment to then really cherish it. And you hold those cherish, you know, those moments, you hold. I mean, I could still share with you so many of my nursing moments, but you know, that's a whole other pocket. But they still sit with me. You know, those are the greatest moments of my life.

Nate Houchens (48:51)

That will be the second episode with Dr. Heather Gilmartin when we invite her back to share all of her sacred moments from nursing. Man, I can't wait. Thank you so much for spending your time today and for sharing these insights with us. It really has been a privilege and an honor to have you on the podcast.

Heather Gilmartin (49:10)

I love your work. Please keep it up. Thank you.

Nate Houchens (49:14)

Absolutely. Thank you.

Postlude

Nate Houchens (49:31)

We would love for you to be a part of this movement, and we would be honored to hear your story. If you have experienced a moment of grace, connection, or empathy that changed you, we invite you to submit it for consideration to be shared on Boundless Moments by sharing, you not only contribute to a collective celebration of human connection, you may also inspire others to recognize and cherish the sacred moments in their own lives. To discover more about sacred moments and to share your own story, please visit sacredmomentsinitiative.org.

This episode of boundless moments was produced, edited, and mixed by Nathan Houchens. Our program manager is Jessica Ameling, and our publishing and social media manager is Rachel Ehrlinger. Our podcast is made possible by the Sacred Moments Initiative, a humanistic project whose aim is to study, catalog, and share sacred moments. Learn more at sacredmomentsinitiative.org. Boundless Moments is also made possible by donations from listeners like you. Thank you so much for supporting our work in sharing sacred moment stories. If you enjoyed this episode, please subscribe to the show wherever you get your podcasts and drop us a rating or review to help others connect with us. I'm your host, Nathan Houchens. Thank you for joining and until next time, be well.